References of "Current Opinion in Anaesthesiology"
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See detailConsciousness and responsiveness: Lessons from anaesthesia and the vegetative state
Boly, M; Sanders, RD; Mashour, GA et al

in Current Opinion in Anaesthesiology (2013), Vol 26

PURPOSE OF REVIEW: The aim of this article is to review recent behavioural and neuroimaging studies in anaesthesia and the vegetative state. RECENT FINDINGS: These studies highlight possible dissociations ... [more ▼]

PURPOSE OF REVIEW: The aim of this article is to review recent behavioural and neuroimaging studies in anaesthesia and the vegetative state. RECENT FINDINGS: These studies highlight possible dissociations between consciousness and responsiveness in both these states. SUMMARY: We discuss future avenues of research in the field, in order to improve the detection of awareness during anaesthesia and the vegetative state using neuroimaging and neurophysiologic techniques. [less ▲]

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See detailInfluence of anesthesia on cerebral blood flow, cerebral metabolic rate, and brain functional connectivity.
BONHOMME, Vincent ULiege; BOVEROUX, Pierre ULiege; HANS, Pol ULiege et al

in Current Opinion in Anaesthesiology (2011), 24(5), 474-9

PURPOSE OF REVIEW: To describe recent studies exploring brain function under the influence of hypnotic anesthetic agents, and their implications on the understanding of consciousness physiology and ... [more ▼]

PURPOSE OF REVIEW: To describe recent studies exploring brain function under the influence of hypnotic anesthetic agents, and their implications on the understanding of consciousness physiology and anesthesia-induced alteration of consciousness. RECENT FINDINGS: Cerebral cortex is the primary target of the hypnotic effect of anesthetic agents, and higher-order association areas are more sensitive to this effect than lower-order processing regions. Increasing concentration of anesthetic agents progressively attenuates connectivity in the consciousness networks, while connectivity in lower-order sensory and motor networks is preserved. Alteration of thalamic sub-cortical regulation could compromise the cortical integration of information despite preserved thalamic activation by external stimuli. At concentrations producing unresponsiveness, the activity of consciousness networks becomes anticorrelated with thalamic activity, while connectivity in lower-order sensory networks persists, although with cross-modal interaction alterations. SUMMARY: Accumulating evidence suggests that hypnotic anesthetic agents disrupt large-scale cerebral connectivity. This would result in an inability of the brain to generate and integrate information, while external sensory information is still processed at a lower order of complexity. [less ▲]

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See detailManagement of the unstable cervical spine: elective versus emergent cases.
Bonhomme, Vincent ULiege; Hans, Pol ULiege

in Current Opinion in Anaesthesiology (2009), 22(5), 579-85

PURPOSE OF REVIEW: The present review focuses on similarities and discrepancies in the management of emergent and elective unstable cervical spine (C-spine) patients. RECENT FINDINGS: During mobilization ... [more ▼]

PURPOSE OF REVIEW: The present review focuses on similarities and discrepancies in the management of emergent and elective unstable cervical spine (C-spine) patients. RECENT FINDINGS: During mobilization, lifting is superior to rolling in limiting spine movements. Before prone position surgery, the transfer of the patient on a rotating table is preferable to rolling. In trauma patients, helical computed tomography (CT) with sagittal reconstruction is the first choice for clearing the C-spine. In those patients, airway compromise may be related to hidden cervical edema or hematoma. Several devices can be of help in performing safe tracheal intubation in patients with limited neck movements, but awake fiberoptic intubation remains the safest procedure. The muscle relaxant antagonist sugammadex can improve safety for rapid sequence induction. It can rapidly reverse profound steroid-based neuromuscular blockade and allows avoidance of succinylcholine in this indication. Propofol anesthesia better prevents coughing upon emergence than inhaled anesthesia. Neuroprotection in cord-damaged patients is disappointing, and the controversy on the efficacy of high-dose methylprednisolone is not closed. Nevertheless, maintenance of homeostasis remains the cornerstone of neuroprotection. SUMMARY: Subtle details differentiate the management of emergent and elective unstable C-spine patients. In both situations, the presence or the absence of a neurological insult governs the therapeutic strategy. [less ▲]

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See detailSomething new about ketamine for pediatric anesthesia?
Lois, Fernande ULiege; De Kock, Marc

in Current Opinion in Anaesthesiology (2008), 21(3), 340-4

PURPOSE OF REVIEW: This review discusses the place of the old anesthetic ketamine in pediatric anesthesia. RECENT FINDINGS: Despite the availability of modern alternatives, ketamine remains a frequently ... [more ▼]

PURPOSE OF REVIEW: This review discusses the place of the old anesthetic ketamine in pediatric anesthesia. RECENT FINDINGS: Despite the availability of modern alternatives, ketamine remains a frequently used drug particularly for anesthesia in high-risk children and for procedures outside the operating room. In adult patients undergoing surgery, a renewed interest in this drug is noted. It is the consequence of recent demonstrations of the following effects. First, ketamine is highly effective against surgery and opiate-induced hyperalgesia. Second, it has original antiproinflammatory properties. In other words, it promotes self-limitation of the inflammatory response that follows surgery. In the pediatric population, these benefits wait to be confirmed. Finally, questions arise about the safety of ketamine anesthesia. Ketamine is a potent proapoptotic drug. In rodents treated during the critical period for central nervous system development, long-term behavioral deficits were noted after an anesthetic dose of ketamine. The exact consequences of these proapoptotic properties on human brain tissue development have to be exactly determined and are still debatable. SUMMARY: Ketamine has not yet revealed all its interactions in humans. Recent discoveries indicate interesting properties on the one hand and potentially deleterious effects on the other. [less ▲]

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See detailStress and burnout in anesthesia
Nyssen, Anne-Sophie ULiege; Hansez, Isabelle ULiege

in Current Opinion in Anaesthesiology (2008)

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See detailWhy We Still Use Intravenous Drugs as the Basic Regimen for Neurosurgical Anaesthesia
Hans, Pol ULiege; BONHOMME, Vincent ULiege

in Current Opinion in Anaesthesiology (2006), 19(5), 498-503

PURPOSE OF REVIEW: Evolution of neurosurgery mainly trends towards minimally invasive and functional procedures including endoscopies, small-size craniotomies, intraoperative imaging and stereotactic ... [more ▼]

PURPOSE OF REVIEW: Evolution of neurosurgery mainly trends towards minimally invasive and functional procedures including endoscopies, small-size craniotomies, intraoperative imaging and stereotactic interventions. Consequently, new adjustments of anaesthesia should aim at providing brain relaxation, minimal interference with electrophysiological monitoring, rapid recovery, patients' cooperation during surgery and neuroprotection. RECENT FINDINGS: In brain tumour patients undergoing craniotomy, propofol anaesthesia is associated with lower intracranial pressure and cerebral swelling than volatile anaesthesia. Hyperventilation used to improve brain relaxation may decrease jugular venous oxygen saturation below the critical threshold. It decreases the cerebral perfusion pressure in patients receiving sevoflurane, but not in those receiving propofol. The advantage of propofol over volatile agents has also been confirmed regarding interference with somatosensory, auditory and motor evoked potentials. Excellent and predictable recovery conditions as well as minimal postoperative side-effects make propofol particularly suitable in awake craniotomies. Finally, the potential neuroprotective effect of this drug could be mediated by its antioxidant properties which can play a role in apoptosis, ischaemia-reperfusion injury and inflammatory-induced neuronal damage. SUMMARY: Although all the objectives of neurosurgical anaesthesia cannot be met by one single anaesthetic agent or technique, propofol-based intravenous anaesthesia appears as the first choice to challenge the evolution of neurosurgery in the third millennium. [less ▲]

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See detailNeuroprotection with Anaesthetic Agents
Hans, Pol ULiege; BONHOMME, Vincent ULiege

in Current Opinion in Anaesthesiology (2001), 14(5), 491-6

The term 'neuroprotection' is used to refer to any prophylactic measure that is initiated during the peri-ischaemic period in order to improve neuronal survival. Cell death after ischaemia has an ... [more ▼]

The term 'neuroprotection' is used to refer to any prophylactic measure that is initiated during the peri-ischaemic period in order to improve neuronal survival. Cell death after ischaemia has an immediate, necrotic and a delayed, apoptotic origin. The major biochemical mechanisms that are involved in this process include transmembrane ionic fluxes and intracellular calcium increase, excitotoxicity, free radical formation, peroxynitrite production, release of inflammatory mediators, mitochondrial dysfunction, cytochrome c release, and activation of caspases and transcription factors. Strategies of neuroprotection essentially impact on those biochemical pathways. The label 'neuroprotectant' requires that the therapy has basic properties that are consistent with potential mechanisms of neuroprotection, and that conclusive results are available from animal studies that can be converted into clinical benefit. The present review focuses on neuroprotective effects of anaesthetics and is based on the most recently published reports. [less ▲]

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See detailNew evaluation therapies for sepsis.
Deby; Damas, Pierre ULiege; Lamy, Maurice ULiege

in Current Opinion in Anaesthesiology (1999), 12(2), 121-7

This article presents an analysis of the literature of the last 2 years on the treatment of sepsis and septic shock. It appears that most of the antimediator therapies applied in phase II or III clinical ... [more ▼]

This article presents an analysis of the literature of the last 2 years on the treatment of sepsis and septic shock. It appears that most of the antimediator therapies applied in phase II or III clinical trials yielded disappointing results. But, many other therapeutic approaches are proposed or are ongoing, and many papers report critical analysis of the reasons for the lack of success of past clinical trials. [less ▲]

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See detailAnaesthesia for thoracoscopic surgery
Larbuisson, Robert ULiege; Lamy, Maurice ULiege

in Current Opinion in Anaesthesiology (1997), 10

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See detailAnaesthesia for cardiac surgery
Larbuisson, Robert ULiege; Lamy, Maurice ULiege

in Current Opinion in Anaesthesiology (1996), 9

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See detailEditorial comment intensive care
Lamy, Maurice ULiege

in Current Opinion in Anaesthesiology (1994), 7

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See detailLaparoscopy, urology, and gynaecology
Joris, Jean ULiege

in Current Opinion in Anaesthesiology (1993), 6

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See detailLaparoscopic surgery, urology and gynaecology
Joris, Jean ULiege

in Current Opinion in Anaesthesiology (1993), 6

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See detailThe cytokines: a possible role in sepsis
Damas, Pierre ULiege

in Current Opinion in Anaesthesiology (1991), 4(2), 241-246

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See detailInterpleural, intercostal and thoracic epidural analgesia
Joris, Jean ULiege

in Current Opinion in Anaesthesiology (1991), 4

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