Minerva anestesiologica
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Minerva anestesiologica · Oct 2011
WITHDRAWN The analgesic effect of paracetamol when added to lidocaine for intravenous regional anesthesia.
Ninety patients undergoing elective hand surgery with IVRA were randomly assigned to three groups to receive either IV saline and C-IVRA with 0.5% lidocaine 3 mg/kg (control group, N=30), IV saline and IVRA with 0.5% lidocaine and 20 mL paracetamol (10 mg/cc) (P-IVRA group, N=30) or IV paracetamol and IVRA with 0.5% lidocaine (L-IV group, N=30). The following were measured: 1) sensory and motor block onset and recovery time, 2) tourniquet pain after tourniquet application and at 10, 20 and 30 min after tourniquet deflation, 3) the visual analog scale (VAS) scores of tourniquet pain at 30 min and 1, 2, 4, 6 and 24 h postoperatively, 4) the time to first analgesic requirement, 5) total analgesic consumption in 24 h and 6) side effects. ⋯ Perfalgan as an adjunct to lidocaine improves postoperative analgesia in IVRA without adverse effects.
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Minerva anestesiologica · Oct 2011
WITHDRAWN Coronary artery spasm associated with blood brain barrier disruption induced by carotid sinus stimulation.
Ahead of Print article withdrawn by publisher Blood brain barrier disruption (BBBD) is a novel technique for treating central nervous system lymphoma. This technique depends on the disruption of the tight junctions between endothelial cells (which represent the blood brain barrier) by intra-arterial injection of mannitol. ⋯ Here, the authors present a rare complication of coronary artery spasm manifested by elevation of the ST segment and bradycardia due to carotid sinus stimulation in a 33 year-old-male during blood brain barrier disruption. To the authors' knowledge, this is the first report of a coronary artery spasm complicating blood brain barrier disruption.
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Ahead of Print article withdrawn by publisher Although anesthesia has become increasingly safe, there remain significant differences among countries in terms of training standards and practice regulations. There is evidence and widespread consensus that the occasional practice of pediatric anesthesia should be avoided, and there is a trend towards the centralization of pediatric surgical activity. ⋯ In recent years, focus has been directed at validating the efficacy of simulation training and at its cost-effectiveness for improving learning and patient outcomes. Future challenges will include the best way to integrate simulation into the existing pediatric anesthesia training curricula, the determination of better evidence of its impact on clinical performance and the design and validation of assessment tools for technical and non-technical skills.
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Minerva anestesiologica · Oct 2011
Randomized Controlled Trial Comparative StudyThe nerve stimulation technique versus the loss of resistance technique for the posterior approach to lumbar plexus block: a randomized, prospective, observer-blinded, pilot study.
This prospective, randomized, observer-blinded, pilot study compares the effects of the nerve stimulation guidance technique (NS) with the loss of resistance technique (LOR) on readiness for surgery during the posterior approach to lumbar plexus block. ⋯ Nerve stimulation allowed faster readiness for surgery than loss of resistance. Nevertheless, the two techniques seem to be comparable in terms of local anesthetic consumption, morphine requirements and pain scores.
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Minerva anestesiologica · Oct 2011
ReviewItalian intersociety consensus statement on antithrombotic prophylaxis in hip and knee replacement and in femoral neck fracture surgery.
Anticoagulant prophylaxis for preventing venous thrombembolism (VTE) is a worldwide established procedure in hip (HR) and knee replacement (KR) surgery, as well as in the treatment of femoral neck fractures (FNF). Different guidelines are available in the literature, with quite different recommendations. None of them is a multidisciplinary effort as the one presented. ⋯ This inter-society consensus statement aims at simplifying the grading system reported in the literature, and thus at improving its proper application. Special focus is given to fragile patients, those with high bleeding risk, and on those receiving chronic antiplatelet and vitamin K antagonists treatment. A special chapter is dedicated to regional anesthesia and VTE prophylaxis.