Minerva anestesiologica
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Minerva anestesiologica · Feb 2017
Randomized Controlled Trial Multicenter Study Pragmatic Clinical TrialNeurological assessment with validated tools in general ICU: multicenter, randomized, before and after, pragmatic study to evaluate the effectiveness of an e-learning platform for continuous medical education.
International guidelines recommend systematic assessment of pain, agitation/sedation and delirium with validated scales for all ICU patients. However, these evaluations are often not done. We have created an e-learning training platform for the continuous medical education, and assessed its efficacy in increasing the use of validated tools by all medical and nursing staff of the participating ICUs during their daily practice. ⋯ This e-learning program shows encouraging effectiveness, and the increase in the use of validated tools for neurological monitoring in critically ill patients lasts over time.
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Minerva anestesiologica · Feb 2017
Comparative Study Observational StudyLMA Supreme and Ambu AuraGain in anesthetized adult patients: a prospective observational study.
Second-generation laryngeal masks with gastric access are increasingly used in daily practice and expand the indications for laryngeal masks in the OR. Only limited data exist comparing different types of laryngeal masks. We investigated the second-generation laryngeal masks LMA Supreme™ and Ambu® AuraGain™ in a clinical setting. We hypothesized that the two devices would be comparable in terms of success rate and airway complications. ⋯ Supreme was superior to Gain in terms of insertion time and airway morbidity. Novices were more successful at first attempt using Supreme. These differences between supraglottic airway devices might be due to the different shapes and materials of the masks.
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Minerva anestesiologica · Feb 2017
Controlled Clinical TrialMinimum local anaesthetic volumes for a selective saphenous nerve block: a dose-finding study.
Saphenous nerve block contributes to analgesia after knee and lower leg surgery. However, literature reports a wide range of volumes of local anesthetic being used for this block. ⋯ For a selective ultrasound-guided saphenous nerve block, the ED95 MLAV of mepivacaine 2% is 1.9 mL.
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Minerva anestesiologica · Feb 2017
Meta AnalysisAnalgesia-Nociception monitoring for opioid guidance: meta-analysis of randomized clinical trials.
The adequate suppression of nociception is, besides induction of unconsciousness and immobility, the main objective during anesthesia. Analgesics, most commonly opioids, are usually titrated by established clinical surrogates of nociception. Recently, monitoring techniques became available to evaluate analgesia/nociception during anesthesia and provide better measures then clinical evaluation alone. They are primarily derived from autonomic response on physiologic standard measures. ⋯ Monitoring analgesia/nociception is often reliant on regular physiologic conditions, like sinus rhythm. Opioid guidance dependent on analgesia/nociception monitoring during anesthesia may have beneficial and clinically relevant effects, however the number of currently available randomized controlled studies is low and conclusions are hampered by heterogeneity. More studies with focussed clinical endpoints are therefore needed.