Anesthetic Implications of Robotic Gynecologic Surgery.

Surgery using robotic techniques is becoming more and more common. One of the specialties at the fore-front of robotic surgery has been gynecology, much like it was at the fore-front a generation ago in bringing laparoscopy into the operating room. New considerations have been noted and new techniques have been learned on both sides of the drape in order to ensure a successful outcome for the patient undergoing robotic gynecologic surgery. The purpose of this article is to bring, to light the concerns facing the anesthesiologist in regards to robotic procedures. We discuss the problems facing anesthesiologists, when a patient is experiencing both intraabdominal insufflation and steep Trendelenburg position, and also the intraoperative management of such a patient.

The impaired anesthesiologist: not just about drugs and alcohol anymore.

The safety of patients and the health of clinicians are affected by drug and alcohol abuse. Affective disorders such as depression are also common in medical professionals, including anesthesiologists. The suicide rate among anesthesiologists is high. Since depression is the most common psychological characteristic associated with suicide, it may be a marker for risk of suicide.

Epidural haloperidol enhances epidural morphine analgesia: three case reports.

Epidural opioids provide significant postoperative analgesia; however, their use is often limited by side effects such as nausea and pruritus, or they require the addition of epidural local anesthetics with possible side effects of motor block and hypotension. Adjuncts to epidural opioid analgesia would benefit pain management. There is evidence that epidural butyrophenones may enhance opioid analgesics and reduce side effects. The authors present the first reported use of epidural haloperidol to enhance epidural morphine analgesia in three individuals. Pharmacodynamic interactions of haloperidol, which may explain its analgesic efficacy, are summarized.