Minerva anestesiologica
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Minerva anestesiologica · May 2009
Randomized Controlled Trial Comparative StudyRegional anesthesia for carotid endarterectomy: a comparison between ropivacaine and levobupivacaine.
This study compares ropivacaine and levobupivacaine when administered for cervical plexus block. The authors therefore compared the arterial pressure profile and the incidence of hypotension between drugs. ⋯ Levobupivacaine has a greater vasodilatory effect than ropivacaine. Its higher incidence of hypotension, although not statistically significant, suggests ropivacaine as the drug of choice for cervical plexus block.
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Minerva anestesiologica · May 2009
Case ReportsProbable case of vascular air embolism during endonasal CO2 laser surgery.
Laser surgery in narrow luminal cavities can lead to venous air embolism (VAE) due to high pressure or high flow clearing/cooling systems. We report the first case of initially misdiagnosed VAE during endonasal CO(2) laser surgery. A 56-year-old patient underwent uvulopalatopharyngoplasty and septoplasty with bilateral CO(2) laser turbinoplasty for turbinate hypertrophy and uvula deviation. ⋯ The literature reports cases of VAE during laser surgery in narrow luminal cavities. When operating in narrow luminal cavities, using a liquid instead of a gas as a clearing/cooling system for the distal end of the probe in laser instruments and avoiding direct contact with tissues is advisable. Anesthesiologists, surgeons and the nursing staff practicing endoscopic laser surgery should have wide knowledge of the risks linked to this technique in order to minimize risk to the patient and to manage VAE should it eventually occur.
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Minerva anestesiologica · May 2009
Focused echocardiography entry level: new concept of a 1-day training course.
We describe a training programme for non-specialists in focused echocardiography in the periresuscitation setting which represents an entry level in echocardiography training (FEEL) for emergency and critical care medicine physicians. ⋯ Periresuscitation echocardiography, performed safely, within the competence of practitioners in an ALS-compliant manner is a potentially valuable skill to be acquired by physicians caring for the critically ill, regardless of the environment in which they work, or their level of seniority. This newly-developed blended learning periresuscitation echocardiography programme (FEEL) may serve as entry level in peri-resuscitation echocardiography for both emergency physicians and critical care practitioners.
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Minerva anestesiologica · May 2009
ReviewInfluence of beta-blockers on the outcome of at risk patients.
Present recommendations for perioperative ss-blockade are solely based on the findings of two randomized controlled trials of inadequate methodology and data analysis in just a little over 300 patients performed in the late 1990s. The PeriOperative ISchemic Evaluation study is the first adequately powered controlled randomized trial on the efficacy and safety of perioperative ss-blocker therapy. ⋯ A recently published meta-analysis confirmed in large parts these findings. Based on these publications, most of the present recommendations for perioperative ss-blocker therapy are no longer supported by evidence and respective revision is needed.