Minerva anestesiologica
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Minerva anestesiologica · Aug 2018
ReviewThe role of cannabinoids in pain control: the good, the bad, and the ugly.
Cannabinoids appear to possess many potential medical uses, which may extend to pain control. A narrative review of the literature has found a variety of studies testing botanical and synthetic cannabinoids in different pain syndromes (acute pain, cancer pain, chronic noncancer pain, fibromyalgia pain, migraine, neuropathic pain, visceral pain, and others). Results from these studies are mixed; cannabinoids appear to be most effective in controlling neuropathic pain, allodynia, medication-rebound headache, and chronic noncancer pain, but do not seem to offer any advantage over nonopioid analgesics for acute pain. ⋯ Cannabinoid-based analgesia has been linked to potential memory deficits and cognitive impairment. A great deal more remains to be elucidated about cannabinoids which may emerge to play an important role in the treatment of neuropathic and possibly other painful conditions. There remains a great deal more to learn about the role of cannabinoids in pain management.
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Minerva anestesiologica · Aug 2018
Randomized Controlled Trial Comparative StudySugammadex antagonism of rocuronium-induced neuromuscular blockade in patients with liver cirrhosis undergoing liver resection: a randomized controlled study.
This randomized controlled study compared the recovery times of sugammadex and neostigmine as antagonists of moderate rocuronium-induced neuromuscular block in patients with liver cirrhosis and controls undergoing liver resection. ⋯ Sugammadex rapidly antagonize moderate residual rocuronium-induced neuromuscular block in patients with Child class "A" liver cirrhosis undergoing liver resection. Sugammadex antagonism is associated with 80% reduction in the time to adequate neuromuscular recovery compared to neostigmine.
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Minerva anestesiologica · Aug 2018
Comparative StudyInjection pressure mapping of intraneural vs. perineural injections: further lessons from cadaveric studies.
The aim of the study was to investigate the difference between intraneural and perineural injection pressures in human cadavers. Targeted nerves included the cervical roots, the supraclavicular and infraclavicular brachial plexus, the sciatic-subgluteal nerve and the common peroneal and tibial nerves. ⋯ The study has consistently demonstrated statistically significant differences between intraneural and perineural injection pressures. It effectively created a "map" of intraneural injection pressures for the most common peripheral nerves blocks and demonstrated a pattern between proximal and distal locations. The study also revealed limitations of either techniques, ultrasound and injection pressure monitoring reinforcing the concept of their simultaneous application.
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Minerva anestesiologica · Aug 2018
Editorial CommentOffice-based anesthesia: hot topics and expert opinions.