Minerva anestesiologica
-
Minerva anestesiologica · Jan 2012
Influence of opioid choice on mechanical ventilation duration and ICU length of stay.
The aim of this study was to assess the impact on mechanical ventilation and ICU outcomes of substituting remifentanil for sufentanil, in an analgesia-based sedation protocol. A database of data prospectively collected was retrospectively analyzed. The study was carried out in a 16-bed tertiary-care ICU. ⋯ Our study suggests that using a short-acting opiate with short context-sensitive half-life in an analgesia-based sedation protocol may significantly decrease the duration of mechanical ventilation and the ICU length of stay even though not significantly in long term sedation, while improving the achievement of sedation goals despite a lower requirement for adjunctive hypnotic agents, with no additional costs.
-
Minerva anestesiologica · Jan 2012
Case ReportsUltrasound-guided posterior approach to brachial plexus for the treatment of upper phantom limb syndrome.
The purpose of the case is to report the clinical value of the ultrasound-guided posterior approach to the brachial plexus in the treatment of phantom limb syndrome after an upper extremity amputation. The author experienced ultrasound guidance as sole technique to localize the brachial plexus for the purpose of placing a catheter for continuous infusion of a local anesthetic in a patient where standard landmark-based nerve stimulation for placement of a continuous perineural block was not possible.
-
Minerva anestesiologica · Jan 2012
Letter Case Reports Comparative StudyProlonged neuromuscular block associated to non-alcoholic steatohepatitis in morbidly obese patient: neostigmine versus sugammadex.
-
Minerva anestesiologica · Dec 2011
ReviewUse of synthetic colloids in sepsis: a critical review on efficacy, safety and patient benefits.
In this narrative review, the studies and analyses are discussed that pertain to benefits and detriments of synthetic colloids versus natural colloids or crystalloids used for fluid resuscitation in sepsis and septic shock. The relative amount of fluid infusions used to reach clinical or hemodynamic end-points are reviewed, as well as potential toxicity of starch solutions on the kidney. Hence, it cannot be excluded that adverse effects partly offset beneficial hemodynamic effects that are similar to that of natural colloids, so that in most analyses a mortality benefit of synthetic colloid fluid resuscitation in sepsis and septic shock cannot be demonstrated.