Current opinion in anaesthesiology
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Curr Opin Anaesthesiol · Oct 2016
ReviewSafety and efficiency of dexmedetomidine as adjuvant to local anesthetics.
To review the current knowledge of dexmedetomidine as an additive drug to local anesthetics in peripheral and neuraxial regional anesthesia. ⋯ Dexmedetomidine has a potency to ameliorate pharmacodynamic characteristics of peripheral and neuraxial regional anesthetic techniques and is therefore currently the most promising additive drug in regional anesthesia. Future scientific efforts should focus on dose finding studies for particular regional anesthetic techniques. Approval of dexmedetomidine for regional anesthetic indications should be the final target.
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Curr Opin Anaesthesiol · Oct 2016
ReviewAnesthetic management and human factors in the intraoperative MRI environment.
The use of intraoperative MRI technology during neurosurgery has become increasingly more common over the past several years. These surgical procedures require a specialized operating room designed to accommodate an MRI machine, as well as MRI-compatible anesthesia equipment and monitors. The MRI environment also poses unique risks and challenges to both patients and medical staff. ⋯ The use of checklists and teamwork training can maximize both patient and provider safety in the intraoperative MRI environment.
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The study focuses on neural blocks with local anesthetics in postoperative and chronic pain. It is prompted by the recent publication of several systematic reviews and guidelines. ⋯ Recent literature strongly supports the use of regional anesthesia for postoperative pain, whereby infusions at peripheral nerves and surgical site are gaining increasing importance. Local anesthetic blocks are valid for the diagnosis of facet joint pain and effective in treating headache. There is a need for further research in diagnostic and therapeutic blocks for chronic pain.