Minerva anestesiologica
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Minerva anestesiologica · Dec 2008
Randomized Controlled Trial Comparative StudyComparison of forced-air warming and resistive heating.
Perioperative hypothermia is common during anesthesia and surgery and is accompanied by several complications. Forced-air warming is recognized as an effective procedure to prevent hypothermia. The aim of this study was to compare a resistive heating device with a forced-air warming device. ⋯ Heat transfer in the resistive heating system was significantly greater than that of the forced-air warming system.
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Minerva anestesiologica · Dec 2008
ReviewIntrathecal therapy with ziconotide: clinical experience and considerations on its use.
Ziconotide is a synthetic peptide equivalent of an w-conotoxin, obtained from the marine snail Conus magus, which acts by blocking N-type calcium channels in the spinal cord, reducing the perception of pain. It is a newly marketed drug, exclusively for intrathecal use, indicated for severe chronic pain. Ziconotide came to the physicians' table with both doubts and promises; to determine its safety and efficacy, one of the largest and most well-designed randomized double-blind studies in the history of intrathecal therapy was undertaken, and this drug demonstrated efficacy in relieving chronic pain in patients coming from many years of different therapies and therapy failures. ⋯ We noted differences between the well-known activity of morphine on pain and mood, and the more focused action of ziconotide on pain. In addition, it is important to consider the lack of addiction, opioid-induced hyperalgesia and other systemic effects that are common with morphine. These are the reasons why the Polyanalgesic Consensus Conference of 2007 put ziconotide in the first line of intrathecal therapy management.
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Minerva anestesiologica · Dec 2008
Randomized Controlled TrialSpinal anesthesia for transurethral resection operations: bupivacaine versus levobupivacaine.
This study tested the hypothesis that 0.5% levobupivacaine might be a good alternative to 0.5% plain bupivacaine for local spinal anesthesia during transurethral resection (TUR) operations. ⋯ Administration of 0.5% levobupivacaine may be a good alternative to 0.5% plain bupivacaine for local spinal anesthesia during TUR operations.
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Nutrition support in critically ill patients is not merely simple nutrition, but rather metabolic support. In the last few years, the pharmacological properties of nutrients have been specifically addressed in a new field called pharmaconutrition. This review will offer a deeper insight into this field, focusing on the properties of arginine, glutamine, antioxidants, and omega-3 fatty acids as well as the level of blood glycemia which should be maintained in critically ill patients.
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Minerva anestesiologica · Dec 2008
Helicopter rescue and prehospital care for drowning children: two summer season case studies.
Drowning is the second leading cause of unintentional injury-related death in children <14 years of age and is one of the most important causes of accidental injury between the ages of 1 and 4 years. In this study, the characteristics of non-fatal unintentional drownings in a small series of pediatric victims were examined. ⋯ Assuring safe tracheal ventilation, achieving intravenous access, and stabilizing both respiratory and hemodynamic disturbances on the ground before transferring the patient are the keys to out-of-hospital management. Our 100% survival rate likely results from adequate primary out of-hospital care. Promptly dispatching a helicopter with a specialized medical crew is very expensive, but is worth the cost because it offers a better chance of survival.