Minerva anestesiologica
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Minerva anestesiologica · Oct 2021
Randomized Controlled TrialThe effects of two-handed jaw thrust on i-gel™ placement in anesthetized non-paralyzed patients.
I-gelTM is a second-generation supraglottic airway device with a non-inflatable cuff. In this prospective randomized investigation, we evaluated the effects of two-handed jaw thrust technique on i-gel insertion in anesthetized non-paralyzed patients. ⋯ The two-handed jaw thrust technique facilitated i-gel insertion compared to the conventional technique in anesthetized non-paralyzed patients.
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Minerva anestesiologica · Oct 2021
Randomized Controlled TrialSafety and efficacy of remimazolam compared with propofol in induction of general anesthesia.
Remimazolam is a new ultrashort acting benzodiazepine anesthetic which has predictable sedative duration and rapid recovery in gastrointestinal endoscopy. Propofol is a commonly used intravenous anesthetic in clinical work which also has rapid action, short action time and rapid recovery. To date, there have been relatively few articles comparing the two for general anesthesia induction. So, we conducted a randomized trial to evaluate whether remimazolam is superior to propofol during anesthesia induction in terms of efficacy and safety. ⋯ Remimazolam is a safe and effective sedative drug during induction with less adverse effects for general anesthesia in ASA I or II patients.
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Minerva anestesiologica · Oct 2021
Randomized Controlled TrialWhat's new on EEG monitoring in the ICU.
Continuous video-EEG (cEEG, lasting hours to several days) is increasingly used in ICU patients, as it is more sensitive than routine video-EEG (rEEG, lasting 20-30 min) to detect seizures or status epilepticus, and allows more frequent changes in therapeutic regimens. However, cEEG is more resource-consuming, and its relationship to outcome compared to repeated rEEG has only been formally assessed very recently in a randomized controlled trial, which did not show any significant difference in terms of long-term mortality or functional outcome. ⋯ Prolonged EEG has been used recently in patients with severe COVID-19 infection, the proportion of seizures seems albeit relatively low, and similar to ICU patients with medical conditions. As a timely EEG recording is recommended in the ICU in any case, recent technical developments may ease its use in clinical practice.
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Minerva anestesiologica · Sep 2021
Randomized Controlled Trial Observational StudyComparison of LMA® gastro airway and gastro-laryngeal tube in endoscopic retrograde cholangiopancreatography: a prospective randomized observational trial.
New generation airway devices with different designs have been developed as an alternative to endotracheal intubation in order to avoid adverse events associated with sedation in endoscopic procedures and to provide patent airway. We aimed to compare two supraglottic airway devices (SGADs), the LMA® Gastro™ airway and gastrolaryngeal tube (GLT), in terms of airway efficiency, performance during procedure and adverse events in endoscopic retrograde cholangiopancreatography (ERCP). ⋯ LMA® Gastro™ had a higher OLP than GLT. However, GLT was better for endoscopist satisfaction, as it provides more satisfying maneuverability. As to secondary outcome advers events were lower in LMA® Gastro™. The lower complication rates associated with the device and providing a more patent airway also highlighted the apparent clinical efficacy of LMA® Gastro™ than GLT, in ERCP.
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Minerva anestesiologica · Sep 2021
Randomized Controlled TrialEffects of direct laryngoscopy versus Glidescope videolaryngoscopy on subjective and objective measures of cognitive workload: an in-vivo randomized trial.
Laryngoscopy and tracheal intubation are associated with high operators' workload, which potentially causes lower performance and risk of errors. Measuring anesthesiologists' mental workload during instrumental procedures allows to test the usability of the devices and, by managing operators' workload, improve clinical decision making. The aim of this study was to investigate the differences in subjective and objective cognitive workload between videolaryngoscopy with hyperangulated blade (Glidescope) vs. direct laryngoscopy in a real clinical setting. ⋯ A videolaryngoscope with hyperangluated blade used in a real clinical scenario of elective surgery significantly reduced both subjective and objective workload compared to a direct laryngoscope. Physical demand and effort were the key components in reducing operators' mental workload. Therefore, the expert use of a videolaryngoscope with hyperangulated blade constitutes an ergonomic option that could limit operators' workload and improve patients' safety and operators' well-being.