PURPOSE To review the effects of hereditary hemorrhagic telangiectasia (HHT) in the parturient and the anesthetic management of such patients during pregnancy and delivery. SOURCE A literature search (1966-2008) was performed using Medline and EMBASE databases. Bibliographies of retrieved articles were searched for additional sources. PRINCIPAL FINDINGS Hereditary hemorrhagic telangiectasia...

Local anesthetic toxicity can have catastrophic outcome in an otherwise benign procedure. Introduction of even a small amount of local anesthetic into the bloodstream can cause cardiac arrest in a healthy patient. Most healthcare facilities rely on standard resuscitative techniques to treat such events; however, treatment via infusion of lipid emulsion has been used successfully to stabilize th...

Selective nerve root blocks (SNRB) have been used for many years as a diagnostic tool in patients with low back pain with radicular symptoms. However the accuracy, specificity, and sensitivity of these blocks has been questioned as a screening tool for spine surgery. The utility of current SNRB techniques relies primarily on the relief of pain when local anesthetic is injected. However, patient...

PURPOSE OF REVIEW This article introduces the use of ultrasound to facilitate peripheral regional anesthesia. RECENT FINDINGS Regional anesthesia, despite its well known clinical benefits, has not gained the popularity of general anesthesia. This is secondary to multiple shortcomings including a defined failure rate, lack of simplicity, and the potential for patient discomfort or injury. Many...

Emergence agitation (EA) is an important issue in pediatric anesthesia. This phenomenon arises more frequently with the use of inhalational agents. Three commonly used general anesthesia techniques in children were evaluated as to the associated incidence of emergence reactions. An extensive literature review was performed to evaluate these anesthetic practices and the occurrence of EA in young...

PURPOSE OF REVIEW This review focuses on the utilization of the effects of general anesthetics on cerebral metabolism as revealed by imaging for therapeutic and preventive purposes, for understanding mechanisms of anesthetic action, and for elucidating mechanisms of cerebral processing in humans. RECENT FINDINGS General anesthetics suppress cerebral metabolism significantly. This effect has b...

Discharge time (total recovery time) is one determinant of the overall cost of outpatient surgery. We performed this study to determine what factors affect discharge time. Details regarding patients, anesthesia, surgery, and recovery were recorded prospectively for 1088 adult patients undergoing ambulatory surgery over an 8-mo period. The contribution of factors to variability in the discharge ...

AANA Journal/June 2007/Vol. 75, No. 3 193 Carotid endarterectomy is a procedure used to treat severe atherosclerotic occlusive disease involving the internal carotid arteries, most often at the common carotid artery bifurcation. The operation is performed by opening the common carotid arteries and the proximal internal carotid arteries in the neck, removing plaques from the inside of the arteri...