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Controversial issues in ambulatory anesthesia.

Abstract

Many controversies surround ambulatory anesthesia, but this article concentrates on two major areas: monitoring devices and airway management. Being able to monitor the depth of anesthesia has been a long-term goal with the aim of avoiding awareness during surgery. As monitoring devices are developed, they are being used to reduce anesthetic delivery and reduce costs, possibly increasing the risk of awareness. Management of the airway has been revolutionized by the laryngeal mask, and this article reviews some controversial uses. Several other airway devices that have been developed and promoted as suitable alternatives also are evaluated.

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BibTeXRIS

Moses Chikungwa, Ian Smith. 2003. Controversial issues in ambulatory anesthesia.. https://doi.org/10.1016/s0889-8537(02)00077-9

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The role of gait analysis in the orthopaedic management of ambulatory cerebral palsy.

PURPOSE OF REVIEW: The literature was reviewed to describe the role of gait analysis in the orthopaedic management of ambulatory children with cerebral palsy and examine the current best evidence to support these roles. RECENT FINDINGS: Gait laboratory analysis is superior to visual or observational analysis of gait because it provides an objective record of gait that is able to quantify the magnitude of deviations of pathologic gait from normal and also explain these abnormalities. Recognizable gait patterns can be classified and used for making treatment decisions, the effectiveness of which can be assessed using gait analysis as a measure of gait outcomes. There are many sources of variability, however, including patients themselves, the gait laboratories and testing processes, interpretation of data and surgeons' surgical recommendations. SUMMARY: Although gait analysis has been shown to alter decision making, there is little evidence that the decisions based on gait analysis lead to better outcomes. Consequently, clinical gait analysis remains controversial, with wide variation in the rates of utilization of gait analysis in the management of children with ambulatory cerebral palsy. The time is ripe for clinical trials and cohort studies to provide the evidence to establish the appropriate utilization of this technology.

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