Minerva anestesiologica
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Minerva anestesiologica · Mar 2019
LetterDelirium in the post-anesthesia care unit may be associated with the development of postoperative delirium in a cohort of elderly patients.
Abstract
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Minerva anestesiologica · Mar 2019
Editorial CommentErector spinae plane block: the only block you need to know or the poor man's paravertebral?
Abstract
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Minerva anestesiologica · Mar 2019
Randomized Controlled TrialMulti-parametric functional hemodynamic optimization improves postsurgical outcome after intermediate risk open gastrointestinal surgery: a randomized controlled trial.
Perioperative goal directed therapy (pGDT) using flow monitoring has been associated with improved outcomes. However, its protocols are often based on stroke volume only: as a target for fluid loading, inotropic support and vasopressors (via mathematical coupling of systemic vascular resistance). In this trial, we have tested the multi-parametric pGDT protocol based on esophageal Doppler variables (corrected flow time, peak velocity) in intermediate-to-high risk patients undergoing gastrointestinal surgery. ⋯ In this monocentric trial the multi-parametric pGDT protocol based on domain specific functional hemodynamic parameters was associated with lower rate of postoperative complications in intermediate-to-high risk patients undergoing scheduled gastrointestinal procedures.
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Minerva anestesiologica · Mar 2019
Randomized Controlled Trial Comparative StudyStimulating versus non-stimulating catheter for lumbar plexus continuous infusion after total hip replacement.
This study was aimed to investigate whether stimulating catheters for continuous lumbar plexus block reduce local anesthetic consumption after hip arthroplasty if compared with traditional non-stimulating catheters. ⋯ The study showed comparable local anesthetic consumption, pain scores and muscle strength preservation between the two groups. The stimulating catheter allowed a significant, although underpowered, reduction in opioid consumption.
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Minerva anestesiologica · Mar 2019
Observational StudyEvaluation of an active decision support system for hemodynamic optimization during elective major vascular surgery.
Active decision support systems implementing goal directed therapy may be an approach to reduce disparities in outcome between different health care providers. We assessed feasibility of and adherence to an active decision support system (ADSS) comprising fluids, vasopressors, and dobutamine to optimize hemodynamics during high-risk vascular surgery. ⋯ High rates of compliance underline clinical acceptability and feasibility of this ADSS during vascular surgery. It may therefore facilitate the work of anesthesiologists and reduce disparities in patient outcomes due to different healthcare providers. Particularly, rapidly developing hemodynamic perturbances as well as co-factors the ADSS as of now does not anticipate are current limitations. These findings may serve to further improve this stand-alone real-time ADSS.