Minerva anestesiologica
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Minerva anestesiologica · Jun 1998
Randomized Controlled Trial Clinical Trial[The effects of a dose of epidural clonidine combined with intrathecal morphine for postoperative analgesia].
To evaluate the effectiveness of a single bolus of epidural (ED) clonidine (C) associated with intrathecal morphine (M) on postoperative analgesia after cesarean section (CS). ⋯ A single ED bolus of C 150 micrograms after CS significantly enhances and prolongs the analgesic effect of M 250 micrograms without important side effects.
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Minerva anestesiologica · May 1998
Review Randomized Controlled Trial Clinical Trial[Indications for steroid and tirilazad treatment in patients with subarachnoid hemorrhage].
Tirilazad mesylate, a nonglucocorticoid 21-aminosteroid, has been used in two randomized, double-blind, vehicle-controlled trials in Europe, Australia, New Zealand, and in North America in patients with aneurysmal subarachnoid hemorrhage. The first trial has been concluded, enrolled 1023 patients, and demonstrated a dramatic reduction in mortality from 27% to 3% (p = 0.01) in males receiving 6 mg/kg/day tirilazad for 10 days, when compared to vehicle-treated patients. ⋯ This clinical trial suggest that tirilazad mesylate, at a dosage of 6 mg/kg/day, improves overall outcome in aneurysmal subarachnoid hemorrhage patients. Further data from the North America trial and the trial in women receiving higher doses of tirilazad are still pending.
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Minerva anestesiologica · Jan 1998
Randomized Controlled Trial Comparative Study Clinical Trial[The effect of anesthesiologic technique on the mental state of elderly patients submitted for orthopedic surgery of the lower limbs].
Influence of anesthetic technique on mental status in elderly patients submitted to major orthopedic procedures of lower limbs. Mental impairment is a common occurrence in elderly patients after major orthopedic surgery. Few studies have been published so far on this topic in spite of its relevant clinical and economic implications. ⋯ Mental status of elderly patients submitted to femoral neck repair doesn't seem to be influenced by the anesthetic technique chosen, independent of preoperative psychic conditions.
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Minerva anestesiologica · Dec 1997
Randomized Controlled Trial Comparative Study Clinical TrialComparative evaluation of the cardiorespiratory effects of assist control ventilation vs pressure support ventilation in patients following orthotopic liver transplantation.
1) To compare the haemodynamic tolerance of ACV and PSV in patients mechanically ventilated after orthotopic liver transplantation; 2) to compare patients comfort during ACV and PSV. ⋯ ACV and PSV provided a comparable haemodynamic tolerance in our patients, although during PSV the PaO2 was slightly decreased, probably due to decreased mean airway pressure (from 9.3 +/- 1.2 cmH2O during ACV to 6.6 +/- 1 cmH2O during PSV). PSV can be considered as a good alternative to the standard weaning techniques following orthotopic liver transplantation.
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Minerva anestesiologica · Apr 1997
Randomized Controlled Trial Clinical TrialSpinal anesthesia with clonidine and bupivacaine in young humans: interactions and effects on the cardiovascular system.
Clonidine, an alpha 2 agonist, is known to prolong the action of local anesthetics, and to provide a satisfactory analgesia; hypotension and bradycardia have been observed after its intrathecal administration. The aim of our study was to determine whether intrathecal administration of clonidine can reduce the dose of local anesthetic, and the effects of clonidine on the cardiovascular system, and on arousal level. ⋯ In summary, the addition of clonidine to hyperbaric bupivacaine seems to be particularly useful in unilateral spinal anesthesia, exerting minimal influence on haemodynamic parameters, and guaranting a satisfactory postoperative analgesia.