Minerva anestesiologica
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Minerva anestesiologica · Mar 2019
Randomized Controlled TrialEffect of adding nalbuphine to intrathecal bupivacaine with morphine on postoperative nausea and vomiting and pruritus after elective cesarean delivery: a randomized double blinded study.
The use of intrathecal morphine may result in serious side effects in parturients undergoing cesarean delivery. Nalbuphine, is a mu receptor antagonist and a ĸappa receptor agonist. Combinations of opioid agonist and agonist antagonist can decrease the incidence of opioid related side effects. We aimed to investigate the effect of adding nalbuphine, to intrathecal morphine on postoperative nausea and vomiting and pruritus after a cesarean delivery. ⋯ We concluded that the addition of nalbuphine to intrathecal bupivacaine plus morphine significantly reduced the incidence and severity of postoperative nausea and vomiting and pruritus without affecting analgesic potency.
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Minerva anestesiologica · Mar 2019
Randomized Controlled TrialInvestigating propofol-sufentanil interaction using clinical endpoints and processed electroencephalography: a prospective randomized controlled trial.
Propofol and sufentanil target controlled infusion technology is used with increasing frequency. Drug interaction modelling, using clinical endpoints and processed electroencephalography helps determine optimal drug concentrations to assure adequate anesthesia. ⋯ Sufentanil has a synergistic effect on the clinically observed hypnotic properties of propofol. These findings apply also to the depth of hypnosis measured by the Bispectral Index, Narcotrend Index and cAAI.
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Minerva anestesiologica · Mar 2019
Randomized Controlled TrialMulti-parametric functional hemodynamic optimization improves postsurgical outcome after intermediate risk open gastrointestinal surgery: a randomized controlled trial.
Perioperative goal directed therapy (pGDT) using flow monitoring has been associated with improved outcomes. However, its protocols are often based on stroke volume only: as a target for fluid loading, inotropic support and vasopressors (via mathematical coupling of systemic vascular resistance). In this trial, we have tested the multi-parametric pGDT protocol based on esophageal Doppler variables (corrected flow time, peak velocity) in intermediate-to-high risk patients undergoing gastrointestinal surgery. ⋯ In this monocentric trial the multi-parametric pGDT protocol based on domain specific functional hemodynamic parameters was associated with lower rate of postoperative complications in intermediate-to-high risk patients undergoing scheduled gastrointestinal procedures.
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Minerva anestesiologica · Mar 2019
Randomized Controlled TrialEffects of dexmedetomidine on inflammatory mediators after tourniquet-induced ischemia-reperfusion injury: a randomized, double-blinded, controlled study.
Tourniquet use during total knee arthroplasty (TKA) produces ischemia-reperfusion injury (IRI), with systemic release of inflammatory cytokines and reactive oxygen species upon tourniquet release. We conducted a randomized, placebo-controlled, double-blind trial to examine whether dexmedetomidine (DEX) as an adjunct during general anesthesia in patients undergoing unilateral TKA could attenuate the rise in inflammatory cytokines and oxidative stress. ⋯ Our results suggest that dexmedetomidine as an adjunct to general anesthesia attenuated the rise in proinflammatory cytokines, providing protective effects in tourniquet-induced IRI.
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Minerva anestesiologica · Mar 2019
Randomized Controlled Trial Comparative StudyStimulating versus non-stimulating catheter for lumbar plexus continuous infusion after total hip replacement.
This study was aimed to investigate whether stimulating catheters for continuous lumbar plexus block reduce local anesthetic consumption after hip arthroplasty if compared with traditional non-stimulating catheters. ⋯ The study showed comparable local anesthetic consumption, pain scores and muscle strength preservation between the two groups. The stimulating catheter allowed a significant, although underpowered, reduction in opioid consumption.