Articles: operative.
-
Minerva anestesiologica · Jun 2023
Randomized Controlled TrialComparison of ultrasound-guided erector spinae plane block and thoracic paravertebral block for postoperative analgesia after laparoscopic nephrectomy: a randomized controlled non-inferiority clinical trial.
Thoracic paravertebral block offers effective analgesia after laparoscopic nephrectomy but has potential severe complication risks. Erector spinae plane block has been described for analgesia after abdominal surgery. However, there are no prospective randomized trials determining if ultrasound-guided erector spinae plane block is non-inferior to thoracic paravertebral block in terms of analgesia after abdominal surgeries including laparoscopic nephrectomy. ⋯ This study demonstrates that erector spinae plane block provides non-inferior analgesia for pain at rest within 24 postoperative hours in comparison to thoracic paravertebral block for laparoscopic nephrectomy.
-
Randomized Controlled Trial Observational Study
Intravascular volume status and stress markers in patients observing long and short duration of fasting: A prospective single blinded observational study.
Preoperative fasting may lead to intravascular volume depletion and this volume depletion may be a cause of perioperative stress. This study intends to compare the levels of stress markers in patients undergoing long and short duration fasting before an elective laparoscopic surgery. ⋯ CTRI/2021/02/031456.
-
Minerva anestesiologica · Jun 2023
ReviewThe efficacy of 5HT3-receptor antagonists in postoperative nausea and vomiting: the role of pharmacogenetics.
Genetic variants may affect drug efficacy on postoperative nausea and vomiting (PONV). The understanding of these mechanisms will help to identify the surgical patients who might benefit from specific prophylactic and therapeutic antiemetic treatment. The aim of the present review was to investigate gene polymorphisms that influence 5-hydroxytryptamine (serotonin) type 3 receptor antagonists (5HT3RA) efficacy in PONV. ⋯ This review highlights that inefficacy of a specific drug in managing PONV could be attributed to specific genetic profiles and patients would possibly benefit from a drug switch.
-
Curr Opin Anaesthesiol · Jun 2023
ReviewRegional anesthesia as part of enhanced recovery strategies in pediatric cardiac surgery.
The purpose of this review article was to highlight the enhanced recovery protocols in pediatric cardiac surgery, including early extubation, rapid mobilization and recovery, reduction of opioid-related side effects, and length of pediatric ICU and hospital stay, resulting in decreased costs and perioperative morbidity, by introducing recent trends in perioperative anesthesia management combined with peripheral nerve blocks. ⋯ Recent remarkable advances in combined ultrasound techniques have made it possible to perform various peripheral nerve blocks. The major strategy underlying fast-track anesthesia management is to achieve good analgesia while reducing perioperative opioid use. Furthermore, it is important to consider early extubation not only as a competition for time to extubation but also as the culmination of a qualitative improvement in the outcome of treatment for each patient.
-
Curr Opin Anaesthesiol · Jun 2023
ReviewA new view on old problems in paediatric anaesthesia: premedication, postoperative agitation and dosing.
The aim of this review is to discuss recent developments in paediatric anaesthesia, which have evolved in an undulating fashion. ⋯ Midazolam and dexmedetomidine are not interchangeable; each compound has its pros and cons. As an anxiolytic drug, midazolam indisputably deserves its place, whereas dexmedetomidine is a better sedative and particularly beneficial in the postoperative period. New data will allow more precise age-adapted dosing of propofol.