Minerva anestesiologica
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Minerva anestesiologica · Apr 2007
Randomized Controlled Trial Comparative StudyPrevention of pain on injection of propofol: a comparison of remifentanil with alfentanil in children.
Propofol has a high incidence of pain on injection, particularly when a vein on the back of hand is used. Administration of lidocaine, either before or mixed with propofol remains the most widely used method to attenuate this pain. The use of opioids such as alfentanil and fentanyl has been found to decrease pain induced by propofol injection. The purpose of this study was to evaluate the effects of different doses of remifentanil and alfentanil in minimizing the pain caused by propofol. ⋯ Pretreatment with intravenous remifentanil 0.5 microg kg(-1), alfentanil 15 microg kg(-1) and 20 microg kg(-1) were equally effective in reducing pain associated with propofol injection in children between the age group of 5-12 years.
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Minerva anestesiologica · Apr 2007
ReviewFocussing cellular function. Metabolic monitoring in perioperative and Intensive Care Medicine.
In the clinical field microdialysis today is a routine technique for monitoring the chemistry of tissues and organs in physiological and pharmacological research on animals. In more than 10.000 papers on microdialysis research it is used to uncover physiological mechanisms and the influence of drugs in almost every organ of the body. ⋯ This article gives an overview over current results of clinical studies using microdialysis in critical care medicine and tries to focus on possible indications for clinical biochemical monitoring. However, despite numerous publications available microdialysis has not been shown to improve outcome of the patients yet.
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Minerva anestesiologica · Apr 2007
ReviewAnesthesia for non-obstetric surgery in the pregnant patient.
Surgery during pregnancy is relatively common. The present review of the literature will focus on relevant issues such as maternal safety during non-obstetric surgery in pregnancy, teratogenicity of anesthetic drugs, the avoidance of fetal asphyxia, the prevention of preterm labor, the safety of laparoscopy, the need to monitor the fetal heart rate and will finally give a practical approach to manage these patients.
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Minerva anestesiologica · Apr 2007
Randomized Controlled TrialFluid challenge in patients submitted to spinal block.
The practice of routinely prehydrating patients by infusing a colloid solution for prevention of spinal anesthesia-induced hypotension has been challenged recently. The aim of the study was to evaluate the influence of a 15 mL/kg pre-emptive bolus of colloids (6% hydroxyhethyl starch) on heart rate (HR), mean arterial blood pressure (MAP), cardiac index (CI) in patients submitted to subarachnoid block with hyperbaric bupivacaine 0.5%, 0.2 mg/kg for orthopedic surgery of the lower limb. ⋯ Our data show that despite to fluid challenge, we could not prevent MAP decrease in Group A, even if it is more marked in Group B.
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Despite routine postoperative pain management improves recovery and reduces postoperative morbidity and overall costs, and the availability of a large armamentarium of analgesic techniques and drugs, a significant portion of patients do not receive adequate postoperative pain control. We describe a recovery room (RR) based acute pain service model. ⋯ A RR-based APS can effectively act as coordinating centre for acute pain treatment without adjunctive personnel.