Current opinion in anaesthesiology
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Curr Opin Anaesthesiol · Dec 2008
ReviewPostdischarge complications and rehabilitation after ambulatory surgery.
To present the literature on recent developments in anesthetic and analgesic techniques in ambulatory surgery. ⋯ During the last year, several studies have demonstrated the benefits of regional anesthesia techniques in reducing postdischarge complications and improving rehabilitation. Perioperative use of the COX-2 selective inhibitor celecoxib seems to provide short-term and long-term postoperative advantages.
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Curr Opin Anaesthesiol · Dec 2008
ReviewRegional anesthesia techniques for ambulatory orthopedic surgery.
The purpose of this review is to present advances in the use of regional anesthetic techniques in ambulatory orthopedic surgery. New findings regarding the use of both neuraxial anesthesia and peripheral nerve block are discussed. ⋯ In summary, shorter acting, neuraxial, local anesthetic agents, specific to the expected duration of surgery, may provide superior recovery profiles in the ambulatory setting. A trend towards more peripheral and selective nerve blocks exists. The infrapatellar block is a promising technique to provide analgesia following knee arthroscopy. Improved analgesia seen in the perioperative period can be safely and effectively extended to the postoperative period with the use of perineural catheters.
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Curr Opin Anaesthesiol · Dec 2008
ReviewAirway management in the outpatient setting: new devices and techniques.
There are an ever-increasing number of supraglottic airway devices available on the market, many being suitable for ambulatory surgery and the specific demands it creates. These include constraints of time, high turnover and the need for early and effective discharge. This article hopes to highlight the potential benefits of the current devices available. ⋯ Some of the unique advantages offered by certain devices lend themselves well to anaesthesia in ambulatory surgery. The laryngeal mask airway has a proven track record but newer airway devices are becoming more popular and may offer advantages. Further research is needed in this fast-moving field to assess these benefits, especially in specific cohorts of patients (such as the obese), who are appearing with increasing regularity on outpatient surgery lists.
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Curr Opin Anaesthesiol · Dec 2008
ReviewWeb-based education in anesthesiology: a critical overview.
The purpose of this review is to discuss the rise of web-based educational resources available to the anesthesiology community. ⋯ The worldwide web has made available a large variety of valuable medical information and education resources only dreamed of two decades ago. To a large extent,these developments represent a shift in the focus of medical education resources to emphasize free access to materials and to encourage collaborative development efforts.
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Curr Opin Anaesthesiol · Dec 2008
ReviewChanges in skin conductance as a tool to monitor nociceptive stimulation and pain.
The skin conductance algesimeter (SCA) reflects the sympathetic nervous system influenced by changes in emotions, which releases the acetylcholine that acts on muscarine receptors, causing a subsequent burst of sweat and increased skin conductance. The SCA reacts immediately and is not influenced by hemodynamic variability or neuromuscular blockade. The use of SCA for pain and nociceptive assessment is outlined in this review. ⋯ The SCA detects nociceptive pain fast and continuously, specific to the individual, with higher sensitivity and specificity than other available objective methods.