Minerva anestesiologica
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Minerva anestesiologica · Jun 2021
ReviewA matter of timing: EEG monitoring for neurological prognostication after cardiac arrest in the era of targeted temperature management.
Neuromonitoring with electroencephalography (EEG) is an essential tool in neurological prognostication post-cardiac arrest. EEG allows reliable and real-time assessment of early changes in background patterns, development of seizures and epileptiform activity, as well as testing for background reactivity to stimuli despite use of sedation or targeted temperature management. Delayed emergence of consciousness post-cardiac arrest is common, therefore longitudinal monitoring of EEG allows the detection of trends indicative of neurological improvement before coma recovery can be observed clinically. In this review, we summarize essential recent literature in EEG monitoring for neurological prognostication post-cardiac arrest in the context of targeted temperature management, with a particular focus on the importance of the evolution of EEG patterns in the first few days following resuscitation.
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Minerva anestesiologica · Jun 2021
Randomized Controlled TrialA randomized clinical trial comparing six techniques of postoperative analgesia for elective total hip arthroplasty under subarachnoid anesthesia with opioids.
Optimal control of acute postoperative pain and prevention of chronic persistent pain in total hip arthroplasty (THA) remain a challenge. The main hypothesis was that peripheral nerve blocks improve postoperative analgesia. ⋯ combined with a multimodal analgesic approach, infra-inguinal FICB and LFCNB did not improve immediate postoperative analgesia for THA in our hospital. Other options and longer-term studies should be more extensively investigated to determine the role of peripheral blocks in postoperative pain treatment protocols.
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Minerva anestesiologica · Jun 2021
Observational StudyPredicting difficult spinal anesthesia: development of a neuraxial block assessment score.
Spinal anesthesia is a commonly performed procedure with unpredictable difficulty. The objective of this study was to predict a difficult lumbar spinal anesthesia with clinical elements that are easy to collect. ⋯ The combination of more than one element increased the chance of a second skin puncture of more than 50%. This work proposes a simple clinical scoring system predicting the probability of a difficult spinal anesthesia.
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Minerva anestesiologica · Jun 2021
Modified pediatric Lung Ultrasound Score compared with computed tomography for assessment of lung aeration in children.
Lung ultrasound can be used to assess lung density and aeration at the bedside. Few authors have investigated scores based on the ultrasonographic interstitial syndrome for this purpose, but none have compared them with the gold standard computed tomography in children. ⋯ The pediatric lung ultrasound score correlates with lung density and percentage of hypoaerated lung measured with computed tomography.