Anaesthesia and intensive care
-
Anaesth Intensive Care · May 2018
Review Meta AnalysisEffect on neonatal outcome of pharmacological interventions for attenuation of the maternal haemodynamic response to tracheal intubation: a systematic review.
Although slightly lowering 5 minute Apgar scores, opioids used to attenuate the maternal pressor response to intubation did not have clinically significant effects on neonates.
pearl -
Anaesth Intensive Care · Mar 2018
ReviewRecent advances and anaesthetic considerations in corneal transplantation.
Significant surgical advances have been made recently in corneal transplantation. Penetrating keratoplasty was the dominant method from 1905, until selective lamellar keratoplasty emerged as the preferred technique over the last 20 years. Advanced techniques such as corneal limbal stem cell transplant and keratoprosthesis are also available. ⋯ General anaesthesia remains suitable for a wide range of these procedures especially in repeat surgery, difficult, or prolonged procedures. Regional ophthalmic blocks are ideal for endothelial keratoplasty but can be used in penetrating keratoplasty based on individual risk-benefit assessment, and as a supplement to general anaesthesia. Topical anaesthesia provides an alternative when general anaesthesia and ophthalmic regional blocks are less desirable but overall its use is limited.
-
Failed airway management in the obstetric patient undergoing general anaesthesia is associated with major sequelae for the mother and/or fetus. Effective and adequate pre-oxygenation is an important safety strategy and a recommendation in all current major airway guidelines. ⋯ We review the current literature surrounding high flow nasal oxygen relevant to the pregnant woman. We also propose a basis for potential advantages and complications for its use in this context.
-
Anaesth Intensive Care · Jan 2018
ReviewBasic and advanced echocardiographic evaluation of myocardial dysfunction in sepsis and septic shock.
Sepsis continues to be a leading cause of mortality and morbidity in the intensive care unit. Cardiovascular dysfunction in sepsis is associated with worse short- and long-term outcomes. ⋯ With the increasing use of ultrasonography in the intensive care unit, there is a renewed interest in sepsis-related myocardial dysfunction. This review summarises the current scope of literature focused on sepsis-related myocardial dysfunction and highlights the use of basic and advanced echocardiographic techniques for the diagnosis of sepsis-related myocardial dysfunction and the management of sepsis and septic shock.
-
Anaesth Intensive Care · Jan 2018
ReviewAnaesthetic issues in robotic-assisted minimally invasive surgery.
Over the past decade there has been an exponential increase in the number of robotic-assisted surgical procedures performed in Australia and internationally. Despite this growth, there are no level I or II studies examining the anaesthetic implications of these procedures. ⋯ Most anaesthetic considerations overlap with those of non-robotic surgery. However, issues with limited patient access and extremes of positioning resulting in physiological disturbances and risk of injury are consistently demonstrated concerns specific to robotic-assisted procedures.