Minerva anestesiologica
-
Minerva anestesiologica · Apr 2006
Randomized Controlled TrialLevobupivacaine and ropivacaine in the infraclavicular brachial plexus block.
Infraclavicular brachial plexus block were first described by Raj, yet this block remained underutilized despite theoretical advantages. The aim of this prospective, randomized study was to compare equipotent doses of levobupivacaine and ropivacaine. ⋯ The long duration of sensory block associated with the with good analgesia, less toxicity and the pharmacodynamic properties of levobupivacaine include this new local anaesthetic as a valid choice respect other local anaesthetic for infraclavicular plexus block.
-
Minerva anestesiologica · Mar 2006
ReviewLung protective ventilation in ARDS: the open lung maneuver.
This review addresses the current state of lung protective strategies and their physiological rationale. Lung protective ventilation can reduce mortality in adult respiratory distress syndrome (ARDS) patients. We review the latest knowledge on the progression of lung injury by mechanical ventilation. ⋯ Furthermore, we discuss possible future improvements to mechanical ventilation; especially the open lung maneuver. The rationale behind the open lung maneuver and steps to accomplish an open lung are described, as well as data from animal and human studies. Finally, guidelines for future strategies and/or investigations are presented.
-
Postoperative pain management an important clinical issue. The clinicians tool-bag remains incomplete. Improvements in the management of postoperative pain will ultimately translate into the broader, safer application of surgical procedures upon a wider patient population. The application of multimodal therapy that includes non-pharmacologic therapies, preemptive therapies, and new medications for the treatment of postoperative pain is an emerging concept that provides significant immediate as well as potential future advantages.
-
Severe sepsis is a common disease process in the critically ill and is associated with substantial morbidity and mortality. Continuing research has provided considerable insight into the pathophysiology of sepsis over recent years, enabling various aspects of the sepsis response to be targeted. Discoveries related to the link between coagulation and inflammation have been particularly exciting, leading to the development of recombinant activated protein C. This review will discuss current definitions of sepsis, describe new approaches to classification and diagnosis of patients with sepsis, present recommendations for management, and briefly highlight areas of ongoing and future research.