Current opinion in anaesthesiology
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Postdural puncture headache remains the most frequent complication of neuraxial anesthesia. It can occur following uncomplicated spinal anesthesia as well as unintended dural puncture during epidural anesthesia. ⋯ An epidural blood patch should not be performed until 24 h after dural puncture to increase its success; however, it should not be delayed beyond that period in the symptomatic patient, as this delay increases the amount of time the patient suffers.
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This review will outline old and recent data about the prevalence, causes and potential consequences of intraoperative awareness in children and give details on its detection. ⋯ Intraoperative awareness is a reality in school-aged children. A larger multicentre study and large-scale follow-up is required in order to confirm the higher incidence of awareness and identify the risk factors and long-term psychological sequelae of this complication in the paediatric population.
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This review summarizes the current progress in disease classification, pathophysiology and management of diabetes mellitus with a special focus on treatment modalities and recommendations for the practicing anesthesiologist. ⋯ According to World Health Organization projections, anesthesiologists can expect to care for more diabetic patients than ever before. Diabetes and its associated complications present unique challenges to the perioperative physician. As biomedical research continues to unravel the genetic, cellular and molecular mechanisms of this complex metabolic disease, our specialty must be prominently involved in the design and testing of innovative treatments to protect the diabetic patient from the risks of surgery and anesthesia.