Minerva anestesiologica
-
Minerva anestesiologica · Jul 2018
Randomized Controlled Trial Comparative StudyIntra- versus postoperative initiation of pain control via a thoracic epidural catheter for lumbar spinal fusion surgery: a randomised trial.
Thoracic epidural anesthesia (TEA) is one of the pillars of perioperative pain care. Particularly for spine surgery which causes significant postoperative pain TEA seems like an appealing option. However, beneficial effects of a TEA are questionable when the catheter is not used intraoperatively, a decision that is usually based on the surgeon's wish to perform immediate neurological examination postoperatively. ⋯ Epidural catheters used intraoperatively during TLIF are feasible, significantly reduce pain, intra- and postoperative use of opioids and do not influence the quality of neurological tests directly after the surgical procedure.
-
Minerva anestesiologica · Jul 2018
Observational StudyGastric ultrasound to guide anesthetic management in elective surgical patients non-compliant with fasting instructions. A retrospective cohort study.
Perioperative aspiration leads to significant morbidity and mortality. Standard fasting periods are used to ensure an empty stomach in patients. Anesthesiologists are frequently confronted with cases of dubious adherence to these guidelines. Point-of-care gastric ultrasound is a diagnostic tool that offers information on the type and volume of gastric contents. ⋯ This retrospective study suggests that gastric ultrasound may be a useful diagnostic addition to standard patient assessment in cases of non-compliance to fasting guidelines. It allows to personalize aspiration risk assessment and to tailor anesthetic management to the individual patient.