Minerva anestesiologica
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The infusion of hydroxyethylstarch (HES) containing fluids has been extremely common worldwide over the last decade. Until recently, HES was probably the most commonly prescribed colloidal preparation in the world. Such prescription continued despite concerns that starch molecules might accumulate in vital organs and that starch preparations might decrease the coagulability of blood. ⋯ Subsequent meta-analyses have confirmed these findings. In response to such strong evidence, over the last few weeks, the Food and Drug Administration has issued a major warning and, in Europe, the EMA suspended the marketing authorization for HES. At least in Europe, the clinical story of HES seems to have come to an end.
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Minerva anestesiologica · Sep 2013
Editorial CommentDiagnosis of microaspiration - can we do easier?
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Minerva anestesiologica · Sep 2013
ReviewNon-opioid analgesics for pain management following ambulatory surgery, a review.
Multimodal pain management, combining analgesics with different mode of action in order to minimize occurrence of side-effects still providing safe and efficacious pain management after ambulatory surgery has become standard of care. The combined use of local anaesthesia in order to reduce noxious influx during the procedure and reduce postoperative pain is strongly recommended whenever feasible. ⋯ Single iv. preoperative dose dexamethasone has been shown not only to be effective in reducing postoperative nausea and vomiting but also to improve recovery reduce pain and improve satisfaction. Pregabalin may be used in order to further enhance the recovery and pain management.