Minerva anestesiologica
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Minerva anestesiologica · Nov 2018
ReviewEffects of inhalation and intravenous anesthesia on intraoperative cardiopulmonary function and postoperative complications in patients undergoing thoracic surgery.
There is a high incidence of postoperative cardiopulmonary complications after thoracic surgery with one lung ventilation (OLV), the effect of general anesthetics on intraoperative cardiopulmonary function and postoperative complications is still unclear. ⋯ Inhalation anesthesia can preserve intraoperative cardiac function and reduce postoperative pulmonary complications in patients undergoing thoracic surgery with OLV; although it decreases intraoperative pulmonary function, inhalation anesthesia may be superior to intravenous anesthesia in thoracic surgery. Publication bias existed in some included studies, and the sample size was not large enough in CI and cardiac adverse events.
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Minerva anestesiologica · Nov 2018
Comparative StudyVolatile anesthetics versus propofol in the cardiac surgical setting of remote ischemic preconditioning: a secondary analysis of a Cochrane Systematic Review.
So far, the concept of remote ischemic preconditioning (RIPC) failed its translation from experimental to clinical studies. In addition to our Cochrane Systematic Review, we systematically assessed the use of the intravenous anesthetic propofol, as a potential confounding factor. ⋯ Present data do not permit a final assessment regarding the role of volatile or intravenous anesthetics as a possible confounding factor in RIPC trials.
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Minerva anestesiologica · Nov 2018
ReviewConsiderations in treating obese patients in office-based anesthesia.
The rise in obesity prevalence worldwide has presented problems for practitioners treating patients in the ambulatory setting. As more procedures are being performed in office-based suites, anesthesiologists are being asked to provide more anesthesia services for obese patients that may compromise safety. ⋯ However, not every OBA location is similar, thus contributing to the difficulty in establishing consensus BMI limits. Here, we review literature addressing obesity in ambulatory surgery and point out concerns that anesthesiologists should consider when treating obese patients in an OBA setting.
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Minerva anestesiologica · Sep 2018
ReviewChronic non-cancer pain in children: we have a problem, but also solutions.
Chronic non-cancer pain in children and adolescents has been described as "a modern public health disaster" that has generated significant medical and economic burdens within society. Seen as a disease in its own right, chronic pain has short and long-term consequences that impact not only the patient's health but also that of friends and families, due to significant parenting stress and disruptions in family life and structure. ⋯ Using a bio-psycho-social approach, a multidisciplinary team, including a physiotherapist, nurse, social worker, psychologist, and physician, has been effective in achieving this outcome of improved functioning in children and adolescents with chronic pain. In this review, we discuss the impact, associated conditions, and evolution of chronic pain, along with the crucial role of every member of a multidisciplinary chronic pain clinic involved in the care of the children and adolescents with chronic non-cancer pain.
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Minerva anestesiologica · Sep 2018
ReviewNon-ventilatory therapies for acute respiratory distress syndrome.
Acute respiratory distress syndrome (ARDS) commonly affects intensive care unit patients and is associated with high mortality. In addition to etiologic treatment and protective ventilation, non-ventilatory therapies represent a significant part of ARDS care. Pharmacological treatments, extra corporeal devices and prone positioning are commonly grouped under this term. ⋯ The debate concerning the role of corticosteroids could be renewed considering the emergence of new biomarkers. Finally, the use of extracorporeal membrane oxygenation and extra-corporeal CO2 removal remain under question. The aim of this review is to summarize the latest data concerning the mainly used non-ventilatory therapies and to integrate them into a global strategy of ARDS patient care.