Minerva anestesiologica
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Minerva anestesiologica · Jun 2020
Randomized Controlled TrialPsychology versus medication for pre-anesthesia preparation of children: a randomized controlled trial.
Reducing preoperative anxiety is important as inadequate preoperative management can potentially give rise to behavioral problems in the postoperative course, leading to incalculable quantitative and qualitative handicaps later in life. We compared preanesthetic administration of midazolam to a psychological strategy of walking the children through the operating room and playfully demonstrating anesthesia equipment. ⋯ All psychometric instruments used in this study indicated that our psychological strategy of preanesthesia preparation was capable of successfully reducing anxiety in paediatric patients and their parents.
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Minerva anestesiologica · Jun 2020
Electroencephalographic density spectral array monitoring during propofol sedation in teenagers, using the narcotrend electroencephalographic monitor.
Recently published articles address concerns about the safe use of currently available index-based depth of hypnosis monitors. Electroencephalographic Density Spectral Array monitoring facilitates the interpretation of unprocessed electroencephalogram data, providing the anesthesiologist with real-time drug-specific information on hypnotic depth. The primary aim of this study was to investigate the clinical applicability of Density Spectral Array with a commercially available monitor as the Narcotrend EEG monitor in teenagers under procedural sedation using propofol. ⋯ We were able to show that DSA displayed in real time, on a commercially available DoA monitor (the Narcotrend EEG monitor), can provide the anesthesiologist with understandable information regarding the dose-dependent EEG effects of propofol in teenagers.
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From the initial hypothesis considering 30 years ago the gut as the "motor" of multiple organ failure (MOF) related to an induced hyperpermeability leading to bacterial translocation into the systemic circulation, the reality becomes significantly more complex. The gut contains three interplaying components - the epithelium, the microbiome, and the immune system - that have to cooperate to maintain two opposite function: adsorption of nutrients and maintenance of a barrier to prevent the crossing of intraluminal microbes or their products to avoid host response. ⋯ This review tries to give a comprehensive description of these mechanisms, focused on induced sepsis. Some new therapeutic strategies are discussed.
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Minerva anestesiologica · Jun 2020
Acute reduction of cerebrospinal fluid volume prior to spinal anaesthesia: implications for sensory block extent.
Multiple patient and clinical characteristics contribute to the variable outcome of spinal anesthesia (SPA). Acute reduction of cerebrospinal fluid (CSF) volume may alter the effect of SPA. The objective of the present study was to test if aspiration of 10 mL CSF immediately prior to SPA is associated with higher extent of sensory block. ⋯ Acute reduction of CSF volume by 10 mL prior to SPA leads to a higher thoracic level of sensory block.