Minerva anestesiologica
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Minerva anestesiologica · Jul 2011
Randomized Controlled TrialA liberal preoperative fasting regimen improves patient comfort and satisfaction with anesthesia care in day-stay minor surgery.
The aim of this study was to evaluate whether a single preoperative limited oral intake of a carbohydrate drink could improve perioperative patient comfort and satisfaction with anesthesia care in elective day-stay ophthalmologic surgery. ⋯ Standardized limited oral preoperative fluid intake increases patient comfort and satisfaction with anesthesia care and should be a part of modern day-stay ophthalmologic surgery.
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Minerva anestesiologica · Jul 2011
ReviewPostoperative delirium and postoperative cognitive dysfunction in the elderly - what are the differences?
Postoperative cognitive impairment is an increasingly common problem as more elderly patients undergo major surgery. Cognitive deficits in the postoperative period cause severe problems and are associated with a marked increase in morbidity and mortality. ⋯ Both have multifactorial pathogenesis but differ in numerous other ways, with delirium being well-defined and acute in onset and postoperative cognitive dysfunction (POCD) being subtler and with longer duration. This review aims to provide an overview of the differences in the diagnosis of the two entities and to illustrate the methodological problems that can be encountered when evaluating cognitive deficits postoperatively.
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Minerva anestesiologica · Jul 2011
Randomized Controlled TrialEfficacy of the lidocaine/flurbiprofen axetil combination for reducing pain during the injection of propofol.
Pain during the injection of propofol is a common clinical problem. Lidocaine pretreatment, preceded by venous occlusion, is the most popular method for reducing pain during the injection of propofol but cannot entirely control such pain. We aimed to evaluate the efficacy of lidocaine, flurbiprofen axetil (an injectable prodrug of flurbiprofen), and the two in combination for reducing pain during the injection of propofol. ⋯ The lidocaine/flurbiprofen axetil combination, compared with lidocaine 40 mg or flurbiprofen 50 mg, effectively reduces pain during the injection of propofol.
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Minerva anestesiologica · Jul 2011
ReviewPerioperative management of proximal hip fractures in the elderly: the surgeon and the anesthesiologist.
The comprehensive management of proximal hip fractures in elderly patients requires dedicated and responsive teamwork. Elderly patients often present with several comorbidities and the immediate treatment of a fracture has to optimize both medical therapy and analgesic control in order to reduce surgical and anesthetic complications and to preserve as much cognitive functioning as possible. The elderly are uniquely exposed to complications related to bed rest, delirium and postoperative cognitive dysfunction (POCD), which appear to be independent factors of morbidity. ⋯ The best choice of surgical treatment depends on the type of fracture as well as the patient's age and medical condition. However, the type of anesthesia management, which includes neuraxial blocks, peripheral nerve blocks and/or general anesthesia, has to be tailored towards generated the best outcome. We present a review from a surgical and anesthetic perspective on the most common perioperative issues in proximal fracture repair.