Minerva anestesiologica
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Fluid management during thoracic anesthesia remains as a challenge for the anesthesiologists. The "safe zone" between volume overload (risk of pulmonary edema) and hypovolemia (potential risk of renal failure) is hard to determine and narrow. Relationship between perioperative fluid administration and postoperative lung injury has been clearly demonstrated but lung injury can even occur after the most restrictive management. ⋯ Fluid type (crystalloids or colloids) is also another unclear point, although balanced solutions should be preferred for crystalloids. Minimal discontinuation of oral hydration, early feeding and mobilization should be encouraged. This review summarizes current evidence on the topic and highlights unanswered questions.
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Minerva anestesiologica · Jun 2017
Randomized Controlled TrialAdding dexmedetomidine to ropivacaine for femoral nerve block inhibit local inflammatory response.
Peripheral nerve block has an anti-inflammatory effect that is confirmed in animal studies, while inconclusive in human studies. Dexmedetomidine (DEX), a highly selective α2-adenoceptor agonist, has a potent anti-inflammatory effect. The aim of this study was to evaluate the effect of DEX added to ropivacaine for femoral nerve block (FNB) on local inflammatory response after total knee arthroplasty (TKA). ⋯ Adding 1 µg/kg dexmedetomidine to ropivacaine for femoral nerve block had a significantly inhibitory effect on local inflammatory response and showed superior postoperative pain control to ropivacaine alone after TKA.
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Minerva anestesiologica · Jun 2017
Observational StudyMonitoring depth of sedation: evaluating the agreement between the Bispectral Index, qCON and the Entropy Module's State Entropy during flexible bronchoscopy.
We investigated the correlation and agreement of three depth of anesthesia indices, Bispectral Index (BIS), qCON and state entropy (SE) during propofol sedation, because there is extensive literature that deals with the comparability of these indices during general anesthesia, but not during sedation. ⋯ The results indicate a high probability of similar index performance between SE, BIS and qCON with the caveat of a different index scaling for qCON. These results can help the user of these monitoring devices to translate findings from one index to the other.