Minerva anestesiologica
-
Minerva anestesiologica · Apr 2021
Future in regional anesthesia and pain medicine: neuropathic pain and robotic limbs.
Phantom Limb Pain (PLP) is a dysesthesic painful sensations perceived in the lost limb, resulting from complex interactions between structural and functional nervous systems changes. We analyze its main pathogenetic models and speculate on candidate therapeutic targets. The neuroma model considers PLP to arise from spontaneous activity of residual limb injured axons. ⋯ Relief of PLP depends solely on motor and somatosensory circuitry engagement, making anthropomorphic visual feedback dispensable. Existing and apparently contradicting theories might not be mutually exclusive. All of them involve several intertwined potential mechanisms by which replacing the amputated limb by an artificial one could counteract PLP.
-
Minerva anestesiologica · Apr 2021
Randomized Controlled TrialThe Oxygen Reserve Index as a determinant of the necessary amount of postoperative supplemental oxygen.
Although blood gas analysis (BGA) is important for supplemental oxygen titration, it is invasive, intermittent, costly, and burdensome for staff. We assessed whether the Oxygen Reserve Index (ORi™), a novel pulse oximeter-based index that reflects the partial pressure of oxygen (PaO
2 ), could determine the amount of postoperative supplemental oxygen. We also evaluated the extent of hyperoxia and hypoxia. ⋯ Based on our results, ORi might be useful to titrate postoperative oxygen supplementation. -
Minerva anestesiologica · Apr 2021
Effectiveness and validity of midsagittal tongue cross-sectional area and width measured by ultrasound to predict difficult airways.
Increased tongue volume measured by ultrasound has been proven to be related to difficult airways. Tongue volume is an indirect parameter and is derived from multiplying the midsagittal tongue cross-sectional area (CSA) by the tongue width. However, few studies have focused on the ability of tongue CSA and tongue width to predict difficult airways. This study aimed to investigate the predictive value of tongue CSA and tongue width for predicting difficult laryngoscopy and difficult intubation. ⋯ Ultrasonic measurement of midsagittal tongue CSA may be a valuable predictor of difficult laryngoscopy and difficult intubation. By contrast, tongue width measured by ultrasound may be a weak predictor of difficult laryngoscopy, but its predictive ability was questionable.