ISSN:0952-7907    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Ambulatory surgery has come to the fore in recent years, guided by the twin forces of healthcare economics and pharmacological innovations. In this review the authors will focus on α2-adrenergic agonists, a new class of sedative/analgesic agents and their possible application for conscious sedation in the ambulatory care setting. To put the α2-agonists into clinical context, we will discuss the currently available agents for general anaesthesia as well as for conscious sedation and their respective drawbacks. Thereafter we will compare and contrast the use of α2-agonists with clinically available agents, and speculate as to the direction this field is likely to take in the future.

ISSN:0952-7907    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Since the introduction of the laryngeal mask airway, the majority of day case patients can safely be anaesthetized without the administration of muscle relaxants. If muscle relaxation is required, the modern non-depolarizing agents, vecuronium, rocuronium, atracurium, cisatracurium and mivacurium, provide an excellent choice. Succinylcholine should be regarded mainly as an option in the event of an emergency intubation, especially in paediatric patients.

ISSN:0952-7907    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

General anaesthesia is still the most common anaesthetic technique in the ambulatory surgery setting. With the introduction of propofol, total intravenous anaesthesia gained widespread acceptance. Recently, the combination with remifentanil, an ultra-short acting opioid analgesic, allowed even more control over the duration of the anaesthetic. In comparison to propofol, however, the new inhalational anaesthetics desflurane and sevoflurane possess a pharmacokinetic profile that is preferable to that of propofol. Initial studies show that these pharmacokinetic advantages lead to a faster short-term recovery, although both substances have been associated with a higher incidence of postoperative nausea and vomiting. No differences have so far been demonstrated in respect to long-term recovery, discharge from the post-anaesthesia care unit and discharge from the ambulatory care centre. Currently the anaesthesiologist has the possibility to choose his preferred anaesthetic technique based on individual patient needs, the surgery performed and the side-effects each technique may have. However, in contrast to the situation at the beginning of the 1990s total intravenous anaesthesia is not the technique that fits all needs but balanced anaesthesia presents an alternative.

ISSN:0952-7907    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

The increasing popularity of minimally invasive surgery has grown concurrently with the demand for ambulatory surgery. Standard outpatient procedures such as tubal ligation are now being joined by ambulatory laparoscopic cholecystectomy. In order for ambulatory minimally invasive surgery to succeed, patient selection must be appropriate, careful attention paid to the physiologic changes of pneumoperitoneum, and pain and nausea treated pre-emptively.

ISSN:0952-7907    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Regional anaesthesia plays an important role in day case surgery because it combines reliable effects with low risk and the possibility of local postoperative analgesia without systemic side-effects. Fast-track regional anaesthesia allows short-term postoperative surveillance or even bypassing the post-anaesthesia care unit. Peripheral nerve blocks provide long-lasting pain relief, and can accelerate timely discharge if a persisting motor block is accepted. Multiple peripheral nerve stimulation and injection techniques may help to realize differential blockades with a pronounced analgesic rather than a motor blocking effect. Nerve blocks with local anaesthetics in combination with alpha2-adrenoceptor agonists or non-steroidal anti-inflammatory drugs and short-acting parenteral opioids represent an effective multimodal concept for ambulatory surgery.

ISSN:0952-7907    

出版商:OVID    

年代:2000

数据来源: OVID

ISSN:0952-7907    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Although anaesthesia and intensive care medicine are postgraduate subjects, few would deny the value of exposing medical undergraduates to clinical training in these areas. The present review addresses developments in medical undergraduate training curricula, and the specific benefits that can be provided for medical students, at all stages of training, by anaesthesiologists working in operating theatres, intensive care units and pain clinics.

ISSN:0952-7907    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Anesthesia simulation is generally perceived as involving large simulators that provide a limited number of operating room scenarios, especially crisis management. The scope of both anesthesia and flight simulation is much wider, and this review summarizes the range of the former. The areas where simulation has been used include training, education and science. The diversity of its uses may surprise the reader. The models that are used in simulations are important, and these are discussed in part of the discussion. As a result of the current imbalance in perception, I emphasize the merits of small simulators at the expense of large simulators.

ISSN:0952-7907    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Transoesophageal echocardiography has proved to be a valuable monitor of global and regional ventricular function in the perioperative period. In addition, it is increasingly used by anaesthetists as a diagnostic tool in patients with heart disease. During the past year, important steps towards quality assurance and the standardization of perioperative echocardiography were undertaken, and our understanding of the perioperative cardiovascular structure and function improved.

ISSN:0952-7907    

出版商:OVID    

年代:2000

数据来源: OVID