Fracture Management by Primary Care Providers
The evaluation and management of patients with acute musculoskeletal injuries is a routine part of most primary care practices. Distinguishing a fracture from a soft tissue injury is an essential…
When Should Regional Anesthesia Be Used in Pediatric Patients?
Introduction The role of regional anesthesia in adult practice is well-established. Some of the benefits of regional anesthesia include improvement in postoperative respiratory function and bowel function and a decrease…
Is Pre-Emptive Analgesia Clinically Effective?
Introduction The concept of pre-emptive analgesia originated at a time of growing appreciation for the dynamic characteristics of the pain pathway. Experimental studies made it clear that noxious stimuli could…
How Young Is the Youngest Infant for Outpatient Surgery?
Introduction Outpatient surgery accounts for a significant percentage of anesthetics delivered annually in the United States. Many pediatric procedures, such as hernia repair, circumcision, endoscopy, and heel cord tenotomy, are…
Should a Child with a Respiratory Tract Infection Undergo Elective Surgery?
Introduction Acute respiratory infections are one of the leading medical causes of surgery cancellation in children. Anesthesiologists are often confronted with patients demonstrating symptoms of upper respiratory tract infections (URIs)…
Does Anesthesia Increase the Risk to the Parturient Undergoing Nonobstetric Surgery?
Introduction It is estimated that 0.75% to 2% of pregnant women in developed countries undergo nonobstetric surgery during the course of parturiency; approximately 42% undergo surgery in the first, 35%…
Anesthesia for Cesarean Delivery: Regional or General?
Introduction The cesarean delivery rate has been steadily increasing and in 2009 climbed to 33%. The most common indications for cesarean delivery include prior cesarean delivery, dystocia, breech position, multiple…
Optimal Postoperative Analgesia
Introduction Postoperative pain management in the United States was fairly standardized before the 1980s. Mild-to-moderate pain was treated with acetaminophen or a nonsteroidal antiinflammatory drug (NSAID), and moderate-to-severe pain was…
Does Labor Analgesia Affect Labor Outcome?
Introduction In 1847, only months after the first demonstration of anesthesia, James Simpson, an obstetrician, administered ether to a woman in labor for childbirth. He was quite impressed with the…
When Should a Combined Spinal–Epidural Be Used?
Introduction The combined spinal–epidural (CSE) technique produces reliable and rapid onset of spinal anesthesia combined with the flexibility to extend the height and duration of a block provided by continuous…
