Minerva anestesiologica
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Minerva anestesiologica · Nov 2018
ReviewEffects of inhalation and intravenous anesthesia on intraoperative cardiopulmonary function and postoperative complications in patients undergoing thoracic surgery.
There is a high incidence of postoperative cardiopulmonary complications after thoracic surgery with one lung ventilation (OLV), the effect of general anesthetics on intraoperative cardiopulmonary function and postoperative complications is still unclear. ⋯ Inhalation anesthesia can preserve intraoperative cardiac function and reduce postoperative pulmonary complications in patients undergoing thoracic surgery with OLV; although it decreases intraoperative pulmonary function, inhalation anesthesia may be superior to intravenous anesthesia in thoracic surgery. Publication bias existed in some included studies, and the sample size was not large enough in CI and cardiac adverse events.
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Minerva anestesiologica · Nov 2018
Randomized Controlled Trial Comparative StudyThe role of intraoperative stroke volume variation on bleeding during functional endoscopic sinus surgery.
Functional endoscopic sinus surgery (FESS) is a minimally-invasive surgical technique for patients with paranasal sinus pathology. Surgical bleeding reduces operative field visibility and increases the incidence of serious complications. Epinephrine injection into the nasal mucosa and controlled hypotension are used to minimize bleeding. Hypotension carries risks and sometimes does not reduce surgical bleeding. The goal of this study is to discover which hemodynamic parameter better correlates with surgical bleeding. ⋯ Targeting SVV larger than 12% achieves a possible reduction of the intraoperative bleeding in patients undergoing FESS.
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Minerva anestesiologica · Nov 2018
EditorialRemote ischemic preconditioning: the hunt is still open.
Abstract
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Minerva anestesiologica · Nov 2018
Comparative StudyVolatile anesthetics versus propofol in the cardiac surgical setting of remote ischemic preconditioning: a secondary analysis of a Cochrane Systematic Review.
So far, the concept of remote ischemic preconditioning (RIPC) failed its translation from experimental to clinical studies. In addition to our Cochrane Systematic Review, we systematically assessed the use of the intravenous anesthetic propofol, as a potential confounding factor. ⋯ Present data do not permit a final assessment regarding the role of volatile or intravenous anesthetics as a possible confounding factor in RIPC trials.
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Minerva anestesiologica · Nov 2018
ReviewPreoperative anxiety and implications on postoperative recovery: what can we do to change our history.
Preoperative anxiety can influence the intensity of postoperative pain and anesthesia and analgesia requirement. In certain types of surgery, anxiety may even increase postoperative morbidity and mortality. The goal of this narrative review is to remind anesthesiologists that anxiety measurement using specific tools can be done in clinical practice, to present the implications of preoperative anxiety on postoperative patient recovery, and to acknowledge the importance of a dedicated anesthesia plan in the management of anxious adult patients. ⋯ Patients with preoperative anxiety could benefit from multimodal analgesia, including non-pharmacological methods, such as cognitive therapy and music therapy and relaxation. The authors' opinion is that greater education about preoperative anxiety consequences in the surgical community is needed. A systemized approach and guidelines about the management of preoperative anxiety should be followed.