Minerva anestesiologica
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Minerva anestesiologica · Jan 2008
Randomized Controlled TrialEffects of remifentanil on propofol requirements for loss of consciousness in target-controlled infusion.
We evaluated the effects of various doses of target-controlled remifentanil on the propofol requirements for the loss of consciousness (LOC) and the consequent hemodynamic changes on the induction of intravenous anesthesia in day-case surgery. ⋯ The effect of altering the target-controlled remifentanil concentration during propofol induction was found to be dose-dependent. There was no significant difference in the cardiovascular response with the studied range of concentrations of remifentanil and propofol.
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Minerva anestesiologica · Dec 2007
Randomized Controlled TrialSubhypnotic doses of midazolam prevent nausea and vomiting during spinal anesthesia for cesarean section.
We aimed to evaluate the efficacy of subhypnotic doses of midazolam and propofol for peripartum nausea and vomiting during regional anesthesia for elective cesarean section in order to prevent emesis in at least 50% of patients. ⋯ A subhypnotic dose of midazolam (1 mg x h(-1)) was as effective as the subhypnotic dose of propofol (1 mg x kg(-1) x h(-1)) for the prevention of nausea and vomiting in parturients undergoing cesarean section under spinal anesthesia.
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Minerva anestesiologica · Dec 2007
Randomized Controlled TrialThe analgesic efficacy of tramadol in ambulatory gynecological laparoscopic procedures: a randomized controlled trial.
To evaluate the postoperative analgesic efficacy of intravenous tramadol 50 mg administered before anesthetic induction in patients undergoing ambulatory gynecological laparoscopic procedures. ⋯ Intravenous tramadol 50 mg given before anesthetic induction did not reduce pain intensity but was well tolerated. Although tramadol statistically reduced the paracetamol requirement in the first 24 h postoperatively, it did not seem to provide a significant clinical advantage.
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Minerva anestesiologica · Nov 2007
Randomized Controlled Trial Multicenter Study Comparative StudyThe unanticipated difficult intubation: rigid or flexible endoscope?
Unanticipated difficult intubation occurs with a frequency between 1.5% and 8.5%. The aim of this study was to compare the use of flexible versus rigid endoscopy in such a patient population, with respect to the preparation time and feasibility of each device. ⋯ Both endoscopic techniques enable quick and safe intubation. The Bonfils method could be the method of choice in cases of already relaxed patients with unanticipated difficult conventional laryngoscopy, presuming that the anaesthetist is familiar with this technique. Because the clinical re-evaluation for possible predictors of difficult intubation revealed no unknown new factors, the preoperative examination for anatomical peculiarities and being aware are the best protection against unanticipated intubation problems.
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Minerva anestesiologica · Jun 2007
Randomized Controlled TrialShort term analgesia based sedation in the Intensive Care Unit: morphine vs remifentanil + morphine.
The aim of the study was the evaluation of postoperative short term analgesia-based sedation provided by a continuous i.v. morphine vs morphine+remifentanil infusion in the ICU. ⋯ The combination of morphine + remifentanil provided better analgesia and sedation than morphine alone, with a lower incidence of side effects and a similar hemodynamic profile and patient satisfaction. The adherence to a clear analgesia based sedation protocol probably represents the most important issue carrying out analgosedation; however, the continuous infusion of a short acting drug, although more expensive, allows better titration and adjustment of the desired level of analgesia and sedation, avoiding the risk of undersedation as well as oversedation with a potential reduction of otherwise unnecessary ICU stays and, consequently, a decrease in comprehensive costs.