Current opinion in anaesthesiology
-
Curr Opin Anaesthesiol · Jun 2008
ReviewPostoperative complications in elderly patients and their significance for long-term prognosis.
To outline perioperative risk factors for postoperative mortality in older patients, the relationship of these factors with long-term mortality, and to examine possible strategies to reduce mortality. ⋯ Strategies are needed to prevent, or at least adequately manage, complications in elderly patients. Agreed international definitions for risks and complications can help in assessing risks and benefits.
-
The present article will review the current technology and available literature regarding regional anesthesia in infants and children undergoing head and neck surgery. ⋯ The trigeminal nerve, along with the cervical nerve roots, supplies most of the sensory supply to the head and neck. The knowledge and application of the anatomical distribution of this area can increase the utilization of these blocks for a variety of different settings. The increased use of these blocks can reduce the need for additional postoperative analgesic that could in turn lead to fast-tracking of these patients and decrease the incidence of nausea and vomiting in the postoperative period.
-
Haemorrhage remains a cause of significant maternal morbidity and mortality. This review summarizes the prevention, management and treatment of obstetric haemorrhage and highlights recent advances and developments. ⋯ Accurate diagnosis and appropriate management of obstetric haemorrhage can reduce maternal morbidity and mortality. This review outlines the current evidence.
-
Curr Opin Anaesthesiol · Jun 2008
ReviewNeurological complications following central neuraxial blockades in obstetrics.
The last few decades have seen an increased use of central neuraxial blockades in obstetric patients. Central blockades provide excellent labour analgesia and safe anaesthesia for caesarean section associated with low incidence of severe complications. Therefore, an increasing number of blockades are also performed in women affected by significant disease. The risks and benefits of central blockades, however, might differ in these patients. This review addresses the risks of neurological complications following central neuraxial blockades in healthy parturients as well as in women affected by significant haemostatic and neurological disease. ⋯ Estimation of the incidence of neurological complications following central neuraxial blockades to women affected by significant disease on the basis of case reports and small series of patients is impossible. Prospective registration of high-risk patients may increase our knowledge. Application of central neuraxial blockade must follow individual evaluation.
-
To knock down the following myths: obesity in paediatric patients is rare and mainly a North-American problem; obesity in childhood has no long-term harmful effects. To sensitize the anaesthesiologists to a problem seldom addressed in the anaesthetic literature. ⋯ The early manifestations of the comorbidities associated with obesity in adults are already present in overweight and obese children and should be addressed for their safe anaesthetic management. Perioperative respiratory events seem more frequent in overweight and obese patients.