O uso da cirurgia laparoscópica atualmente é o padrão de terapia para muitos procedimentos abdominais e pélvicos em crianças de todas as idades. Oferece vantagens em comparação a procedimentos abertos em pacientes adultos e pediátricos, incluindo tempos de internação mais curtos, custos mais baixos, menos infecções e complicações (1.2). Os procedimentos aos quais a laparascopia pode ser aplicada incluem várias indicações abdominais, pélvicas e urológicas, como mostrado na Tabela 1. O manejo perioperatório dessas cirurgias apresenta desafios únicos ao anestesista, e os pacientes pediátricos em particular exigem considerações especiais quando comparados a adultos. Isso exige uma compreensão abrangente da fisiologia pediátrica e das nuances do procedimento cirúrgico. Após concluir este tutorial, o aprendiz entenderá o escopo de cirurgias laparoscópicas pediátricas, as alterações fisiológicas associadas e o manejo anestésico de tais casos.
Introduced by Blanco et al, serratus plane block is a novel form of ultrasound guided regional anaesthesia which can achieve complete paraesthesia of the hemithorax. In this tutorial, we will provide an overview of the serratus plane block, considering the anatomy, indications, sonoanatomy and technique.
The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection
COVID-19 will be around for the foreseeable future and infection rates may fluctuate as public health measures relax. A significant backlog of surgical work is being created in addition to those patients on waiting lists before the present crisis. Retaining an expanded workforce and resources to deal with all of these patients is essential, but illness, fatigue and social issues among healthcare workers all threaten the necessary increase in surgical activity that is needed. This document from the Royal College of Surgeons provides a list of principles, recommendations and key considerations in order to facilitate elective surgery. These can be used in combination with national, specialty and local trust recovery plans.
Preventing a Parallel Pandemic — A National Strategy to Protect Clinicians’ Well-Being
As the COVID-19 pandemic continues to place unprecedented demands on healthcare systems across the globe our understanding of how best to care for these patients continues to evolve and presents many fresh challenges. Here we present a systems-based, practical guide for the management of COVID-19 patients in intensive care.
This tutorial covers basic physiology and the principles of pain management including assessment, pharmacologic and regional analgesia techniques in elderly patients.
Pediatric anesthetists have an important role to play in the management of patients suspected or confirmed to have COVID-19. In many institutions, the COVID-19 intubation teams are staffed with anesthetists as the proceduralists working throughout the hospitals also in the ICU and Emergency Departments. As practitioners who perform aerosol generating procedures involving the airway, we are at high risk of exposure to the virus SARS-CoV-2 and need to ensure we are well prepared and trained to manage such cases. This article reviews the relevant pediatric literature surrounding COVID-19 and summarizes the key recommendations for anesthetists involved in the care of children during this pandemic.
Word version of Covid-19 Surgical Patient Checklist for local adaptation
Donning and Doffing Personal Protective Equipment (PPE): Reusable Gowns