Articles: general-anesthesia.
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Curr Opin Anaesthesiol · Jun 2018
ReviewPreoperative fasting guidelines in pediatric anesthesia: are we ready for a change?
Study after study shows that prolonged fasting before anesthesia is common in children. Pediatric anesthesiologists around the world are concerned that the current guidelines may be part of the problem. This review focuses on what can be done about it. ⋯ Accumulating evidence indicates that changes of the current guidelines for preoperative fasting should be considered for children undergoing elective procedures. VIDEO ABSTRACT.
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Best Pract Res Clin Anaesthesiol · Jun 2018
ReviewUpdate on nitrous oxide and its use in anesthesia practice.
Nitrous oxide (N2O) is an anesthetic and analgesic gas with a long history of medical applications. It acts on multiple supraspinal and spinal targets and has utility in a wide range of clinical situations. The relative safety, low incidence, and acuity of adverse effects of N2O, along with the ability to be administered by trained medical providers with varying clinical backgrounds, as well as self-administered by patients, assure its persistent and expanding role in clinical practice.
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Best Pract Res Clin Anaesthesiol · Jun 2018
ReviewNeuromuscular blockers and reversal agents and their impact on anesthesia practice.
Neuromuscular blockers have long been an intricate part of the anesthesia regimen. The scientific progress in pharmacology and physiology has strengthened their clinical relevance, has helped to delineate with precision their medical role, and has enhanced the safety and effectiveness of their use. New frontiers in research will define further the role of these agents in modern anesthesia practice and guide their expanding and discrete clinical applications.
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Best Pract Res Clin Anaesthesiol · Jun 2018
ReviewWhat is new in the battle against postoperative nausea and vomiting?
The issue of postoperative nausea and vomiting (PONV) still poses a significant burden on our patients. Although rarely associated with a life-threatening condition, it is consistently considered as one of the most undesirable side effects of surgery and anesthesia. ⋯ Because pharmacologic interventions for PONV are not without risks, practitioners must assess patient's risk status from low to high and consider the benefits of treatment. This review summarizes the current state of knowledge related to PONV and provides a practical approach toward risk assessment, prevention, and numerous treatment strategies.
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Review Meta Analysis
Postoperative pulmonary complications and hospital stay after lung resection surgery: A meta-analysis comparing nonintubated and intubated anesthesia.
Since postoperative pulmonary complications are one of the main causes of morbidity and mortality in patients undergoing lung resection surgery, we performed a meta-analysis to compare the incidence of postoperative pulmonary complications and hospital death, and the length of hospital stay in patients who received nonintubated or intubated anesthesia during thoracoscopic surgery for lung resection and further explore the tricks in nonintubated anesthesia. ⋯ Nonintubated anesthesia in thoracoscopic surgery for lung resection shortened the length of hospital stay compared with intubated anesthesia. However, the incidence of postoperative pulmonary complications was comparable between nonintubated and intubated group. Given the potential perioperative emergencies, such as persistent hypoxemia, carbon dioxide retention, or extensive pleural adhesions, nonintubated anesthesia in lung resection surgery requires extra vigilance to ensure the safety of the patients and the success of the surgery. Powerful randomized controlled trials in the future are essential to provide more certainty and address long-term effectiveness. Only when anesthesiologists and surgeons make efforts together can better clinical outcomes in lung resection surgery be achieved.