Minerva anestesiologica
-
Minerva anestesiologica · Jan 2017
Randomized Controlled Trial Comparative StudySpatial relationship of I-gelTM and Ambu® AuraOnceTM on pediatric airway: a randomized comparison based on three dimensional magnetic resonance imaging.
Gross morphological differences exist among different brands of pediatric supraglottic devices (SGDs). The aim of this study is to compare the spatial relationship of i-gel® and Ambu® AuraOnce (AO)TM on pediatric airway based on three dimensional (3-D) magnetic resonance imaging (MRI) measurements. ⋯ Based on 3-D MRI measurements done on living patients, both SGDs distorted the anatomy of pediatric airway compared to their respective native values to variable extent. The relevance of these effects needs further studies on larger patient group in order to reduce morbidity on pediatric airway.
-
Minerva anestesiologica · Jan 2017
Randomized Controlled Trial Comparative StudyPostoperative analgesia for elective total knee arthroplasty under subarachnoid anesthesia with opioids: comparison between epidural, femoral block and adductor canal block techniques (with and without perineural adjuvants). A prospective, randomized, clinical trial.
Optimal control of acute postoperative pain and prevention of chronic persistent pain in total knee arthroplasty (TKA) remain a challenge. The main hypothesis was that nerve blocks improve postoperative analgesia especially if perineural adjuvants are added. ⋯ Peripheral nerve blocks with perineural dexamethasone improve postoperative analgesia for TKA. The addition of dexamethasone to adductor canal block open new possibilities to improve analgesia for TKA, and should be investigated as an alternative to femoral nerve block.
-
Minerva anestesiologica · Jan 2017
Randomized Controlled Trial Comparative StudyMay pre-procedure neuroaxial ultrasound improve the identification of potential epidural space when compared with anatomical landmarks? A prospective randomized study.
Regional epidural analgesia is considered the gold standard for pain treatment in labor. However, epidural catheter placement may be a challenging procedure because of the difficulty in the palpation of anatomical landmarks, particularly in pregnant women. Pre-procedural neuroaxial ultrasound may facilitate the procedure. ⋯ The US-assisted technique for epidural catheter placement for labor analgesia is safe, effective, easy to perform, and is a valuable aid to improve the identification of the epidural space compared with the palpation of anatomical landmarks and the loss of resistance technique. Pre-puncture ultrasound assessment shows the exact location of the intervertebral space, the optimal point of insertion and the tilt angle of the needle, the depth of the epidural space and any anatomical abnormalities of the spine, thereby increasing the success rate and reducing procedural complications of the blind approach.
-
Minerva anestesiologica · Jan 2017
Meta AnalysisEfficacy of the prophylactic administration of tramadol against postoperative shivering: a meta-analysis of randomized controlled trials.
Postoperative shivering (POS) is a common complication that occurs after regional and general anesthesia. Thus far, numerous studies have reported on the effectiveness of tramadol in preventing or treating POS. Here, we performed a meta-analysis to assess the efficacy of tramadol in the prevention of POS. ⋯ This meta-analysis revealed that prophylactic tramadol effectively prevents POS and reduces rescue medication use without significant adverse effects.
-
Minerva anestesiologica · Jan 2017
ReviewAcute kidney injury in liver transplant candidates: a position paper on behalf of the LIVER INTENSIVE CARE GROUP of EUROPE.
Acute kidney injury is associated with high mortality in the perioperative period of liver transplantation. The aim of this position paper was to provide an up-to-date overview with special emphases on diagnosis, risk factors, and treatment. ⋯ Perioperative liver transplant risk factors for acute kidney injury are difficult to control. Therefore, the focus should be on intra-operative hemodynamics and nephrotoxic drugs avoidance. Prospective randomized trials are needed to show the beneficial effect of early replacement therapy. In this context, the new biomarkers would be helpful in identifying kidney injury earlier.