Minerva anestesiologica
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Minerva anestesiologica · Sep 2001
Review Comparative Study[Spinal or epidural anaesthesia for caesarean section? Compared opinions].
Regional anaesthesia during caesarean section reduces mortality directly related to anaesthesia. Epidural anaesthesia is a good choice when an epidural anaesthesia was performed during labor. General anaesthesia is recommended only for emergency caesarean section and when regional anaesthesia is contraindicated. ⋯ Epidural opiates have a lower incidence of maddening side effects compared with spinal opiates and allow better maternal satisfaction as regard postoperative analgesia. In accordance with ASA guidelines there are no decisive reasons in order to choice spinal or epidural block: actually literature is unable to give a definitive suggestion about complications and advantages. The choice would be take place weighing up maternal wishes, fetal factors (elective versus urgent caesarean section) and the preferences of the anesthesiologist.
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Minerva anestesiologica · Sep 2001
Randomized Controlled Trial Comparative Study Clinical Trial[Levobupivacaine for peripheral blocks of the lower limb: a clinical comparison with bupivacaine and ropivacaine].
The aim of this study was the comparison of clinical profile of sciatic nerve block performed with either 0,5% levobupivacaine, 0,5% bupivacaine, or 0,5% ropivacaine. ⋯ Using 0,5% levobupivacaine for sciatic nerve block results in similar clinical effects as those produced by using the same volume and concentration of either bupivacaine or ropivacaine.
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Minerva anestesiologica · Sep 2001
Review[Prehydratation and anaesthesia in obstetrics: state of the art].
All epidural or spinal techniques using local anaesthetics causes some degree of sympathetic blockade resulting in peripheral vasodilatation and possibly hypotension or reduction in cardiac output. In the practical clinic, administration of fluids intravenously prior spinal and epidural anaesthesia is required to prevent maternal hypotension and fetal hypoxia. We evaluated in this review the efficacy of volume preloading on the incidence of hypotension after spinal or epidural anaesthesia for caesarean delivery. ⋯ Implications. We performed a review to determine whether fluid loading reduced the incidence of low blood pressure after spinal or epidural anaesthesia for caesarean delivery. Although no technique totally eliminates the occurrence of hypotension, colloid administration (starch or gelatin containing fluids) was the most effective.
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Minerva anestesiologica · Sep 2001
ReviewSufentanil: an overview of its use for acute pain management.
The knowledge of pharmacodynamics and pharmacokinetics of new opioid drugs is necessary so that anaesthesiologists can choose which one to use, considering the patient's pathophysiology, the surgical procedure, and the dose required to obtain the desired effect. Aim of this review was to evaluate relevant trials on perioperative sufentanil in order to design an optimal strategy for administration. ⋯ Efficacy of sufentanil in perioperative epidural or intravenous analgesia resulted the same or better than other drugs used commonly despite context-sensible half-life advantages. Its association with local anaesthetics or adjuvant drugs prolongs its action and sometimes decreases the side effects. From the examined trials results that sufentanil can be used at very low doses and its association with local anaesthetics, clonidine, ketamine, and adrenaline by epidural, intravenous or intrathecal route for perioperative analgesia (intra and postoperative) and by various types of administration (PCA, PCEA, fixed intervals doses, continuous infusion, etc.).
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Minerva anestesiologica · Sep 2001
Randomized Controlled Trial Clinical TrialImplementing sevoflurane anesthesia with small doses opioid for upper abdominal surgery. Postoperative respiratory function after either remifentanil or fentanyl.
The aim of this prospective, randomized study was to compare the effects on intraoperative cardiovascular homeostasis, recovery profile and postoperative oxygen saturation after sevoflurane anesthesia with small doses of either remifentanil or fentanyl in combination with postoperative epidural analgesia. ⋯ Implementing sevoflurane anesthesia with very small remifentanil infusion provides a safe and effective hemodynamic control reducing sevoflurane consumption during the procedure, and produces less respiratory effects postoperatively as compared with intermittent bolus administration of fentanyl.