Minerva anestesiologica
-
Minerva anestesiologica · Sep 2020
Meta AnalysisEffects of deep neuromuscular block on surgical workspace conditions in laparoscopic bariatric surgery: a systematic review and meta-analysis of randomized controlled trials.
Deep neuromuscular blockade For laparoscopic bariatric surgery improves surgical conditions but does not shorten surgical duration.
pearl -
Minerva anestesiologica · Sep 2020
Donation after circulatory death: possible strategies for in-situ organ preservation.
Donation after circulatory death (DCD) is an accepted strategy to expand the potential donor pool. The complexity of organ procurement from DCD donors requires the development of new strategies for organ preservation. Standard DCD organ recovery involves a super rapid technique, with cold thoracic and abdominal perfusion. ⋯ New strategies designed to improve the preservation of in-situ DCD grafts include the use of normothermic regional perfusion (NRP) for abdominal organs and concomitant cold lung flushing. The use of in-situ NRP is a significant advance in abdominal organ retrieval and it has the potential to increase organ recovery rates due to its applicability in both controlled and uncontrolled DCD donors. We describe an innovative preservation strategy based on the combination of donor NRP for abdominal organ preservation and a normothermic open-lung approach with protective mechanical ventilation for lung preservation.
-
Minerva anestesiologica · Sep 2020
A new score for characterizing the visibility of anatomical structures during ultrasound guided regional anesthesia: a retrospective cohort study.
To identify anatomical structures using sonography can be challenging, yet it is a basic requirement for effective and safe ultrasound guided nerve blocks. In clinical routine, we find a wide variety in the visibility of anatomical structures. Aim of this study was to evaluate the feasibility of a newly developed visibility score for anatomical structures in ultrasound guided regional anesthesia. ⋯ VIS was feasible in clinical routine. Compared to the other evaluated blocks, the VIS for the infragluteal access to the sciatic nerve was rated worst. VIS is found to be worse in obese patients. Further research is needed to evaluate VIS and its suitability for specific questions as for instance anesthetists' learning curves, comparison of different patient populations, ultrasound devices or different nerve blocks.