Minerva anestesiologica
-
The demand for total knee arthroplasty (TKA) is rising worldwide. Controversy persists in the literature regarding the benefits of general versus neuraxial anesthesia and which anesthetic is associated with the best outcomes. Likewise, the abundance of analgesic options for post-TKA pain have led to debate regarding the safest, most effective regimens. ⋯ Evidence to guide the creation of pathways of care for TKA abounds, but must be tailored to local practice to maximize chances of success. Recent data supports the use of neuraxial anesthesia and regional analgesia techniques for TKA. Recommendations for clinical practice and future research to improve the state of the art are provided.
-
Minerva anestesiologica · Dec 2018
Randomized Controlled Trial Comparative StudyComparison of the effects of low doses of dexmedetomidine and remifentanil on the maternal hemodynamic changes during caesarean delivery in patients with severe preeclampsia: a randomized trial.
Preoperative remifentanil administration blunts hemodynamic responses to tracheal intubation in parturients with severe preeclampsia. We hypothesized that the preoperative administration of low doses of remifentanil or dexmedetomidine would lead to comparable maternal neurohormonal responses and neonatal outcomes in patients with severe preeclampsia. ⋯ Compared with dexmedetomidine (0.4 µg/kg/h), the preoperative administration of remifentanil (0.1 µg/kg/min) produced a significantly higher effect on maternal hemodynamic responses to caesarean delivery in patients with severe preeclampsia, however maternal hypotension and neonatal respiratory depression were more common with the use of remifentanil.
-
Minerva anestesiologica · Dec 2018
Shivering prevention and treatment during cesarean delivery under neuraxial anesthesia: a systematic review.
Perioperative shivering during cesarean sections (CSs) under neuraxial anesthesia (NA) is clinically common but often under-treated. It may prominently increase oxygen consumption, which can be catastrophic for parturients with ischemic cardiovascular disease. Thus, the prevention and treatment of shivering may be of great significance in parturients. The purpose of this systematic review was to investigate the effectiveness of several drugs on shivering prevention and treatment during CSs under NA. ⋯ Appropriate use of dexmedetomidine, fentanyl, sufentanil, ketamine, meperidine, tramadol and MgSO4 may effectively reduce the incidence and severity of shivering during CSs under NA, while trials on the effect of intravenous ondansetron reached inconclusive results.
-
Minerva anestesiologica · Dec 2018
Anesthesiology residents induction month: a pilot study showing an effective and safe way to train novice residents through simulation.
The transition of new residents from medical school to the post-graduate clinical environment remains challenging. We hypothesized that an introductory simulation course could improve new residents' performance in anesthesiology. ⋯ Data suggest that an intensive simulation-based program can be an effective way for first-year residents to rapidly acquire and develop basic skills specific to anesthesiology. There might be benefits to begin residency with a training program aiming at developing and standardizing technical and non-technical skills.
-
Minerva anestesiologica · Dec 2018
Letter Case ReportsThe combination of Erector Spinae Plane block and PECS blocks could avoid general anesthesia for radical mastectomy in high risk patients.
Abstract