2010

 

The feasibility of laparoscopic general surgery under regional anaesthesia

Pharmacology of the critically ill (Part ΙI). Pharmacodynamic principles and their significance in critical illness

Anaesthesia management during cardiologic interventions

Non invasive methods of postoperative analgesia

Damage control surgery and intensive care

Apneic oxygenation; pulmonary and cardiovascular effects

Postconditioning or manipulating the re-perfusion injury

Extubation in the operating room immediately after orthotopic liver trans-plantation. Case report and review of the literature

The study of mechanisms by which drugs can modify cellular and ultimately whole animal and human performance is still one of the most exciting branches of science. However and despite the fact that many physicians are frequently using some times more than 20 drugs simultaneously in critically ill patients, very few of them are able to understand the enormous complexity and variability of different therapeutic responses within patients and/or between patients suffering from critical illness.

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The management of cardiologic patients who are presenting for diagnostic and theurapeutic cardiac interventions has become a significant topic of interest and concern among anesthesiologists. This review will update recent reports and also will provide practical advice on delivering anesthesia in cardiac catheterization laboratory. During recent years cardiac procedures are more complex, take longer, and involve high risk patients.

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Despite of great interest in understanding the pain mechanisms and pain management, and the foundation of acute pain services; numbers of patients still suffer unacceptable pain even today. Surveys show that there are not many improvements in this area. So, it is quite clear that the solution to post operative pain is not just developing a single technique.

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Damage control surgery is defined as rapid termination of an operation after control of life threatening bleeding and contamination in severely injured and unstable patients, followed by correction of physiologic abnormalities and de-finitive management. Emphasis then shifts from the operating theater to the intensive care unit, where the patient’s physiologic deficits are corrected.

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Apneic oxygenation is an adjunct "ventilation‟ technique that involves insufflation of oxygen at varying flows through a catheter that is inserted through the endotra-cheal tube and is positioned above the carina. Apneic oxygenation improves gas exchange efficiency and preserves the arterial oxygenation at an acceptable level.

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A lot of techniques have been tested for their potential to salvage myocardial tissue during an episode of acute ischaemia. Techniques that are applied before the onset of acute ischaemia, i.e. preconditioning techniques, have proved to be really protective, but scheduled ischaemia or at least high probability for the timing of it’s occurrence, is a pre-requisite for their application. This disadvantage led to experimentation on techniques that can be applied immediately after the onset of acute ischaemia or at least on the time of reperfusion.

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Early tracheal extubation has been safely performed after large operative procedures, questioning the need for routine postoperative ventilation. Because immediate postoperative tracheal extubation of liver transplanted patients has not been previously reported in Greece, we announce the first case report.

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