Minerva anestesiologica
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Minerva anestesiologica · Jan 2012
Multicenter StudyITalian Observational Study of the management of mild-to-moderate Post-Operative Pain (ITOSPOP).
The multicenter observational ITalian Observational Study on the management of mild-to-moderate PostOperative Pain (ITOSPOP) was carried out in 24 hospitals to describe current postoperative pain management in Italy and the intensity of pain experienced by patients during the first 48 hours after surgery. ⋯ The level of organization and standardization of postoperative pain management in Italian hospitals remains low. Postoperative analgesic treatment remained suboptimal and almost two-thirds of patients continued to experience pain.
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Minerva anestesiologica · Jan 2012
Influence of opioid choice on mechanical ventilation duration and ICU length of stay.
The aim of this study was to assess the impact on mechanical ventilation and ICU outcomes of substituting remifentanil for sufentanil, in an analgesia-based sedation protocol. A database of data prospectively collected was retrospectively analyzed. The study was carried out in a 16-bed tertiary-care ICU. ⋯ Our study suggests that using a short-acting opiate with short context-sensitive half-life in an analgesia-based sedation protocol may significantly decrease the duration of mechanical ventilation and the ICU length of stay even though not significantly in long term sedation, while improving the achievement of sedation goals despite a lower requirement for adjunctive hypnotic agents, with no additional costs.
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Minerva anestesiologica · Jan 2012
Comparative StudyDo on- and off-pump coronary bypass surgery differently affect perioperative peripheral tissue metabolism?
Microdialysis allows the in-vivo assessment of interstitial fluids. We studied the metabolic status of peripheral tissues (skeletal muscle) in patients undergoing coronary artery bypass surgery on- (CABG) or off-pump (OPCAB). ⋯ Metabolic changes after coronary bypass surgery occur with some differences related to CPB use. Overall, these changes suggest that, after coronary surgery, a certain degree of hypermetabolic state ensues, lasting up to 24 hours after surgery; the postoperative increase in pyruvate levels in CABG patients, together with the changes in L/P ratio occurring only in OPCAB patients implies an higher risk of tissue hypoperfusion/ischemia for patients submitted to OPCAB, although this does not lead to permanent cellular damage, as the markers of this complication (e.g., glycerol) do not change over time.
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Minerva anestesiologica · Jan 2012
Editorial CommentOff-pump coronary surgery: is it just a surgical matter?