Minerva anestesiologica
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Minerva anestesiologica · Sep 2021
Randomized Controlled Trial Observational StudyComparison of LMA® gastro airway and gastro-laryngeal tube in endoscopic retrograde cholangiopancreatography: a prospective randomized observational trial.
New generation airway devices with different designs have been developed as an alternative to endotracheal intubation in order to avoid adverse events associated with sedation in endoscopic procedures and to provide patent airway. We aimed to compare two supraglottic airway devices (SGADs), the LMA® Gastro™ airway and gastrolaryngeal tube (GLT), in terms of airway efficiency, performance during procedure and adverse events in endoscopic retrograde cholangiopancreatography (ERCP). ⋯ LMA® Gastro™ had a higher OLP than GLT. However, GLT was better for endoscopist satisfaction, as it provides more satisfying maneuverability. As to secondary outcome advers events were lower in LMA® Gastro™. The lower complication rates associated with the device and providing a more patent airway also highlighted the apparent clinical efficacy of LMA® Gastro™ than GLT, in ERCP.
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Minerva anestesiologica · Sep 2021
Clinical TrialComparison of ropivacaine plasma concentration after posterior Quadratus Lumborum Block in Cesarean Section with ropivacaine with epinephrine vs plane.
The posterior quadratus lumborum block (pQLB) has been used in postoperative pain management after cesarean section (CS). However, clinicians have no data about pQLB safety in pregnants, at increased risk of local anesthetic systemic toxicity (LAST). The purpose of the present study was to explore the efficacy and the safety of adding epinephrine to ropivacaine for bilateral pQLB vs. bilateral pQLB performed with ropivacaine alone in CS. ⋯ Adding epinephrine to ropivacaine increases efficacy and duration of pQLB. Moreover it increases block safety, reducing peak and mean venous ropivacaine concentration.
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Minerva anestesiologica · Sep 2021
Thinking fast and slow: Lactate and MELD-XI (Model for End-Stage Liver Disease Excluding INR) are useful for estimating mortality after cardiopulmonary resuscitation.
Intensivists keep getting challenged with prognostication after cardiopulmonary resuscitation (CPR). The model for end-stage liver disease, excluding INR (MELD-XI) Score has proven valuable for assessing illness severity. Serum lactate is a readily available and established indicator of general stress and tissue hypoxia. We aimed to evaluate the prognostic value of MELD-XI combined with serum lactate in patients after CPR. ⋯ The combination of MELD-XI and lactate concentration at ICU admission was superior to the more complex SOFA Score for prediction of mortality after CPR.