Minerva anestesiologica
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Minerva anestesiologica · Dec 2016
ReviewThe aging digestive tract. What should we anesthesiologists know about it?
At present, elderly individuals represent approximately 18.5% of the European population and account for about 23% of surgical procedures performed. This patient population is at a higher risk for perioperative complications and adverse postoperative outcome. This narrative review highlights our current knowledge about physiological changes in the aging gut and the implications for anesthesiologists. ⋯ Healthy aging appears to be associated with modest slowing of gastric emptying, but this does not demand prolonged preoperative fasting. The physiological changes associated with polypharmacy also make elderly patients a risk group for pulmonary aspiration during anesthesia. Further research is needed to determine the effects of commonly used anesthetic agents on the pharyngo-gastrointestinal tract in elderly patients.
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Minerva anestesiologica · Dec 2016
Observational StudyPrognostic value of the reactive oxygen species in severe sepsis and septic shock patients: a-pilot study.
Reactive oxygen species (ROS) have been shown to play a role in the pathophysiology of sepsis. The aim of this study was to investigate ROS production over time in critically ill with sepsis patients and its correlation with outcome. ⋯ Serial measurements of the ROMs plasmatic levels together with the SOFA score and lactate levels could help to identify septic shock patients with a very high probability of death.
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Minerva anestesiologica · Dec 2016
Randomized Controlled TrialContinuous epidural versus wound infusion plus single morphine bolus as postoperative analgesia in open abdominal aortic aneurysm repair: a randomized non-inferiority trial.
We compared a bundle of interventions including wound infiltration and continuous infusion with local anesthetics plus a single morphine bolus (CWI-M) with continuous epidural infusion (CEI) as postoperative analgesia. ⋯ CWI-M was comparable to CEI in in postoperative pain control, but it was associated with higher need of rescue systemic opiates and with a worse early pain control.