Minerva anestesiologica
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Minerva anestesiologica · Mar 2018
Comparative Study Observational StudyPatterns of changes in functional and neurocognitive status in elderly patients after transcatheter vs surgical aortic valve replacements.
Replacement of severely stenotic aortic valve may influence cognitive and physical functioning. The aim of this study was to compare cognitive and functional status after surgical (SAVR) vs. transcatheter aortic valve replacements (TAVR) in the elderly with severe aortic stenosis (AS). ⋯ Cognitive patterns differed between the TAVR and SAVR patients. A transient MMSE decline did not alter the 6-month status. TAVR might improve functionality. Periprocedural SBP decrease and larger changes in SBP are risk factors for functionality deterioration after TAVR.
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Minerva anestesiologica · Mar 2018
ReviewSupraglottic airway devices: indications, contraindications and management.
Supraglottic airway devices (SADs) have become an essential tool in airway management. Over the past three decades, these devices have been increasingly adopted as an alternative to face mask ventilation and/or endotracheal intubation. The range of proposed uses and features has increased significantly. ⋯ With SADs, serious complications such as aspiration and loss of airway are rare and largely preventable. Adequate operator experience, familiarity with the selected device, attention to details and careful patient selection are fundamental to safety and proficiency. In this review, we explore the increasing proposed uses for SADs and discuss possible complications and the management of these.
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Minerva anestesiologica · Mar 2018
Randomized Controlled Trial Comparative StudyA new arterial mechanical property indicator reflecting differences in invasive stimulus intensity induced by alteration of remifentanil concentration during laryngoscopy.
Reliable analgesia monitoring is not available for general anaesthesia cases. In 2003, we introduced a method to characterise arterial mechanical properties, which we termed arterial stiffness (K). However, it is unclear whether differences in K actually indicate changes in the intensity of a noxious stimulus. Thus, we examined the relationship between stress intensity and the value of K. ⋯ The value for arterial stiffness (K) non-proportionally changes in response to stimulus intensity; therefore, it has the potential to be used as an indicator of nociceptive stimulation intensity.