Minerva anestesiologica
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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.
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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
ReviewThe link between anesthesiology and neurology: a mindful cooperation to improve brain protection.
Preventing neurological injury is mandatory during the perioperative period of any kind of surgery and in the care of critically ill patients in the intensive care unit. During daily practice, both anesthesiologists and neurologists focus on brain protection as an integral part of systemic homeostasis maintenance. This article highlights the intriguing overlap between anesthesiology and neurology in clinical practice along with its potential implications for outcome. ⋯ Clinical vigilance and the use of shared monitoring and diagnostic technology could allow early recognition and treatment of cerebral dysfunction occurring in the perioperative period or in the critical care setting, thus reducing morbidity and mortality. In order to improve patient safety and outcome, neurologists and anesthesiologists should more closely and successfully collaborate, using shared monitoring tools and integrating traditional areas of expertise. Daily activity, education, research and training programs in anesthesia and neurology could benefit from a stronger relationship with each other.