Current opinion in anaesthesiology
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Advances in health information technology and broadband Internet connections provide novel opportunities for anesthesiologists to extend perioperative consultation services to remote geographic areas. Increasing economic pressures on healthcare delivery systems make initiatives such as telemedicine, which reduce costs while achieving excellent outcomes, an attractive option. ⋯ Anesthesiologists have the opportunity to develop telemedicine programs that can improve the delivery of care to patients. Current programs offer services ranging from remote preoperative evaluation to international collaboration for intraoperative management and consultation. Simulation using telemedicine services can provide educational opportunities and test the effectiveness of institutions' communications systems.
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Interventional neuroradiology is a rapidly expanding speciality. The aim of this review is to provide the anaesthetist with an up-to-date summary of current and future advances in interventional neuroradiology. ⋯ Providing safe care to patients in the remote radiology suite requires a clear understanding of the complexity of procedures being undertaken, potential complications and careful, thorough assessment of patients.
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Curr Opin Anaesthesiol · Aug 2011
ReviewEffects of anaesthesia on the inflammatory response to injury.
The systemic inflammatory response to injury is essential for wound healing and recovery in concert with other endocrinological, metabolic and immunological changes. However, recent studies suggest that a hyperinflammatory state is associated with adverse perioperative outcomes. Therefore interventions that modulate the inflammatory response, surgical, anaesthetic and pharmacological, may enhance recovery with fewer complications. ⋯ The use of an interleukin-1 receptor antagonist to control wound pain and limit local inflammation is under consideration. The role of glucocorticoids in obtunding the inflammatory response to injury with improved outcome requires confirmation with better-quality trials. Systemic lidocaine is anti-inflammatory but is effective only in abdominal surgery. NSAIDs are neglected, despite their widespread clinical use and merit detailed investigation.