Minerva anestesiologica
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Minerva anestesiologica · Dec 2017
ReviewDexmedetomidine and general anesthesia: a narrative literature review of its major indications for use in adults undergoing non-cardiac surgery.
In Europe, dexmedetomidine has marketing approval only for sedation in intensive care units. However, its use during general anesthesia has been widely reported. The aim of this narrative review is to draw a picture of potential indications in anesthesia. ⋯ The properties of dexmedetomidine lead to its use for elective indications such as awake fiberoptic intubation and neurosurgical anesthesia. New topics are under debate. These subjects must be studied thoroughly because of their implication in the patients' surgical course. These advantages must be weighed against the major drawback of dexmedetomidine administration which is the potential for hemodynamic abnormalities.
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Minerva anestesiologica · Dec 2017
Multicenter StudyEffects of laparoscopic radical prostatectomy on intraoperative autonomic nervous system control of hemodynamics.
Laparoscopic radical prostatectomy induces hemodynamic changes that have been supposed due to autonomic nervous system activity. The aim of this study is to measure the sympathetic and vagal modulation on hemodynamic response to steep Trendelenburg and pneumoperitoneum for laparoscopic surgery. ⋯ Hemodynamic changes occurring during laparoscopic radical prostatectomy reveal autonomic response to the challenges (i.e. general anesthesia and head down position), and non-neurally mediated increase of arterial pressure caused by pneumoperitoneum. This study supports the notion that during laparoscopic radical prostatectomy the association between the vagal stimulation due to Trendelenburg positioning and sympathetic withdrawal caused by general anesthesia could lead to severe bradycardia and cardiac arrest in risky patients.
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Minerva anestesiologica · Dec 2017
Randomized Controlled Trial Comparative StudyPropofol-dexmedetomidine versus propofol-remifentanil conscious sedation for awake craniotomy during epilepsy surgery.
Conscious sedation during awake craniotomy requires balanced anesthesia technique to achieve optimum sedation and analgesia. This technique should be done without causing respiratory depression or loss of consciousness. The present study aimed at evaluating the effect of propofol-dexmedetomidine versus propofol-remifentanil conscious sedation during awake craniotomy for epilepsy surgery. ⋯ Propofol-dexmedetomidine combination is as effective as propofol-remifentanil combination but with fewer side effects for conscious sedation during awake craniotomy for epilepsy surgery.