Minerva anestesiologica
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Minerva anestesiologica · May 2016
Review Meta AnalysisRestrictive versus liberal transfusion strategy for red blood cell transfusion in critically ill patients and in patients with acute coronary syndrome: a systematic review, meta-analysis and trial sequential analysis.
The risks and benefits of transfusing critically ill patients continue to evoke controversy. Specifically, the critically ill patients with active ischemic cardiac disease continue to represent a "gray area" in the literature. ⋯ Restrictive strategy is at least as effective to liberal strategy in critically ill patients. Nevertheless, there is insufficient evidence to recommend a restrictive strategy for patients with acute coronary syndrome.
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Automated anesthesia which may offer to the physician time to control hemodynamic and to supervise neurological outcome and which may offer to the patient safety and quality was until recently consider as a holy grail. But this field of research is now increasing in every component of general anesthesia (hypnosis, nociception, neuromuscular blockade) and literature describes some successful algorithms - single or multi closed-loop controller. ⋯ Literature contains many randomized trials comparing manual and automated anesthesia and shows feasibility and safety of this system. Automation could quickly concern other aspects of anesthesia as fluid management and this review proposes an overview of closed-loop systems in anesthesia.
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Minerva anestesiologica · May 2016
Randomized Controlled TrialPreoperative informational video based on model making reduces preoperative anxiety and postoperative negative behavioral changes in children.
Anesthesia and surgery can lead to major distress for children. Sedative premedication and preoperative preparation techniques are available to reduce preoperative anxiety in children. We aimed to assess the effect of informational video based on role-play modelling on preoperative anxiety and postoperative behavior changes in children undergoing surgery. ⋯ The presentation of an informational video based on model making reduces preoperative anxiety at the time of placement of the facemask and postoperative negative behavioral changes in children.
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Minerva anestesiologica · May 2016
Randomized Controlled TrialNeuraxial anaesthesia for pain control after caesarean section - a prospective randomised trial comparing three different neuraxial techniques in clinical practice.
Cesarean section (CS) is associated with a moderate-high intensity of postoperative pain. We investigate whether continuous local anesthetic/opioid administration using patient controlled epidural anesthesia (PCEA) is superior in controlling pain after CS than epidural (ED) or intrathecal (IT) opioid bolus administration. ⋯ PCEA is less effective then IT and ED opioid bolus administration for post cesarean pain relief. IT provides better analgesia than ED or PCEA, as pointed out by lower ibuprofen consumption.
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Minerva anestesiologica · May 2016
Ultrasound evaluation of the stomach and gastric emptying in pregnant women at term: a case-control study.
This study aims to assess the rate of gastric emptying in pregnant women in the third trimester scheduled for elective caesarean section (CS), in view to highlight the aspiration risk. ⋯ In pregnant women at term, the stomach does not seem to be able to expand immediately after the meal. The transit of food is completed later than in not pregnant women. The ultrasound of the stomach allows identifying delays gastric emptying and highlighting patients at risk of aspiration.