Minerva anestesiologica
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Minerva anestesiologica · Apr 2021
Randomized Controlled TrialEffect of dexmedetomidine on CD4+ T cells and programmed cell death protein-1 in postoperative analgesia: a prospective, randomized, controlled study.
Surgical trauma inhibits cellular immunity. Dexmedetomidine produces opioid-sparing effect and an impact on immune response. ⋯ Dexmedetomidine increases the differentiation of Th1 and Treg cells and reduces the expression of PD-1 on CD4+ T cells. Dexmedetomidine may assist to ameliorate postoperative pain and attenuate proinflammatory response. There might be a negative correlation between pain and Th1 cells.
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Minerva anestesiologica · Apr 2021
Future in regional anesthesia and pain medicine: neuropathic pain and robotic limbs.
Phantom Limb Pain (PLP) is a dysesthesic painful sensations perceived in the lost limb, resulting from complex interactions between structural and functional nervous systems changes. We analyze its main pathogenetic models and speculate on candidate therapeutic targets. The neuroma model considers PLP to arise from spontaneous activity of residual limb injured axons. ⋯ Relief of PLP depends solely on motor and somatosensory circuitry engagement, making anthropomorphic visual feedback dispensable. Existing and apparently contradicting theories might not be mutually exclusive. All of them involve several intertwined potential mechanisms by which replacing the amputated limb by an artificial one could counteract PLP.
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Minerva anestesiologica · Apr 2021
Meta AnalysisReliability of transcranial sonography for assessment of brain midline shift in adult neurocritical patients: a systematic review and meta-analysis.
The aim of this systematic review and meta-analysis was to determine the reliability of transcranial sonography as an alternative to computed tomography for evaluation of brain midline shift in adult neurocritical patients. ⋯ Transcranial sonography may serve as reliable alternative to computed tomography for evaluation of brain midline shift in adult neurocritical patients. Both methods have strong concordance with acceptably narrow limits of agreement.
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Minerva anestesiologica · Apr 2021
Randomized Controlled TrialComparison of the analgesic effect of quadratus lumborum block and epidural block in open uterine surgery: a randomized controlled trial.
Effective regional analgesia during open surgery could reduce opioid consumption and enhance early recovery. We compared the effects of the newly developed quadratus lumborum block (QLB) and the traditional epidural block (EB) in open uterine surgery. ⋯ QLB produces a less intense but longer block and fewer side effects in the first 24 h after open uterine surgery than those produced by EB.