Central recurrent cervical cancer: The role of exenterative surgery
J. Richard Smith, Giuseppe Del Priore, Robert L. Coleman, John M. Monaghan in An Atlas of Gynecologic Oncology, 2018
The patient is occasionally admitted to hospital prior to the planned procedure. Bowel preparation and prolonged antibiotics have been demonstrated to be potentially harmful based on randomized clinical trials. Never the less, surgeons continue to utilize modified versions of both in select cases. The anesthesiologist responsible for the patient’s care will see the patient and explain the process of anesthesia. The author prefers to carry out all radical surgery under a combination of epidural or spinal analgesia together with general anesthesia. Cardiac and blood gas monitoring is essential. Although the majority of patients do not require intensive care therapy, its availability must be ensured prior to the surgical procedure. Prophylaxis against deep venous thrombosis is usually organized by the ward team, utilizing a combination of modern elastic stockings and low-dose heparin, which is initiated immediately following surgery.
Electrical Brain Stimulation to Treat Neurological Disorders
Bahman Zohuri, Patrick J. McDaniel in Electrical Brain Stimulation for the Treatment of Neurological Disorders, 2019
Before ECT is administered, a person is sedated with general anesthesia and given a medication called a muscle relaxant to prevent movement during the procedure. An anesthesiologist monitors breathing, heart rate and blood pressure during the entire procedure, which is conducted by a trained medical team, including physicians and nurses. During the procedure: Electrodes are placed at precise locations on the head.Through the electrodes, an electric current pass through the brain, causing a seizure that lasts generally less than one minute. Because the patient is under anesthesia and has taken a muscle relaxant, it is not painful, and the patient cannot feel the electrical impulses.Five to ten minutes after the procedure ends, the patient awakens. He or she may feel groggy at first as the anesthesia wears off. But after about an hour, the patient usually is alert and can resume normal activities.
Anesthesia Incidents and Accidents
Marilyn Sue Bogner in Misadventures in Health Care, 2003
Anesthesia residents, individuals who, after completing 4 years of medical school and a 1-year internship, are pursuing further training in the medical specialty of anesthesiology, work an average of 73 hours per week including night and weekend responsibilities (Howard, Healzer, & Gaba, 1997). Some work weeks may exceed 100 hours. Many fully trained practicing physicians similarly work extended hours. When on call, anesthesiologists typically work 24-hour shifts, often without sleep. Unlike many other medical specialties, anesthesiology has fostered a culture that discourages providing clinical care after a night on call in which there was acute sleep loss. In spite of this, private practice anesthesiologists often provide care for a short list of identified routine surgical cases the morning after they have worked the preceding day and night. Even a single night of sleep loss, as when on call, produces appreciable fatigue and sleepiness, a depressed mood, and reduced motivation to perform that could lead to an adverse incident (Weinger & Ancoli-Israel, 2002).
Ultrasound-guided transverse abdominis plane and ilioinguinal-iliohypogastric nerve block versus illioinguinal- illiohypogastric nerve block for inguinal hernia repair in patients with liver cirrhosis
Published in Egyptian Journal of Anaesthesia, 2021
Dina Salah, Wael Sayed Algharabawy
An anesthesiologist who is specialised in ultrasound-guided regional anaesthesia, conducted and supervised all blocks. At the end of the injection, sensory block was assessed every 3 min by thermal sensation using an alcohol swab in the skin area overlying the surgical field. The sensory block was considered successful when there was loss of cold sensation in the skin area overlying the surgical field. The period from the injection of local anaesthesia to the complete absence of thermal differentiation was identified as the onset of sensory block. The need for surgical LA infiltration or conversion to GA was evaluated. Surgical duration corresponding to the period from incision of the skin to closure of the skin was recorded. After completion of the surgical procedure, patients were transferred to the post-anesthetic care unit (PACU) and Modified Aldrete Score [6] was assessed and discharged after fulfilling an Aldrete score of ≥9.
Palliative care, when should it be a physicians’ choice of treatment?
Published in Progress in Palliative Care, 2019
E. Ruivo, M. Buni, A. Buketov, A. Lares
Health care organizations worldwide should implement a multidisciplinary team that provides ethical palliative care and works closely with terminally ill patients. The key is a team that works together in providing adequate medical explanations about disease processes, while taking into consideration the personal values and beliefs of patients and their families.9 Anesthesiologists are an essential member of this multidisciplinary team since they are responsible for the peri-operative evaluation of patients, by assessing their medical history and medications, performing appropriate physical examinations, reviewing diagnostic tests and data, and assigning ASA physical status.10 Moreover, anesthesiologists are crucial due to their expertise in different modalities pertaining to pain management as well trained in using multiple approaches to ease suffering and enabling near the end of life patients to have a dignified and peaceful death.11
How Integrated Anesthesia Communication Leads to Dependable IONM Data
Published in The Neurodiagnostic Journal, 2021
Veronica O. Busso, John J. McAuliffe
In summary, the IONM team can serve as culture champions for change. It is imperative that effective communication among the perioperative team exist as exceptional patient care depends on it. Both the IONM and anesthesia teams serve as advocates of the patient when the patient is unable to speak for themselves. Data provided by the IONM team serve both the surgeon and the anesthesiologist. Multiple studies have detailed the impact of inhaled anesthetics on IONM signals. A TIVA technique provides robust signals and more dependable data during complex surgeries. Obviously, the role of the anesthesiologist is to determine the best possible anesthetic plan for each individual patient. That being said, dependable IONM data should be factored into that plan. IONM data is another tool the anesthesia team may utilize to advocate on the behalf of their patient and deliver exceptional care.
Related Knowledge Centers
- Anesthesia
- Nurse Anesthetist
- Pain Management
- Surgery
- Perioperative Medicine
- Intensive Care Medicine
- Physician
- Operating Theater
- Intensive Care Unit
- Injection