Minerva anestesiologica
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Minerva anestesiologica · Sep 2021
Review Meta AnalysisWound infiltration of dexmedetomidine as an adjunct to local anesthesia in postoperative analgesia for lumbar surgery: a systematic review and meta-analysis.
Most patients undergoing lumbar surgery experience varying degrees of incision pain, leading to prolonged postoperative recovery and poor satisfaction with treatment. The objective of this meta-analysis was to evaluate the efficacy and safety of dexmedetomidine as an adjunct to local anesthesia for postoperative pain control after lumbar surgery. ⋯ Dexmedetomidine infiltration appears to be a promising and safe adjunct for postoperative pain control after lumbar surgery. However, more studies are needed to assess the prevalence of other side effects.
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Minerva anestesiologica · Sep 2021
ReviewCorticosteroids in patients with COVID-19, use and misuse: a brief review.
Corticosteroids use in severe and critical COVID-19 patients is recommended by international guidelines, as they reduce mortality. However, the use outside of these indications could be harmful and should be discouraged. The scope of this brief review is to examine the beneficial mechanisms of corticosteroids treatment in COVID-19 and when they should be adopted.
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Minerva anestesiologica · Sep 2021
ReviewMetabolism and energy prescription in critically III children.
Optimal nutrition therapy can positively influence clinical outcomes in critically ill children. Accurate assessment of nutritional status, metabolic state, macronutrient requirements and substrate utilization allows accurate prescription of nutrition in this population. In response to stress and injury, the body undergoes adaptive physiologic changes leading to dysregulation of the inflammatory response and hyperactivation of the inflammatory cascade. ⋯ A comprehensive understanding of the metabolic response is essential when prescribing nutritional interventions aimed to offset the burden of this adaptive stress response in the critically ill. In this narrative review we aim to provide a comprehensive review of the physiologic basis, recent literature and some emerging concepts related to energy expenditure and the practical aspects of energy delivery in the critically ill child. Based on the unique metabolic characteristics of the critically ill child, we aim to provide a pragmatic approach to providing nutrition therapy.
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Minerva anestesiologica · Sep 2021
Randomized Controlled Trial Observational StudyComparison of LMA® gastro airway and gastro-laryngeal tube in endoscopic retrograde cholangiopancreatography: a prospective randomized observational trial.
New generation airway devices with different designs have been developed as an alternative to endotracheal intubation in order to avoid adverse events associated with sedation in endoscopic procedures and to provide patent airway. We aimed to compare two supraglottic airway devices (SGADs), the LMA® Gastro™ airway and gastrolaryngeal tube (GLT), in terms of airway efficiency, performance during procedure and adverse events in endoscopic retrograde cholangiopancreatography (ERCP). ⋯ LMA® Gastro™ had a higher OLP than GLT. However, GLT was better for endoscopist satisfaction, as it provides more satisfying maneuverability. As to secondary outcome advers events were lower in LMA® Gastro™. The lower complication rates associated with the device and providing a more patent airway also highlighted the apparent clinical efficacy of LMA® Gastro™ than GLT, in ERCP.
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Minerva anestesiologica · Sep 2021
Randomized Controlled TrialEffects of direct laryngoscopy versus Glidescope videolaryngoscopy on subjective and objective measures of cognitive workload: an in-vivo randomized trial.
Laryngoscopy and tracheal intubation are associated with high operators' workload, which potentially causes lower performance and risk of errors. Measuring anesthesiologists' mental workload during instrumental procedures allows to test the usability of the devices and, by managing operators' workload, improve clinical decision making. The aim of this study was to investigate the differences in subjective and objective cognitive workload between videolaryngoscopy with hyperangulated blade (Glidescope) vs. direct laryngoscopy in a real clinical setting. ⋯ A videolaryngoscope with hyperangluated blade used in a real clinical scenario of elective surgery significantly reduced both subjective and objective workload compared to a direct laryngoscope. Physical demand and effort were the key components in reducing operators' mental workload. Therefore, the expert use of a videolaryngoscope with hyperangulated blade constitutes an ergonomic option that could limit operators' workload and improve patients' safety and operators' well-being.