Current opinion in anaesthesiology
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Curr Opin Anaesthesiol · Jun 2008
ReviewNeuromuscular and mitochondrial disorders: what is relevant to the anaesthesiologist?
The review provides an up-to-date information to the anaesthesiologist about the more frequent and important neuromuscular disorders for which new basic insights or clinical implications have been reported. ⋯ The increased understanding of the genetics and pathophysiology of common muscle disorders may lead to a decrease in life-threatening complications related to surgery and anaesthesia. However, there is still a lack of prospective clinical studies to determine which is the safest anaesthetic technique for these patients.
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Curr Opin Anaesthesiol · Jun 2008
ReviewManagement of postdural puncture headache in the obstetric patient.
The treatment of postdural puncture headache remains controversial, largely because it is insufficiently evidence based. With high rates of neuraxial block in the obstetric population likely to continue, postdural puncture headache will remain a primary cause of morbidity and increased duration of hospital stay. This review describes new reports of relevance published in 2006 and until October 2007. ⋯ The key reports in this epoch have shed light on the benefits of careful assessment of postpartum headache and treatment with an epidural blood patch. New management paradigms have been suggested and serious complications continue to be reported.
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This review discusses the place of the old anesthetic ketamine in pediatric anesthesia. ⋯ Ketamine has not yet revealed all its interactions in humans. Recent discoveries indicate interesting properties on the one hand and potentially deleterious effects on the other.
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The present study summarizes the knowledge to date of the use of remifentanil in obstetric anaesthesia and analgesia. ⋯ Remifentanil has a place in obstetric anaesthesia and analgesia. Further studies are needed to confirm if background infusions are safe in addition to patient-controlled analgesia. Studies are needed to establish a dose range under general anaesthesia that prevents neonatal respiratory depression at birth.
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Curr Opin Anaesthesiol · Jun 2008
ReviewEpidemiology and morbidity of regional anaesthesia in children.
To evaluate which techniques of regional anaesthesia are made in 2008 and to appreciate and check their safety. ⋯ Regional anaesthesia is very much used in the child and develops very quickly. The peripheral accesses represent the majority of the regional techniques used. Continuous injection, after central or peripheral accesses, also progresses. There are complications in podiatry after regional anaesthesias. In most cases, they are not serious permanent problems, but they are probably underestimated. Modern approaches of treatment for the nervous structures (neurostimulators and echographs) are available and are used more often in order to increase the effectiveness. Careful use of the neurostimulator and ultrasonography may probably improve the safety in paediatric regional anaesthesia in the years to come.