Minerva anestesiologica
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Minerva anestesiologica · Oct 2024
Meta Analysis Comparative StudyComparison between hemodynamic effects of remimazolam and propofol during general anesthesia: a systematic review and meta-analysis.
The need for safe anesthetic agents with minimal side effects has led to the development of remimazolam, a new benzodiazepine designed to be an alternative to the commonly used drug propofol, which has significant hemodynamic effects. This study aims to compare the hemodynamic effects of remimazolam with propofol during general anesthesia. ⋯ This study provides evidence that remimazolam induces fewer cardiorespiratory depressant effects and has a more favorable side effect profile compared to propofol during general anaesthesia.
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Minerva anestesiologica · Oct 2024
Cognitive and non-cognitive factors affecting decision-making about deceased organ donation in Italy: a systematic review.
Decision-making about organ donation (OD) is influenced by interrelated cognitive and non-cognitive factors. The identification of these factors in the general population and among healthcare professionals (HCP) in Italy are key ethical and scientific requirements to inform targeted communication and policy-making interventions, and to promote decision-making processes that are truly informed. ⋯ The majority of the Italian population supports OD, but cognitive and non-cognitive barriers are present even among HCPs. Communication campaigns, encouraging family discussions about OD, providing better education for HCPs (including medical and nursing students), and making it easier to sign OD cards may promote informed decision-making and possibly increase consent rates.
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Minerva anestesiologica · Oct 2024
Risk of pulmonary complications after video-assisted thoracoscopic pulmonary resection in children.
Postoperative pulmonary complications (PPCs) are associated with high mortality and morbidity rates. Children are more susceptible to PPCs owing to smaller functional residual capacity and greater closing volume. Risk factors of PPCs in children undergoing lung resection remain unclear. ⋯ Male sex, longer OLV duration, less surgeon's experience, and lower PEEP were risk factors of PPCs in children undergoing video-assisted thoracoscopic surgery. Our findings may serve as targets for prospective studies investigating specific ventilation strategies for children.
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Minerva anestesiologica · Oct 2024
Impact of anesthesiologist experience on neuraxial anesthesia outcomes in cesarean sections.
Despite the requirement for meticulous management of cesarean anesthesia, no study has explored the impact of novice trainee anesthesiologists in this field. This study assessed challenges in neuraxial anesthesia for cesarean sections and compared outcomes between novice and senior anesthesiologists. ⋯ The effect of maternal BMI on the difficulty of performing neuraxial anesthesia in parturients can be more pronounced for novice anesthesiologists than for experienced ones. Despite requiring more time to perform neuraxial anesthesia, novice anesthesiologists do not significantly affect maternal hemodynamics or newborn distress during obstetric anesthesia, provided that they are under the supervision of experienced anesthesiologists.
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Minerva anestesiologica · Oct 2024
Measuring the outward migration of the nasotracheal tube at vocal cords with head and neck extension: a novel approach using a flexible bronchoscope in patients undergoing head and neck oncosurgery.
Head and neck extension achieves optimal surgical exposure during head and neck oncosurgeries. However, it can lead to cephalad migration of the tracheal tube, causing complications. Preventing shallow intubation is essential, especially in patients with difficult airway. Using an innovative technique, we aimed to measure the proximal migration of the nasotracheal tube at the vocal cords on neck extension in patients with difficult airway. ⋯ The major contributing factor for the increase in TT tip-to-carina distance on neck extension was tracheal elongation rather than outward migration of the TT at vocal cords.