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• W2108658077 abstract "The trend towards cost-containment of medical expenditures that began in earnest in the early 1990s has created the obvious need to decrease the time that patients spend in the hospital. This emphasis places a premium on devising new methods for treating disease that not only cure the patient but also do so in a way that causes less physical impairment, tissue trauma, or prolongation of the recovery period. Accordingly, the last few years have seen a tremendous increase in the number of procedures that are minimally invasive. An astonishing number of procedures that were formerly quite invasive can now be done with techniques using ultrasonography, radiographic guidance, and videoscopic visualization. Some minimally invasive procedures, such as neuroradiologic treatment of difficult-to-reach aneurysms, are unapproachable by any other means. Less invasiveness is usually accompanied by a lessened need for blunting responses to painful stimuli (i.e., anesthesia services). Patients still want to be amnestic for the experience, though. Light intravenous sedation using agents with short duration of action or for which specific antagonists are available may be provided safely by experienced nurses, nurse practitioners, or technicians under physician supervision. Nevertheless, in many cases these procedures will still require the participation of anesthesia personnel. The basic goals of anesthesia—blocking the awareness of pain and producing a motionless field—are made more difficult to achieve because of compounding medical problems. In many cases, minimally invasive procedures are undertaken specifically because a particular patient may have numerous, severe medical problems. In these instances, a physician anesthesiologist is the best person to take these medical conditions into account in producing a patient able and willing to undergo the procedure. In addition, minimally invasive procedures generate new technical issues that produce unique challenges for which anesthesiologists have the perfect training to manage. This article will describe minimally invasive techniques that have been devised to treat coronary artery disease, major vascular disease, and cerebrovascular disease. In addition, it will discuss the anesthetic management of patients undergoing these procedures with special attention to how the peculiarities of these techniques may produce unique problems for the anesthesiologist." @default.
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• W2108658077 date "1999-06-01" @default.
• W2108658077 modified "2023-09-27" @default.
• W2108658077 title "ANESTHETIC CONSIDERATIONS FOR MINIMALLY INVASIVE CARDIOVASCULAR PROCEDURES" @default.
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• W2108658077 doi "https://doi.org/10.1016/s0889-8537(05)70106-1" @default.
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