Minerva anestesiologica
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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
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
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
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.