Patient-administered alfentanil for wound dressing changes in a non-intensive care unit setting

Reducing post-traumatic morbidity with pain management

Since significant pain can adversely affect multiple organ systems, many anesthesiologists believe that effective pain control can decrease perioperative and post-trauma morbidity. To achieve the goal of attenuating the physiological stress response associated with trauma, modalities such as patient-controlled analgesia, epidural infusions and peripheral nerve blocks are being utilized. This article will review the physiological response to pain, the new strategies and techniques for providing pain relief, and recent literature that evaluates the effect of the newer pain modalities on perioperative morbidity.

Anesthesia and sedation in the endoscopy suite? (influences and options)

Advances in technology and pharmacology have enabled gastrointestinal endoscopists to expand the diagnostic and therapeutic capabilities of the specialty. Research into the impact of the endoscopy environment on patient stress, acknowledgement of the various patient coping styles, development and deployment of procedural preparative programs and information streamlining have been shown to be of value in decreasing anxiety and reducing sedative requirements. Being aware of procedure-related stressors, and factors associated with complications, allows us to tailor our sedation or anesthesia plan to the individual patient.