Minerva anestesiologica
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Minerva anestesiologica · Jul 2014
Review Meta AnalysisEffect of epinephrine on survival after cardiac arrest: a systematic review and meta-analysis.
The use of epinephrine is currently recommended as a treatment option for patients with cardiac arrest. The primary objective of this systematic review was to determine if epinephrine use during cardiac arrest is associated with improved survival to hospital discharge. MEDLINE, EMBASE, The Cochrane Library (Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, International Pharmaceutical Abstracts, and Biological Abstracts (BIOSIS Previews), and bibliographies of previous systematic reviews. ⋯ But epinephrine was associated with decreased survival in observational-A studies (OR 0.43, 95% CI 0.40 to 0.48; P<0.01; I2=0.00%). Epinephrine use during cardiac arrest is not associated with improved survival to hospital discharge. Observational studies with a lower-risk for bias suggest that it may be associated with decreased survival.
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Minerva anestesiologica · Jul 2014
Randomized Controlled Trial Comparative StudyComparison of palonosetron with palonosetron-dexamethasone combination for prevention of postoperative nausea and vomiting in patients undergoing laparoscopic cholecystectomy.
This randomized double-blind study was designed to compare palonosetron with palonosetron-dexamethasone combination for prevention of post operative nausea and vomiting (PONV) in patients undergoing laparoscopic cholecystectomy. ⋯ The palonosetron-dexamethasone combination was more effective as compared to only palonosetron for reducing PONV after laparoscopic cholecystectomy.
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Minerva anestesiologica · Jul 2014
Randomized Controlled Trial Comparative StudyThe effects of subfascial wound versus epidural levobupivacaine infusion on postoperative pain following hysterectomy.
Local analgesia through wound catheters is used as a part of multimodal analgesia. The efficacy of continuous subfascial wound infusion compared to epidural analgesia is unknown for abdominal hysterectomy and bilateral salpingo-oophorectomy (TAH-BSO) via Pfannenstiel incision. The aim of this study was to compare the aforementioned two methods in this type of surgery for postoperative morphine consumption, acute and persistent postsurgical pain. ⋯ Wound analgesia via subfascial catheter with continuous levobupivacaine infusion decreases postoperative morphine consumption and increases patient satisfaction compared to epidural analgesia with no difference in persistent postsurgical pain following TAH-BSO via Pfannenstiel incision.
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Minerva anestesiologica · Jul 2014
Observational StudyImmediate postoperative and mid-term survival in nonagenarians undergoing non-traumatic emergency surgery.
Nonagenarian people are increasingly using the emergency services, however, few studies have addressed this population. The goal of this prospective observational study is to determine relevant factors that independently reduce their immediate postoperative and mid-term survival. ⋯ Postoperative complications are an important predictor of reduced survival both immediately, and in the mid-term. Furthermore, most postoperative mortality occurs within the first 26 days postsurgery; hence the need for an aggressive treatment of such complications during this period.