Minerva anestesiologica
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Minerva anestesiologica · Feb 2020
ReviewImmunomodulatory effects of anesthetic agents in perioperative medicine.
Anesthetics comprise a heterogeneous group of drugs with multiple functions and mechanisms of action, which are not yet fully elucidated. In the clinical setting, it is difficult to isolate the effects of anesthetic agents from those of surgical stress itself or of other individual covariates. For this reason, several methods involving human immune cells and animal models have been used to study the effects of anesthetic agents on the immune system. ⋯ The immunomodulatory consequences of general anesthesia are complex. Immunosuppression can lead to beneficial effects, reducing systemic and local inflammation, or negative effects, which result in increased risk of infection. Anesthesiologists should choose the most appropriate agents based on the immune status of each patient.
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Minerva anestesiologica · Feb 2020
Randomized Controlled TrialGastric emptying of "clear liquid drinks" assessed with gastric ultrasonography: a blinded, randomized pilot study.
Protein-containing liquids may delay gastric emptying and increase risk of aspiration. Commercial whey protein nutritional drinks (WPNDs) are advertised as "clear liquid nutritional drinks" and can be mistaken for protein-free, carbohydrate-based clear liquids. We used gastric ultrasonography to compare gastric emptying of a protein-free, carbohydrate-based clear liquid with that of a WPND in healthy volunteers. ⋯ Although consumption of a WPND was associated with a larger estimated GV in this pilot study, a larger study is necessary to conclude whether patients must fast longer than two hours after consumption of a WPND.
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Minerva anestesiologica · Feb 2020
Regional air trapping in acute exacerbation of obstructive lung diseases measured with electrical impedance tomography: a feasibility study.
Since bronchial abnormalities often exhibit spatial non-uniformity which may be not correctly assessed by conventional global lung function measures, regional information may help to characterize the disease progress. We hypothesized that regional air trapping during mechanical ventilation could be characterized by regional end-expiratory flow (EEF) derived from electrical impedance tomography (EIT). ⋯ Regional EEF characterizes air trapping and intrinsic PEEP, which could provide diagnostic information for monitoring the disease progress during treatment.
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Minerva anestesiologica · Feb 2020
Meta AnalysisContinuous nerve block versus single-shot nerve block for total knee arthroplasty: a meta-analysis from randomised controlled trials.
This meta-analysis aims to determine whether continuous nerve block (CNB) provides better pain relief and functional recovery than single-shot nerve block (SSNB) after total knee arthroplasty (TKA). ⋯ CNB and SSNB have similar effects on pain relief, complications and functional recovery in patients receiving TKA. The optimal analgesic regimen for patients after TKA needs further identification.