Current opinion in anaesthesiology
-
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.
-
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.
-
Curr Opin Anaesthesiol · Jun 2008
ReviewManagement of postdural puncture headache in the obstetric patient.
The treatment of postdural puncture headache remains controversial, largely because it is insufficiently evidence based. With high rates of neuraxial block in the obstetric population likely to continue, postdural puncture headache will remain a primary cause of morbidity and increased duration of hospital stay. This review describes new reports of relevance published in 2006 and until October 2007. ⋯ The key reports in this epoch have shed light on the benefits of careful assessment of postpartum headache and treatment with an epidural blood patch. New management paradigms have been suggested and serious complications continue to be reported.
-
Recently, many researchers have been studying stress and burnout in anaesthesia. Some researchers have examined the effects of stress in the workplace. Others have identified some job characteristics that have an impact on anaesthetist's well-being. Yet, few studies use the same measure of stress and/or define the concept of stress in the same way, making comparison and aggregation of results difficult, and therefore minimizing the general impact of these research findings. ⋯ From the referred studies, the review challenges the more practical problems of prevention of stress and burnout and provides some avenues for future investigations.