Minerva anestesiologica
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Minerva anestesiologica · Jul 2021
Randomized Controlled TrialUpdate on the SedLine algorithm for calculating the Patient State index of older individuals during general anesthesia: a randomized controlled trial.
The SedLine® sensor processes (Masimo Corporation; Irvine, CA, USA) raw electroencephalogram (EEG) signals and displays the depth of sedation as a Patient State Index (PSi). Reliance on standard processed EEG data and failure to recognize age-related effects can lead to an erroneous interpretation that low-amplitude EEG findings in an older patient signify an insufficient depth of anesthesia presented as abnormally high PSi values (AHPSi). We hypothesized that the incidence of AHPSi would decrease with the use of the recently-updated version of the SedLine® sensor, in which the Bispectral Index (BIS) values were used to titrate anesthesia. ⋯ The incidence of AHPSi decreased with the use of the updated version of the SedLine® algorithm.
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Minerva anestesiologica · Jul 2021
Observational StudyDetermination of the initial minimum effective dose of 0.5% bupivacaine with 20mcg of fentanyl for an operative fixation of fractured neck of femur. A prospective, observational trial.
Fractured neck of femur (FNF) is a common cause of morbidity and mortality in elderly. Spinal catheter allows fractionation of local anesthetic dose which combined with intrathecal opioid leads to a dose reduction and better hemodynamic stability. The primary objective of this paper was to investigate the initial minimum local anesthetic dose (iMLAD) of 0.5% isobaric bupivacaine with 20 μg of fentanyl administered via spinal catheter in order to commence the operative fixation of FNF. ⋯ This study demonstrates that the placement of a spinal catheter allows for careful titration of local anesthetic, enabling a reduction of the initial intrathecal dose of 0.5% isobaric bupivacaine below 0.4 mL (2 mg) and leading to a significant reduction of a dose required for the whole surgery when combined with an intrathecal opioid.