Minerva anestesiologica
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Control of pain has a central role in patients treatment either in advanced cancer or other terminal illnesses and in acute postsurgical or chronic non-malignant diseases. Hospitals should promote programs of research on genetic mechanism, and also biochemical and physiological aspects of pain through highly specialized labs. Opioids are the first choice drugs for moderate to severe chronic pain, especially at the end of life, and among them oral morphine is worldwide recognized by the World Health Organization and by the European Association for Palliative Care as the conventional therapy. ⋯ Up to now no one can easily predict which patient will experience side effects or an inadequate pain control. The growing body of evidence concerning a sound genetic background of this human intervariability has prompted research on the field of a personalized therapy, focusing on single nucleotide polymorphisms (SNPs), being the most common and diffuse form of genetic variation. This review has the main goal to report the most promising human genetic polymorphisms involved in opioid treatment, and address the relationship between these polymorphisms and the clinical outcome.
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Minerva anestesiologica · Apr 2012
Randomized Controlled TrialEffect of three different doses of ketamine prior to general anaesthesia on postoperative pain following Caesarean delivery: a prospective randomized study.
Ketamine is an analgesic suitable for the induction of anesthesia during Caesarean delivery. This double blind, randomized trial examined the effect of intravenous ketamine used before the induction of general anesthesia on morphine consumption, immediate and long term postoperative pain after Cesarean delivery. ⋯ There was no difference regarding early and late postoperative pain and morphine consumption with ketamine at doses of 0.25, 0.5, and 1 mg kg(-1) in women undergoing Caesarean delivery under general anaesthesia, compared with the control group.
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Minerva anestesiologica · Apr 2012
ReviewHumidification of inspired gases during mechanical ventilation.
Humidification of inspired gas is mandatory for all mechanically ventilated patients to prevent secretion retention, tracheal tube blockage and adverse changes occurring to the respiratory tract epithelium. However, the debate over "ideal" humidification continues. Several devices are available that include active and passive heat and moisture exchangers and hot water humidifiers Each have their advantages and disadvantages in mechanically ventilated patients. This review explores each device in turn and defines their role in clinical practice.
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Minerva anestesiologica · Apr 2012
Impact of the European Paediatric Life Support course on knowledge of resuscitation guidelines among Austrian emergency care providers.
Even though anaesthetists do not resuscitate children on a daily basis, they need to perform paediatric life support regularly due to their different duties. As the knowledge of international guidelines varies widely, highly standardized European Paediatric Life Support (EPLS) courses have been introduced to improve standards of care. This national survey among Austrian anaesthetists and EPLS course participants evaluated the impact of this course at the end of the guideline period 2005-2010. ⋯ The attendance of an EPLS course within the guideline period 2005 significantly increased the theoretical knowledge of paediatric resuscitation guidelines.