Minerva anestesiologica
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Minerva anestesiologica · Apr 2012
ReviewMyths and facts in neuromuscular pharmacology. New developments in reversing neuromuscular blockade.
Fink & Hollman describe and refute several commonly-held myths regarding neuromuscular pharmacology. Their evidence-supported arguments are:
- Intubating patients without muscle relaxants is less safe and sub-optimal.
- Even if you know muscle relaxant pharmacokinetics, it is sufficiently unpredictable that neuromuscular monitoring and reversal is still necessary.
- Post-operative residual curarization (PORC) is clinically significant with real consequences.
- Postoperative residual curarization (PORC) is common.
- Postoperative residual curarisation (PORC) (TOFR < 0.9) can only be diagnosed with a quantitative neuromuscular monitor. Clinical tests are insufficient and poorly sensitive.
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Minerva anestesiologica · Apr 2012
Randomized Controlled Trial Comparative StudySelf-directed deliberate practice with virtual fiberoptic intubation improves initial skills for anesthesia residents.
Fiberoptic intubation is a core skill in anesthesiology. However, this complex psychomotor skill is challenging to learn in the clinical setting. The goal of this study was to evaluate the Virtual Fiberoptic Intubation (VFI) software as an adjunct to the traditional fibreoptic intubation teaching. ⋯ Self-directed practice using VFI software may improve the initial acquisition of fibreoptic intubation skills for anesthesia residents.
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Minerva anestesiologica · Apr 2012
Randomized Controlled TrialEffect of three different doses of ketamine prior to general anaesthesia on postoperative pain following Caesarean delivery: a prospective randomized study.
Ketamine is an analgesic suitable for the induction of anesthesia during Caesarean delivery. This double blind, randomized trial examined the effect of intravenous ketamine used before the induction of general anesthesia on morphine consumption, immediate and long term postoperative pain after Cesarean delivery. ⋯ There was no difference regarding early and late postoperative pain and morphine consumption with ketamine at doses of 0.25, 0.5, and 1 mg kg(-1) in women undergoing Caesarean delivery under general anaesthesia, compared with the control group.