Minerva anestesiologica
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Minerva anestesiologica · May 2014
ReviewOutcome after regional anesthesia: weighing risks and benefits.
Regional anesthesia has become a widely used method to provide intraoperative anesthesia, and postoperative analgesia. This review seeks to address the question whether patient outcomes are improved to an extent that justifies using regional anesthesia as a routine method. During the past decade, a very critical appraisal of risks and benefits of regional anesthetic procedures has taken place. ⋯ A substantial share of the beneficial effects of regional anesthesia on the immune system, hemostasis, pain, and the duration of ileus can be duplicated using intravenous administration of local anesthetics. In general, the use of regional anesthesia should always be preceded by a weighing of potential risks and proven benefits. Regional anesthesia continues to play a major role in perioperative medicine, but its role keeps getting more defined and less non-committal.
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Minerva anestesiologica · May 2014
Review Meta AnalysisHigh volume hemofiltration in critically ill Patients - a systematic review and Meta-analysis.
High volume hemofiltration (HVHF) has been proposed as method for blood purification, especially under the condition of systemic inflammatory syndromes. Our goal was to evaluate the effects of HVHF in critically ill patients. ⋯ No clear overall beneficial effect of HVHF or PHVHF compared to standard volume hemofiltration can be detected.
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Minerva anestesiologica · May 2014
ReviewChemotherapy induced cardiovascular toxicity: Beyond anthracyclines.
It is not uncommon for anesthesiologists to encounter cancer patients who have received chemotherapy agents known to cause cardiovascular toxicities such as heart failure, systemic hypertension and thromboembolic events. Anthracyclines have been for several decades the most studied agents because of their known cardiovascular effects and relatively high incidence of heart failure. ⋯ Thus, anesthesiologist needs to be aware of the clinical features of each type of cardiac toxicity. This review will summarize the current clinical evidence on cardiovascular toxicity induced by chemotherapeutic agents and will try to shed light on the current information regarding the perioperative management of patients with chemotherapy-induced cardiovascular toxicity.
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Minerva anestesiologica · May 2014
Review Meta AnalysisEfficacy and safety of gabapentin for treatment of post-herpetic neuralgia: a meta-analysis of randomized controlled trials.
Postherpetic neuralgia (PHN) is a common type of neuropathic pain occurring after resolution of herpes zoster rash. Although gabapentin is a widely used treatment, some disagreements exist about its efficacy and safety. Meta-analysis was performed to better evaluate the efficacy and safety of gabapentin for management of PHN. ⋯ This meta-analysis indicates that gabapentin is an effective and well-tolerated treatment for patients with PHN.
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Minerva anestesiologica · May 2014
Review Meta AnalysisWhat is the clinical significance of pulmonary hypertension in acute respiratory distress syndrome? A review.
Elevated pulmonary arterial pressures appear to be a prominent feature of the acute respiratory distress syndrome (ARDS). Current clinical guidelines for the management of ARDS do not specifically address treatment of pulmonary hypertension or associated right ventricular dysfunction because the clinical significance of this entity remains unclear. ⋯ While studies of pulmonary vasodilator therapies have not shown a mortality benefit in ARDS, such trials have targeted improved oxygenation rather than improved pulmonary hemodynamics so that the possible contribution of improved right ventricular function to better outcomes has not been directly tested in large trials. Future studies are needed to determine if treatment of pulmonary hypertension and associated right ventricular dysfunction will affect mortality in patients with ARDS.