Minerva anestesiologica
-
Minerva anestesiologica · Jun 2021
Randomized Controlled TrialEffects of lung-protective ventilation strategy on lung aeration loss and postoperative pulmonary complications in moderate-risk patients undergoing abdominal surgery.
There is a controversy about whether the use of a lung-protective ventilation strategy(LPVS) can reduce the incidence of postoperative pulmonary complications (PPCs) and improve the clinical outcomes in moderate-risk patients were assessed by the Assess Respiratory Risk in Surgical Patients in Catalonia(ARISCAT). ⋯ The LPVS can decrease lung aeration loss assessed by LUS and reduce the incidence of PPCs in moderate-risk patients.
-
Minerva anestesiologica · Jun 2021
Causes of arterial hypotension during anaesthetic induction with propofol investigated with perfusion index and ClearSightTM in young and elderly patients.
Mechanism underlying the hypotension during anesthetic induction in elderly patients is inferred to differ from that in younger patients due to structural changes in arteries. The aim of the study was to determine if a decrease in cardiac output (CO) or systemic vascular resistance (SVR) is the main mechanism of the hypotension. ⋯ The main mechanisms of hypotension during anesthetic induction contribute to the decrease in CO in elderly and reduction of SVR in younger. PI only shows the vascular tone of a finger but can be a surrogate for SVR.
-
Minerva anestesiologica · Jun 2021
ReviewA matter of timing: EEG monitoring for neurological prognostication after cardiac arrest in the era of targeted temperature management.
Neuromonitoring with electroencephalography (EEG) is an essential tool in neurological prognostication post-cardiac arrest. EEG allows reliable and real-time assessment of early changes in background patterns, development of seizures and epileptiform activity, as well as testing for background reactivity to stimuli despite use of sedation or targeted temperature management. Delayed emergence of consciousness post-cardiac arrest is common, therefore longitudinal monitoring of EEG allows the detection of trends indicative of neurological improvement before coma recovery can be observed clinically. In this review, we summarize essential recent literature in EEG monitoring for neurological prognostication post-cardiac arrest in the context of targeted temperature management, with a particular focus on the importance of the evolution of EEG patterns in the first few days following resuscitation.
-
Minerva anestesiologica · Jun 2021
Randomized Controlled TrialA randomized clinical trial comparing six techniques of postoperative analgesia for elective total hip arthroplasty under subarachnoid anesthesia with opioids.
Optimal control of acute postoperative pain and prevention of chronic persistent pain in total hip arthroplasty (THA) remain a challenge. The main hypothesis was that peripheral nerve blocks improve postoperative analgesia. ⋯ combined with a multimodal analgesic approach, infra-inguinal FICB and LFCNB did not improve immediate postoperative analgesia for THA in our hospital. Other options and longer-term studies should be more extensively investigated to determine the role of peripheral blocks in postoperative pain treatment protocols.