Minerva anestesiologica
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Minerva anestesiologica · Jul 1999
Randomized Controlled Trial Clinical TrialShortening the discharging time after total hip replacement under combined spinal/epidural anesthesia by actively warming the patient during surgery.
To compare passive thermal insulation by reflective blankets with forced-air active warming on the efficacy of normothermia maintenance and time for discharging from the recovery room after combined spinal/epidural anesthesia for total hip arthroplasty. ⋯ Forced-air cutaneous warming allows the anesthesiologist to maintain normothermia during combined spinal/epidural anesthesia for total hip replacement even if the convective blanket is placed on a relatively small skin surface with reflex vasoconstriction. Maintaining core normothermia decreased the duration of postanesthesia recovery and may, therefore, reduce costs of care.
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Minerva anestesiologica · Jul 1999
Randomized Controlled Trial Comparative Study Clinical Trial[Percutaneous or surgical trachetomy. Prospective, randomized comparison of the incidence of early and late complications].
To compare early and late complications after either conventional surgical or percutaneous dilatational tracheostomy. ⋯ In experienced hands, percutaneous dilatational tracheostomy is as safe and effective as the conventional surgical tracheostomy. The percutaneous technique is less time-consuming and has a lower rate of early infectious complications with better cosmetic results than the surgical technique.
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Minerva anestesiologica · Jul 1999
Case Reports[Use of the laryngeal mask for airway control in difficult intubations in children].
LMA was introduced in clinical practice by Arthur Brain in 1983 as a valuable substitute of tracheal tube in adult who underwent general anaesthesia; since then its applications have been extensively studied. LMA is a relatively new non-invasive ventilatory device which has allowed a radical change in the management of modern general anaesthesia. ⋯ In all these cases, LMA provided a patient airway and a satisfactory ventilation during both induction and the repeated attempts of inserting the tracheal tube; in one case, since the orotracheal intubation failed, LMA has proved to be as effective as the tracheal tube during the maintenance of general anaesthesia. Therefore, LMA is recommended as an essential ventilatory device in the hands of paediatric anaesthesiologists.
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Minerva anestesiologica · Jul 1999
Case Reports[NMR in the diagnosis and treatment of neurologic lesions in decompression sickness].
The case of a decompression sickness in woman, diving to 26 meter depth is reported. The patient was helped by instructor's computer (error!) and she presented risk factors for embolic disease (obesity, smoke, estroprogestinic therapy). ⋯ She was not treated on the place of incident, but only 36 hours later at our center of hyperbaric medicine. Her Magnetic Resonance imaging showed hyperintensity lesions of white matter.
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A variety of drugs and techniques have been introduced into day surgery over recent years and, although the tide of development appears to have slowed, may of these will still be relatively new to many. Experience with the laryngeal mask continues to grow and it is now a firmly-established airway management tool in a wide variety of procedures. The cuffed oropharyngeal airway is an interesting recent arrival, but produces inferior airway control and is not a true alternative to the laryngeal mask. ⋯ The long-awaited "depth of anaesthesia" monitor may have arrived, offering the possibility of more finely titrated anaesthesia with earlier (but not intraoperative!) awakening. Reliability is as yet uncertain and a simple technique with spontaneous ventilation may achieve similar results at substantially lower cost. The relative place of all these developments will take several years to become apparent and the future remains interesting.