Minerva anestesiologica
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Bleeding is a major adverse effect of veno-venous extracorporeal membrane oxygenation (vvECMO) therapy in surgical patients. This study retrospectively describes the amount of transfused packed red blood cells (PRBC) and coagulation parameters of patients requiring surgery during vvECMO therapy. ⋯ In patients requiring surgery during vvECMO therapy with perioperative transfusion of two or more PRBCs preoperative fibrinogen levels were significantly reduced compared to patients with transfusion of less than two PRBCs. No other analyzed lab value showed any predictive qualities in terms of bleeding.
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Minerva anestesiologica · Jan 2020
Randomized Controlled Trial Comparative StudyPerifascial plane versus perineural approaches for ultrasound-guided axillary block: go to the simplest?
Ultrasound-guided axillary block is widely used in daily practice for upper limb orthopedic surgery. A simple, safe, efficacious and time-saving technique is mandatory to optimize surgical turnover and costs. In this perspective, we compared, in a randomized, single-blinded study, a standardized perifascial technique and the selective perineural technique. ⋯ We reported that the ultrasound-guided axillary perifascial block is easier to perform and saves procedural time compared to the classic perineural technique. Considering the same anesthetic success rate in both groups, the perifascial plane technique should be considered a daily practice technique and the first level of learning procedure for axillary block.
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Minerva anestesiologica · Jan 2020
Randomized Controlled TrialRole of preoperative pregabalin in reducing inhalational anesthetic requirements in abdominal hysterectomy: randomized controlled trial.
Preoperative oral pregabalin controls postoperative pain and decreases anesthetic requirements in total intravenous anesthesia. In this study, we hypothesized that preoperative pregabalin reduces inhaled isoflurane requirements. ⋯ Preoperative pregabalin 150 mg, 1 h before total abdominal hysterectomy has an inhaled anesthetic-sparing effect, maintain hemodynamics and optimizes postoperative analgesia.
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Minerva anestesiologica · Jan 2020
ReviewHyperoxia and oxidative stress in anesthesia and critical care medicine.
Oxygen administration is particularly relevant in patients undergoing surgery under general anesthesia and in those who suffer from acute or critical illness. Nevertheless, excess O2, or hyperoxia, is also known to be harmful. Toxicity arises from the enhanced formation of reactive oxygen species (ROS) that, exceeding the antioxidant defense, may generate oxidative stress. ⋯ To this purpose, we searched the PubMed database according to the following combination of key words: ("hyperoxia" OR "FiO2" OR "oxygen therapy") AND ("oxidative stress" OR "ROS" OR "RNS" OR "lipid peroxidation") AND ("anesthesia" OR "surgery" OR "intensive care"). We focused in the results from the past 20 years. Available evidence points toward a conservative monitoring and use of oxygen, unless there is solid proof of its efficacy.