Minerva anestesiologica
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Minerva anestesiologica · Jun 2021
Randomized Controlled TrialA randomized clinical trial comparing six techniques of postoperative analgesia for elective total hip arthroplasty under subarachnoid anesthesia with opioids.
Optimal control of acute postoperative pain and prevention of chronic persistent pain in total hip arthroplasty (THA) remain a challenge. The main hypothesis was that peripheral nerve blocks improve postoperative analgesia. ⋯ combined with a multimodal analgesic approach, infra-inguinal FICB and LFCNB did not improve immediate postoperative analgesia for THA in our hospital. Other options and longer-term studies should be more extensively investigated to determine the role of peripheral blocks in postoperative pain treatment protocols.
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Minerva anestesiologica · Jun 2021
ReviewA matter of timing: EEG monitoring for neurological prognostication after cardiac arrest in the era of targeted temperature management.
Neuromonitoring with electroencephalography (EEG) is an essential tool in neurological prognostication post-cardiac arrest. EEG allows reliable and real-time assessment of early changes in background patterns, development of seizures and epileptiform activity, as well as testing for background reactivity to stimuli despite use of sedation or targeted temperature management. Delayed emergence of consciousness post-cardiac arrest is common, therefore longitudinal monitoring of EEG allows the detection of trends indicative of neurological improvement before coma recovery can be observed clinically. In this review, we summarize essential recent literature in EEG monitoring for neurological prognostication post-cardiac arrest in the context of targeted temperature management, with a particular focus on the importance of the evolution of EEG patterns in the first few days following resuscitation.
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Minerva anestesiologica · Jun 2021
ReviewUpdates on neurologic complications in pediatric regional anesthesia.
Regional anesthesia has grown in popularity as a multimodal approach to analgesia. However, some anesthesiologists are fearful of regional blocks in pediatric patients as most require general anesthesia. ⋯ This review aimed to provide an update on the relevant literature regarding neurologic complications and the safety of regional blocks in pediatric patients. These large data sets have confirmed that regional anesthesia is a useful and safe modality in pediatric patients.
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Minerva anestesiologica · Jun 2021
Randomized Controlled TrialEffects of lung-protective ventilation strategy on lung aeration loss and postoperative pulmonary complications in moderate-risk patients undergoing abdominal surgery.
There is a controversy about whether the use of a lung-protective ventilation strategy(LPVS) can reduce the incidence of postoperative pulmonary complications (PPCs) and improve the clinical outcomes in moderate-risk patients were assessed by the Assess Respiratory Risk in Surgical Patients in Catalonia(ARISCAT). ⋯ The LPVS can decrease lung aeration loss assessed by LUS and reduce the incidence of PPCs in moderate-risk patients.