Minerva anestesiologica
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Minerva anestesiologica · Jan 2014
Clinical Characteristics, Hospital outcome and Prognostic Factors of Patients with Ventilator-related Pneumothorax.
Mechanical ventilation is a common cause of iatrogenic pneumothorax in intensive care units (ICU). Most of the patients with ventilator-related pneumothorax (VRP) have underlying lung diseases and is associated with increased morbidity and mortality. The prognostic factors of VRP are not clear. The objective of this study was to find the possible prognostic factors. ⋯ VRP patients with tension pneumothorax or PaO2/FiO2<200 had a higher risk of death. APACHE II scores were associated with mortality in the VRP patients with PaO2/FiO2≥200 mmHg.
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Minerva anestesiologica · Jan 2014
The effects of intrathecal and systemic adjuvants on subarachnoid block.
Various intrathecal and systemic adjuvants to local anaesthetics have been found to improve the quality and extend the duration of spinal block. Intrathecal opioids are the most frequently used; the lipophilic fentanyl and sufentanil enhance and moderately prolong the sensory block, whereas the hydrophilic morphine significantly prolongs spinal analgesia. Nausea/vomiting, pruritus, urinary retention and respiratory depression are possible side effects. ⋯ Opioids enhance, alpha-2 agonists and ketamine prolong the block, magnesium sulphate reduces postoperative analgesic consumption and nimodipine may delay the regression of sensory block. Nitrous oxide inhalation has also been found to enhance the level of sensory spinal block. Even though opioids are the most popular adjuvants to spinal local anaesthetics, a variety of drugs given intrathecally or systemically, can accelerate, improve and extend the spinal block.
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Minerva anestesiologica · Jan 2014
Editorial CommentDiagnosing brain death - just a matter of good sense?
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Minerva anestesiologica · Jan 2014
Randomized Controlled Trial Comparative StudySupplemental single shot femoral nerve block for total hip arthroplasty - Impact on early postoperative care, pain management and lung function.
Peripheral regional anesthesia is beneficial in the management of postoperative pain in hip surgery, and can also reduce post-operative care unit (PACU) stay. Its opioid-sparing actions may also be beneficial for respiratory mechanics and pulmonary function. The aim of our pilot study was to evaluate the effect of a supplemental single shot femoral block for elective total hip arthroplasty on early respiratory function and postoperative management within the first 24 postoperative hours. ⋯ Supplemental single shot femoral nerve block for total hip arthroplasty resulted in earlier PACU discharge capability, improved lung function during the first six hours and better pain control within the first 24 postoperative hours.