Perioperative management of patients treated with the non-vitamin K antagonist oral anticoagulants is an ongoing challenge. Due to the lack of good clinical studies involving adequate monitoring and reversal therapies, management requires knowledge and understanding of pharmacokinetics, renal function, drug interactions, and evaluation of the surgical bleeding risk. Consideration of the benefit of reversal of […]
The perioperative use and relevance of protective ventilation in surgical patients is being increasingly recognized. Obesity poses particular challenges to adequate mechanical ventilation in addition to surgical constraints, primarily by restricted lung mechanics due to excessive adiposity, frequent respiratory comorbidities (i.e. sleep apnea, asthma), and concerns of postoperative respiratory depression and other pulmonary complications. The […]
Liposomal-encased bupivacaine (LEB) is a good, cost-effective medical choice for pain control after breast surgery.
I describe here a new, modified, ultrasound-guided penile block for male pediatric patients undergoing circumcision. The technique uses portable ultrasound with a linear probe and real-time scan at the base of the penis to identify vessels and fascia layers, which allows safe advancement of the needle and injection of local anesthesia bilaterally. The technique allows […]
Management of the difficult airway remains one of the most relevant and challenging tasks for anesthesia care providers. This review focuses on several of the alternative airway management devices/techniques and their clinical applications, with particular emphasis on the difficult or failed airway. It includes descriptions of many new airway devices, several of which have been […]