Minerva anestesiologica
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Minerva anestesiologica · May 2020
ReviewVasopressors to treat refractory septic shock: a narrative review.
Norepinephrine is the first line vasopressor used in patients with septic shock. However, norepinephrine doses above 1 µg/kg/min are associated with mortality rates of over 80%, suggesting a need to implement adjunctive strategies prior to reaching this dosage. The present study therefore sought to review the existing and emergent vasopressor agents for patients with refractory septic shock. ⋯ Angiotensin II is another emerging option that uses a different signaling pathway. However, nitric oxide synthase inhibitors and methylene blue do not appear to be appropriate in the management of patients with refractory septic shock. In conclusion, the use of different adjunctive agents in combination with the use of norepinephrine may be useful in patients with refractory septic shock, but care must be taken to avoid excessive vasoconstriction.
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Minerva anestesiologica · May 2020
Meta AnalysisLidocaine for postoperative sore throat: a meta-analysis of randomized controlled trials.
Postoperative sore throat (POST) is a common complication after tracheal intubation. Various studies have examined the efficacy of interventions using lidocaine to prevent POST. Here, we present a meta-analysis assessing their efficacy. ⋯ This meta-analysis indicated that intracuff lidocaine and intravenous lidocaine are effective in preventing POST. In addition, intracuff lidocaine was associated with reducing the risk of both cough and hoarseness.
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Minerva anestesiologica · May 2020
Randomized Controlled TrialLong-term effect of oxycodone/naloxone on the management of post-operative pain after hysterectomy: a randomised prospective study.
The analgesic efficacy of oxycodone prolonged-release (PR) combined with naloxone PR (OXN) in postoperative pain management is recognized, however, few studies have examined the efficacy of OXN on pain relief and bowel function following hysterectomy. This study compared the effect of OXN vs. standard treatment for post-operative pain management and bowel function following hysterectomy. ⋯ Improved pain control, bowel function and reduced side effects were observed with OXN compared to morphine in patients who underwent hysterectomy.
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Minerva anestesiologica · May 2020
Randomized Controlled TrialChanges in plasma volume before and after major abdominal surgery following stroke volume variation-guided fluid therapy: a randomized controlled trial.
The aim of intraoperative fluid therapy is to avoid both hypovolemia and hypervolemia; however, the patient's exact volume status is difficult to determine during surgery. Fluid optimization guided by stroke volume variation (SVV) has been widely used in patients undergoing major open abdominal surgery. The aim of this study was to evaluate the changes in plasma volume before and after surgery following SVV-guided fluid therapy. ⋯ Fluid administration during surgery to maintain SVV below 13% was effective for maintaining the preoperative plasma volume until the end of surgery in patients undergoing major open stomach or colorectal surgery. This result supports the validity of SVV-guided fluid therapy, which maintains the SVV value below 13%, in terms of maintaining patient volume status.
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Minerva anestesiologica · May 2020
Randomized Controlled TrialGlideScope® versus Macintosh laryngoscope for assessment of post-thyroidectomy vocal cord dysfunction: prospective randomized study.
Early detection of post-thyroidectomy vocal cord dysfunction is crucial. This study compared GlideScope® with Macintosh direct laryngoscope (MDL) regarding the accuracy of assessment of post-thyroidectomy vocal cord dysfunction. ⋯ This study demonstrates that GlideScope® is a better alternative to MDL for an accurate detection of post-thyroidectomy vocal cord dysfunction.