Current opinion in anaesthesiology
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To summarize recent findings for the optimal airway device for patients in the operating room and for medical personnel with limited experience in out-of-hospital airway management. ⋯ Extraglottic airway devices are increasingly used for airway management not only in patients for elective surgery, but also in out-of-hospital settings, when less experienced personnel have to secure the airway.
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Curr Opin Anaesthesiol · Dec 2007
ReviewAre there any benefits from minimizing fasting and optimization of nutrition and fluid management for patients undergoing day surgery?
As a result of advances in anaesthesia and surgery, an increasing number of surgical procedures are currently possible in the ambulatory setting. Nausea/vomiting and sedation/drowsiness are often associated with delayed discharge and readmission. These symptoms are also related to pharmacological treatment as well as dehydration and fasting. The evidence that preoperative fasting and dehydration not only reduces preoperative well being, but may also affect postoperative recovery is currently being reviewed. ⋯ When preoperative dehydration is corrected, postoperative well being and clinical outcome improves. Avoiding preoperative fasting by administration of carbohydrate-rich beverages improves preoperative well being while effects on postoperative recovery in patients undergoing ambulatory surgery need to be further evaluated.
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Curr Opin Anaesthesiol · Dec 2007
ReviewThe European Working Time Directive: effect on education and clinical care.
In 2009 the European Working Time Directive limits the weekly working hours to an average of 48 in all European Union member states. The recent published effects on education and patient care are discussed. ⋯ There are less measured clinical facts than political statements published. The actual working time directives in the European Union member states are inconsistent and further political development on this topic across the European Union remains unclear.
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Curr Opin Anaesthesiol · Dec 2007
ReviewManaging intergenerational differences in academic anesthesiology.
Common definitions for workplace generations are the silent generation (born 1925-1945), the baby boomer generation (1946-1962), generation X (1963-1981), and generation Y (1982-2000). Distinct motivational and value perceptions stereotype generations. This review defines the characteristics of workplace generations today and provides insight into how differences influence the workplace environment. ⋯ Understanding, improved communication strategies, mentorship, and flexibility in methods employed to achieve common goals are most likely to capture the interest and cooperation of members of generation X and possibly Y. Future studies should test effects of particular interventions on outcome in terms of recruitment and performance milestones.
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Curr Opin Anaesthesiol · Dec 2007
ReviewLow-dose aspirin and clopidogrel: how to act in patients scheduled for day surgery.
With the increasing use of antiplatelet drug treatment, complications resulting from its interference with invasive procedures (surgery or regional anaesthesia) have become an everyday challenge to the surgical team. The purpose of this review is to examine the most recent findings and integrate them into the ambulatory surgery setting. ⋯ Most ambulatory surgical procedures present low bleeding risk. The current attitude in this setting is to maintain aspirin therapy and possible antiplatelet drug inhibitors throughout the perioperative period. High-risk patients proposed for high-risk surgery should not be treated as outpatients.