Articles: general-anesthesia.
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Advances in imaging and technique have pushed the boundaries of the types of surgical interventions available to fetuses with congenital and developmental abnormalities. This review focuses on fundamental aspects of fetal anesthesia, including the physiologic changes of pregnancy, uteroplacental perfusion, and fetal physiology. We discuss the types of fetal surgeries and procedures currently being performed and discuss the specific anesthetic approaches to different categories of fetal surgeries. We also discuss ethical aspects of fetal surgery and anesthesia.
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Curr Opin Anaesthesiol · Dec 2019
ReviewIndications, contraindications, and safety aspects of procedural sedation.
There is a steadily increasing demand for procedural sedation outside the operating room, frequently performed in comorbid high-risk adult patients. This review evaluates the feasibility and advantages of sedation vs. general anesthesia for some of these new procedures. ⋯ Anesthesiologists are facing continuously new indications for procedural sedation in sometimes sophisticated diagnostic or therapeutic procedures. Timely availability of anesthesia staff will mainly influence who is performing sedation, anesthesia or nonanesthesia personal. While the number of absolute contraindications for sedation decreased to almost zero, relative contraindications are becoming more relevant and should be tailored to the individual procedure and patient.
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Review
[Regional anesthesia in daily clinical practice: an economic analysis based on case vignettes].
The economic effect is a crucial aspect of every medical procedure. This article analyzes the economic implications of various methods in anesthesia based on three case vignettes. ⋯ Even considering that this cost analysis was calculated based on data from only one medical institution (General Hospital of Vienna, Medical University of Vienna), regional anesthesia appeared to be cost efficient compared with other anesthesia procedures. Main cost drivers in this example were personnel costs.
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Int J Obstet Anesth · Nov 2019
Review Meta AnalysisInduction opioids for caesarean section under general anaesthesia: a systematic review and meta-analysis of randomised controlled trials.
Remifentanil and alfentanil effectively reduce the pressor response to intubation for general anaesthesia cesarean section, without depressing neonatal Apgar scores.
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Meta Analysis Comparative Study
High-dose versus low-dose opioid anesthesia in adult cardiac surgery: A meta-analysis.
We performed a systematic comparison of high-dose and low-dose opioid anesthesia in cardiac surgery. ⋯ Our data suggest that low-dose opioids, both short acting and long acting, are safe and effective to use in adult cardiac surgery patients, independent of the clinical characteristics of the patients and the type of opioid used. In view of the current opioid epidemic, low-dose opioid anesthesia should be considered for cardiac surgery patients.