Minerva anestesiologica
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Minerva anestesiologica · Sep 2001
Review[Complications related to epidural catheter in caesarean delivery].
A review of complications related to epidural catheters in caesarean delivery is presented. Catheters for prolongation of nerve blocks were first used in 1940s. Thereafter, there has been steady development in the design and plastic material technology of the different catheters. ⋯ Broken parts of the catheters should be left as a rule within the spinal space. Test dose should be always done for continuous epidural anaesthesia. Early diagnosis and prompt appropriate treatment will usually lead to complete resolution of the neurological deficit even in cases of epidural haematoma or abscess.
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Minerva anestesiologica · Sep 2001
Randomized Controlled Trial Comparative Study Clinical TrialEffects of sevoflurane versus propofol on QT interval.
Prolongation of the QT interval is an alteration of the electrocardiogram (ECG) that may result in a potentially dangerous polymorphic ventricular tachycardia known as torsade de pointes. Michaloudis et al. investigated the effect of isoflurane and halothane on the QT interval in premedicated and non premedicated children, and in premedicated adults. Isoflurane significantly prolonged the QTc interval, in contrast to halothane, which shortened the QTc interval. The aim of the study was to evaluate the effect of sevoflurane on the QT interval in patients undergoing non-cardiac surgery. ⋯ The amount the sevoflurane-associated QT prolongation may possibly be of clinical significance in some patients presenting long QT syndrome, hypokalemia, or in presence of other agents or factors that lengthen QT.
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Minerva anestesiologica · Sep 2001
Randomized Controlled Trial Comparative Study Clinical TrialHypertonic saline solution: a safe alternative to mannitol 18% in neurosurgery.
To evaluate the usefulness of hypertonic saline solutions (HTS) as an alternative to mannitol in neurosurgery. ⋯ HTS can safely be used in humans they obtain a reduction of ICP without reducing CVP, serum osmolality and Na+ serum values. Our data underline the possibility of their use as an alternative to mannitol in the treatment of patients scheduled for intracranial surgery, especially when multiple doses are needed.
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The constant search for increased efficiency and reduction of hospital length of stay has led to an increase number of major orthopedic procedures performed as outpatients and the increase in the associated intensity and duration of acute postoperative pain. Although, it is well established that single peripheral blocks provide adequate anesthesia and excellent immediate postoperative analgesia in patients undergoing minor ambulatory orthopedic surgery, the postoperative acute pain benefit is limited to less than 24 hours. However, many patients required over 24 hours of intensive postoperative analgesia. ⋯ The recent introduction of safer local anesthetics producing preferential sensory blocks along with the development of ambulatory pumps has allow to extend the use of these continuous block techniques to ambulatory patients. Recent development also included the use of cox2 inhibitors along with cold maximize postoperative analgesia. This multimodal approach has been proven to be safe and efficacious as much for resting pain than pain associated with exercise.
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Minerva anestesiologica · Sep 2001
Randomized Controlled Trial Clinical TrialImplementing sevoflurane anesthesia with small doses opioid for upper abdominal surgery. Postoperative respiratory function after either remifentanil or fentanyl.
The aim of this prospective, randomized study was to compare the effects on intraoperative cardiovascular homeostasis, recovery profile and postoperative oxygen saturation after sevoflurane anesthesia with small doses of either remifentanil or fentanyl in combination with postoperative epidural analgesia. ⋯ Implementing sevoflurane anesthesia with very small remifentanil infusion provides a safe and effective hemodynamic control reducing sevoflurane consumption during the procedure, and produces less respiratory effects postoperatively as compared with intermittent bolus administration of fentanyl.