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Posted in: ATOTW > Paediatric Anaesthesia 2020 Language: english

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.

Posted in: ATOTW > Regional Anaesthesia 2020 Language: english

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.

Posted in: ATOTW > COVID-19 2020 Language: english

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.

Posted in: ATOTW > Pain 2020 Language: english

This tutorial covers basic physiology and the principles of pain management including assessment, pharmacologic and regional analgesia techniques in elderly patients.

Posted in: ATOTW > Anaesthesia 2020 Language: english

Overview of traumatic rib fracture management including common mechanism of injury, associated complications and predictors of poorer outcomes. Appropriate work-up and clinical assessment including scoring systems used to guide ongoing management. Summary of key treatment modalities including pharmacological, non-pharmacologcial and regional anaesthetic techniques which may be appropriate.

Posted in: ATOTW > Paediatric Anaesthesia 2020 Language: english

Paediatric radiotherapy is an area of practice that possesses its own unique challenges. This tutorial details the various types of radiotherapy, in practical terms how they are delivered and the environmental and anaesthetic considerations that are required for safe anaesthetic practice.

Posted in: ATOTW > Regional Anaesthesia 2020 Language: english

Although nerve injuries associated with peripheral nerve blockade (PNB) are often temporary, the potential long-term consequences of nerve injury following PNB include sensory and motor deficits, neuropathic pain, and permanent disability, with an associated decrease in a patients’ quality of life. This article aims to explore the pathophysiology of nerve injury from PNB, suggest preventative strategies therein, and provide a common sense approach to their management.

Posted in: ATOTW > General Topics 2020 Language: english

COVID-19 has become a pandemic. Anaesthesiologists play significant role in patient care, infection control in the perioperative period and airway management. Caring for patients with COVID-19 requires multi-disciplinary effort. Disease transmission can be minimised when perioperative care is thoroughly planned.

Posted in: ATOTW > Intensive Care Medicine 2020 Language: english

Cocaine toxicity has a myriad of end organ complications, both in acute ingestion and chronic abuse. An appreciation for nuances of this presentation is required to provide excellent critical care.

Posted in: ATOTW > Pain 2020 Language: english

Opioids are a cornerstone of anaesthetic practice. This tutorial will discuss a common opioid side effect - Opioid-induced Hyperalgesia (OIH). OIH is a phenomenon for which we have an increasing appreciation. We will discuss its proposed mechanism, clinical relevance and, lastly, evidence on its management strategies.

Posted in: ATOTW > Paediatric Anaesthesia 2020 Language: english

This tutorial is a succinct guide to current practices in patient blood management for the pediatric population. It gives practical guidelines for bleeding concerns and management in the perioperative period and emphasizes care related to massive transfusion in the pediatric population.

Posted in: ATOTW > Anaesthesia 2020 Language: english

Test your knowledge across the board of anaesthesia specialities with our ATOTW Quarterly quiz!

Posted in: ATOTW > Paediatric Anaesthesia 2020 Language: english

The tutorial will describe the anaesthetic management of paediatric patients undergoing laparoscopic surgery. The reader will be guided through the physiologic changes that occur during laparoscopy as well as appropriate perioperative management, from the pre-operative interview until discharge from the post-anaesthesia care unit.

Posted in: ATOTW > Anaesthesia 2020 Language: english

Between September 2017 and January 2019, WFSA conducted an online survey to evaluate the utility of ATOTW. We are delighted to present the survey report to demonstrate ATOTW’s impact and also highlight areas for improvement and expansion of this valuable resource.

Posted in: ATOTW > Anaesthesia 2019 Language: english

This tutorial summarizes the current data and controversies surrounding the use of the bispectral index (BIS™, Medtronic, Minneapolis, MN, USA)—one of the more commonly used processed EEG devices—and provides recommendations regarding appropriate use of this technology in general anesthesia to prevent awareness

Posted in: ATOTW > Basic Sciences 2019 Language: english

This tutorial will initially look at the pharmacodynamics and pharmacokinetic properties of clonidine. The article will then cover the clinical use of clonidine in anaesthetic practice including its use in sedation, analgesia, adjunct to local anaesthetics in regional blocks and other relevant uses.

Posted in: ATOTW > Regional Anaesthesia 2019 Language: english

This tutorial will explore the currently published literature on erector spinae plane blocks and discover its versatility in regional anaesthesia.

Posted in: ATOTW > Intensive Care Medicine 2019 Language: english

Infective encephalitis is the acute, usually viral, infective inflammation of the brain parenchyma. A few patients will develop a severe manifestation and may deteriorate and require organ support. A low index of clinical suspicion and prompt antimicrobial treatment is crucial for the best chance of recovery without a disability. Management in the critical care setting focuses on treating the primary pathology whilst preventing secondary brain injury.

Posted in: ATOTW > Regional Anaesthesia 2019 Language: english

The use of perineural catheter could provide prolonged pain relief after major surgeries. The following tutorial covers the indications, techniques and the post operative management of patients with these catheters. Particular emphasis is on the safety aspect while the catheters are sited with strict aseptic precautions and clear instructions to prevent any complications.

Posted in: ATOTW > Anaesthesia 2019 Language: english

ARDS is a syndrome of hypoxaemic respiratory failure associated with non-cardiogenic pulmonary oedema which occurs in 10% of ICU patients. ARDS is often associated with multiple organ dysfunction and carries a high mortality, morbidity and financial cost. Due to its prevalence in the critical care patient population, it is important for physicians to understand some principles of management that may help reduce the mortality and morbidity of the syndrome.

Posted in: ATOTW > General Topics 2019 Language: english

The tutorial aims to raise awareness of irrigation fluids that are commonly come across in operations. It covers the pharmacological properties of irrigation fluid, potential complications associated with its intraoperative use and measures to limit negative outcomes.

Posted in: ATOTW > Regional Anaesthesia 2019 Language: english

This tutorial provides a review of the ultrasound guided infraclavicular brachial plexus block including clinical indications and contraindications, sonoanatomy, and helpful tips on block performance.

Posted in: ATOTW > General Topics 2019 Language: english

This tutorial reviews the anaesthetic considerations for urological robotic procedures, covering the pre, intra and post operative stages.

Posted in: ATOTW > Pain 2019 Language: english

Tramadol and tapentadol are two related molecules that are being used to treat acute pain. In this tutorial we discuss the basic pharmacology, safety and efficacy of both medications. As well, indications for use, safety recommendations and abuse potential are discussed.

Posted in: ATOTW > Basic Sciences 2019 Language: english

This tutorial reviews the clinical uses of tranexamic acid, its mechanism of action and pharmacokinetics, contraindications and side effects.