Minerva anestesiologica
-
Minerva anestesiologica · Jun 2007
Randomized Controlled TrialPostoperative vomiting reduction after laparoscopic cholecystectomy with single dose of dexamethasone.
The incidence of postoperative nausea and vomiting (PONV) is high after laparoscopic surgery. A number of drugs have been used for prevention; in some studies a single dexamethasone dose before induction of anaesthesia has been effective. ⋯ Although only a small number of patients were tested, we confirm the efficacy of dexamethasone therapy for reduction of PONV. We suggest routine use of a single dose of dexamethasone for the prevention of PONV in laparoscopic cholecystectomy.
-
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.