Minerva anestesiologica
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Minerva anestesiologica · Sep 2010
Randomized Controlled TrialDifferent patterns of lung recruitment maneuvers in primary acute respiratory distress syndrome: effects on oxygenation and central hemodynamics.
The aim of this study was to test if different recruitment maneuver (RM) patterns, that achieve the same maximum pressure for the same length of time in humans, have a similar efficacy on alveolar recruitment, intrathoracic vascular pressures and flows, and on cardiac function and ventricular filling. ⋯ Given its comparable, or even superior, performance over the SI RM, we favor the PCV technique over the time-honored SI maneuver.
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Minerva anestesiologica · Sep 2010
Randomized Controlled TrialPropofol injection pain: is it still an issue? The effect of premedication.
The use of propofol often results in pain upon injection. Various strategies can be used to reduce this pain, ranging from the administration of analgesics to modification of the propofol emulsion. However, basic premedication protocol aimed at peri- and postoperative pain reduction could also sufficiently reduce propofol injection pain, rendering other special interventions redundant. ⋯ Even when injection pain is reduced, the use of a premedication regimen clearly has additional value with respect to the patients' experience. Considering the low VAS scores observed overall, it might be worthwhile to reserve additional injection pain-reducing interventions for individual patients rather than adding them as a component of standard practice.
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Medical mistakes have been identified as resulting from a breakdown in one or more of five major areas: equipment performance, communication, staffing levels, complex environments and workloads. Because many of these areas relate directly to the practice of anesthesiology, they can contribute significantly to the safety and quality of the use of anesthesia. ⋯ Despite these improved rates, there are still areas that can be improved. This paper describes the background of these issues, discusses areas where performance has improved and identifies the areas in which there is room for further improvement.
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Minerva anestesiologica · Sep 2010
A structured training program for awake fiber optic intubation: teaching the complete package.
We organized a training program for oral fiber optic intubation (FOI) under conscious sedation. The efficacy of the program was evaluated by comparing the performances of experts and novices. ⋯ This study highlights the importance of a structured FOI training program, demonstrating that it is possible to learn to perform FOI proficiently by practicing on dummies.
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Minerva anestesiologica · Sep 2010
Conversion of spinal anesthesia into general anesthesia: an evaluation of more than 35,000 spinal anesthetics.
The aim of this study was to evaluate the number of conversions from spinal anesthesia (SA) into general anesthesia (GA) in a large number of patients who underwent surgery over a period of twenty-one years. ⋯ SA has been found to be a safe and highly effective technique. Failure of SA was infrequent in a large number of patients surveyed and most often occurred with less experienced anesthesiologists. Conversion to GA did not produced different outcomes in comparison with planned GA. Prospective studies with a definite protocol for recording data performed on a large number of patients may help in determining the factors associated with conversion from SA into GA and how to avoid these unexpected situations.