Current opinion in anaesthesiology
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Ketamine has been used for decades for a variety of indications. Beyond the historical benefits and effects of ketamine, newer developments have occurred worthy of an update. This review will discuss common uses and indications for ketamine in the perioperative setting, as well as highlight newer indications in recent years. ⋯ Ketamine is regaining popularity in the field of anesthesia and beyond. New studies provide insight on the many indications and use that anesthesia providers may encounter during their perioperative care of patients. Ongoing research is needed to further elucidate ketamine's effects on the management of psychiatric conditions and potential indications for ketamine metabolites.
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Curr Opin Anaesthesiol · Oct 2020
ReviewDouble standard: why electrocardiogram is standard care while electroencephalogram is not?
Should the EEG and it'a processed derivatives be elevated to routine standard of care monitoring during general anaesthesia?
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Curr Opin Anaesthesiol · Oct 2020
ReviewCurrent understanding of the fascial plane blocks for analgesia of the chest wall: techniques and indications update for 2020.
Thoracic myofascial plane blocks have gained popularity because of their ease of performance and relative safety. This review highlights current research demonstrating the efficacy of these blocks for specific surgical procedures and provides a brief description of how these techniques are performed. ⋯ Thoracic fascial plane blocks provide the anesthesiologist a number of techniques to address postsurgical pain. The relative ease of performance and safety profile of these blocks make them an appealing option for pain control for many patients undergoing thoracic or chest wall surgery. Further research is needed to not only define additional indications for each of these blocks, but also explore optimal dosing including the use of continuous catheter techniques.
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Curr Opin Anaesthesiol · Oct 2020
ReviewWrong-site nerve blocks: evidence-review and prevention strategies.
There has been increasing attention to wrong site medical procedures over the last 20 years. This review aims to provide a summary of the current understanding and recommendations for the prevention of wrong-site nerve blocks (WSNB). ⋯ Though the evidence is limited, it is recommended that a combination of multiple strategies should be employed to prevent WSNB. These include the use of preprocedural markings, well constructed checklists, time-out/stop-moments, and cognitive/physical aids. Effective implementation requires team education and engagement that empowers all team members to speak up as part of a culture of safety.
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Curr Opin Anaesthesiol · Oct 2020
ReviewInterventions to improve perioperative neurologic outcomes.
Few outcomes in surgery are as important to patients as that of their neurologic status. The purpose of this review is to discuss and categorize the most common perioperative neurologic complications. We will also discuss strategies to help prevent and mitigate these complications for our patients. ⋯ A thorough understanding of threats to patients' neurologic well-being is essential to excellent clinical practice.