ISSN:0952-7907    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

&NA;Cardiac diseases are present in 0.5‐4% of pregnancies, and they remain a frequent cause of death during pregnancy. Pregnancy per se imposes significant hemodynamic changes, placing a major burden on the cardiovascular system. The early recognition and close follow‐up of patients with cardiac diseases will improve maternal tolerance to the cardiovascular burden imposed by pregnancy, promote fetal growth and neonatal survival. Rheumatic heart disease remains the most frequent heart disease in the pregnant population with pulmonary edema as the most frequent complication. Atrial septal defect is the most frequent congenital heart disease in the adult population, whereas tetralogy of Fallot is the most common cyanotic congenital heart disease. An improvement in modern techniques of monitoring, a better understanding of the pathophysiology of cardiac disease, as well as multidisciplinary care has led to a substantial improvement in outcome of the pregnant cardiac patient. Management should be initiated before conception as it will provide optimal clinical conditions and sufficient information on the underlying pathophysiology. Curr Opin Anaesthesiol 15:285‐291. © 2002 Lippincott Williams & Wilkins.

ISSN:0952-7907    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

&NA;In many countries there has been an increase in the number of women who deliver by caesarean section. This article reviews anaesthetic management of non‐scheduled caesarean section. The choice of anaesthetic technique (regional anaesthesia versus general anaesthesia) is discussed and highlighted particularly from the viewpoint of urgency of operative delivery. A multidisciplinary approach is mandatory especially in emergency cases to prevent morbidity and mortality in mothers and neonates. Curr Opin Anaesthesiol 15:293‐298. © 2002 Lippincott Williams & Wilkins.

ISSN:0952-7907    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

&NA;Neuraxial opioids have changed the practice of obstetric anaesthesia and analgesia dramatically. Excellent analgesia with minimal side effects started an era of ever increasing numbers of women who opt for the ‘painless birth experience’. Several papers have been reported during 2001 that examine analgesic efficacy, maternal side effects, and effect on foetal well‐being of epidural and spinal opioids. Foetal bradycardia following intrathecal opioid analgesia, an increasingly popular technique, has attracted particular attention over the past few years. The present review addresses recently reported work that, according to the author, is key to this field. Curr Opin Anaesthesiol 15:299‐303. © 2002 Lippincott Williams & Wilkins.

ISSN:0952-7907    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:0952-7907    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Purpose of reviewThis review aims to summarize results of recently published studies concerning clonidine application in paediatric anaesthesia, to analyse trends in these studies, and to discuss perspectives of the perioperative use of clonidine for children.Recent findingsReassessment of clonidine premedication has revealed that oral clonidine is inferior to midazolam for preoperative sedation. Oral or intravenous clonidine has been successfully used for the prevention of sevoflurane‐induced agitation during emergence from anaesthesia. Peripheral injection or caudal (epidural) administration of clonidine prolonged the duration and enhanced the quality of postoperative analgesia by local anaesthetics without severe side effects. However, some negative results concerning potentiation of postoperative analgesia with clonidine have been reported.SummaryClonidine may be less favored than midazolam as premedication for children because of inferior clonidine‐induced sedation. Additional comparative studies are required, however, to confirm this finding. On the other hand, clonidine‐induced analgesia may well be useful and find wide application in paediatric anaesthesia. Prospective multicentre trials using a larger number of patients will be needed to verify the usefulness of caudal clonidine for postoperative pain relief. Prophylactic use of clonidine against sevoflurane‐induced agitation may represent a new and promising application. Assessment of the efficacy of clonidine in potentiating regional anaesthesia/analgesia by local anaesthetics in children also needs more investigation. Moreover, it may be worthwhile to try new successful applications demonstrated in adults for paediatric anaesthesia.

ISSN:0952-7907    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

&NA;Anesthesia for the child with an upper respiratory infection remains one of the most common, yet contentious, issues facing the pediatric anesthesiologist. A general lack of evidence‐based research has led to disparities in the manner in which children with upper respiratory infections have been traditionally managed. More recent research, however, suggests that children with uncomplicated infections can be managed safely, given that most complications can be anticipated, recognized, and treated. This review summarizes the evolving literature regarding cancellation of surgery for the child with an upper respiratory infection, perioperative outcomes, and anesthetic management. Curr Opin Anaesthesiol 15:317‐322. © 2002 Lippincott Williams & Wilkins.

ISSN:0952-7907    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Purpose of reviewRecent data in both adults and children have suggested that the incidence and severity of the pulmonary aspiration of gastric contents has declined. Previous studies have indicated that aspiration is more common in children than in adults. This review will examine the available data to compare the incidence and severity of aspiration in adults and children.Recent findingsThere are several studies, some of which have been published recently, that have provided an epidemiologic perspective on the problem of aspiration.SummaryBased on the available data, aspiration appears to be slightly more common in children than in adults. The difference, however, is less than that previously reported. Morbidity associated with aspiration is rare in all age groups. This is especially true for children.

ISSN:0952-7907    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

&NA;During the last 2 years, some interesting new devices have been made available to improve airway management in children and infants, and several studies have advanced our understanding concerning risks and benefits of the current practice in the field. Certain risk factors for airway related problems during anaesthesia in children having a cold have been identified, and new aspects of the controversy concerning the use of cuffed endotracheal tubes in children presented. Novel video‐assisted systems have been introduced for the management of the difficult airway in paediatric patients, and new applications for well known devices have been suggested, such as the laryngeal mask airway serving as guidance for fibreoptic intubation. Recent studies also demonstrated specific problems with the laryngeal mask airway in infants, as well as the advantages of a new prototypic laryngeal mask airway for children, similar to the ProSealTM(LMA International S.A. Group, USA). Furthermore, the following review presents new data about the use of the cuffed oropharyngeal airway, the laryngeal tube, and the Arndt bronchus blocker in paediatric patients. Curr Opin Anaesthesiol 15:329‐337. © 2002 Lippincott Williams & Wilkins.

ISSN:0952-7907    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

&NA;Propofol has been an immensely successful anaesthetic induction agent but there is an increasing number of reports of serious complications when it has been used as an infusion to provide sedation for prolonged periods. The first reports involved children who died from intractable myocardial failure preceded by a metabolic acidosis, lipaemic plasma, fatty infiltration of the liver and evidence of muscle damage. As more cases have been reported the association between propofol and the syndrome has become more certain. Recently adult cases have appeared and a metabolic explanation has been suggested. The syndrome has a high mortality and the only effective treatment appears to be dialysis. Curr Opin Anaesthesiol 15:339‐342. © 2002 Lippincott Williams & Wilkins.

ISSN:0952-7907    

出版商:OVID    

年代:2002

数据来源: OVID