High flow nasal cannula oxygenation therapy enables intraoperative TOE at TAVI under MAC
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Nasal cannula
Regional anaesthesia
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Local anaesthetic
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Regional anaesthesia
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Any anaesthetic technique, either regional or general, has potential for complications. Moreover, it has been seen that in obstetric patients, the complications are potentiated due to pregnancy-related changes in physiology and due to various other factors. Increasing trend of caesarean section in the setting of increasing maternal age, obesity and other concomitant diseases will continue to challenge the obstetric anaesthetist in his/her task of providing safe regional and general anaesthesia. This review has highlighted the possible complications of regional and general anaesthesia encountered during the obstetric anaesthesia practice.
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Regional anaesthesia is now a well recognized and accepted technique in the practice of paediatric anaesthesia. It may be used in conjunction with general anaesthesia or as an alternative to general anaesthesia, for example, in high-risk infants. This technique offers excellent postoperative pain relief. However, age-dependent and clinical differences must be recognized for safety.
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The incidence of long-term pain (between 1 and 48 weeks and at 2 year follow-up) unrelated to the surgical site following either regional brachial plexus or general anaesthesia was determined. In 834 patients with regional anaesthesia, the incidence (11.1%) was significantly higher than in the 86 patients with general anaesthesia (3.6%; P =0.03). The incidence of pain was not significantly different among four common techniques of positioning the needle tip in the axillary sheath (9.9 to 11.1%). Parascalene blocks had a slightly but not significantly higher rate (16.3%). A regional re-block was not associated with a higher incidence when compared to those blocked only once. A more distal local re-block was associated with a higher incidence of pain (23%). 2 years post-operatively, 0.5% of patients had pain related to the regional block. A significant proportion of patients developed some long-lasting post-operative pain following regional brachial plexus anaesthesia, although ultimate morbidity was minimal.
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The use of regional anaesthesia as an effective alternative to general anaesthesia in thyroid surgeries is now being accepted in many parts of the world. In this day of computers and technology, there is an increased awareness among the people of the available options of anaesthesia and the adverse effects of general anaesthesia. They thus have an inclination to avoid general anaesthesia wherever feasible. This study dwells on the use of regional anaesthesia as an alternative tool that can be offered to the patients undergoing thyroidectomy.
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Cervical plexus
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The debate over the theoretical superiority of regional over general anaesthesia has persisted throughout most of the twentieth century, and there is still no satisfactory answer to the question of whether avoidance of general anaesthesia saves lives or reduces morbidity. This chapter reviews and analyses the evidence supporting an effect on surgical outcome of anaesthetic choice. For carotid endarterectomy, using regional anaesthesia rather than general anaesthesia enables keeping patients awake during carotid artery clamping. The chapter summarizes the key evidence supporting advantages or disadvantages of intraoperative neuraxial anaesthesia on postoperative outcomes. It also discusses selected topics regarding postoperative outcome after sole regional anaesthesia versus general anaesthesia. Meta-analysis and systematic reviews are cited, and emphasis is given to randomised controlled trials (RCTs). Evidence suggests the possibility of reduced mortality among several specific patient populations such as hip fracture surgery under spinal anaesthesia.
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This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To compare the effects of regional anaesthesia with those of general anaesthesia on the outcomes of caesarean section.
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Section (typography)
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We conducted a postal survey of 221 anaesthetists in the Oxford region to determine their views and actual clinical practice regarding regional anaesthesia in adult patients undergoing limb surgery, when a combined regional and general anaesthetic was planned. Of the 162 respondents (73.3%), 142 (87.6%) regularly practised regional blocks for limb surgery in adult patients. For all the regional anaesthetic techniques in question, more anaesthetists felt it was safer to perform these blocks before induction of general anaesthesia than after induction. However, their actual practice varied markedly from their views, with more anaesthetists performing these blocks after general anaesthesia. Overall, trainees performed blocks before induction of general anaesthesia more often than consultants (p = 0.047).
Regional anaesthesia
SAFER
Local anaesthetic
General anaesthetic
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