Minerva anestesiologica
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Bleeding is a major adverse effect of veno-venous extracorporeal membrane oxygenation (vvECMO) therapy in surgical patients. This study retrospectively describes the amount of transfused packed red blood cells (PRBC) and coagulation parameters of patients requiring surgery during vvECMO therapy. ⋯ In patients requiring surgery during vvECMO therapy with perioperative transfusion of two or more PRBCs preoperative fibrinogen levels were significantly reduced compared to patients with transfusion of less than two PRBCs. No other analyzed lab value showed any predictive qualities in terms of bleeding.
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Minerva anestesiologica · Jan 2020
Meta AnalysisHemodynamic stability of closed-loop anesthesia systems: a systematic review.
This systematic review investigates the effect of closed-loop anesthesia delivery on the maintenance of cardiovascular parameters. The specific challenges arise from the fact that many physiological variables used for the control of anesthetic delivery and maintenance of hemodynamic stability are regulated by the autonomic nervous system, which is subject to high inter-individual variability. ⋯ The findings support the use of closed-loop systems for anesthetic delivery. Interpretation should take into account limitations, such as the large variations in the selected studies in the type of parameters used to measure outcomes. In summary, this review provides evidence supporting the importance of considering cardiovascular variables in the design of automated anesthetic delivery systems.
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Minerva anestesiologica · Jan 2020
Randomized Controlled Trial Comparative StudyPerifascial plane versus perineural approaches for ultrasound-guided axillary block: go to the simplest?
Ultrasound-guided axillary block is widely used in daily practice for upper limb orthopedic surgery. A simple, safe, efficacious and time-saving technique is mandatory to optimize surgical turnover and costs. In this perspective, we compared, in a randomized, single-blinded study, a standardized perifascial technique and the selective perineural technique. ⋯ We reported that the ultrasound-guided axillary perifascial block is easier to perform and saves procedural time compared to the classic perineural technique. Considering the same anesthetic success rate in both groups, the perifascial plane technique should be considered a daily practice technique and the first level of learning procedure for axillary block.
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Minerva anestesiologica · Jan 2020
Randomized Controlled TrialRole of preoperative pregabalin in reducing inhalational anesthetic requirements in abdominal hysterectomy: randomized controlled trial.
Preoperative oral pregabalin controls postoperative pain and decreases anesthetic requirements in total intravenous anesthesia. In this study, we hypothesized that preoperative pregabalin reduces inhaled isoflurane requirements. ⋯ Preoperative pregabalin 150 mg, 1 h before total abdominal hysterectomy has an inhaled anesthetic-sparing effect, maintain hemodynamics and optimizes postoperative analgesia.
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Minerva anestesiologica · Jan 2020
Randomized Controlled TrialEfficacy of intraperitoneal bupivacaine, hydrocortisone, and magnesium sulfate in different combinations for pain relief after laparoscopic ovarian cystectomy: a double-blind randomized controlled trial.
The aim of this study was to assess the efficacy of intraperitoneal different combinations for postoperative pain relief in patients undergoing laparoscopic unilateral ovarian cystectomy. ⋯ Intraperitoneal bupivacaine-magnesium combination provides better analgesia and reduces postoperative morphine consumption than bupivacaine-hydrocortisone or magnesium-hydrocortisone combinations after laparoscopic ovarian cystectomy.