Minerva anestesiologica
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Minerva anestesiologica · Mar 2008
Comparative StudyComparing the efficacy and safety of continuous epidural analgesia in abdominal and urological surgery between two opioids with different kinetic properties: morphine and sufentanyl.
Ample evidence is now available showing the analgesic efficacy of a local anaesthetic-opioid combination to control postoperative pain. This retrospective study aimed to analyze any improvement in the ability of sufentanyl, a highly lipophilic opioid, and morphine, a poorly lipophilic opioid, to control postoperative pain at rest and in motion when combined with ropivacaine 0.2%. ⋯ Both protocols providing a combination of a local anaesthetic and an opioid demonstrated an excellent safety and efficacy profile. The differing lipophilicity of the opioids did not cause any clinically or statistically significant differences in terms of efficacy or safety, other than a reduced onset time of sufentanyl, ensuring better pain control upon waking. We therefore believe that morphine should be the standard opioid for neuraxial use, although these results must be confirmed in the setting of a randomized controlled clinical trial.
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Minerva anestesiologica · Mar 2008
ReviewAdvances in neuraxial blocks for labor analgesia: new techniques, new systems.
Neuraxial block for labor analgesia is widely accepted and highly effective. Much progress has been achieved in terms of providing safer and more efficacious analgesia. Emphasis has been placed on maternal autonomy and individualization of therapy. ⋯ The introduction of the computer-assisted approach to provide a more interactive background infusion could potentially refine the delivery of patient-controlled epidural analgesia. The enhanced effectiveness of synchronized basal automated boluses has also been exploited for patient-controlled epidural analgesic systems. The quest to provide seamless analgesia that empowers the laboring parturient in a cost effective way continues to be a developing area of research.
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Minerva anestesiologica · Mar 2008
Assisted sedation: a safe and easy method for pain-free percutaneous vertebroplasty.
This study was performed to describe a method of assisted sedation for percutaneous vertebroplasty (PVP). ⋯ Assisted sedation is a safe and easy method for pain free PVP procedures. Age is an important factor to titrate propofol dose. However, it is noteworthy that no adverse effects were observed independent of age and physical status.