The management of the pregnant woman with a history of addiction or substance abuse can be challenging. This tutorial focuses on the pathophysiological effects of drug addiction, providing safe perioperative care and achieving effective analgesia both during labour and post-caesarean section.
Trans-Oral Robotic Surgery (TORS) is used for minimally invasive procedure for head and neck surgery. Potentially difficult airway and stimulating nature of the procedure requires a specific anaesthetic technique. Opioid based multi-modal analgesia is required for possible severe post-operative pain. This tutorial presents anaesthesia management for TORS.
The tutorial describes post-operative cognitive disorders and the implications on anaesthesia practice. An understanding of post-operative delirium and use of preventative strategies can improve morbidity and mortality in this vulnerable patient group.
This tutorial is a practical guide to ultrasound guided supraclavicular brachial plexus block. Relevant anatomy and indications for the block are described in detail. It also contains useful advice on which local anaesthetic to use, relevant doses, potential complications and side effects.
The Maternal Early Warning Score (MEWS) is a system designed to help early detection of sick mothers and potentially allows the opportunity to intervene and prevent deterioration. This tutorial discusses the application of MEWS and the evidence behind its use.
Ventilator-associated pneumonia is a significant cause of morbidity and mortality in critically unwell patients who undergo invasive mechanical ventilation via an endotracheal tube or tracheostomy. Throughout this article we will discuss the incidence, scoring systems, pathophysiology, prevention, risk factors, diagnosis and treatment of this condition.
A review of the evidence and utility of ketamine. This includes discussion of its role as an anaesthetic and analgesic drug for use in the pre-hospital environment, emergency department, operating theatre and critical care unit.
Intraoperative cell salvage in obstetrics is a safe adjunct or alternative treatment to allogenic blood transfusions during a postpartum hemorrhage. This tutorial will describe how the cell salvage circuit works and review the indications, contraindications, advantages, disadvantages and risks of intraoperative cell salvage in obstetrics.
Hyperthermic intraperitoneal chemotherapy (HIPEC) is a highly concentrated, heated chemotherapy treatment that is delivered directly to the abdomen during surgery as an effective multimodality treatment option for selected patients with peritoneal surface malignancies. This tutorial discusses the anaesthetic considerations and physiological impacts of the procedure.
This case report describes a number of risk factors that are associated with potential deformation or fracture of spinal needles during subarachnoid anaesthesia, followed by some practical tips on how to avoid this complication and how to deal with it if it occurs.