Minerva anestesiologica
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Minerva anestesiologica · May 2021
Randomized Controlled TrialSuperficial cervical plexus block alone or combined with interscalene brachial plexus block in surgery for clavicle fractures: a randomized clinical trial.
The regional anesthesia technique which is suitable for fracture clavicle is a matter of debate. This study aimed to compare the use of superficial cervical plexus alone or in combination with interscalene block in patients undergoing internal fixation of fractured clavicle. ⋯ In patients undergoing internal fixation of clavicular fracture, the perioperative analgesic effect of SCP alone is equally effective to its use in combination with ISB.
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Minerva anestesiologica · May 2021
Direct oral anticoagulants in point-of-care monitoring: an ex-vivo study (NOAPOC).
Anticoagulatory activity of direct oral anticoagulants (DOACs) is not routinely measurable by point-of-care monitoring. Thus, the aim of this study was to evaluate the influence of dabigatran/rivaroxaban on point-of-care testing. ⋯ Prolongation of CT-EXTEM and CT-INTEM indicates delayed initiation of clot formation. The CT-EXTEM seems to facilitate qualitative monitoring of dabigatran. In contrast, qualitative monitoring of rivaroxaban by CT-EXTEM may be limited as rivaroxaban may affect the measurement at therapeutic plasma levels. It seems that clot formation is faster/firmer in the presence of increased dabigatran plasma levels. This can be attributed to a non-dose-dependent effect via increased fibrin polymerization and second to a dose-dependent effect via increased platelet sensitivity to thrombin.