Current opinion in anaesthesiology
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This article reviews the challenging practice of systemic analgesia as an alternative to epidural analgesia for labor pain, and places remifentanil within the context of opioid analgesics suitable for managing for labor pain. ⋯ Remifentanil is now gaining popularity. Remifentanil may be more suitable than other traditional opioids for inducing labor analgesia. Careful monitoring of the parturient and the newborn is recommended, however, to mitigate the potential for maternal and neonatal hypoxemia.
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Changes in practice and the development of new anesthetic drugs have influenced the use of muscle relaxants in children. This article reviews these developments, and defines the current role and factors affecting the choice of muscle relaxant drugs in pediatric anesthesia. ⋯ Recent developments in clinical practice have reduced or obviated the need for muscle relaxants in pediatric anesthesia. Muscle relaxants are still indicated for intubation and procedures requiring profound muscle relaxation, and to minimize the amounts of anesthetic drugs given to infants and sick children. Specific relaxants and doses can be chosen to suit the clinical circumstances.
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Curr Opin Anaesthesiol · Apr 2007
Review Comparative StudyWhy is there such a difference in outcome between Australian intensive care units and others?
The aim of this article is to assess the data on clinical outcomes for critically ill patients admitted to Australian and New Zealand intensive care units in comparison to information available for similar patients in other counties ⋯ Although comparisons in outcome between Australia and New Zealand intensive care units and other units worldwide may not have sufficient scientific rigour to truly reflect better national outcomes, many features of Australian and New Zealand units are unique and worthy of consideration by other national systems as they consider their strategic national goals for the next decade.