Current opinion in anaesthesiology
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Curr Opin Anaesthesiol · Dec 2015
ReviewLaryngeal mask airway indications: new frontiers for second-generation supraglottic airways.
Because of the many advantages of supraglottic airways (SGA) compared to mask ventilation and endotracheal intubation, their areas of application are constantly expanding. The development of second-generation SGAs in particular has led to a widening of the indications for use thanks to the improved oropharyngeal leak pressure and the possibility of inserting a gastric tube. The identification of possible malpositions and any increased ventilation requirements using simple clinical tests must be given particular emphasis. The question of patient safety for expanded indications has to be evaluated. ⋯ The use of second-generation SGA for expanded indications seems useful and safe, provided the contraindications are heeded, the placement and performance tests are successfully completed and there is adequate clinical expertise.
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Curr Opin Anaesthesiol · Dec 2015
ReviewAirway management for anaesthesia in the ambulatory setting.
The number of anaesthetic procedures in the ambulatory setting is steadily increasing. During the last years, more and more patients with complex medical conditions undergo ambulatory interventions. This review will focus on airway management practices, but especially on techniques used in the ambulatory setting. It will highlight recent literature published in the focus of ambulatory anaesthesia and will discuss relevant findings of the last year. ⋯ There are several points which should be considered for ambulatory anaesthesia. Selected patient groups (e.g., obstructive sleep apnoea, obesity) may have a higher anaesthesia-related risk. To handle the more and more complex conditions in a growing number of ambulatory patients, straightforward concepts, especially for the (un)expected difficult airway, are required.
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The aim of this review was to discuss recent developments in paediatric anaesthesia, which are particularly relevant to the practitioner involved in paediatric outpatient anaesthesia. ⋯ Perfect organization of the whole process is a prerequisite for successful paediatric outpatient anaesthesia. In addition, the skilled practitioner is able to provide a smooth anaesthetic, minimizing complications, and, finally, he has a clear concept for avoiding postoperative pain, agitation and vomiting.
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Curr Opin Anaesthesiol · Dec 2015
ReviewOrganizational aspects to optimize patient's ambulatory pathway.
Successful ambulatory care implementation should combine both medical and organizational features. These two components are closely interrelated. Only optimal organization, part of a quality management program, will allow us to perform safe medical procedures and provide good patient satisfaction. This review is intended to update organizational concepts that could improve ambulatory surgery center efficiency. ⋯ Organizational feature in ambulatory surgery center is a major determinant of patient flow, activity, resource utilization, safety, and patient satisfaction. Most of these basic principles may contribute to improve the quality of care that can also be of benefit to conventional surgical activity.
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Curr Opin Anaesthesiol · Dec 2015
ReviewWhich anesthetic agents for ambulatory electro-convulsive therapy?
There have been a considerable number of research articles published in the last 10 years outlining possible advances in the provision of electro-convulsive therapy (ECT) anaesthesia. This has resulted in a range of new drugs having been proposed as useful in the ECT setting. In particular, the use of adjuvant drugs that might improve outcomes to treatment has been investigated. ⋯ This review covers the major recent trials involving new and emerging treatments in ECT, and brings the reader up to date with state of knowledge of ECT anaesthesia and pharmacology.