Minerva anestesiologica
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Minerva anestesiologica · Jul 2014
Randomized Controlled Trial Comparative StudyThe effects of subfascial wound versus epidural levobupivacaine infusion on postoperative pain following hysterectomy.
Local analgesia through wound catheters is used as a part of multimodal analgesia. The efficacy of continuous subfascial wound infusion compared to epidural analgesia is unknown for abdominal hysterectomy and bilateral salpingo-oophorectomy (TAH-BSO) via Pfannenstiel incision. The aim of this study was to compare the aforementioned two methods in this type of surgery for postoperative morphine consumption, acute and persistent postsurgical pain. ⋯ Wound analgesia via subfascial catheter with continuous levobupivacaine infusion decreases postoperative morphine consumption and increases patient satisfaction compared to epidural analgesia with no difference in persistent postsurgical pain following TAH-BSO via Pfannenstiel incision.
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Minerva anestesiologica · Jul 2014
ReviewRecent Advances and Contributions to Procedural Sedation with Considerations for the Future.
As the demand for sedation services have increased, the delivery of sedation has shifted from the operating room setting to areas distant to the operating room, both within and outside the hospital setting. Sedation delivery is not monopolized by any one specialty, but rather is being delivered by anesthesiologists as well as non-anesthesiologists. As the field of sedation burgeons and multi-specialists enter the realm of meeting the demands, so also have the politics increased. ⋯ Rather, new formulations of approved agents are being reexamined. The safe, efficient and predictable delivery of sedation remains at the forefront of discussion and review worldwide. This review will explore the recent, significant and noteworthy contributions to the field of sedation.
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Minerva anestesiologica · Jul 2014
Observational StudyAssociation between intra-abdominal pressure and jugular bulb saturation in critically ill patients.
Disorders in cerebral circulation following elevated intra-abdominal pressure (IAP) may lead to silent brain ischemia, which can be serious problem in sedated critically ill patients. The aim of the present study was to analyse the possible association between jugular venous bulb pressure (JVBP) and jugular venous bulb saturation (SjO2) to IAP in critically ill patients. ⋯ IAP is correlated to JVBP and inversely correlated to SjO2. Increase in IAP leads to elevation in JVBP and decrease in SjO2. Renal replacement therapy disturbs the correlation between IAP, JVBP and SjO2.