This tutorial aims to provide the reader with a framework for approaching the complex physiologic changes and challenges of liver transplant anesthesiology. After reading this article the reader should be able to understand the common perioperative issues surrounding the patient with liver failure and recognize that outcomes are dependent on a multidisciplinary approach to management.
This tutorial covers ultrasound-guided paravertebral nerve block. It discusses the basic anatomy, indications and complications associated with this peripheral regional anaesthesia. The article goes into detail the preparation required to carry out this block and discusses 3 common ultrasound-guided approaches that can be utilized.
This article highlights factors that make patients at high risk of perioperative myocardial ischaemia. It also discusses evidence for anaesthetic technique for this high-risk group and the management of intra-operative myocardial ischaemia.
This tutorial is based on learning from incidents reported to the National Health Service England and Wales National Reporting and Learning System, and covers infusion safety, preoperative assessment and bone cement implantation syndrome.
This tutorial describes the conduct of Deep Hypothermic Circulatory Arrest and its relevance to the anaesthetist, using the latest available evidence. The concept of therapeutic hypothermia, options for intraoperative monitoring and the different neuroprotective strategies are discussed.
The management of perioperative bleeding involves multiple assessments and strategies to ensure appropriate patient care. Initially, it is important to identify those patients with an increased risk of perioperative bleeding. Next, strategies should be employed to correct preoperative anaemia and to stabilise macrocirculation and microcirculation to optimise the patient's tolerance to bleeding. Finally, targeted interventions should be used to reduce intraoperative and postoperative bleeding, and so prevent subsequent morbidity and mortality. The objective of these updated guidelines is to provide healthcare professionals with an overview of the most recent evidence to help ensure improved clinical management of patients.
The aim of these guidelines is to provide a comprehensive range of evidence-based recommendations for interventions to be applied during the pre-, intra- and postoperative periods for the prevention of SSI, while also considering aspects related to resource availability and values and preferences.
Angela Enright, MB, FRCPC, Kate Grady, BSc, MB, BS, FRCA, FFPMRCA, FRCOG, Faye Evans, MD Journal of Obstetrics and Gynaecology Canada (Oct 2015)
Liberation from mechanical ventilation and the artificial airway support in the intensive care unit is difficult and challenging. Success hinges on the perfect blend of art and science. An algorithmic evidence based approach along with a very strong clinical acumen is possibly the best recipe for success. This tutorial attempts to summarise the currently accepted guidelines in this area.
Possible reasons for the inadequate postoperative pain management include limited financial resources, lack of time and personnel, but also reluctance to address this issue, organizational aspects of the health care facility, and lack of simple and clear guidelines for the treatment of postoperative pain. Providing such easy-to-follow recommendations is one of the objectives of this book. The availability of postoperative analgesia to anyone who needs it requires a high-quality postoperative pain management, as well as accepting and understanding the fact that good analgesia is not only necessary, but also a fundamental right of every patient suffering from pain and a basic duty of any health care facility that treats these patients.