Minerva anestesiologica
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Minerva anestesiologica · Dec 2004
Randomized Controlled Trial Comparative Study Clinical TrialLevobupivacaine versus ropivacaine in psoas compartment block and sciatic nerve block in orthopedic surgery of the lower extremity.
The aim of this study was to compare the clinical profiles of psoas block and sciatic nerve block performed with either 0.5% levobupivacaine or 0.75% ropivacaine. ⋯ The differences between Groups L and R were characterised by: a faster motor onset time in Group L with a longer time between motor and sensitive resolution determining a lower demand for analgesic drugs postoperatively and greater support for motor control recovery.
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Minerva anestesiologica · Dec 2004
ReviewPost-dural puncture headache in the obstetric patient: an old problem. New solutions.
More than 100 years have passed since the initial description of the postdural puncture headache (PDPH). However, this unique clinical entity still continues to fascinate anesthesiologists, and numerous studies on its pathophysiology, prevention, and treatment, have been published. There is considerable variability in the incidence of PDPH, which is affected by many factors such as age, gender, pregnancy, and needle type and size. ⋯ The incidence of epidural needle-induced PDPH in parturients following dural puncture with a large bore needle has been reported to range 76-85%. Although a few measures have been proposed to prevent PDPH (intrathecal injection of saline, insertion of the epidural catheter into the subarachnoid space through the dural hole), none have been shown to work with certainty to date. This article reviews the latest developments (maintaining cerebrospinal fluid volume) aimed at prevention of PDPH.
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Minerva anestesiologica · Nov 2004
Clinical TrialAcute Pain Service and multimodal therapy for postsurgical pain control: evaluation of protocol efficacy.
The institution of a postoperative Acute Pain Control Service is mandatory to improve the control of pain induced by surgical injury. Treatment of postoperative pain may be achieved using a combination of analgesic agents and techniques, reducing the incidence of side effects owing to the lower doses of the individual drugs. In 1997 we established an Acute Pain Service (APS) at the San Raffaele Hospital in Milan. The aim of this study was to assess the efficacy and safety of our APS both in terms of treatment protocols and organisational issues. ⋯ In agreement with previous literature, this study confirmed that a multimodal approach to pain treatment provides an adequate control of postoperative pain, minimizing side effects.
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Minerva anestesiologica · Nov 2004
Comparative Study Clinical TrialPrilocaine or mepivacaine for combined sciatic-femoral nerve block in patients receiving elective knee arthroscopy.
The aim of this study was to evaluate the onset time of surgical block, recovery of motor function and duration of post-operative analgesia of combined sciatic-femoral nerve block performed with either mepivacaine or prilocaine. ⋯ Prilocaine 1% provides adequate sensory and motor block for arthroscopic knee surgery, with a clinical profile similar to that produced by 2% mepivacaine, and may be a good option for surgical procedures of intermediate duration and not associated with severe postoperative pain.
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Minerva anestesiologica · Nov 2004
Comparative StudyComparison between local and general anaesthesia for carotid endarterectomy. A retrospective analysis.
The aim of this study was to compare by a retrospective analysis local anesthesia (LA) versus general anesthesia (GA) for carotid endarterectomy (CEA). ⋯ In our experience, LA seems to be the approach of choice for CEA because 1) by preserving the state of consciousness, it allows a simple clinical monitoring of cerebral perfusion maintenance; 2) it reduces the number of intraoperative shunts and the risk of admission to the ICU; 3) it is cost-effective.