Minerva anestesiologica
-
Minerva anestesiologica · Feb 2010
Open intensive care units: a regional survey about the beliefs and attitudes of healthcare professionals.
We aimed at assessing the opinion and degree of acceptance of physicians and nurses in Intensive Care Units (ICUs) toward an open ICU as our regional ethical committee has advised that ICU visitation policies be reformed using such a new approach. ⋯ This study points out that, in our region, physicians are more liberal and able than nurses to "customize" their wards to the specific psychosocial and emotional needs of patients and visitors.
-
Postoperative pulmonary complications (PPC) account for a substantial portion of the risks related to surgery and anesthesia and are a source of postoperative morbidity, mortality and longer hospital stays. The current basis for our understanding of the nature of PPC is weak; only a small number of high-quality studies are available, a uniform definition has not emerged, and studies have focused on specific patients and kinds of surgeries. ⋯ Age, general co-morbidity, pre-existing respiratory and cardiac diseases, the use of general anesthesia and the overall surgical insult. are the most significant factors associated with complications. Election of anesthetic technique, postoperative analgesia and physical therapy seem to be the preventive measures that are best supported by evidence.
-
Minerva anestesiologica · Feb 2010
The pharmacodynamic effects of rocuronium during general anesthesia in patients with type 2 diabetes mellitus.
The aim of this prospective study was to investigate whether the neuromuscular response to rocuronium is affected by the presence of type 2 diabetes mellitus. ⋯ The present study has proven that the rocuronium-induced neuromuscular block was not affected in patients with type 2 diabetes mellitus during isoflurane based general anesthesia.
-
Minerva anestesiologica · Feb 2010
Case ReportsAnesthetic management for right upper extremity amputation due to recidivous cutaneous carcinoma and acute postoperative pain control in patients affected by epidermolysis bullosa.
A 22-year-old male who was affected by epidermolysis bullosa (EB) and xeroderma pigmentosa (with structural and pathological changes that preclude orotracheal intubation) underwent right upper extremity amputation and ipsilateral axillary lymphadenectomy. The patient was operated without intubation, thereby assuring an optimal state of acute postoperative pain control by regional anesthesia. Intravenous administration of ketamine and remifentanil plus low-dose sevoflurane resulted in anesthesia with spontaneous breathing by the patient. Moreover, the intraoperative brachial plexus nerve block before amputation followed by positioning of an epidural catheter to deliver continuous infusion of local anesthetics close to the cut nerves during surgery obtained a very good level of acute postoperative pain control.