Minerva anestesiologica
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Minerva anestesiologica · Mar 2010
Case ReportsImportance of perioperative monitoring of cerebral tissue saturation in elderly patients: an interesting case.
The authors describe the case of an elderly diabetic patient with a hip fracture who developed neurocognitive dysfunction and dysarthria preoperatively. Upon arrival in the operating room, the monitoring of cerebral oxygenation by near-infrared spectroscopy (NIRS) showed cerebral desaturation (44% on the left hemisphere and 46% on the right). ⋯ The patient's cerebral saturation was 60% on the left and 58% on the right hemisphere after the end of surgery and he was in normal neurological status. Observations underlined the importance of preoperative evaluation of cerebral tissue oxygenation by non-invasive cerebral NIRS in elderly diabetic patients who develop hypovolemia and anemia due to major fracture.
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Minerva anestesiologica · Mar 2010
Effects of tracheal intubation on ventilation with LMA classic for percutaneous dilation tracheostomy.
The classic laryngeal mask airway (cLMATM) can be used in place of an endotracheal tube (ETT) as the ventilatory device during percutaneous dilational tracheostomy (PDT). We aimed to investigate the possible loss of efficacy of cLMATM after tracheal intubation. ⋯ Efficacy of cLMATM was maintained after short tracheal intubation and decreased after long intubation.
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Minerva anestesiologica · Feb 2010
Case ReportsThe Hutchinson-Gilford Progeria Syndrome: a case report.
The HGPS (Hutchinson Gilford Progeria Syndrome) is a rare genetic disorder with an incidence of 1 per 8 million live births. Originally described in 1886, less than 100 cases have been reported. ⋯ The diagnosis is usually made by age 2, the mean survival age is 13.4 years and the most common cause of death is myocardial infarction. Recent genetic advances have identified the cause as a defect in the LMNA gene of chromosome 1.
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Postoperative urinary retention (POUR) occurs after lower joint arthroplasty with an incidence between 0% and 75%. This vast range reflects the differences in diagnosis and management of POUR. At present, clinical practice includes either preoperative insertion of an indwelling catheter to be removed after 24-48 postoperative hours or postoperative intermittent in-and-out catheterization performed either at scheduled times (every 6-8 hours) or as necessary. ⋯ The purpose of the present article is to review the published data on the effects of analgesia techniques on the development of POUR after hip and knee arthroplasty. General and regional anesthesia are implicated in the etiology of POUR; however, type and duration do not correlate with its incidence. Of the different postoperative analgesic techniques currently used, continuous peripheral nerve block has the least impact on POUR.