Minerva anestesiologica
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Minerva anestesiologica · Jul 2006
Randomized Controlled TrialLevobupivacaine versus racemic bupivacaine for spinal anaesthesia in orthopaedic major surgery.
Levobupivacaine, a new local anaesthetic, has been recently introduced into clinical practice because of its lower toxic effects for heart and central nervous system. It has been already investigated in epidural and loco-regional techniques, but more has to be known regarding its characteristics in spinal anaesthesia. The aim of our study was to compare clinical and anaesthetic features of levobupivacaine and racemic bupivacaine when intrathecally administered in 60 patients undergoing major orthopaedic surgical procedures. ⋯ In conclusion, levobupivacaine results a valid alternative to racemic bupivacaine for spinal anaesthesia, the latter remaining a cheap and effective local anaesthetic yet. Notwithstanding the complete absence of any significant hemodynamic complications in the patients of group L, further and larger studies are needed in order to assess if levobupivacaine is preferable to bupivacaine for minimizing the possible cardiovascular impact of spinal anaesthesia.
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Minerva anestesiologica · Jul 2006
Randomized Controlled TrialThe effects of hydroxyethyl starch solution in critically ill patients.
In the treatment of the critically ill patients an adequate fluid therapy appears to be essential to optimize hemodynamics and to get a suitable tissue perfusion. In this study we have evaluated the effects of volume replacement, carried out with 2 different solutions: hydroxyethyl starch 6% (HAES) and albumin 20% (HA). ⋯ Since hydroxyethyl starch induced a hemodynamic and clinical improvement, these effects translated into an improvement of sensorium and a reduction of APACHE II score, without causing pulmonary edema, we can conclude that hydroxyethyl starch 6% ws 130,000 dalton ms 0.4 (Voluven) is an effective fluid for resuscitation of hypovolemic patients and represent an attractive alternative to albumin.
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Minerva anestesiologica · May 2006
Randomized Controlled Trial Multicenter Study Comparative StudyCisatracurium versus vecuronium: a comparative, double blind, randomized, multicenter study in adult patients under propofol/fentanyl/N2O anesthesia.
The aim of this study was to compare the time course characteristics of cisatracurium (C) and vecuronium (V) induced neuromuscular block (NMB) following multiple doses, allowing spontaneous complete recovery (SCRT) and evaluating the influence of age. ⋯ C and V allow predictable NMB duration and spontaneous recovery even if administered in multiple repeated doses; but in elderly patients duration of block and recovery time is longer following V.
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Minerva anestesiologica · May 2006
Randomized Controlled Trial Comparative StudyRemifentanil vs fentanyl with a target controlled propofol infusion in patients undergoing craniotomy for supratentorial lesions.
Remifentanil hydrochloride is an ultra-short acting m-opioid receptor agonist. This study compared the use of remifentanil with that of fentanyl during elective supratentorial craniotomy in a target controlled infusion (TCI)-propofol anesthesia regimen and evaluated the quality of recovery from anesthesia. ⋯ Remifentanil appears to be a reasonable alternative to fentanyl during elective surgery of supratentorial lesions.
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Minerva anestesiologica · Apr 2006
Randomized Controlled TrialLevobupivacaine and ropivacaine in the infraclavicular brachial plexus block.
Infraclavicular brachial plexus block were first described by Raj, yet this block remained underutilized despite theoretical advantages. The aim of this prospective, randomized study was to compare equipotent doses of levobupivacaine and ropivacaine. ⋯ The long duration of sensory block associated with the with good analgesia, less toxicity and the pharmacodynamic properties of levobupivacaine include this new local anaesthetic as a valid choice respect other local anaesthetic for infraclavicular plexus block.