Minerva anestesiologica
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Minerva anestesiologica · Feb 2020
Randomized Controlled TrialUltrasound-guided central venous catheter placement through the axillary vein in cardiac critical care patients: safety and feasibility of a novel technique in a prospective observational study.
Central venous catheterization is essential for careful administration of fluids and drugs in cardiac critical care patients. The axillary vein might represent an alternative to subclavian and jugular vein accesses, with the advantage of being extra-thoracic, more distal from the pleural space and with more likehood of comfort for the patient. Conventional ultrasound-guided cannulation of the axillary vein is technically demanding and does not guarantee precise visualization of the needle tip. ⋯ Placement of a central line catheter in the axillary vein using a novel ultrasound-guided bracket-assisted technique may be a feasible, safe and rapid alternative to the conventional jugular and subclavian approaches.
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Minerva anestesiologica · Feb 2020
Randomized Controlled TrialRespiratory and hemodynamic effects of three different sedative regimens for drug induced sleep endoscopy in sleep apnea patients. A prospective randomized study.
Drug induced sleep endoscopy (DISE) has emerged as a promising tool for customizing the adequate surgical approach to relieve airway obstruction in sleep apnea patients. We aimed to compare propofol, dexmedetomidine or ketofol with regards their efficacy and safety for sedation in patients with obstructive sleep apnea (OSA) undergoing DISE procedure. ⋯ Dexmedetomidine and ketofol provided a safe respiratory profile compared to propofol during DISE without significant hemodynamic adverse events.
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Minerva anestesiologica · Feb 2020
Randomized Controlled TrialEffect of quadratus lumborum block on postoperative analgesic requirements in pediatric patients: a randomized controlled double blinded study.
Quadratus lumborum block (QLB) is a newly-defined trunk block performed with local anesthetic injection by imaging the abdominal muscles with ultrasonography (US) guidance; thus, analgesia is expected to be ensured from the T7-L1 dermatomal segment level. In the study, the aim was making the comparison between the quadratus lumborum block and the intravenous analgesia with tramadol on postoperative analgesic effect in pediatric patients undergoing lower abdominal surgery. ⋯ In conclusion, we believe QLB1 provides effective analgesia in the postoperative period for lower abdominal surgery in pediatric patients.
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Minerva anestesiologica · Feb 2020
Randomized Controlled TrialGastric emptying of "clear liquid drinks" assessed with gastric ultrasonography: a blinded, randomized pilot study.
Protein-containing liquids may delay gastric emptying and increase risk of aspiration. Commercial whey protein nutritional drinks (WPNDs) are advertised as "clear liquid nutritional drinks" and can be mistaken for protein-free, carbohydrate-based clear liquids. We used gastric ultrasonography to compare gastric emptying of a protein-free, carbohydrate-based clear liquid with that of a WPND in healthy volunteers. ⋯ Although consumption of a WPND was associated with a larger estimated GV in this pilot study, a larger study is necessary to conclude whether patients must fast longer than two hours after consumption of a WPND.
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Minerva anestesiologica · Feb 2020
Randomized Controlled TrialRandomized controlled trial of acupuncture to prevent emergence delirium in children undergoing myringotomy tube placement.
Myringotomy tube placement is a pediatric procedure frequently performed under inhalational anesthesia without intravenous line placement. Emergence delirium is common following sevoflurane anesthesia, and can lead to patient harm and escalation of nursing care. Our goal was to determine if intraoperative acupuncture, compared to standard of care, reduces emergence delirium in children undergoing myringotomy tube placement. ⋯ Intraoperative acupuncture at HT7 and ear Shen Men did not reduce PAED scores after myringotomy tube placement. Based on these data, it is therefore unlikely that a larger study of the same design would demonstrate a significant effect of intraoperative acupuncture on emergence delirium after brief sevoflurane anesthesia. However, other acupuncture points or techniques could be considered.