Current opinion in anaesthesiology
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Curr Opin Anaesthesiol · Aug 2021
ReviewAn update on pediatric sedation techniques in nonoperating room locations.
To review advancements in care for pediatric patients in nonoperating room settings. ⋯ Pediatric NORA requires thorough preparation, flexibility, and vigilance to provide safe anesthesia care to children in remote locations. Emerging techniques to reduce anesthetic exposure, improve monitoring, and alternative staffing models are expanding the boundaries of pediatric NORA to provide a safer, more satisfying experience for diagnostic and interventional procedures.
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Curr Opin Anaesthesiol · Aug 2021
ReviewNational trends in nonoperating room anesthesia: procedures, facilities, and patient characteristics.
Nonoperating room anesthesia (NORA) continues to increase in popularity and scope. This article reviews current and new trends in NORA, trends in anesthesia management in nonoperating room settings, and the evolving debates surrounding these trends. ⋯ NORA is a rapidly growing field of anesthesia. Continuing discussions of complication rates and mortality in different subspecialty areas will determine the need for anesthesia care and quality improvement efforts in each setting. As new noninvasive procedures are developed, new data will continue to shape debates surrounding anesthesia care outside of the operating room.
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Curr Opin Anaesthesiol · Aug 2021
ReviewAnaesthesia for minimally invasive cardiac procedures in the catheterization lab.
The share of cardiac procedures performed in settings involving nonoperating room anaesthesia (NORA) continues to grow rapidly, and the number of publications related to anaesthetic techniques in cardiac catheterization laboratories is substantial. We aim to summarize the most recent evidence about outcomes related to type of anaesthetic in minimally invasive cardiac procedures. ⋯ Inappropriate sedation and concurrent inadequate oxygenation are main risk factors for claims involving NORA care. Current evidence deriving from TAVR shows that monitored anaesthesia care (MAC) is associated with shorter length of stay and lower mortality.
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Curr Opin Anaesthesiol · Aug 2021
ReviewAnesthetic Management of Acute Ischemic Stroke in the Interventional Neuro-Radiology Suite: State of the Art.
This review discusses the general anesthetic approach of endovascular stroke therapy and highlights recent advances and considerations for optimal intraoperative management of acute ischemic stroke. ⋯ Optimal time to intervention, hemodynamic stability, novel imaging techniques, and careful consideration of anesthetic plan can impact patient outcomes in reperfusion stroke therapy.
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Curr Opin Anaesthesiol · Aug 2021
ReviewFrameworks for trainee education in the nonoperating room setting.
As the volume and types of procedures requiring anesthesiologist involvement in the nonoperating room anesthesia (NORA) setting continue to grow, it is important to create a formal curriculum and clearly define educational goals. ⋯ As educators, we must foster and grow a resident's resilience by continually challenging them with new clinical scenarios and giving them appropriate autonomy to take risks and move outside of their comfort zone. Residents should understand that exposure to such unique and demanding environment can be transformative.