Current opinion in anaesthesiology
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Curr Opin Anaesthesiol · Oct 2014
ReviewPostoperative ICU management of patients after subarachnoid hemorrhage.
This article reviews recent advances in the postoperative ICU management of patients after subarachnoid hemorrhage (SAH), especially with regards to hemodynamic management, methods of improving neurological outcomes, and management of cardiac and pulmonary complications. ⋯ The postoperative ICU period after SAH is associated with a significant morbidity and mortality risk, and recent studies have greatly contributed to our understanding of how to optimally manage these patients.
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Curr Opin Anaesthesiol · Oct 2014
ReviewRegional anesthesia in patients with pre-existing neurologic disease.
Regional anesthesia is controversial in patients with pre-existing neurologic disease. This study reviews the published evidence regarding the utilization and outcomes of regional anesthetics in this population. ⋯ Regional anesthesia can be safely utilized in patients with pre-existing neurological disease and may have benefits over general anesthesia; however, a conservative approach is warranted. In addition, further publications regarding regional techniques in this population are needed.
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Curr Opin Anaesthesiol · Oct 2014
ReviewAnesthesia for intracranial surgery in infants and children.
Age-related differences in the surgical lesions, anatomy and physiological responses to surgery and anesthesia underlie the clinically relevant differences between pediatric patients and their adult counterparts. Anesthesiologists need to be aware of the unique challenges in the anesthetic management of the pediatric neurosurgical patient. ⋯ The aim of this review is to highlight the impact of these techniques on the intraoperative management of the pediatric neurosurgical patient. These issues are essential in minimizing perioperative morbidity and mortality.
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To present the recent literature on chronic postsurgical pain in children. ⋯ The literature on the topic is sparse. Prospective studies, including clinical examination, quantitative sensory testing, and long-term follow-up, are needed to increase our knowledge about the prevalence, risk factors, and underlying mechanisms.
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Postoperative pain remains poorly treated in many patients. One reason is the inadequate use of nonopioid analgesics. This review examines the most recent findings on nonopioid analgesics and how these translate into clinical practice. ⋯ Nonopioid analgesics are important components of multimodal postoperative analgesia. The selection of the most appropriate compound for an individual patient can be based more and more on ever increasing data on these important analgesics.