Minerva anestesiologica
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Minerva anestesiologica · Dec 2015
ReviewMaxillofacial trauma in the emergency department: pearls and pitfalls in airway management.
Maxillofacial trauma poses a challenge for the anesthesiologist because injuries can often compromise the patient's airways. Airway maintenance is the first step in the American College of Surgeons Advance Trauma Life Support (ATLS®) protocol. However, clinical dilemmas may arise about the best way to manage a potentially life-threatening injury. ⋯ It is also necessary to recognize and be able to manage specific problems in this scenario where clinical priorities may be conflicting, may suddenly change or may be hidden. This clinical review discusses the complexity of this scenario, providing an overview of the conditions at greatest risk for airway obstruction and the options for airway management, on the basis of the recent literature. Clinicians must recognize the milestones and pitfalls of this topic in order to adopt a systematic approach for airway management, to identify specific characteristics associated with it, and to establish the utility of different instruments for airway management.
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Minerva anestesiologica · Dec 2015
ReviewVasopressin in cirrhosis and sepsis: Physiology and clinical implications.
Arginine-vasopressin (AVP) is an important hormone in the regulation of plasma osmolality and blood volume/pressure. In clinical practice it is frequently used in the treatment of septic shock and decompensated cirrhosis. In this review the physiology of AVP and its analogues is presented. In addition the use of AVP in cirrhosis and sepsis is reviewed.
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Minerva anestesiologica · Dec 2015
Randomized Controlled Trial Multicenter Study Comparative StudyThe effects of plasmalyte-148 versus hartmann's solution during major liver resection: a multicentre, double-blind, randomized controlled trial.
The acid-base, biochemical and hematological effects of crystalloid solutions have not been comprehensively evaluated in patients with liver resection. ⋯ In liver resection patients, HS and PL led to similar base excess values but different post operative plasma biochemistry and hematology values. Understanding of these effects may help clinicians individualize fluid therapy in these patients.
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Minerva anestesiologica · Dec 2015
Review Meta Analysis Comparative StudySciatic-femoral nerve block versus unilateral spinal anesthesia for outpatient knee arthroscopy: A meta-analysis.
Because of the short hospital stay involved in outpatient knee arthroscopy, anesthesiologists should provide an effective and safe anesthesia scheme. Unilateral spinal anesthesia is a conventional choice for outpatient knee arthroscopy, and combined sciatic-femoral nerve block also permits successful results. This study aimed to compare sciatic-femoral nerve block with unilateral spinal anesthesia for outpatient knee arthroscopy. ⋯ SFB provided faster bladder function recovery and faster discharging from hospital, hence it could be a good alternative to USA for outpatient knee arthroscopy.