Minerva anestesiologica
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Minerva anestesiologica · Nov 2012
Randomized Controlled TrialRespiratory mechanics at different PEEP level during general anesthesia in the elderly: a pilot study.
General anesthesia could imply that the closing capacity exceed the functional residual capacity. This phenomenon, associated with a reduction of maximal expiratory flow, could lead to expiratory flow limitation (EFL). The aim of our study was to verify 1) a new method of determining EFL during anesthesia (PEEP test); 2) if anesthesia could be associated with the development of EFL; 3) if the use a small amount of PEEP is able to reverse the possible negative effects of low lung volume ventilation. ⋯ The PEEP test allowed to verify that EFL during anesthesia is a valuable phenomenon. The use of 5 cmH(2)O of PEEP was helpful to prevent the deterioration of lung mechanics that occurs during surgery.
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Minerva anestesiologica · Nov 2012
Randomized Controlled TrialTransversus abdominis plane block in combination with general anesthesia provides better intraoperative hemodynamic control and quicker recovery than general anesthesia alone in high-risk abdominal surgery patients.
Patients with severe cardiovascular disease are frequently hemodynamically unstable during abdominal surgery. Improving the safety of such patients by stabilizing intraoperative hemodynamics remains a major concern for anesthesiologists. Transversus abdominis plane (TAP) block in combination with general anesthesia may facilitate optimum anesthetic management of these high-risk patients. ⋯ For abdominal surgery in patients with severe cardiovascular disease, combining TAP block with general anesthesia promotes intraoperative hemodynamic stability and early emergence from anesthesia.