Minerva anestesiologica
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Minerva anestesiologica · Dec 2013
Randomized Controlled Trial Comparative StudyRandomized controlled comparison of combined general and epidural anesthesia versus general anesthesia on diaphragmatic function after laparoscopic prostatectomy.
Little is known about the effect of anesthetic technique on postoperative diaphragmatic function, which is associated with postoperative morbidity and recovery in patients undergoing laparoscopic pelvic surgery. The aim of this trial was to study the effect of combined general and epidural anesthesia versus general anesthesia on postoperative diaphragmatic function measured by ultrasonography in patients undergoing robot-assisted laparoscopic radical prostatectomy (RALRP). ⋯ Combined general and epidural anesthesia may attenuate the severity of postoperative diaphragmatic dysfunction after RALRP compared to conventional general anesthesia.
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Minerva anestesiologica · Dec 2013
Comparative Study Clinical TrialComparison of Three High Flow Oxygen Therapy Delivery Devices: A Clinical Physiological Cross-over Study.
High-flow-oxygen-therapy is provided by various techniques and patient interfaces, resulting in various inspired-fraction of oxygen (FiO2) and airway-pressure levels. However, tracheal measurements have never been performed. ⋯ On one hand, Boussignac(TM) is the only device that generates a relevant positive-airway-pressure during both inspiration-and-expiration, independently of mouth-position. Optiflow(TM) provides a low positive-airway-pressure (<4 cmH2O), highly dependent of mouth-closing. The reservoir-bag-facemask provides no positive-airway-pressure. On the other hand, FiO2 are slightly but significantly higher for Optiflow(TM) and reservoir-bag-facemask than for Boussignac(TM). Discomfort was lesser for Optiflow(TM) and reservoir-bag-facemask.
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Minerva anestesiologica · Dec 2013
Randomized Controlled TrialUltrasound-guided single shot caudal block anesthesia reduces postoperative urinary catheter-induced discomfort.
Urinary catheter-induced discomfort during the postoperative period can be distressing, and sometimes results in severe restlessness and agitation, especially in middle-aged and elderly male patients. Recent advances in ultrasound technology have increased the consistency, safety, and ease of a caudal block even in older patients. We speculated that an ultrasound-guided caudal block would be reliable and safe as treatment for such postoperative discomfort. ⋯ Preoperative ultrasound-guided single shot caudal block anesthesia safely reduced postoperative urinary catheter-induced discomfort in our male patients.
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Minerva anestesiologica · Dec 2013
Multicenter StudyClinical characteristics and prognosis of pneumonia and sepsis: multicenter study.
Pneumonia is the primary source of sepsis and is significantly associated with mortality. However, only a few studies focus on its clinical characteristics and outcomes. ⋯ In patients admitted with sepsis, the pneumonia infection independently predicts 28-day in-hospital mortality. Combining the levels of serum lactate and PF ratio could be a useful approach in predicting mortality of these patients.
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Interest in techniques and applications of the transversus abdominis plane (TAP) block has expanded exponentially since its introduction over ten years ago. The choice of techniques and approaches has been assisted with the availability of ultrasound, but the optimal injection for certain surgical incisions are not yet clear. A literature search was performed looking at anatomical and distribution studies, and clinical trials evaluating the effects of TAP blocks in patients undergoing abdominal surgery. ⋯ Clinical and contrast studies indicate that the landmark and ultrasound guided TAP blocks differ in their spread and mode of action. Regardless, both techniques provide effective analgesia for abdominal surgery. Further research is required to compare TAP blocks with epidural analgesia.