Minerva anestesiologica
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Minerva anestesiologica · Oct 2009
Randomized Controlled Trial Comparative StudyPosterior psoas vs 3-in-1 approach for lateral femoral cutaneous and obturator nerve block for anterior cruciate ligament repair.
The aim of this article was to test the hypothesis that the posterior psoas compartment approach to the lumbar plexus help to achieve better blockade of the lateral femoral cutaneous and obturator nerves than the classic anterior 3-in-1 femoral nerve block. ⋯ The posterior psoas compartment approach provides a more reliable block of the lateral femoral cutaneous and obturator nerves than the anterior 3-in-1 approach.
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Minerva anestesiologica · Sep 2009
Randomized Controlled Trial Comparative StudyA comparison of morphine concentrations for patient-controlled epidural analgesia following gynecological surgery.
To compare the analgesic efficacy of a lower (12.5 mg/mL) vs. higher (25 mg/mL) concentration of morphine with 0.2% ropivacaine for patient-controlled epidural analgesia (PCEA) following gynecological surgery. ⋯ PCEA using 0.2% ropivacaine and 12.5 mg/mL morphine compared with 0.2% ropivacaine and 25 mg/mL morphine provides equianalgesia with no differences in bolus administration. With respect to the analgesic efficacy and the potential risk for side effects, PCEA using 0.2% ropivacaine and 12.5 mg/ml morphine is a better choice for postoperative gynecological patients.
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Minerva anestesiologica · Sep 2009
Randomized Controlled TrialEffect of locally administered lornoxicam in the management of low back pain after lumbar epidural anesthesia: a double-blind, randomized, controlled study.
Low back pain after lumbar epidural anesthesia remains an important clinical problem. Possible causes of the back pain associated with epidural anaesthesia are localized trauma, aseptic periosteitis, tendonitis, inflammation of the ligaments, and osteochondritis. Lornoxicam is a new nonsteroidal anti-inflammatory drug (NSAID) that has been shown to be effective and well tolerated in the treatment of postoperative pain. The use of locally administered lornoxicam for the relief of low back pain following lumbar epidural anesthesia has not yet been studied. Thus, the aim of the present study was to investigate the efficacy of lornoxicam in the management of pain after lumbar epidural anesthesia. ⋯ Our study demonstrated that local administration of Lornoxicam before epidural anesthesia for pilonidal sinus surgery decreased the frequency and severity of low back pain following lumbar epidural anesthesia with lidocaine. In conclusion, local administration of lornoxicam during epidural anesthesia may present a useful option for the relief of post-epidural low back pain.
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The application of transesophageal echocardiography (TEE) in the perioperative setting has been expanding over the past decades. TEE has become increasingly important in the management of critically ill patients both in the operating room and in the intensive care unit (ICU). TEE is a semi-invasive imaging technique that provides a rapid, real-time, bedside assessment of cardiac function and morphology. ⋯ Hemodynamic parameters, such as volumes and pressures, can be obtained via TEE assessment of cardiac performance and may be helpful for diagnosis and treatment. Intraoperative TEE is actually considered an important diagnostic tool in patients scheduled for cardiac surgery as well as in high-risk patients undergoing non-cardiac surgery. All types of hemodynamic impairment can be quickly assessed via TEE, and the management of the echo data can define both the cause and the diagnosis.
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Minerva anestesiologica · Sep 2009
Randomized Controlled TrialExpression of monocyte human leukocyte antigen-DR in relation with sepsis severity and plasma mediators.
After an initial septic hit, the immune response to a new antigen changes as time progresses, with an unpredictable efficiency. The aim of this study was to characterize the monocyte functional phenotype by HLA-DR expression in septic patients at the onset of sepsis and during recovery in relation to organ failure and plasma mediators. ⋯ At the onset of sepsis, an initial low mHLA-DR was not related to any prior IS drug regimen, the severity of the sepsis or the outcome. The duration of mHLA-DR downregulation could be related to plasma factors in SOF, while other mechanisms may be implicated in MOF evolution.