ISSN:0952-7907    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Sevoflurane and desflurane have important advantages over isoflurane and halothane. Disadvantages, which the clinician should keep in mind, include the degradation of both agents by soda lime under certain circumstances during closed circuit anaesthesia. As a result compound A and carbon monoxide (CO) may be generated in soda lime canisters and may be inhaled by patients. The extent to which this constitutes a significant problem during routine anaesthesia in humans is not clear. Recent developments in absorbent technology have the potential to reduce any hazard to negligible proportions. Other undesirable properties of the newer inhalation agents include agitation with sevoflurane in children and cardiovascular and airway effects with desflurane.

ISSN:0952-7907    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Intravenous anesthetics continue to be a mainstay in the modern anesthesiologist's armamentarium. In this review the authors will discuss new advancements in the use of propofol, as well as a greater understanding as to its mechanism of action. Further, we will discuss the use of target controlled infusion systems, touch upon the possible benefits of the ultra-short acting opioids, and consider the role of alpha-2 agonists as an adjunct to anesthetic management.

ISSN:0952-7907    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Since the introduction of d-tubocurarine into clinical practice, neuromuscular relaxants have been widely used in anaesthesia. Although their clinical use is easy, several points still require further attention and research. There is still a need for a drug with the clinical profile of succinylcholine but fewer unwanted side-effects. A better understanding of the effects of muscle relaxants on different muscles could help in their clinical use during the perioperative period. Much knowledge is needed about residual neuromuscular block and its detection in order to improve the quality of recovery from neuromuscular blockade. If some questions remain to be answered, several recent articles have increased our knowledge and should improve our clinical practice.

ISSN:0952-7907    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Despite their many and sometimes life-threatening side-effects, opioids in general and morphine in particular are valuable and potent painkillers. This article describes recent developments in sex-related differences in opioid (morphine) pharmacodynamics, morphine metabolites, the nociceptin/orphanin FQ receptor system, acute opioid tolerance and opioid-induced side-effects, such as opioid-induced respiratory depression and itch, and P-glycoprotein modulation of opioid effect.

ISSN:0952-7907    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

The prevalence of undesirable drug interactions is substantial but largely unknown. Although drug interactions are certainly an important cause of drug toxicity, their clinical significance may have been exaggerated. This review presents a brief overview of possible drug interactions.

ISSN:0952-7907    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

The optimal management of postoperative pain is a prerequisite for early recovery and shorter hospital stays. The use of multimodal analgesia techniques involving the use of opioid and non-opioid (local anesthetics, ketamine, acetaminophen, and non-steroidal anti-inflammatory drugs) analgesic drugs can markedly enhance pain relief in the perioperative period.

ISSN:0952-7907    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

A recent world expert conference on resuscitation and emergency cardiac care led to evidence-based international guidelines for cardiopulmonary resuscitation (CPR). Several changes to CPR interventions were recommended, and will have to be implemented into clinical practice. The poor prognosis of patients who suffer in-hospital cardiac arrest may be improved with developments in CPR interventions. In the present review the most important changes recommended by the new CPR guidelines and the latest promising CPR investigations are described, focusing on their impact on in-hospital resuscitation.

ISSN:0952-7907    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Burns resuscitation has evolved over the past few decades towards more evidence-based management. It has been shown that patients with major burns (i.e. involving more than 30% of the body surface) benefit from invasive monitoring, and physiological variable targeted resuscitation using vasoactive agents for cardiovascular support. The invasive approach results in a reduction of mortality rates. Since the introduction of the Parkland formula in 1968, there has been a trend towards the administration of fluid resuscitation far in excess of the volume predicted with this formula. This has led to an increase in complication rates, with more pulmonary oedema, and the appearance of abdominal compartment syndrome. Hypertonic saline solutions, whether with dextran or not, have shown no advantage over the classic Ringer's lactate solution. The colloid controversy has reached burns resuscitation, with the demonstration that the liberal use of albumin is associated with higher mortality rates. Fresh frozen plasma should only be used for specific coagulation disorders. On the other hand, artificial colloids, particularly gelatines, remain a useful tool in patients with major burns and haemodynamic instability, particularly, and can be given as early as 6 h after injury. Considering the actual evidence, using inotropes and vasopressors to reach supranormal haemodynamic endpoints seems preferable to delivering unrestricted amounts of fluid.

ISSN:0952-7907    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Anaesthesiologists are regularly consulted to provide anaesthesia for children in settings other than an operating room. Current debate focuses on the appropriateness of the presence of an anaesthesiologist versus a nonanaesthesiologist. There is mounting evidence that the presence of an anaesthesiologist is safer. We will review the recent literature concerning paediatric anaesthesia outside the operating room and offer recommendations that may impact on efficacy and safety.

ISSN:0952-7907    

出版商:OVID    

年代:2001

数据来源: OVID