Minerva anestesiologica
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Minerva anestesiologica · Jul 2019
Postoperative pain (POP) after vitreo-retinal surgery is influenced by duration of surgery and anaesthesia conduction; opioids are not necessary for its management.
The control of postoperative pain (POP) is a key component of perioperative care. POP after vitreo-retinal surgery (VRS) has been under-investigated, and its incidence remains elusive. ⋯ The incidence of POP after VRS is low but not absent, especially for long procedures, it does not require postoperative opioids and can be modified by anesthesiologic choices.
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Minerva anestesiologica · Jul 2019
ReviewDeath by neurologic criteria: pathophysiology, definition, diagnostic criteria and tests.
Death by neurologic criteria is an irreversible sequence of events culminating in permanent cessation of cerebral functions. In this context, there are no responses arising from the brain, no cranial nerve reflexes nor motor responses to pain stimuli, and no respiratory drive. ⋯ The diagnosis, confirmation, and certification of death are core skills for medical practitioners. The aim of this review is to discuss the pathophysiology and definition of death by neurological criteria, describing the clinical assessment, and the use of ancillary tests for the diagnosis of brainstem death.
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Minerva anestesiologica · Jul 2019
Comparative Study Observational StudyLMA protector versus traditional LMA for performing endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA), a retrospective analysis.
The aim of this study was to evaluate the use of laryngeal mask airway (LMA)® Protector™ by comparison with traditional LMA for performing endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). ⋯ EBUS-TBNA conducted with LMA Protector is a useful strategy that reduced the procedural time and in theory ensured the comfort of patients. Our results should be confirmed by larger, prospective, randomized studies.
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Minerva anestesiologica · Jul 2019
Discrimination and calibration properties of the hypotension probability indicator during cardiac and vascular surgery.
Hypotension during surgery is linked to postoperative complications. Recently, a new hemodynamic algorithm intended to predict hypotensive events (hypotension probability indicator [HPI]) has been developed. The aim of the present study is to test the discrimination and calibration properties of the HPI. ⋯ The HPI5-7 may offer some useful insights. Values ≤85% carry a clinically acceptable NPV for hypotensive events at the observed prevalence and may represent a "safe zone" during surgery. Values >85% do not carry enough PPV to trigger hemodynamic interventions, but represent a warning signal. Values >98% are highly suggesting a hypotensive event after 5-7 minutes. Further studies exploring the predictive ability of the HPI at different times are needed.
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Minerva anestesiologica · Jul 2019
Clinical TrialPerfusion index and ultrasonography in the evaluation of infraclavicular block.
It has been reported that noninvasive, objective tests are needed for determining the success of peripheral nerve blocks because conventional methods necessitate the cooperation of the patient. It is also known that the brachial plexus block causes vasodilatation and an increase in blood flow due to its sympathectomy effect. Our study aimed to determine whether Perfusion Index (PI) and measured regional hemodynamic changes using ultrasound were reliable parameters in evaluating the early success of an infraclavicular block. ⋯ Changes in EDV, especially RI and PI, provide more effective and objective results for the assessment of early regional block success.