Ambulatory surgery for cancer patients: current controversies and concerns
Purpose of review
This review aims to describe the main concerns and controversies of ambulatory surgery in cancer patients while providing an overview of ambulatory cancer anaesthesia.
Recent findings
Cancer patients can undergo a variety of ambulatory surgeries. The introduction of robotic approach and the implementation of enhanced recovery programmes have allowed patients to avoid hospital admissions after more complex or invasive surgeries. In this context, the anaesthesiologist plays a key role in ensuring that the ambulatory surgical centre or the hospital-based ambulatory department is equipped for the p...
Source: Current Opinion in Anaesthesiology - December 1, 2021 Category: Anesthesiology Tags: AMBULATORY ANESTHESIA: Edited by Girish P. Joshi Source Type: research
Sedation/analgesia techniques for nonoperating room anesthesia: new drugs and devices
Purpose of review
The purpose of this article is to review new drugs and devices for nonoperating room anesthesia (NORA).
Recent findings
Remimazolam is an ultra-short-acting, water-soluble intravenous benzodiazepine with a fast onset and offset that has been approved recently for use in procedural sedation. Phase III trials have established the effectiveness of remimazolam sedation compared with placebo and midazolam in gastrointestinal endoscopy and bronchoscopy. More research is required investigating remimazolam in real-world NORA settings, including comparisons with propofol sedation. Oliceridine is a μ-ag...
Source: Current Opinion in Anaesthesiology - December 1, 2021 Category: Anesthesiology Tags: AMBULATORY ANESTHESIA: Edited by Girish P. Joshi Source Type: research
Telemedicine for preanesthesia evaluation: review of current literature and recommendations for future implementation
Purpose of review
The in-person preanesthesia visit serves multiple purposes including identification and optimization of comorbid conditions as well as patient education. However, it imposes a significant burden on patients and healthcare providers. In this review, we define the scope of telemedicine and present the most up-to-date literature supporting its role for the preanesthesia evaluation. The opportunities and challenges are discussed and approaches to implementation of telemedicine in preanesthesia care are offered. Finally, the future of telemedicine as it pertains to preanesthesia care is examined.
Recent...
Source: Current Opinion in Anaesthesiology - December 1, 2021 Category: Anesthesiology Tags: AMBULATORY ANESTHESIA: Edited by Girish P. Joshi Source Type: research
Putting patients first: ambulatory surgery facilitates patient-centered care
This article discusses the approach to improving patient-centered care and patient-reported outcomes (PROs).
Recent findings
It is necessary to recognize that each patient is different and may have different needs and preferences. Patient education and shared decision-making are critical components of patient-centered care. Shared decision-making emphasizes patient engagement in an effort to improve PROs. Implementation of enhanced recovery after surgery principles in ambulatory surgery is necessary to improve PROs.
Summary
Delivery of patient-centered care will require modification of the current approach to...
Source: Current Opinion in Anaesthesiology - December 1, 2021 Category: Anesthesiology Tags: AMBULATORY ANESTHESIA: Edited by Girish P. Joshi Source Type: research
Editorial introductions
No abstract available (Source: Current Opinion in Anaesthesiology)
Source: Current Opinion in Anaesthesiology - December 1, 2021 Category: Anesthesiology Tags: EDITORIAL INTRODUCTIONS Source Type: research
High turnover for ambulatory orthopedic surgery
Purpose of review
The trend in the perioperative management of patients having orthopedic surgery in the ambulatory setting emphasizes time-efficiency and rapid turnovers. Anesthetic techniques and management continue to evolve to increase efficiency and decrease time spent in recovery.
Recent findings
Minimizing time patients spend in phase 1 recovery or bypassing phase 1 altogether, known as fast-tracking, has become an important goal in containing costs in high turnover, ambulatory settings. Anesthetic techniques, particularly implementation of regional anesthesia and multimodal analgesia, have evolved to max...
Source: Current Opinion in Anaesthesiology - September 2, 2021 Category: Anesthesiology Tags: REGIONAL ANESTHESIA: Edited by Admir Hadzic Source Type: research
Training strategies for point of care ultrasound in the ICU
Purpose of review
Ultrasound in critical care medicine (CCUS) is a relatively young tool that has been evolving rapidly as skillsets, applications and technology continue to progress. Although ultrasound is identified as a core competency in intensive care unit (ICU) training, there remains significant variability and inconsistencies in the delivery of ultrasound training. The goal of this narrative review is to explore areas of consensus and highlight areas where consensus is lacking to bring attention to future directions of ultrasound training in critical care medicine.
Recent findings
There exists considerab...
Source: Current Opinion in Anaesthesiology - September 2, 2021 Category: Anesthesiology Tags: REGIONAL ANESTHESIA: Edited by Admir Hadzic Source Type: research
Ultrasound-guided regional anesthesia in COVID-19 and future pandemics: infection control
Purpose of review
Infection control is inherent in ultrasound-guided regional anesthesia practice, because ultrasound transducer and coupling gel can be vectors for pathogen transmission. We reviewed the current standards and recommendations of ultrasound transducer cleaning, disinfection, and safe handling of ultrasound equipment. Based on the available data, we propose a set of practical recommendations applicable to coronavirus disease 2019 (COVID-19) pandemic and future epidemics.
Recent findings
Regional anesthesia is often preferred over general anesthesia for COVID-19 patients. Avoidance of general anesth...
Source: Current Opinion in Anaesthesiology - September 2, 2021 Category: Anesthesiology Tags: REGIONAL ANESTHESIA: Edited by Admir Hadzic Source Type: research
From emergency department to operating room: interventional analgesia techniques for hip fractures
Purpose of review
To provide an update on pain management options with regional anesthesia for patients with hip fractures at the emergency department (ED).
Recent findings
Patients who sustain a hip fracture are typically admitted and diagnosed in the ED before being transferred to the operating room for surgery. Studies have clearly demonstrated the ability of the fascia iliaca compartment blocks (FICBs) and femoral nerve blocks (FNBs) to reduce pain and the risk of an acute confusional state. Their administration at an early stage of the patient's trajectory in the ED is beneficial. Recent anatomical studies ...
Source: Current Opinion in Anaesthesiology - September 2, 2021 Category: Anesthesiology Tags: REGIONAL ANESTHESIA: Edited by Admir Hadzic Source Type: research
New ultrasound-guided techniques in chronic pain management: an update
Purpose of review
The introduction of ultrasound guidance in interventional pain management leads to the development of new interventional pain management techniques. Ultrasound-guided (UG) interventional pain management is rapidly developing and increasingly more commonly used, due to its many advantages over traditional radiologic imaging modalities. This review will summarize recent literature around novel interventional pain techniques with ultrasound guidance published over the last 18 months.
Recent findings
Many new interventional pain management methods have been described in the last few years in the li...
Source: Current Opinion in Anaesthesiology - September 2, 2021 Category: Anesthesiology Tags: REGIONAL ANESTHESIA: Edited by Admir Hadzic Source Type: research
e-Learning in regional anesthesia
Purpose of review
To explore the role and impact of e-learning technologies on regional anesthesia.
Recent findings
21st century technologies, such as ‘smart’ medical appliances, personal computers, sophisticated apps, the ubiquitous Internet, and online ‘e-learning’ curricula, are having a powerful impact on anesthesia training: when we learn, what we learn, and how we learn. But is ‘new’ necessarily ‘better’? The answer will result from the application of developments in IT technology through the current vision of architects of future anesthesia training programs. This narrative review aims to ...
Source: Current Opinion in Anaesthesiology - September 2, 2021 Category: Anesthesiology Tags: REGIONAL ANESTHESIA: Edited by Admir Hadzic Source Type: research
Role of regional anesthesia in Enhanced Recovery After Surgery (ERAS) protocols
Purpose of review
Enhanced Recovery After Surgery (ERAS) protocols and interventional locoregional anesthesia (LRA) techniques continuously evolve. This review outlines the latest recommendations for the use of regional anesthesia in ERAS protocols and emerging interventional analgesia techniques.
Recent findings
Research in ultrasound-guided regional anesthesia has led to a refinement of the traditional techniques and the introduction of a number of new approaches to complement ERAS strategies. The efficacy and versatility of LRA enable its use in an increasing number of ERAS indications.
Summary
The imp...
Source: Current Opinion in Anaesthesiology - September 2, 2021 Category: Anesthesiology Tags: REGIONAL ANESTHESIA: Edited by Admir Hadzic Source Type: research
Regional anesthesia in coronavirus disease 2019 pandemic
Purpose of review
Coronavirus disease 19 (COVID-19) has presented numerous challenges to healthcare systems worldwide. The virus is highly contagious and infectious since transmission can occur via multiple routes. General measures to prevent viral transmission to patients and healthcare personnel, such as a reduction in clinical load and routine testing, must be coupled with multiple additional safety measures in perioperative services.
Recent findings
Regional anesthesia preserves respiratory function and reduces aerosol-generating procedures typically associated with airway management in general anesthesia, m...
Source: Current Opinion in Anaesthesiology - September 2, 2021 Category: Anesthesiology Tags: REGIONAL ANESTHESIA: Edited by Admir Hadzic Source Type: research
Editorial: Point-of-care ultrasound revolution in anesthesiology
No abstract available (Source: Current Opinion in Anaesthesiology)
Source: Current Opinion in Anaesthesiology - September 2, 2021 Category: Anesthesiology Tags: REGIONAL ANESTHESIA: Edited by Admir Hadzic Source Type: research
Noble gases and neuroprotection: summary of current evidence
Purpose of review
To summarize the current data on neuroprotection derived by noble gas treatment focusing on xenon and argon.
Recent findings
Both xenon and argon have demonstrated neuroprotective properties in an array of disease models. However, current data for argon after traumatic brain injury (TBI) is conflicting. Recent human data is only available for xenon showing some beneficial aspects (fewer adverse events) but no effect on outcomes, such as incidence of postoperative delirium.
Summary
Promising results are available for neuroprotection derived by noble gas treatment. Results for xenon are mo...
Source: Current Opinion in Anaesthesiology - September 2, 2021 Category: Anesthesiology Tags: NEUROANESTHESIA: Edited by Anthony R. Absalom Source Type: research
