Minerva anestesiologica
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Minerva anestesiologica · Jun 2019
The effect of scoliosis on surface landmarks for lumbar plexus block: a magnetic resonance imaging-based retrospective case-control series.
Degenerative scoliosis (DS) may affect surface landmarks for performance of lumbar plexus (LP) block. We hypothesized the extent of any difference in surface landmarks could be calculated by a formula based on measured degree of DS, body mass index, sex, and age. ⋯ There is a larger degree of lateral deviation of the LP on the concave side of scoliosis compared to medial deviation on the convex side. These deviations remained consistent irrespective of the direction of scoliosis. A review of the imaging studies and preprocedural ultrasound assessment of anatomy should be strongly considered prior to needle puncture. In patients with severe DS, an alternative approach may be considered to avoid the possibility of visceral organ injury.
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Minerva anestesiologica · Jun 2019
Editorial CommentMonitoring cerebrovascular autoregulation: a potential new tool to prevent neurocognitive complications after cardiac surgery.
Abstract
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Minerva anestesiologica · Jun 2019
Observational StudyCerebrovascular autoregulation impairments during cardiac surgery with cardiopulmonary bypass are related to postoperative cognitive deterioration: prospective observational study.
Postoperative cognitive dysfunction (POCD) occurs in approximately 33-83% of patients after cardiac surgery with cardiopulmonary bypass (CPB). Recent clinical data suggest that real-time, intraoperative monitoring of patient-specific cerebrovascular autoregulation (CA) may help to prevent POCD by detecting individual critical limits for mean arterial pressure (MAP) outside which CA is impaired. Objectives of the study were to detect the episodes of impaired CA during cardiac surgery with CPB, and to investigate the association between CA impairment and POCD. ⋯ Prospective clinical study showed that single longest CA impairment may result in post-operative deterioration of mental abilities. The duration of the single longest CA impairment event is the risk factor that is associated with POCD.
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Minerva anestesiologica · Jun 2019
Editorial CommentLow dose spinal anaesthesia plus Epidural Volume Extension for ambulatory obstetric surgery: is it a suitable option?
Abstract