Minerva anestesiologica
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Minerva anestesiologica · Nov 2018
ReviewPreoperative anxiety and implications on postoperative recovery: what can we do to change our history.
Preoperative anxiety can influence the intensity of postoperative pain and anesthesia and analgesia requirement. In certain types of surgery, anxiety may even increase postoperative morbidity and mortality. The goal of this narrative review is to remind anesthesiologists that anxiety measurement using specific tools can be done in clinical practice, to present the implications of preoperative anxiety on postoperative patient recovery, and to acknowledge the importance of a dedicated anesthesia plan in the management of anxious adult patients. ⋯ Patients with preoperative anxiety could benefit from multimodal analgesia, including non-pharmacological methods, such as cognitive therapy and music therapy and relaxation. The authors' opinion is that greater education about preoperative anxiety consequences in the surgical community is needed. A systemized approach and guidelines about the management of preoperative anxiety should be followed.
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Minerva anestesiologica · Nov 2018
The presence of elastic compression stockings reduces the fluid responsiveness of patients in the operating room.
The aim of this study was to investigate whether elastic compression stockings (ECS) can affect fluid responsiveness parameters before and during passive leg raising (PLR) maneuvers. ⋯ In the OR, ECS provoke a self-fluid loading increasing ABF, decreasing ΔPP and PLR response. The presence of ECS should be considered when managing hemodynamic parameters of patients.
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Minerva anestesiologica · Nov 2018
Comparative StudyAssessment of left ventricular ejection fraction in critically ill patients at the time of speckle tracking echocardiography: intensivists in training for echocardiography versus experienced operators.
The biplane Simpson's method is considered the gold standard to assess and monitor left ventricular (LV) ejection fraction (EF) in critically ill patients. Recently, a new semi-automatic technique based on speckle tracking echocardiography called "Auto-EF" has been introduced. We compared LVEF values obtained with biplane Simpson's method and Auto-EF by two groups of operators: trainee echocardiography intensivists and experienced echocardiographers. ⋯ Due to its semiautomatic nature, for inexpert operators Auto-EF seems more reproducible than the traditional Simpson's method for monitoring left ventricular function in critically ill patients.
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Minerva anestesiologica · Nov 2018
Letter Case ReportsSpontaneous coronary artery dissection complicated by cardiac arrest in pregnancy.
Abstract
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Minerva anestesiologica · Nov 2018
ReviewEffects of inhalation and intravenous anesthesia on intraoperative cardiopulmonary function and postoperative complications in patients undergoing thoracic surgery.
There is a high incidence of postoperative cardiopulmonary complications after thoracic surgery with one lung ventilation (OLV), the effect of general anesthetics on intraoperative cardiopulmonary function and postoperative complications is still unclear. ⋯ Inhalation anesthesia can preserve intraoperative cardiac function and reduce postoperative pulmonary complications in patients undergoing thoracic surgery with OLV; although it decreases intraoperative pulmonary function, inhalation anesthesia may be superior to intravenous anesthesia in thoracic surgery. Publication bias existed in some included studies, and the sample size was not large enough in CI and cardiac adverse events.