Minerva anestesiologica
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Minerva anestesiologica · Oct 2020
Randomized Controlled TrialEfficacy of dexmedetomidine as an adjuvant to Quadratus lumborum block for paediatrics undergoing laparoscopic pyeloplasty. A prospective randomized double blinded study.
We designed this study to evaluate dexmedetomidine as an adjuvant to local anesthetics in Quadratus lumborum block (QLB) in pediatrics either interfascial versus intravenous on the quality of postoperative analgesia and incidence of side effects. ⋯ Interfascial dexmedetomidine adjuvant to QLB provided better postoperative analgesia in terms of less morphine consumption, better pain scores and longer time to first analgesic request when compared with the IV dexmedetomidine.
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Minerva anestesiologica · Oct 2020
ReviewA practical approach to the use of targeted temperature management after cardiac arrest.
Among comatose survivors after cardiac arrest, target temperature management (TTM) is considered the most effective treatment to reduce the consequences of postanoxic brain injury. Several international guidelines have thus incorporated TTM in the management of the postresuscitation phase. ⋯ There is indeed still relatively large uncertainty concerning some practical aspects related to TTM application, such as: A) how to select patients who will benefit the most from TTM; B) the optimal time to initiate TTM; C) the best target temperature; D) the most effective methods to provide TTM; E) the length of the cooling phase; and F) the optimal rewarming rate and fever control strategies. The purpose of this manuscript is to review and discuss the most recent advances in TTM use after cardiac arrest and to give some proposals on how to deal with all these relevant practical questions.
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Minerva anestesiologica · Oct 2020
Observational StudyThe influence of pain expectation on pain experience after orthopedic surgery: an observational cohort study.
Current literature about the effects of patients' expectations on relevant outcome measures is still conflicting and incomplete. The aim of this prospective observational study was to assess the influence of expectations and the fulfillment of expectations on postoperative pain intensity and pain relief. Furthermore, clinical characteristics influencing expectations and the fulfillment of expectations were explored. ⋯ Our study indicates that postoperative pain and satisfaction with the treatment are associated with the degree of fulfillment of expectations rather than the expected pain itself.