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
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.
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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.