Minerva anestesiologica
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Minerva anestesiologica · Sep 2013
ReviewNon-opioid analgesics for pain management following ambulatory surgery, a review.
Multimodal pain management, combining analgesics with different mode of action in order to minimize occurrence of side-effects still providing safe and efficacious pain management after ambulatory surgery has become standard of care. The combined use of local anaesthesia in order to reduce noxious influx during the procedure and reduce postoperative pain is strongly recommended whenever feasible. ⋯ Single iv. preoperative dose dexamethasone has been shown not only to be effective in reducing postoperative nausea and vomiting but also to improve recovery reduce pain and improve satisfaction. Pregabalin may be used in order to further enhance the recovery and pain management.
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Minerva anestesiologica · Sep 2013
ReviewECMO in acute and chronic adult respiratory failure: recent trends and future directions.
Extracorporeal membrane oxygenation (ECMO) can be used to preserve or enhance systemic oxygen delivery in patients with refractory cardiac or respiratory failure. Although widely accepted as a standard of care for many indications in children and for adult cardiogenic shock, ECMO for adult respiratory failure is more controversial. ⋯ In spite of this, there is probably now more evidence to support the use of ECMO in refractory acute respiratory distress syndrome than for any other form of rescue therapy. The purpose of this review is to update clinicians regarding trends in ECMO research over the last 12 months and speculate on how the clinical use of ECMO and associated technology will evolve.
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Minerva anestesiologica · Sep 2013
Global and regional parameters to visualize the 'best' PEEP during a PEEP trial in a porcine model with and without acute lung injury.
Setting the optimal level of positive end-expiratory pressure (PEEP) in critically ill patients remains a matter of debate. "Best" PEEP is regarded as minimal lung collapse and overdistention to prevent lung injury. In this study, global and regional variables were evaluated in a porcine model to identify which variables should be used to visualize "best" PEEP. ⋯ Most of the evaluated parameters indicate comparable 'best' PEEP levels. However, a combination of these parameters, and especially EIT-derived intratidal gas distribution, might provide additional information. The application of lung recruitment was beneficial in both ALI and the "healthy" lung.
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Minerva anestesiologica · Sep 2013
Letter Case ReportsParadoxical air embolism after cardiac Computed tomography scan.