Minerva anestesiologica
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Minerva anestesiologica · May 2013
Randomized Controlled TrialPreoperative medication with oral morphine sulphate and postoperative pain.
The administration of an analgesic drug prior to nociceptive surgical stimulus could result in a better postoperative pain management. The aim of this study was to evaluate the effect of preoperative oral morphine sulphate on postoperative pain relief. ⋯ In major abdominal surgery, premedication with oral morphine sulphate produces better postoperative pain control and has an opioid-sparing effect without delaying gastrointestinal canalization time.
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Minerva anestesiologica · May 2013
Comparative Study Clinical TrialT-piece improves arterial and central venous oxygenation in trachestomized patients as compared to continuous positive airway pressure/pressure support ventilation.
T-piece has been widely used as T-piece trial to identify patients who are ready for extubation but it is seldom used as a weaning tool. Our objective was to investigate the effects of breathing via T-piece on gas exchange as compared to continuous positive airway pressure with pressure support (CPAP+PS) and CPAP with automatic tube compensation (CPAP+ATC) as it has not been evaluated yet. ⋯ On the same FiO2 and PEEP setting, breathing via T-piece improved oxygenation and resulted in increased ScvO2 as compared to breathing on CPAP with PS. Our observations suggest a potential role of T-piece during weaning from mechanical ventilation.
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Minerva anestesiologica · May 2013
Current practice of brain death determination and use of confirmatory tests in an Italian University hospital: a report of 66 cases.
Time to final brain death (BD) determination is fundamental to rapidly identify donors without organ deterioration. Guidelines for BD determination are different from country to country and, through years, they have been subjected to several revisions, to simplify the procedure. The aim of this study was to describe a one-year experience according to the latest Italian Guidelines for BD in our University hospital and to focus on timing of final BD declaration according to the ancillary tests executed. ⋯ In Italy, the same guidelines ensure the same approach in every hospital, with multi-specialist cooperation. The EEG is mandatory and prompt recognition of the first, flat EEG is fundamental to reduce time to the final procedure. A multimodal neurophysiological approach with trained specialists, neurosonologists and monitoring devices in intensive care units may represents a valid help to further reduce time for BD diagnosis.