Minerva anestesiologica
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Minerva anestesiologica · Dec 2010
ReviewOROS® hydromorphone in chronic pain management: when drug delivery technology matches clinical needs.
The osmotic-controlled release oral delivery system (OROS®) is an innovative drug delivery technology that uses osmotic pressure as the driving force to deliver pharmacotherapies in many therapeutic areas. In chronic pain management requiring long-term therapy, pharmaceutical technologies that ensure the controlled release of analgesic medications are imperative. In addition, once-daily formulations ensure better patient compliance to prescribed therapies. ⋯ These studies support the clinical utility of the 5:1 ratio used for the conversion of oral morphine to oral OROS® hydromorphone. Furthermore, once-daily OROS® hydromorphone has been shown to be effective in patients with chronic cancer and non-cancer pain, and it provides similar pain relief to SR morphine and ER oxycodone. In chronic pain management, OROS® products can result in more stable drug concentrations, reduced dosing frequency and an improved safety profile.
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Minerva anestesiologica · Dec 2010
Randomized Controlled TrialA comparison of spinal anesthesia with low-dose hyperbaric levobupivacaine and hyperbaric bupivacaine for transurethral surgery: a randomized controlled trial.
The aim of this study was to compare spinal anesthesia effects of low-dose hyperbaric levobupivacaine and low-dose hyperbaric bupivacaine for transurethral procedures. ⋯ Although both techniques provide adequate spinal block and have few similar side effects for transurethral surgery, the use of low-dose hyperbaric levobupivacaine plus fentanyl may be preferable to low-dose hyperbaric bupivacaine plus fentanyl because of the reduced motor block, shorter duration of motor block, longer duration of sensory block and longer time to the first requirement for analgesia.
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Minerva anestesiologica · Dec 2010
Comparative StudyA prospective study of the accuracy and precision of continuous cardiac output monitoring devices as compared to intermittent thermodilution.
Pulse pressure (PP) analysis from a radial arterial line is available with the LiDCO plus monitor (LiDCO, Cambridge, UK) and FloTrac/Vigileo (Edwards Lifesciences, Irvine, CA, USA). The aim of this study was to investigate the agreement of continuous PP analysis against intermittent thermodilution (ITD) using the pulmonary artery catheter (PAC). ⋯ APCO (Vigileo software 1.03) and PulseCOLi showed a moderate agreement with the PAC. When PulseCO was calibrated with ITD (PulseCOITD) it showed excellent agreement, demonstrating that PulseCO performs well against ITD when the calibration process is optimally performed.
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Minerva anestesiologica · Dec 2010
Ex vivo changes in blood glucose levels seldom change blood glucose control algorithm recommendations.
Hyperglycemia and glycemic variabilities are associated with adverse outcomes in critically ill patients. Blood glucose control with insulin mandates an adequate and precise assessment of blood glucose levels. Blood glucose levels, however, can change ex vivo after sampling. The aim of this study was to determine whether this phenomenon affects the practice of blood glucose control. ⋯ Ex vivo changes in blood glucose levels, although statistically significant, seem clinically irrelevant.