Current opinion in anaesthesiology
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Simulation training in obstetric anesthesia has become widespread in recent years. Simulations are used to train staff and trainees, assess and improve team performance, and evaluate the work environment. This review summarizes current research in these categories. ⋯ Simulation allows for practice of tasks and teamwork in a controlled manner. There is little data whether simulation improves patient outcomes and metrics to predict the long-term retention of skills by simulation participants have not been developed.
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Curr Opin Anaesthesiol · Dec 2017
ReviewPerioperative point of care ultrasound in ambulatory anesthesia: thinking beyond nerve blocks.
Ultrasound has become readily available in the perioperative area. In this review, we aim to bring forth some uses of ultrasound beyond that in regional anesthesia. ⋯ Focus towards improving patient outcomes is the goal of all physicians and point of care ultrasound is one modality that can help us manage some common conditions in the perioperative period. Perioperative point of care ultrasound training may soon become a prerequisite for an anesthesiology residency.
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The purpose of this review is to take a look on some practical aspects of anesthetic care in the endoscopy suite, concerning the general approach, safety, and monitoring issues. ⋯ Sedation or anesthesia in the endoscopy suite is not without risk. For complex and longer lasting procedures and in patients with significant comorbidities and risk factors, good clinical judgment, built on experience, is essential and to foster this, it seems prudent to build up a group of anesthesiologists dedicated to a special sedation service.
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The current review considers an array of recent applications for point-of-care ultrasound in clinical practice including diagnostic and therapeutic procedures that may be relevant for the obstetric anesthesiologist. The rapid advancement of technology and clinical applications for bedside ultrasound in obstetric anesthesiology requires an appraisal of the limitations and uses. ⋯ Anesthesiologists have clearly embraced this facile versatile tool for bedside diagnostics and procedures. One limitation to widespread adoption is availability of suitable ultrasound skills and technology. Many of these ultrasound techniques have not yet established clear patient benefit, yet the sheer breadth of ultrasound techniques reported in the past few years demonstrate that our colleagues are becoming more proficient. It is important to follow the development of this emerging field to be aware of limitations to learning these skills and their potential clinical benefit. Proficiency in some of these point-of-care ultrasound techniques may become prerequisite for obstetric anesthesiologists to provide the best care.
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Curr Opin Anaesthesiol · Oct 2017
ReviewRegional blocks carried out during general anesthesia or deep sedation: myths and facts.
More patients will accept regional blocks if these are performed during sedation or general anesthesia. This review discusses regional anesthesia in sedated or anesthetized patients. ⋯ With the use of ultrasound guidance in skilled hands, it is a reasonable option to perform neuraxial and peripheral regional blocks in sedated or anesthetized patients. Performing the procedure safely and effectively requires an adequate level of experience with the specific block technique in question.