Minerva anestesiologica
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Minerva anestesiologica · Apr 2023
Meta AnalysisEfficacy and safety of oral versus intranasal midazolam as premedication in children: a systematic review and meta-analysis.
Midazolam hydrochloride is a widely accepted benzodiazepine for premedication in pediatric patients. However, there is no consistent conclusion regarding which route of administration is best. We performed a meta-analysis to assess the efficacy and safety of oral versus intranasal midazolam premedication in children. ⋯ Differences between intranasal and oral midazolam in satisfactory mask acceptance for induction, satisfactory sedation at separation from parents, and postoperative recovery time were not significant. Intranasal midazolam premedication was associated with shorter onset time and higher incidence of nasal irritation.
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Minerva anestesiologica · Apr 2023
Randomized Controlled TrialUse of a curved needle to facilitate four-in-one nerve block performance after total knee arthroplasty in elderly patients: a randomized clinical trial.
Peripheral nerve block is the main analgesic technique for total knee arthroplasty (TKA) in elderly patients. Accurate delivery of the needle tip to the target nerve under ultrasound-guided is a prerequisite for successful nerve block. Failed needle-tip positioning in sciatic nerve (SN) or medial femoral cutaneous nerve (MFCN) block can be due to anatomical structure shadow. The aim of the study was to compare curved and straight needles in regard to the time needed to perform the nerve block for TKA in elderly patients. ⋯ The use of a curved needle can reduce the time required to perform the nerve block, with reduction in the number of attempts and needle redirections. Curved needle also resulted in lesser procedural pain and higher satisfaction compared with the straight needle.
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Minerva anestesiologica · Apr 2023
ReviewPotential nutritional and pharmacological treatment of glycocalyx alterations during sepsis.
During sepsis, a combination of pathophysiological insults disrupts the glycocalyx. The thickness of the glycocalyx is correlated with parameters of disease severity, making it a potential new and independent target for therapeutic strategies in sepsis. The aim of this review was to examine potential beneficial effects of nutritional and pharmacological measures on glycocalyx alterations during sepsis and their timing.
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Minerva anestesiologica · Apr 2023
ReviewPerioperative management and surgical field optimization in functional endoscopic sinus surgery.
A sound anesthesiologist-surgeon collaboration is crucial for the success of functional endoscopic sinus surgery (FESS). The aim of this narrative review was to describe if and how anesthetic choice can decrease bleeding and improve visibility in the surgical field (VSF) and thus contribute to successful FESS. A literature search was conducted on evidence-based practices published from 2011 to 2021 describing perioperative care, intravenous/inhalation anesthetics, and operative approaches for FESS and their effects on blood loss and VSF. ⋯ We recommend that anesthesiologists use the anesthetic technique with which they are most comfortable to facilitate efficiency, recovery, cost, and collaboration with the perioperative team. Future studies should be designed to consider disease severity, the method for measuring blood loss, and a standardized VSF score. Studies should also investigate the long-term effects of TIVA- and IA- induced hypotension.
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Minerva anestesiologica · Apr 2023
Observational StudyImpact of the presence of a humanoid robot in the anesthesia visit waiting room on patient's satisfaction. The PEPPER before-after study.
The quality of information during a medical visit, such as a preoperative anesthesia visit, impacts patient's satisfaction. New digital supports, including humanoid robots, have been recently proposed to provide medical information to patients. We aimed to assess whether the presence of a PEPPER humanoid robot, programmed to deliver information about anesthesia and surgery and placed in the waiting room for a preoperative anesthesia visit, can improve patient overall satisfaction. ⋯ The presence of a humanoid PEPPER robot in the waiting room did not improve patient's global satisfaction about anesthesia visit.