Current opinion in anaesthesiology
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Curr Opin Anaesthesiol · Aug 2012
ReviewAnesthetic management of children undergoing hematologic-oncologic procedures outside the operating room.
There is an increasing demand on anesthetic services to provide care for children undergoing hematologic-oncologic procedures outside the operation room; in particular, to mitigate the pain and unpleasant side-effects of these treatments. This review provides an update of the latest findings on this topic. ⋯ Treatment of children undergoing hematologic-oncologic procedures outside the operation room is challenging. Expertise and high standards are essential to assure patient safety.
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Curr Opin Anaesthesiol · Aug 2012
ReviewMonod-Wyman-Changeux allosteric mechanisms of action and the pharmacology of etomidate.
Formal Monod-Wyman-Changeux allosteric mechanisms have proven valuable in framing research on the mechanism of etomidate action on its major molecular targets, γ-aminobutyric acid type A (GABAA) receptors. However, the mathematical formalism of these mechanisms makes them difficult to comprehend. ⋯ Allosteric co-agonism provides a robust framework for design and interpretation of structure-function experiments aimed at understanding where and how etomidate affects its GABAA receptor target molecules.
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Curr Opin Anaesthesiol · Aug 2012
ReviewAnesthetic management of endovascular procedures for cerebrovascular atherosclerosis.
The article reviews the treatment options for cerebrovascular atherosclerosis and highlights the challenges of anesthesia in this complex group of patients. ⋯ The anesthetist plays a key role in the endovascular management of patients with cerebrovascular atherosclerosis. Optimization of comorbidities, meticulous control of systemic physiologic variables and aggressive management of complications contribute to enhanced patient outcome.
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Curr Opin Anaesthesiol · Aug 2012
ReviewAirway management outside the operating room: hazardous and incompletely studied.
The review examines recent knowledge regarding techniques and complications of airway management in hospitals, outside the operating room. The review does not consider airway management at the time of cardiopulmonary resuscitation as this is a separate topic. ⋯ The notably high rate of failure of primary intubation attempts and high complication rates of airway procedures create a strong argument for increased research focus in this area of high-risk and incomplete knowledge.
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Pain management is one of the most important fields in the practice of anesthesiology. The concept that genes involved in the absorption, metabolism, and receptor affinity of analgesics are critical to a drug's efficacy is becoming widely accepted. A review of pharmacogenomics and how it affects the response to analgesics, mainly opioids, is presented in this article. ⋯ Through increased knowledge in the area of pharmacogenomics, it is hoped that that treatment of pain will move into the realm of personalized medicine. This should result in greater treatment success and a reduction of significant side-effects.