Current opinion in anaesthesiology
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Curr Opin Anaesthesiol · Oct 2024
ReviewCurrent opinion: optimize radiofrequency ablation through electrophysiological principles, modeling, and clinical recommendations.
This article aims to empower the interventional pain physician to utilize RFA effectively by explaining the technical and electrophysiological features of monopolar, bipolar, and internally cooled RFA. Scientific data are used to provide advice on the effective, well tolerated, and rational application of these techniques. Moreover, physicians need to know how to analyze and generalize ex-vivo and in-vivo models to the clinical setting to optimize clinical outcomes. ⋯ To optimize both the efficacy and safety of RFA, physicians must understand, conceptualize, interpret, and clinically translate the basic science of RFA. This knowledge is crucial for optimizing equipment selection and settings based on target location to enhance clinical outcomes and limit technical failures.
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Curr Opin Anaesthesiol · Oct 2024
ReviewAn update on the perioperative management of postcraniotomy pain.
Pain after craniotomy is often severe and undertreated. Providing adequate analgesia while avoiding medication adverse effects and physiological complications of pain remains a perioperative challenge. ⋯ Improving analgesia following craniotomy continues to be a challenge that should be managed with multimodal medications and regional techniques. Additional studies are needed to identify the most effective regimen, balancing efficacy and adverse drug effects.
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Curr Opin Anaesthesiol · Oct 2024
ReviewUpdate on the anesthesia management in adult patients with moyamoya disease.
The anesthetic management of patients with Moyamoya disease (MMD) is challenging and continues to evolve. The goal of this review is to provide updated recommendations on the anesthetic management of adult MMD patients based on the relevant existing literature. ⋯ Strategies in the preoperative, intraoperative, and postoperative anesthetic management of MMD patients should aim to maintain adequate cerebral perfusion to prevent cerebral ischemia.
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Curr Opin Anaesthesiol · Oct 2024
Meta AnalysisPerioperative care of patients with recent stroke undergoing nonemergent, nonneurological, noncardiac, nonvascular surgery: a systematic review and meta-analysis.
To systematically review and perform a meta-analysis of published literature regarding postoperative stroke and mortality in patients with a history of stroke and to provide a framework for preoperative, intraoperative, and postoperative care in an elective setting. ⋯ In patients with a history of a recent stroke, anesthesiology, surgery, and neurology experts should create a shared mental model in which the patient/surrogate decision-maker is informed about the risks and benefits of the proposed surgical procedure; secondary-stroke-prevention medications are reviewed; plans are made for interruptions and resumption; and intraoperative care is individualized to reduce the likelihood of postoperative stroke or death.
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Curr Opin Anaesthesiol · Oct 2024
ReviewPostoperative pain management after thoracic transplantations.
Heart and lung transplantation evolution marked significant milestones. Pioneering efforts of Dr Christiaan Barnard with the first successful heart transplant in 1967, followed by advancements in heart-lung and single-lung transplants by Drs Bruce Reitz, Norman Shumway, and Joel Cooper laid the groundwork for contemporary organ transplantation, offering hope for patients with end-stage heart and pulmonary diseases. ⋯ This review emphasizes the importance of tailored pain management in heart and lung transplant recipients. It advocates for extended follow-up and alternative analgesics to minimize opioid dependency and enhance quality of life. Further high-quality research is needed to optimize postoperative analgesia and improve patient outcomes.