Current opinion in anaesthesiology
-
The purpose of this review is to discuss the risk factors associated with laryngospasm and the techniques used for prevention and treatment. We also summarize the prevention and treatment modalities in organized algorithms. ⋯ Identifying the risk factors and taking the necessary precautions are the key points in prevention of laryngospasm. An experienced anesthesiologist is associated with lower incidence of laryngospasm. Airway management is the most essential part of treatment of laryngospasm. Drugs can be used as an adjunct in treatment of laryngospasm, especially when anesthesia is administered by beginners.
-
Human immunodeficiency virus (HIV) infection is one of the major global health problems. Because the advances in treatment of HIV infection increase the patient's survival, anaesthesiologists may care for these patients during their practice. This article highlights HIV infection and anaesthetic implications. ⋯ Anaesthesia in HIV-infected patients should be individualized and depend on the status of the patient.
-
Obese, morbidly obese and ultra-obese patients have multiple surgical procedures. Although they can have an acute abdomen, obstetric procedures, trauma-related procedures and many others, morbidly obese patients are most consistently cared for in the bariatric surgery operating room. The lessons from that group of patients can, could and, usually, should be applied in all patients who are morbidly obese and present for anesthetic care. ⋯ The number of patients with obesity and morbid obesity continues to increase. Following certain guidelines will ease the management and improve outcomes of the morbidly obese patient presenting for any surgery.
-
Curr Opin Anaesthesiol · Jun 2009
ReviewCan we predict persistent postoperative pain by testing preoperative experimental pain?
Although it is recognized that medical and surgical procedures may lead to persistent postoperative pain, predicting which patients are at risk for developing chronic pain presents an ongoing challenge. Clinical observations indicate that similar invasive procedures associated with consequent peripheral tissue damage can cause a wide range of pain experience. This broad variability is likely a consequence of the diversity in the central pain processing of the peripherally generated noxious stimulation. Therefore, advanced psychophysical measures that dynamically represent central pain modulation mechanisms may be used to determine an individual's susceptibility to developing persistent postoperative pain. This review highlights how, and to what extent, preoperative experimental pain testing can be utilized in predicting persistent postoperative pain. ⋯ The preoperative identification of individuals who have enhanced pain sensitivity and are at risk for developing persistent postoperative pain is important to providing them with better treatment that is specifically tailored to their altered pain modulation, as represented psychophysically.
-
Curr Opin Anaesthesiol · Jun 2009
ReviewPresent and emerging strategies for reducing anesthesia-related maternal morbidity and mortality.
As the demographic of pregnant women continues to change, anesthesiologists will need to continue to find new ways to prevent morbidity and mortality. In this article several new and emerging strategies to meet this challenge are discussed. ⋯ Over the past 50 years, the field of anesthesiology has reduced the rates of anesthesia-related maternal mortality and major morbidity considerably. As the obstetric demographic becomes older and more obese, new technologies and strategies can assist in keeping maternal death and major morbidity vanishingly rare.