Current opinion in anaesthesiology
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Curr Opin Anaesthesiol · Dec 2017
ReviewOptimizing education in difficult airway management: meeting the challenge.
The last 2 decades have seen a vast change in the science and technology of airway management. As a result, there is an increasing need to equip anesthesiologists with the new knowledge and skills for the safe management of a difficult airway. ⋯ There is need for research on difficult airway management and optimized training methods. Research is also required to determine the barriers to adoption of guidelines and strategies to ensure widespread dissemination and implementation of guidelines and best practices for difficult airway management.
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Curr Opin Anaesthesiol · Dec 2017
ReviewHeart rate variability: implications for perioperative anesthesia care.
Heart rate variability (HRV) is a measure of the balance between both the parasympathetic and sympathetic nervous system and may provide useful information for anesthesia care providers. HRV may offer predictive information about critically ill and operative patients. Further, HRV collection provides real-time information of patient autonomic nervous system status and may allow tailoring of the analgesia for patients in the ICU and operating room. ⋯ Not applicable.
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Curr Opin Anaesthesiol · Dec 2017
ReviewComplications and unplanned admissions in nonoperating room procedures.
The purpose of this article is to review complications and unplanned hospital admissions in patients presenting for ambulatory procedures requiring anesthesia care in the gastrointestinal endoscopy, bronchoscopy, and radiology suites. ⋯ Sedation and anesthesia are required for the increasing number of increasingly complex procedures being undertaken outside the operating suite. Large randomized trials are required to define the optimum sedation drugs, sedation depth and sedation provider.
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Curr Opin Anaesthesiol · Dec 2017
ReviewChallenges in the anesthetic management of ambulatory patients in the MRI suites.
MRI is becoming an indispensable diagnostic tool. The need for prolonged motion-free periods has substantially increased the need for deep sedation or anesthesia in a challenging environment. This review summarises recent literature with respect to pharmacological sedative strategies, nonpharmacological alternative approaches, airway management and safety issues in the ambulatory setting. ⋯ The anesthetic management of ambulatory patients in the MRI environment has its specific challenges and safety issues. However, the implementation of safety guidelines, new pharmacological and alternative nonpharmacological sedation strategies offer interesting perspectives to tackle these challenges.
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Curr Opin Anaesthesiol · Dec 2017
ReviewAnesthesia information management: clinical decision support.
Perioperative informatics tools continue to be developed at a rapid pace and offer clinicians the potential to greatly enhance clinical decision making. The goal of this review is to bring the reader updates on perioperative information management and discuss future research directions in the field. ⋯ Perioperative informaticians continue to test new and innovative ways to enhance the delivery of anesthesia care, improving the safety and efficacy of perioperative management. Future work will continue to refine tools to ensure that perioperative informatics provides clinicians timely and accurate feedback, with demonstrable evidence that a decision support system improves patient outcomes.