Minerva anestesiologica
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Minerva anestesiologica · Aug 2021
Meta AnalysisVolatile anesthetics versus intravenous anesthetics for noncardiac thoracic surgery: a systematic review and meta-analysis.
We performed this meta-analysis of randomized controlled trials (RCTs) to investigate two types of anesthetics for noncardiac thoracic surgery regarding their effects on clinical outcomes and the inflammatory response. ⋯ In lung surgery, but not esophagectomy, volatile anesthetics may be a better choice than intravenous anesthetics, possibly because volatile anesthetics reduce airway inflammation.
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Minerva anestesiologica · Aug 2021
Postoperative pain after intrathecal analgesia in laparoscopic liver resection: a retrospective chart review.
Intrathecal analgesia (IA) has been recommended by the enhanced recovery after surgery (ERAS) Society for laparoscopic colon resections; however, although IA is used in open liver resections, it has not been extensively studied in laparoscopic hepatobiliary surgery. This retrospective chart review was undertaken to explore postoperative pain within 48 hours among patients who underwent laparoscopic liver resections (LLR), receiving either IA with or without patient-controlled analgesia (IA±PCA) versus PCA alone. ⋯ IA has the potential to decrease postoperative opioid use for patients undergoing LLR, and appears to be safe and effective in the setting of LLR. These findings are consistent with the ERAS Society recommendations for laparoscopic colorectal surgery.
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Minerva anestesiologica · Aug 2021
Observational StudyProspective observational study evaluating the C-MAC Video Stylet for awake tracheal intubation: a single-center study.
The gold standard for management of known or predicted difficult airways is awake tracheal intubation. The newly developed C-MAC Video Stylet promises to combine the advantages of rigid stylets and flexible optical scopes. We therefore evaluated the feasibility of awake orotracheal intubations with this device. ⋯ The new C-MAC Video Stylet has the potential to serve as a suitable device for visualized oral awake intubation in difficult airway situations.
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Children with symptoms of hypotonia (reduction of postural tone of lower limbs and trunk with or without changes in phasic tone) are frequently anesthetized for diagnostic and therapeutic interventions. This review outlines the underlying causes and classifications, and the anesthesiologic pre- and peri-operative management of hypotonic children. Hypotonia may have a large range of etiologies that are categorized into central and peripheral hypotonia. ⋯ Adequate postoperative pain treatment is essential to limit stress and metabolic alteration. Preferably a locoregional technique is used to reduce the increased risk of respiratory depression. A multidisciplinary preoperative approach taking into account the differential diagnosis of the underlying disease of the floppy child is recommended.