Minerva anestesiologica
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Minerva anestesiologica · Jun 2022
Randomized Controlled TrialAnalgesic benefit of metamizole and ibuprofen vs. either medication alone: a randomized clinical trial.
Postoperative pain relief remains a key problem after surgery. Multimodal pain therapy has proven beneficial in alleviating pain to a certain extent. However, when combining non-opioids, the focus has been on NSAIDs and paracetamol, but effects of combined use are only moderate. Metamizole could be a potent adjunct, due to its preclusion in several countries, data on its combined use are sparse, despite its common use in many countries. The aim of this study was to examine whether the combination of metamizole and ibuprofen is superior in relieving postoperative pain to either drug alone. ⋯ Combined use enables superior pain control compared to ibuprofen after molar extraction and tends to be superior to metamizole alone. The premature study-termination may overestimate this effect.
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Head imaging is an essential diagnostic tool for the management of patients with most acute neurological emergencies involving the brain. While numerous modalities including magnetic resonance imaging and catheter angiography play a role, computed tomography (CT) of the brain is far and away the most widely utilized technique because of its widespread availability and the fact that it is usually easier to implement in critically ill and potentially unstable patients. ⋯ The critical role played by intensivists in managing neurocritical care patients necessitates familiarity and ability with viewing and understanding the advantages and shortcomings of head CT imaging and under which circumstances other modalities may be appropriate to obtain. This manuscript provides ten different circumstances commonly encountered in neurocritical care and how intensivists can use CT for the benefit of their patients.
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Minerva anestesiologica · Jun 2022
ReviewPrediction, prevention and management of new onset peri-operative atrial fibrillation and flutter in patients undergoing non-cardiac thoracic surgery: a narrative review.
Perioperative atrial fibrillation and flutter (POAF) is recognized as a common complication of non-cardiac thoracic surgery. It is associated with hemodynamic instability, prolonged hospital stays, a risk of stroke and increased risk of mortality. ⋯ Evaluation of risk factors and prediction of POAF can be beneficial for prevention and management of POAF in patients undergoing non-cardiac thoracic surgery. In this article, we reviewed related studies to provide a practically and clinically applicable strategy for anesthesiologists to effectively predict, prevent and manage new onset POAF in patients undergoing non-cardiac thoracic surgery.
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Minerva anestesiologica · Jun 2022
Randomized Controlled TrialBilateral lumbar ultrasound-guided erector spinae plane block versus local anaesthetic infiltration for perioperative analgesia in lumbar spine surgery: a randomized controlled trial.
Lumbar spinal surgery is associated with severe postoperative pain. We examined the analgesic efficacy of bilateral lumbar ultrasound-guided erector spinae plane block (ESPB) with ropivacaine compared with local infiltration. ⋯ Bilateral ultrasound-guided ESPB offers improved postoperative analgesia compared with local infiltration in patients undergoing lumbar spinal surgery.
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Minerva anestesiologica · Jun 2022
Observational StudyDifferences in early, intermediate, and long-term mortality among elderly patients admitted to the ICU. Results of a retrospective observational study.
Few studies have investigated both short- and long-term prognostic factors, and the differences between chronic and acute conditions in the very old critically ill patient. Our study aims to shed light in this field and to provide useful prognostic factors that may support clinical decisions in the management of the elderly. ⋯ Among very old ICU patients, prognostic factors shift from acute to chronic conditions in passing from in-hospital to posthospital outcomes.