Minerva anestesiologica
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Minerva anestesiologica · Mar 2001
Multicenter StudyUse of sedative and analgesic drugs in the first week of ICU stay. A pharmaco-epidemiological perspective.
To assess the current practice of pharmacological sedation and analgesia in patients admitted in Italian intensive care units. ⋯ Our results depict a relatively low prevalence of sedation in Italy, with the use of large number of different agents. We also observed a larger than expected use of some drugs, like propofol and fentanyl, that could be due to the unavailability of new sedative and analgesic drugs in Italy on 1994. In conclusion, Italian intensivists seem to be very conservative about the practice of pharmacological sedation in critically ill patients.
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Minerva anestesiologica · Mar 2001
Randomized Controlled Trial Clinical TrialApplication of the self-inflating bulb to a hollow intubating introducer.
The aspiration test, performed by a self-inflating bulb (SIB), is a simple and reliable method to detect an accidental esophageal intubation. The aim of the study, in case of employment of a hollow intubating introducer (HII), was to verify the possibility to directly perform the test with the introducer and its efficacy in allowing the detection of its position. ⋯ The aspiration test with the SIB allows the proper detection of the introducer in esophagus. When used in combination with a HII, both time and local trauma associated with an erroneous, introducer-guided esophageal intubation in case of difficult laryngoscopy may be reduced.
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Minerva anestesiologica · Mar 2001
Clinical Trial[Alterations in left ventricular-arterial coupling and mechanical efficiency produced by remifentanil during cardiac anesthesia].
The performance of the cardiovascular system depends on the interaction of the left ventricle and arterial system. An appropriate coupling of these two components is important to quantify the efficiency of myocardium, determined by Ea/Ees. The end-systolic elastance of the left ventricle (Ees) is an index of contractility which is independent of loading conditions, while the arterial end-systolic elastance (Ea) represents the properties of the arterial system. The aim of our study is to investigate the effects of a bolus of remifentanil (R) on myocardial efficiency. ⋯ The results suggest that R preserves a good left ventricular-arterial coupling and mechanical efficiency, despite a little increase of coupling, probably because ventricular and arterial properties are so matched as to minimize the systolic work of the left ventricle.
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Minerva anestesiologica · Mar 2001
Review[Thoracic epidural analgesia (TEA) in clinical practice: effects, technique, complications and suggestions during anticoagulant treatment].
The effects of thoracic peridural analgesia (TEA) on the neuroendocrine response to surgery are well known, but, at the present this technique is not widely used especially in Italy. The aim of this paper is to give information and suggestions on thoracic epidural analgesia in thoracic and cardiac surgery, and to discuss how anticoagulant therapy may interfere on this technique.