Minerva anestesiologica
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Minerva anestesiologica · Jul 2017
Anesthetic complications during general anesthesia without intravenous access in pediatric ophthalmologic clinic: assessment of 5216 cases.
General anesthesia utilizing inhalational agents without intravenous (IV) access for minor procedures is controversial. Eliminating IV access increases efficiency and patient satisfaction; however, the ability to introduce rapid acting medications into the circulation during an unanticipated emergency becomes challenging. The objective of this study was to examine complication risk following pediatric ophthalmologic examinations under anesthesia (EUA) without IV placement. ⋯ The current study shows that it is safe to perform EUA and procedures for the diagnosis and treatment of retinoblastoma in pediatric patients without securing IV access. All emergency post-complication IV placements were successful and no long-term sequelae were seen.
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Minerva anestesiologica · Jul 2017
Randomized Controlled Trial Comparative StudyEffects of intravenous lidocaine, dexmedetomidine and their combination on the postoperative pain and recovery of bowel function in patients undergoing abdominal hysterectomy.
Intravenous (IV) lidocaine and dexmedetomidine have been shown to decrease postoperative pain, reduce analgesic consumption and facilitate return of bowel function. We investigated whether lidocaine combined with dexmedetomidine infusion was superior in controlling pain and recovery of bowel function. ⋯ Lidocaine combined with dexmedetomidine infusion significantly improved postoperative pain and enhanced recovery of bowel function undergoing abdominal hysterectomy.
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Minerva anestesiologica · Jul 2017
Meta AnalysisEffect of anesthesia methods on postoperative major adverse cardiac events and mortality after non-cardiac surgeries: a systematic review and meta-analysis.
Postoperative major adverse cardiac events (MACEs) are the main cause of postoperative mortality, and controversies exist regarding the effects of anesthesia methods on postoperative MACEs and mortality in high-risk cardiac patients after non-cardiac surgeries. ⋯ Sevoflurane anesthesia, or epidural combined with general anesthesia can provide short-term myocardial protective effect in high-risk cardiac patients undergoing intermediate- or high-risk non-cardiac surgeries.
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Minerva anestesiologica · Jul 2017
ReviewHalogenated volatile anesthetics in the intensive care unit: current knowledge on an upcoming practice.
The aim of this narrative review was to highlight key points of volatile anesthetics administration in the intensive care unit (ICU), including AnaConDa® and Mirus® devices characteristics and the reported findings on clinical outcomes in critically ill patients. Intravenous sedation in the ICU is associated with issues, such as over- and under-sedation. Halogenated compounds, which can be safely administered by inserting a device in any ICU ventilation circuit, have interesting pharmacodynamic and pharmacokinetic profiles for patients with multi-organ failure. ⋯ Apart from sedation, volatile anesthetics were therapeutic in case reports of status asthmaticus and epilepticus and data are cumulating for benefits in cases of acute respiratory distress syndrome. According to current literature, they should be withheld in cerebral injury. To summarize, the use of volatile anesthetics for sedation is yet only approved by German guidelines, but could spread due to its potential benefits.
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Minerva anestesiologica · Jul 2017
ReviewExtracorporeal CO2 removal (ECCO2R) in critically ill patients: a systematic review.
The use of extracorporeal CO2 removal (ECCO2R) is increasingly employed in critically ill patients. However, the clinical evidence supporting its efficacy remains currently poor. ⋯ In COPD patients, a significantly reduced need for endotracheal intubation was reported. However, the use of ECCO2R has not shown significant improvement on the outcome of critically ill patients in the reviewed studies. Therefore appropriately powered, randomized, controlled studies are urgently needed.