Minerva anestesiologica
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Minerva anestesiologica · Jan 2009
Randomized Controlled Trial Comparative StudyProspective randomized, blind comparison of ropivacaine and levobupivacaine for superficial plexus anesthesia in carotid endoarterectomy.
The authors performed a study to evaluate if the onset time, duration of sensory block, and quality of postoperative analgesia in superficial cervical plexus anesthesia with 0.5% levobupivacaine (1 mg/kg) was greater than 0.75% ropivacaine (1.5 mg/kg). ⋯ No beneficial effect was noted in the quality of nerve block or patient's satisfaction for 0.5% levobupivacaine when compared to 0.75% ropivacaine.
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Non-invasive ventilation (NIV) is an effective technique that can avert side effects and complications associated with endotracheal intubation. NIV is primarily used to avert the need for endotracheal intubation in patients with early stage acute respiratory failure (ARF), and to prevent postextubation respiratory failure in patients considered to be at risk. ⋯ The success of NIV relies on several factors including the type and severity of ARF, the underlying disease, the timing, the location of treatment, and the experience of the team. In this review article, we analyze, compare, and discuss the results of studies in which NIV was applied in different pathologies and with different timing during the evolution of ARF.
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The noble gas xenon exerts favorable anesthetic properties along with remarkable hemodynamic stability in healthy patients undergoing elective surgery. Recent investigations documented that it does not prolong the duration of widely used neuromuscular blocking agents, including mivacurium and rocuronium. Some studies also suggest reduced neurocognitive compromise in the very early phase after general anesthesia. ⋯ Results from in vitro studies and various animal models have consistently demonstrated organoprotective properties of xenon, mainly in settings of ischemia and reperfusion injury. Interestingly, these effects have frequently been observed at subanesthetic concentrations and seem to be synergistic when used in combination with therapeutic hypothermia. Future studies will have to prove whether the high costs of xenon administration might be outweighed by its ability to substantially reduce the sequelae of myocardial and cerebral ischemia.
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Minerva anestesiologica · Jan 2009
A survey of 1000 consecutive epidural catheter placements performed by inexperienced anesthesia trainees.
Education is the core activity of academic anaesthesia departments. One of the main difficulties appears to be the development of realistic high-quality 'training' practices that are safe for patients. The aim of this study was to determine the incidence of complications occurring after epidural catheter placement by inexperienced anaesthesia trainees and their possible relationship with the experience of the operator. ⋯ Epidural catheterization performed under supervision by inexperienced anaesthesia residents is not associated with a significantly greater number of complications than reported in the literature. Moreover, at the early stage of training, we could not demonstrate any correlation between the experience of the operator and the incidence of complications incidence.