Minerva anestesiologica
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Minerva anestesiologica · Jul 2009
Randomized Controlled TrialSubarachnoid anesthesia vs monitored anesthesia care for outpatient unilateral inguinal herniorrhaphy.
Inguinal herniorrhaphy is one of the most commonly performed surgical procedures in a same-day surgery setting. The prerequisite of having to discharge the surgical outpatient on the same day has an influence on the choice of the anesthetic technique. ⋯ LA+TCI was shown to be more effective than selective SA at low doses in terms of shorter time to recovery after unilateral inguinal herniorrhaphy procedures.
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Minerva anestesiologica · Jul 2009
Randomized Controlled TrialEffects of recombinant human activated protein C on the fibrinolytic system of patients undergoing conventional or tight glycemic control.
Recombinant human activated protein C (rh-APC) and tight glycemic control (TGC) have been shown to reduce mortality in septic patients. Both interventions can reduce the plasma concentration and/or activity of the most powerful suppressor of fibrinolysis, plasminogen activator inhibitor-1 (PAI-1). Our aim was to evaluate the effects on the fibrinolytic system after the administration of rh-APC in septic patients undergoing conventional or TGC. ⋯ Both rh-APC and TGC appear to improve fibrinolysis in septic patients. The reduction in the impairment of fibrinolysis associated with rh-APC treatment seems greater in patients undergoing conventional glycemic control than in those undergoing TGC.
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Minerva anestesiologica · Jun 2009
Randomized Controlled Trial Comparative StudyAssessment of recovery, dreaming, hemodynamics, and satisfaction in postcardiac surgery patients receiving supplementary propofol sedation with S(+)-ketamine.
S(+)-ketamine is an analgesic and sedative drug with dissociative attributes. When it is used without sedatives, nightmares have been described. The aim of this study was to assess the effects of postoperative analgosedation with propofol and S(+)-ketamine when compared to standard propofol analgosedation in terms of recovery, dreaming, hemodynamics, and patient satisfaction. ⋯ Patients receiving S(+)-ketamine showed higher satisfaction for pain management and dreamed more often, but they did not have more nightmares.
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Minerva anestesiologica · May 2009
Randomized Controlled TrialBispectral index-guided intraoperative sedation with dexmedetomidine and midazolam infusion in outpatient cataract surgery.
This study aimed to evaluate the role of alfa-2 agonist infusion, with dexmedetomidine or midazolam, on hemodynamic and respiratory parameters while titrating the sedation level with the bispectral index (BIS) during cataract surgery. ⋯ Dexmedetomidine infusion mildly decreased heart rate in the later periods of surgery with better pain scores in the postoperative period. Dexmedetomidine should be an alternative for intraoperative sedation in outpatient cataract surgery.
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Minerva anestesiologica · May 2009
Randomized Controlled Trial Comparative StudyRegional anesthesia for carotid endarterectomy: a comparison between ropivacaine and levobupivacaine.
This study compares ropivacaine and levobupivacaine when administered for cervical plexus block. The authors therefore compared the arterial pressure profile and the incidence of hypotension between drugs. ⋯ Levobupivacaine has a greater vasodilatory effect than ropivacaine. Its higher incidence of hypotension, although not statistically significant, suggests ropivacaine as the drug of choice for cervical plexus block.