Recent advances in cardiac anaesthesia

Abstract

The speciality of cardiac anaesthesia has rapidly evolved over the past few decades with advances in technology, including artificial intelligence (AI), newer devices, techniques, imaging, pain relief and a better understanding of the pathophysiology of disease states. Incorporation of the same has led to improved patient outcomes in terms of morbidity and mortality benefits. With the advent of minimally invasive surgical methods, minimising the dose of opioids and ultrasound-guided regional anaesthesia for pain relief, enhanced recovery after cardiac surgery has been made possible. Perioperative imaging including 3D transoesophageal echocardiography, newer devices and drugs and AI algorithms will play a significant role in cardiac anaesthesia. This review briefly addresses some of the recent advances that the authors believe can impact the practice of cardiac anaesthesia.

Keywords: Anaesthesiology; artificial intelligence; recent advances.

Figure 1

(a) Paravertebral space and its boundaries. (b) Sagittal section—needle walking over the transverse process after piercing superior costotransverse ligament. (Adapted from the primary author’s previous publication[1])

Figure 2

Points of injection. (Adapted from the primary author’s previous publication[1])

Figure 3

Showing plane for injection in Pecs 1 and Pecs 2 block. (Adapted from the primary author’s previous publication[1])

Figure 4

Blue arrow—plane for injection in erector spinae block. EIM = external intercostal muscle, IIM = internal intercostal muscle, InIM = innermost intercostal muscle. (Adapted from the primary author’s previous publication[1])

Figure 5

(a) Intercostal nerve anatomy in the parasternal region (b) Drug deposition for pecto-intercostal fascial block. PM = pectoralis major; IIC = internal intercostal muscle; TTM = transverse thoracic muscle. (Adapted from the primary author’s previous publication[1]