Minerva anestesiologica
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Minerva anestesiologica · May 2018
Randomized Controlled TrialGabapentin given before laparoscopic sleeve gastrectomy reduces postoperative oxycodone consumption in obese patients. A randomized double-blind placebo-controlled trial.
Postoperative pain can be prevented. Gabapentin may be effective in this role. Our primary objective was to test the hypothesis that a prophylactic administration of gabapentin in obese patients before surgery has an opioid-sparing effect and reduces postoperative oxycodone consumption more efficiently than placebo. ⋯ The demand for oxycodone was delayed in the gabapentin group; also, the total 12-hour dose requirement of oxycodone was lower in the gabapentin group.
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Minerva anestesiologica · May 2018
ReviewVentilator-induced lung injury: does it occur in children?
Mechanical ventilation is one of the most practiced interventions in the pediatric intensive care unit (PICU). Although unmistakable life-saving, it can also injury the lung, a process coined ventilator induced lung injury (VILI). To date, almost all of our knowledge VILI has been obtained from studies in adults or experimental studies mimicking the adult critical care situation. ⋯ However, the question whether or not there is an age-related susceptibility to VILI remains puzzling and unanswered. It is remarkable that one of the most practiced interventions such as pediatric MV is hardly supported by any scientific evidence but rather based on personal experience and data from adults. This signifies the need for clinical and experimental studies in order to better understand the use and effects of MV in pediatric patients with or without lung injury.
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Minerva anestesiologica · May 2018
Intracerebral hemorrhage in intensive care unit: early prognostication fallacies. A single center retrospective study.
Intracerebral hemorrhage (ICH) admitted to Intensive Care is deem of poor prognosis. The aim of this study was to compare observed and predicted 30-day mortality and to evaluate long term functional outcome in a consecutive ICH cohort. ⋯ Mortality and functional outcome is less severe than predicted in patients with ICH receiving a full medical and/or surgical treatment.
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Minerva anestesiologica · May 2018
ReviewCommitted to be fit. The value of preoperative care in the perioperative medicine era.
In the era of perioperative medicine, important advances have been made in the perioperative care of patients, usually within those known as enhanced recovery after surgery (ERAS) protocols. These have led to a decrease in postoperative complications and the duration of hospital stays; however, there is still a lack of preoperative care, which could make perioperative medicine more prominent. Elderly patients, malnourished, anemic and ones with a low physical function before surgery are likely to have sub-optimal recovery from surgery. ⋯ Prehabilitation consists of exercise training and nutritional and psychological support, which increases the physiological reserve before surgical stress. The integration of exercise, adequate nutrition, anemia correction and psycho-social components, with multi-modal optimization in the preoperative period leads to an improvement in the functional capacity of the patients undergoing surgery, with the consequent improvement in terms of outcomes. The present article discusses specific aspects of preoperative care which are not well defined in the ERAS protocols and which represent fundamental shifts in surgical practice, including preoperative nutrition, management of preoperative anemia and prehabilitation.
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Minerva anestesiologica · May 2018
Randomized Controlled TrialTwo different placement paths in popliteal fossa with a novel nerve block needle with external indwelling cannula for postoperative analgesia after foot and ankle surgery: a randomized controlled trial.
Previous studies have documented that single injection nearby the sciatic nerve bifurcation would influence the anesthesia and analgesia effect. But this is uncertain for preoperative continuous popliteal sciatic nerve block. This trial was conducted to compare two paths (proximal to the bifurcation and at the bifurcation) of ultrasound-guided continuous popliteal sciatic nerve block in foot and ankle surgery. ⋯ Continuous popliteal sciatic nerve block at nerve bifurcation could receive better analgesia effect and more patients' satisfaction, rather than proximal to the bifurcation.