Minerva anestesiologica
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Minerva anestesiologica · Nov 2018
Randomized Controlled Trial Comparative StudyThe role of intraoperative stroke volume variation on bleeding during functional endoscopic sinus surgery.
Functional endoscopic sinus surgery (FESS) is a minimally-invasive surgical technique for patients with paranasal sinus pathology. Surgical bleeding reduces operative field visibility and increases the incidence of serious complications. Epinephrine injection into the nasal mucosa and controlled hypotension are used to minimize bleeding. Hypotension carries risks and sometimes does not reduce surgical bleeding. The goal of this study is to discover which hemodynamic parameter better correlates with surgical bleeding. ⋯ Targeting SVV larger than 12% achieves a possible reduction of the intraoperative bleeding in patients undergoing FESS.
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Minerva anestesiologica · Nov 2018
Comparative StudyVolatile anesthetics versus propofol in the cardiac surgical setting of remote ischemic preconditioning: a secondary analysis of a Cochrane Systematic Review.
So far, the concept of remote ischemic preconditioning (RIPC) failed its translation from experimental to clinical studies. In addition to our Cochrane Systematic Review, we systematically assessed the use of the intravenous anesthetic propofol, as a potential confounding factor. ⋯ Present data do not permit a final assessment regarding the role of volatile or intravenous anesthetics as a possible confounding factor in RIPC trials.
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Minerva anestesiologica · Nov 2018
ReviewConsiderations in treating obese patients in office-based anesthesia.
The rise in obesity prevalence worldwide has presented problems for practitioners treating patients in the ambulatory setting. As more procedures are being performed in office-based suites, anesthesiologists are being asked to provide more anesthesia services for obese patients that may compromise safety. ⋯ However, not every OBA location is similar, thus contributing to the difficulty in establishing consensus BMI limits. Here, we review literature addressing obesity in ambulatory surgery and point out concerns that anesthesiologists should consider when treating obese patients in an OBA setting.
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Minerva anestesiologica · Nov 2018
Observational StudyBronchial blocker positioning: learning curve and confidence in its use.
Despite being simple and safe to use and cheap, EZ blocker (EZB) remains underused probably because it requires particular skills in recognizing airway and in using fiber-bronchoscopy to check the exact position of their cuffs. Thus, we planned an education training program on the use of EZB for novices in anesthesia and evaluated the number of procedures required for the acquisition of the skills of this technique. ⋯ EZB is a valid strategy for obtaining one lung ventilation. Thus, it should be included in the armamentarium of all anesthetists interested in the field of thoracic surgery. Our teaching course seems to be a valuable method to instill easily and speedily in training novices in anesthesia the skills in placing EZB.
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Minerva anestesiologica · Nov 2018
Editorial CommentSeeking an answer to an unanswered question: gas or drip.
Abstract