Minerva anestesiologica
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Minerva anestesiologica · Dec 2007
Randomized Controlled TrialThe analgesic efficacy of tramadol in ambulatory gynecological laparoscopic procedures: a randomized controlled trial.
To evaluate the postoperative analgesic efficacy of intravenous tramadol 50 mg administered before anesthetic induction in patients undergoing ambulatory gynecological laparoscopic procedures. ⋯ Intravenous tramadol 50 mg given before anesthetic induction did not reduce pain intensity but was well tolerated. Although tramadol statistically reduced the paracetamol requirement in the first 24 h postoperatively, it did not seem to provide a significant clinical advantage.
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Minerva anestesiologica · Dec 2007
Randomized Controlled TrialSubhypnotic doses of midazolam prevent nausea and vomiting during spinal anesthesia for cesarean section.
We aimed to evaluate the efficacy of subhypnotic doses of midazolam and propofol for peripartum nausea and vomiting during regional anesthesia for elective cesarean section in order to prevent emesis in at least 50% of patients. ⋯ A subhypnotic dose of midazolam (1 mg x h(-1)) was as effective as the subhypnotic dose of propofol (1 mg x kg(-1) x h(-1)) for the prevention of nausea and vomiting in parturients undergoing cesarean section under spinal anesthesia.
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Minerva anestesiologica · Dec 2007
ReviewCritical care of HIV infected patients in the highly active antiretroviral therapy era.
Since there are more than 150 000 Italians (about 25 for every 10,000 inhabitants) infected with HIV, Intensive Care Units (ICU) often come across patients who are HIV positive. The aim of this study was to provide current information on the epidemiology of human immunodeficiency virus (HIV)-infected patients admitted to ICU during the era of highly active antiretroviral therapy (HAART) and to review issues related to the administration of antiretroviral therapy relevant to the ICU staff. ⋯ More HIV-infected patients survive ICU admission and are less likely to be admitted to the ICU for related infections; in most cases, they need critical care for problems unrelated to HIV infection or for conditions related to HAART toxicity. ICU staff need to be familiar with HAART for the following reasons: 1) to recognize life-threatening toxicities unique to these drugs; 2) to avoid drug interactions, which are extremely common and potentially life-threatening; and 3) to avoid enhancing HIV drug resistance, an occurrence that could have devastating consequences for the patient after discharge from the ICU.
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Six years ago, a publication in a quite well known scientific medical journal brought hope and a good dose of optimism to sepsis therapy and the critical care community. For the first time, a careful randomized controlled trial in patients with severe sepsis or septic shock seemed to show a clearly beneficial effect of a new drug, i.e. of activated recombinant human protein C. ⋯ However, further evaluation of the results of the trial and new investigations did not confirm entirely the initial optimism. As a consequence, the adequate indications for this expensive drug remain controversial.