Key Points ▪ Emergence from general anesthesia and surgery may be accompanied by a number of physiologic disturbances that affect multiple organ systems. Most common are postoperative nausea and vomiting (PONV), hypoxia, hypothermia and shivering, and cardiovascular instability. ▪ In…
Key Points ▪ Congenital heart disease causes significant alterations in oxygenation, perfusion, and myocardial function after birth, and it can be categorized into hypoxic and normoxic lesions. ▪ The overall goal of therapy in shock is to treat the underlying…
Key Points ▪ Organ system maturation, from birth through adolescence, affects physiologic function and therefore anesthetic and surgical management and outcome. ▪ The understanding of congenital heart disease (CHD) and consequent anesthetic management is based on the pathophysiologic determinants of…
Key Points ▪ At birth the circulation undergoes a fundamental change as blood oxygenation occurs through the lungs rather than the placenta. This transition places some newborns at risk of sudden increases in pulmonary artery pressure with resultant shunting of…
Key Points ▪ Over the last three decades, regional anesthesia in pediatrics has become an integral part of everyday practice. ▪ Regional anesthesia appears as a viable option for treating intraoperative and postoperative pain control in children. ▪ In recent…
Key Points ▪ Immersion in water causes acute redistribution of blood from the extremities and splanchnic vessels to the heart and pulmonary vessels. This can precipitate pulmonary edema (immersion pulmonary edema [IPE], swimming-induced pulmonary edema [SIPE]) in some individuals, especially…
Key Points ▪ High altitude or space environments present a number of extreme physiologic challenges that must be overcome in order to survive. ▪ Given sufficient time, humans can adapt to both hypobaric hypoxia and microgravity. ▪ Lack of adaptation…
Key Points ▪ The non-operating room arena represents an expansion of the traditional environment for anesthesia practice with significant implications for patients and providers. As technology advances and patient acuity increases, non-operating room anesthesia (NORA) cases have become more demanding…
Key Points ▪ The use of ambulatory surgery continues to increase, mostly as a result of less invasive surgical techniques, improved patient selection and preparation, and an expansion of office-based practice. ▪ Few absolute contraindications exist to ambulatory surgery. Patients…
Key points: Robotic surgery has witnessed explosive growth. Currently (2018) more than 3 million procedures have been performed using the da Vinci system worldwide. Robotic surgery is not true autonomous surgery but instead the robot is used as mechanical “helping…