Minerva anestesiologica
-
Minerva anestesiologica · Feb 2017
Comparative Study Observational StudyLMA Supreme and Ambu AuraGain in anesthetized adult patients: a prospective observational study.
Second-generation laryngeal masks with gastric access are increasingly used in daily practice and expand the indications for laryngeal masks in the OR. Only limited data exist comparing different types of laryngeal masks. We investigated the second-generation laryngeal masks LMA Supreme™ and Ambu® AuraGain™ in a clinical setting. We hypothesized that the two devices would be comparable in terms of success rate and airway complications. ⋯ Supreme was superior to Gain in terms of insertion time and airway morbidity. Novices were more successful at first attempt using Supreme. These differences between supraglottic airway devices might be due to the different shapes and materials of the masks.
-
Minerva anestesiologica · Feb 2017
Randomized Controlled Trial Multicenter Study Pragmatic Clinical TrialNeurological assessment with validated tools in general ICU: multicenter, randomized, before and after, pragmatic study to evaluate the effectiveness of an e-learning platform for continuous medical education.
International guidelines recommend systematic assessment of pain, agitation/sedation and delirium with validated scales for all ICU patients. However, these evaluations are often not done. We have created an e-learning training platform for the continuous medical education, and assessed its efficacy in increasing the use of validated tools by all medical and nursing staff of the participating ICUs during their daily practice. ⋯ This e-learning program shows encouraging effectiveness, and the increase in the use of validated tools for neurological monitoring in critically ill patients lasts over time.
-
Minerva anestesiologica · Feb 2017
Randomized Controlled Trial Comparative StudyComparison of three different doses sugammadex based on ideal body weight for reversal of moderate rocuronium-induced neuromuscular blockade in laparoscopic bariatric surgery.
The majority of authors and the literature recommend sugammadex dose to be calculated according to RBW without taking fat content into consideration. Our aim was to compare the efficacy and safety of sugammadex at doses of 1.5, 2, and 4 mg/kg, calculated according to ideal body weight basis, for the reversal of moderate rocuronium-induced neuromuscular blockade in laparoscopic bariatric surgery. ⋯ A dose of sugammadex of 1.5 mg/kg calculated according to IBW successfully reversed moderate rocuronium-induced NMB in laparoscopic bariatric surgeries.
-
Minerva anestesiologica · Feb 2017
ReviewBurnout syndrome and wellbeing in anaesthesiologists: the importance of emotion regulation strategies.
Anesthesiologists face stressful working conditions that can culminate in burnout syndrome. Despite various studies and protective measures which have attempted to prevent this situation, burnout continues to be a problem within the profession, impacting negatively on physicians' lives and their performance. In this review article mechanisms and consequences of burnout are described in addition to individual strategies for stress management and burnout reduction with potential impact on health care quality and wellbeing in anesthesiologists. ⋯ New measures of emotion regulation strategies such as mindfulness, self-compassion, resilience and empathy promotion have been shown to be approaches with substantial supporting evidence for reducing burnout and improving stress management. The evaluation and implementation of these self-regulatory competencies is a challenge. Further research is necessary to identify which programs will best suit the needs of anesthesiologists and to measure their effects on patient care and health care system quality.
-
Minerva anestesiologica · Feb 2017
Comparative StudyImpact of opening hours of the post anaesthetic care unit on fast-track success in cardiac surgery.
Fast-track (FT) treatment in cardiac anesthesia is a state-of-the-art technique. The aim of our study was to compare FT treatment in a post-anesthetic care unit (PACU) with limited opening hours with a PACU opened for unlimited hours. Primary endpoints were extubation time (ET), length of stay (LOS) in PACU and LOS in intermediate care unit (IMC). Secondary endpoints were FT success/failure, hospital LOS, re-intubation and in hospital mortality. ⋯ FT treatment in a PACU with limited opening hours leads to more effective treatment for patients regarding extubation time and LOS in IMC than in a PACU with limited opening hours, without compromising safety.