Anesthesia and analgesia
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Anesthesia and analgesia · Mar 2017
ReviewThe Use of Ultrasound Guidance for Perioperative Neuraxial and Peripheral Nerve Blocks in Children: A Cochrane Review.
Objectives were to determine whether the use of ultrasound guidance offers any clinical advantage in the performance of neuraxial or peripheral nerve blocks in children in terms of increasing the success rate or decreasing the rate of complications. ⋯ Ultrasound guidance seems advantageous, particularly in young children, for whom it improves the success rate and increases block duration. Additional data are required before conclusions can be drawn on the effect of ultrasound guidance in reducing the rate of bloody puncture.
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Anesthesia and analgesia · Mar 2017
Randomized Controlled TrialDoes Preprocedural Ultrasound Increase the First-Pass Success Rate of Epidural Catheterization Before Cesarean Delivery? A Randomized Controlled Trial.
Preprocedural ultrasound may improve the efficacy and safety of epidural catheterization, especially in difficult cases. Most studies of ultrasound-assisted epidural catheterization in the obstetric population are dated and nonblinded with inconsistent designs. This double-blind, randomized controlled study aimed to compare the ultrasound-assisted with the conventional palpation techniques for epidural catheterization in parturients undergoing cesarean delivery. We hypothesized that the use of preprocedural ultrasound would increase the success rate of epidural catheterization at the first needle pass. ⋯ For experienced anesthesiologists, it remains unclear whether preprocedural ultrasound improves the epidural catheterization technique in parturients with palpable anatomical landmarks undergoing cesarean delivery.
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Anesthesia and analgesia · Mar 2017
ReviewMobile Technology in the Perioperative Arena: Rapid Evolution and Future Disruption.
Throughout the history of medicine, physicians have relied upon disruptive innovations and technologies to improve the quality of care delivered, patient outcomes, and patient satisfaction. The implementation of mobile technology in health care is quickly becoming the next disruptive technology. We first review the history of mobile technology over the past 3 decades, discuss the impact of hardware and software, explore the rapid expansion of applications (apps), and evaluate the adoption of mobile technology in health care. ⋯ This enhanced patient and provider connection has demonstrated benefits including reducing unnecessary hospital readmissions, improved perioperative health maintenance coordination, and improved care in remote and underserved areas. A significant portion of the future of health care, and specifically perioperative medicine, revolves around mobile technology, nimble learners, patient-specific information and decision-making, and continuous connectivity between patients and health care systems. As such, an understanding of developing or evaluating mobile technology likely will be important for anesthesiologists, particularly with an ever-expanding scope of practice in perioperative medicine.
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Anesthesia and analgesia · Mar 2017
ReviewWhy Anesthesiologists Must Incorporate Focused Cardiac Ultrasound Into Daily Practice.
The size, availability, cost, and quality of modern ultrasound devices have, for the first time in modern medicine, enabled point-of-care ultrasound by the noncardiologist physician. The appropriate application of focused cardiac ultrasound (FoCUS) by anesthesiologists has the potential to alter management and affect outcomes for a wide range of patients. In this article, the indications, benefits, and limitations of FoCUS are described. The training and equipment required to perform FoCUS are also discussed.
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Anesthesia and analgesia · Mar 2017
ReviewThe Nuts and Bolts of Performing Focused Cardiovascular Ultrasound (FoCUS).
The benefit of focused cardiovascular ultrasound as an adjunct to physical examination has been shown in numerous specialties and in diverse clinical settings. Although the value of these techniques to the practice of anesthesiology is substantial, they have only begun to be incorporated. This article reviews the basic techniques required to perform a bedside focused cardiovascular ultrasound (ie, FoCUS examination). This includes a discussion of patient positioning, breath control, probe position, and manipulation and was supplemented by normal and abnormal examples for review.