Minerva anestesiologica
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Minerva anestesiologica · Jun 2019
Randomized Controlled Trial Comparative StudyComparing low-dose bupivacaine with epidural volume extension to standard bupivacaine dosing for short obstetric procedures: a prospective, randomized study.
Intrathecal bupivacaine's long duration of action can unnecessarily increase the time to meet Postanesthesia Care Unit (PACU) discharge criteria for patients undergoing short obstetric procedures. We sought to use a technique known as epidural volume extension (EVE) to determine if we could provide an adequate surgical block while significantly decreasing the time required to meet PACU discharge criteria for patients undergoing short obstetric procedures. ⋯ The use of low-dose isobaric bupivacaine in combination with 10 mL of saline EVE allows for faster motor recovery and time to meet PACU discharge criteria in patients undergoing short obstetric procedures.
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Minerva anestesiologica · Jun 2019
Randomized Controlled TrialClosed loop administration of propofol based on a Smith predictor: a randomized controlled trial.
Delay in the propofol pharmacodynamics effect is commonly observed in total intravenous anesthesia (TIVA). To face the delay in the hypnosis control, we have proposed a proportional-integral (PI) controller with a Smith predictor (PI+Smith). We have evaluated the feasibility of this closed-loop control for propofol administration and compared the performance with manual administration guided by the Bispectral Index (BIS). ⋯ The use of a specific mechanism in the PI controller to deal with the delay outperformed satisfactorily manual practice. The controller was able to regulate propofol administration, maintaining the BIS value within a desirable range and coping with oscillations.