Minerva anestesiologica
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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.
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Minerva anestesiologica · Apr 2021
Meta AnalysisReliability of transcranial sonography for assessment of brain midline shift in adult neurocritical patients: a systematic review and meta-analysis.
The aim of this systematic review and meta-analysis was to determine the reliability of transcranial sonography as an alternative to computed tomography for evaluation of brain midline shift in adult neurocritical patients. ⋯ Transcranial sonography may serve as reliable alternative to computed tomography for evaluation of brain midline shift in adult neurocritical patients. Both methods have strong concordance with acceptably narrow limits of agreement.
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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.