Current opinion in anaesthesiology
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Ambulatory procedural sedation is used to relieve anxiety, pain and discomfort in a broad spectrum of patients during many types of diagnostic or therapeutic procedures. This review focuses on recent comparative studies of commonly used and new drugs for adult ambulatory sedation. ⋯ The properties that would constitute the ideal sedative have yet to be combined in one drug. The selection of the drugs used for ambulatory sedation depends on many factors such as procedure type, patient characteristics and the expectations of patients and the healthcare provider. Because of this, the literature cannot yet provide a definitive answer to the question which drug is best selected in a specific situation.
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Curr Opin Anaesthesiol · Dec 2018
ReviewBest perioperative practice in management of ambulatory patients with obstructive sleep apnea.
Obstructive sleep apnoea patients receiving opioids should have post-operative continuous monitoring.
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The current review will discuss the current literature on genetics of pain and analgesia, with special emphasis on perioperative setting. We will also discuss pharmacogenetics-based management guidelines, current clinical status and future perspectives. ⋯ Pharmacogenetic approach marks the dawn of personalized pain medicine both in perioperative and chronic pain settings.
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This article reviews the recent clinical evidence published between January 2017 and June 2018 - related to perioperative cognitive evaluation. Namely, new insights into risk factors, prevention, diagnosis and diagnostic tools and treatment. ⋯ Clinical evidence on POD/POCD is continuously evolving, which is essential in guiding clinical management to provide the highest quality of clinical care.
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Curr Opin Anaesthesiol · Dec 2018
ReviewWhat we can learn from Big Data about factors influencing perioperative outcome.
This narrative review will discuss what value Big Data has to offer anesthesiology and aims to highlight recently published articles of large databases exploring factors influencing perioperative outcome. Additionally, the future perspectives of Big Data and its major pitfalls will be discussed. ⋯ Big Data is becoming increasingly popular with the collaborative collection of registries offering anesthesia a way to explore rare perioperative complications and outcome to encourage further hypotheses testing. Although Big Data has its flaws in security, lack of expertise and methodological concerns, the future potential of analytics combined with genomics, machine learning and real-time decision support looks promising.