Minerva anestesiologica
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Delirium is a common complication during the postoperative period. Because of its significant associations with physical and cognitive morbidity, clinicians should be aware of the evidence-based practices relating to its diagnosis, treatment, and prevention. Here, we review select recent literature pertaining to the epidemiology and impact of postoperative delirium, the perioperative risk factors for its development and/or exacerbation, and the strategies for its management, with additional attention paid to the population of patients in intensive care units.
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Minerva anestesiologica · Apr 2011
Randomized Controlled TrialThe effects of physostigmine on recovery from general anesthesia in elderly patients.
Transient cognitive dysfunction after general anesthesia is a frequent finding among elderly patients. The aim of this study was to evaluate whether the use of physostigmine may enhance recovery from general anesthesia in elderly patients. ⋯ The intraoperative infusion of physostigmine enhances alertness, coordination, manual dexterity and mobilization after general anesthesia in elderly patients, but physostigmine administration does not affect orientation or sedation.
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Minerva anestesiologica · Apr 2011
Comparative StudyContinuous spinal anesthesia versus continuous femoral nerve block for elective total knee replacement.
Continuous spinal analgesia (CSA) and continuous femoral nerve blockade (CFNB) are well-established procedures for postoperative pain relief. This study compares the efficacy, adverse effects and complications associated with these two analgesic methods in patients undergoing total knee arthroplasty (TKA). ⋯ Both methods demonstrated analgesic efficacy after total knee arthroplasty, although there was less pain severity and opioid consumption use reported with continuous spinal analgesia. However, the use of continuous spinal analgesia is limited by concerns about the risk profile and absence of approved devices for continuous intrathecal infusion.
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Minerva anestesiologica · Apr 2011
Outcome and mortality risk factors in long-term treated ICU patients: a retrospective analysis.
Little is known about the prognosis and outcome of critically ill patients with a prolonged length of stay (LOS). The aim of this study was to examine mortality and its risk factors in patients requiring intensive care therapy for more than 30 days. ⋯ Although the long-term treatment of critically ill patients requires significant effort, the outcome for this particular cohort was reasonably favorable. Prolonged mechanical ventilation and weaning are the factors that influence mortality independently of sepsis. Because reasonable improvements can be shown even after a prolonged LOS, further attention should be paid to weaning processes.