Minerva anestesiologica
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Minerva anestesiologica · Dec 2017
Accuracy of transcutaneous laryngeal ultrasound for detecting vocal cord paralysis in the immediate postoperative period after total thyroidectomy.
Transcutaneous laryngeal ultrasound (TLUS) has emerged as a promising imaging tool for vocal cord examination in patients undergoing thyroid surgery. The focus of this prospective, double-blind study was to assess the accuracy of TLUS in the diagnosis of vocal cord paralysis in the immediate postoperative period following total thyroidectomy. ⋯ TLUS may be a suitable technique for detecting vocal cord paralysis shortly after total thyroidectomy.
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Minerva anestesiologica · Dec 2017
Randomized Controlled TrialThe impact of Dexmedetomidine or Xylocaine continuous infusion on opioid consumption and quality of recovery following laparoscopic sleeve gastrectomy: a randomized double blinded controlled study.
Postoperative pain control for morbidly obese patients represents a challenge because of their sensitivity towards opioid-induced respiratory depression. We elected both dexmedetomidine and xylocaine (lidocaine) continuous infusions as adjuvants because they lack respiratory depression side effect. ⋯ Continuous infusion of either dexmedetomidine or xylocaine reduces postoperative opioid consumption, pain and improve the quality of recovery following laparoscopic sleeve gastrectomy.
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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.
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Minerva anestesiologica · Dec 2017
ReviewThe surgical stress response and the potential role of preoperative glucocorticoids on post-anesthesia care unit recovery.
The immediate postoperative course in the post-anesthesia care unit (PACU) remains a challenge across surgical procedures. Postoperative pain, sedation/cognitive dysfunction, nausea and vomiting (PONV), circulatory and respiratory problems and orthostatic intolerance constitute the bulk of the difficulties that may delay the postoperative recovery. ⋯ The main finding is that current evidence suggests inflammation to potentially impair on almost all organ dysfunctions observed in the post-anesthesia care unit (PACU), but with a scarcity of intervention studies using glucocorticoids to control inflammation. We, therefore, suggest a future research focus on the role of inflammation and effect of glucocorticoids in the PACU setting to improve patient recovery.