Minerva anestesiologica
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Minerva anestesiologica · Jan 2017
ReviewAcute kidney injury in liver transplant candidates: a position paper on behalf of the LIVER INTENSIVE CARE GROUP of EUROPE.
Acute kidney injury is associated with high mortality in the perioperative period of liver transplantation. The aim of this position paper was to provide an up-to-date overview with special emphases on diagnosis, risk factors, and treatment. ⋯ Perioperative liver transplant risk factors for acute kidney injury are difficult to control. Therefore, the focus should be on intra-operative hemodynamics and nephrotoxic drugs avoidance. Prospective randomized trials are needed to show the beneficial effect of early replacement therapy. In this context, the new biomarkers would be helpful in identifying kidney injury earlier.
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Minerva anestesiologica · Jan 2017
Characteristics and outcomes of chronic pain patients referred to hospital pain clinics: a prospective observational study.
Understanding the patient referral patterns and medical profiles of patients attending hospital pain clinics, and the therapies offered to them, can provide a useful starting point for evaluating their effectiveness and identifying areas for improvement. ⋯ Pain clinicians refined the diagnoses and treatments of patients referred to hospital pain clinics and improved outcomes. Relatively few patients are referred from primary care considering the prevalence of chronic pain in this setting.
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Minerva anestesiologica · Jan 2017
Goal-directed fluid management in free flap surgery for cancer of the head and neck.
Goal-directed fluid management using stroke volume variation (SVV) analysis is not well studied in free flap reconstruction surgery in patients with head and neck cancer. ⋯ The SVV-guided fluid management reduces fluid administration in free flap reconstruction surgery with head and neck cancer.
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Minerva anestesiologica · Jan 2017
Randomized Controlled Trial Comparative StudyPostoperative analgesia for elective total knee arthroplasty under subarachnoid anesthesia with opioids: comparison between epidural, femoral block and adductor canal block techniques (with and without perineural adjuvants). A prospective, randomized, clinical trial.
Optimal control of acute postoperative pain and prevention of chronic persistent pain in total knee arthroplasty (TKA) remain a challenge. The main hypothesis was that nerve blocks improve postoperative analgesia especially if perineural adjuvants are added. ⋯ Peripheral nerve blocks with perineural dexamethasone improve postoperative analgesia for TKA. The addition of dexamethasone to adductor canal block open new possibilities to improve analgesia for TKA, and should be investigated as an alternative to femoral nerve block.
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Minerva anestesiologica · Jan 2017
Meta AnalysisEfficacy of the prophylactic administration of tramadol against postoperative shivering: a meta-analysis of randomized controlled trials.
Postoperative shivering (POS) is a common complication that occurs after regional and general anesthesia. Thus far, numerous studies have reported on the effectiveness of tramadol in preventing or treating POS. Here, we performed a meta-analysis to assess the efficacy of tramadol in the prevention of POS. ⋯ This meta-analysis revealed that prophylactic tramadol effectively prevents POS and reduces rescue medication use without significant adverse effects.