Current opinion in anaesthesiology
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Curr Opin Anaesthesiol · Jun 2020
ReviewFetal anesthesia: intrauterine therapies and immediate postnatal anesthesia for noncardiac surgical interventions.
This review describes maternal and fetal anesthetic management for noncardiac fetal surgical procedures, including the management of lower urinary tract obstruction, congenital diaphragmatic hernia (CDH), myelomeningocele, sacrococcygeal teratoma, prenatally anticipated difficult airway and congenital lung lesions. ⋯ Maternal and fetal anesthetic management is tailored to the fetal intervention and the underlying health of the fetus and mother.
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Simulation training (crew resource management training and scenario training) has become an important tool in the education of anesthesiologists. This review summarizes recent research performed in this area, focusing more specifically on obstetric anesthesia. ⋯ Simulation training has acquired a central role in modern education of anesthesiologists. Further research regarding elements to optimize simulation training in terms of learning outcomes and long-term skill retention is desirable. In addition, little data exist concerning the effect of simulation training on possible improvement of patient outcomes in anesthesia.
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Curr Opin Anaesthesiol · Jun 2020
ReviewCombined spinal epidural for labour analgesia and caesarean section: indications and recommendations.
The combined spinal-epidural offers faster-onset and superior labour analgesia.
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Curr Opin Anaesthesiol · Jun 2020
ReviewAnesthesia teams managing pacemakers and ICDs for the perioperative period: enhanced patient safety and improved workflows.
There have been both technological and philosophical advances over the last decade regarding pacemakers and implanted cardioverter defibrillators (ICDs). Collectively, these devices are currently referred to as cardiac implantable electronic devices (CIEDs). Technological advances include the introduction of leadless pacemakers, subcutaneous defibrillators and cardiac event recorders, enhancements regarding compatibility of CIEDs for MRI scanning, the ability to interrogate devices remotely, and improved programming modes that preserve battery life. Philosophical advances have been mainly in the area of perioperative management of CIED patients. ⋯ Educated anesthesia teams can independently manage the vast majority of CIED patients perioperatively with magnet application alone. Furthermore, this portends enhanced patient safety and improved workflows in the perioperative period.
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Curr Opin Anaesthesiol · Jun 2020
ReviewPractice horizons in pediatric nonoperating room anesthesia.
Anesthesia outside the operating room is rapidly expanding for adult and pediatric patients. Anesthesia clinicians practicing in this area need a good understanding of the challenges of the NORA environment and the anesthetic risks and perioperative implications of practice so that they can deliver safe care to their patients. ⋯ With appropriate attention to organizational concerns (i.e. team environment, safety protocols) and unrelenting focus on patient safety, anesthesiologists can assist in safely providing the benefit of cutting-edge technical advancements to pediatric patients in these challenging environments.