Anaesthetists provide comprehensive perioperative medical care to patients undergoing surgical and diagnostic procedures, including postoperative intensive care when needed. They are involved in the management of perioperative acute pain as well as chronic pain. This manuscript considers some of the recent advances in modern anaesthesia and their contribution to surgery, from the basic mechanis...

This review summarises the new insights into the physiology of perioperative fluid therapy and analyses recent studies of the safety of the use of HES solutions in the fluid management of critically ill patients. This analysis reveals a number of methodological issues in the three major studies that have initiated the recommendation of the European Medicine Agency to ban hydroxyethyl starches f...

ORL procedures are the most common operations in children - an optimal anesthetic management provides an uncomplicated, safe perioperative process with as little discomfort for the child as possible. Children at risk must already be identified preoperatively: the combination of ORL surgery, airway susceptibility and age below 3 years can increase the risk of perioperative respiratory adverse ev...

The management of patients with coronary artery stents during the perioperative period is one of the most important patient safety issues clinicians confront. Perioperative stent thrombosis is a life-threatening complication for patients with either bare-metal or drug-eluting stents. Noncardiac surgery appears to increase the risk of stent thrombosis, myocardial infarction, and death, particula...

OBJECTIVES This study was carried out to improve patient safety in the operating theatre by the introduction of perioperative briefing and debriefing, which focused on an optimal collaboration between surgical team members. DESIGN A prospective intervention study with one pretest and two post-test measurements: 1 month before and 4 months and 2.5 years after the implementation of perioperativ...

This review summarises the new insights into the physiology of perioperative fluid therapy and analyses recent studies of the safety of the use of HES solutions in the fluid management of critically ill patients. This analysis reveals a number of methodological issues in the three major studies that have initiated the recommendation of the European Medicine Agency to ban hydroxyethyl starches f...

Perioperative nurses are likely to encounter the use of pneumatic tourniquets in a variety of operative and invasive extremity procedures. Use of a pneumatic tourniquet offers an opportunity to obtain a near-bloodless surgical field; however, the use of tourniquets is not without risk. Unfavorable outcomes include pain, thrombotic events, nerve compression injuries, and disruption of skin integ...

Use of thoracic epidurals is widespread for intraoperative and postoperative analgesia. Thoracic epidural anaesthesia (TEA) reduces sympathetic activity and thereby influences perioperative function of vital organ systems. A results of recent studies suggest that TEA decreases postoperative morbidity and mortality. There is better pain control with TEA in a wide range of surgical procedures. Us...

CRITICALCARENURSE Vol 27, No. 2, APRIL 2007 53 Angela Smith Collins has more than 30 years of experience in nursing, the past 13 years as an advanced practice nurse. She is an associate professor of nursing at the Capstone College of Nursing in Tuscaloosa, Ala, where she teaches pharmacology, critical care nursing, and perioperative nursing. She holds APN certification as a medical-surgical cli...