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Regional Anaesthetic Techniques (regional + anaesthetic_techniques)
Selected AbstractsRegional anaesthesia and pain managementANAESTHESIA, Issue 2010I. Power Summary Despite recent advances in analgesia delivery techniques and the availability of new analgesic agents with favourable pharmacokinetic profiles, current evidence suggests that postoperative pain continues to be inadequately managed, with the proportion of patients reporting severe or extreme postoperative pain having changed little over the past decade. Regional techniques are superior to systemic opioid agents with regards to analgesia profile and adverse effects in the context of general, thoracic, gynaecological, orthopaedic and laparoscopic surgery. Outcome studies demonstrate that regional analgesic techniques also reduce multisystem co-morbidity and mortality following major surgery in high risk patients. This review will discuss the efficacy of regional anaesthetic techniques for acute postoperative analgesia, the impact of regional block techniques on physiological outcomes, and the implications of acute peri-operative regional anaesthesia on chronic (persistent) postoperative pain. [source] Regional anaesthesia in day-stay and short-stay surgeryANAESTHESIA, Issue 2010S. L. Kopp Summary The goals for ambulatory surgery are rapid recovery with minimal side effects, adequate postoperative pain control, rapid patient discharge and overall cost containment. The addition of regional anaesthetic techniques has been shown to decrease nausea, postoperative pain scores and the need for post-anaesthesia care unit monitoring. The use of regional anaesthesia is increasing as studies confirm the goals for ambulatory anaesthesia can be met with a combination of regional anaesthesia and a multimodal pain management regimen. [source] Current trends in paediatric regional anaesthesiaANAESTHESIA, Issue 2010H. Willschke Summary Regional anaesthesia is a cornerstone in paediatric anaesthesia today. Many paediatric anaesthetists include regional anaesthetic techniques in their daily clinical practice to provide superior and long-lasting analgesia without the risk of respiratory depression. The first part this article reviews new scientific findings in the field of paediatric regional anaesthesia. The second part focuses on safety aspects and on the impact of ultrasound on paediatric regional anaesthesia. [source] Improved survival in pregnancy and pulmonary hypertension using a multiprofessional approachBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 5 2010DG Kiely Please cite this paper as: Kiely D, Condliffe R, Webster V, Mills G, Wrench I, Gandhi S, Selby K, Armstrong I, Martin L, Howarth E, Bu'Lock F, Stewart P, Elliot C. Improved survival in pregnancy and pulmonary hypertension using a multiprofessional approach. BJOG 2010;117:565,574. Objective, Pregnancy in women with pulmonary hypertension (PH) is reported to carry a maternal mortality rate of 30,56%. We report our experience of the management of pregnancies using a strategy of early introduction of targeted pulmonary vascular therapy and early planned delivery under regional anaesthesia. Design, Retrospective observational study. Setting, Specialist quaternary referral pulmonary vascular unit. Population, Nine women with PH who chose to proceed with ten pregnancies. Methods, A retrospective review of the management of all women who chose to continue with their pregnancy in our unit during 2002,2009. Main outcome measures, Maternal and fetal survival. Results, All women commenced nebulised targeted therapy at 8,34 weeks of gestation. Four women required additional treatment or conversion to intravenous prostanoid therapy. All women were delivered between 26 and 37 weeks of gestation. Delivery was by planned caesarean section in nine cases. All women received regional anaesthesia and were monitored during the peripartum period in a critical care setting. There was no maternal mortality during pregnancy and all infants were free from congenital abnormalities. One woman died 4 weeks after delivery following patient-initiated discontinuation of therapy. All remaining women and infants were alive after a median of 3.2 years (range, 0.8,6.5 years) of follow-up. Conclusion, Although the risk of mortality in pregnant women with PH remains significant, we describe improved outcomes in fully counselled women who chose to continue with pregnancy and were managed with a tailored multiprofessional approach involving early introduction of targeted therapy, early planned delivery and regional anaesthetic techniques. [source] | ||||||||||