Minerva anestesiologica
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Minerva anestesiologica · Apr 2022
Randomized Controlled TrialEffect of ultrasound angle for radial artery cannulation in adults: a randomized controlled trial.
Although the first attempt success rate of radial artery cannulation has been significantly improved by using dynamic needle tip positioning (DNTP) method, there are still problems with long cannulation time. We hereby observe the effect of ultrasound angle for radial artery cannulation in adult patients. ⋯ The usage of the U-P-needle approach could remarkably reduce radial arterial cannulation time at the first attempt as well as total puncture procedure duration, comparing with the U-P-artery approach.
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Minerva anestesiologica · Apr 2022
ReviewOpioid use, misuse, and abuse: a narrative review about interventions to reduce opioid consumption and related adverse events in the perioperative setting.
Opioids remain the most potent and predictable drug available for perioperative analgesia and moderate-to-severe cancer-related pain. However, their efficacy has been questioned in other clinical settings. ⋯ Thus, there has been a significant effort to develop strategies to curtail their unnecessary prescription. Here, we summarize the history, current trends, and new directions in perioperative opioid prescription in an unbiased manner.
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Minerva anestesiologica · Apr 2022
Adjacent segment syndrome after failed back surgery: biomechanics, diagnosis, and treatment.
The adjacent segment syndrome is defined as the changes in the adjacent structures of an operated spinal level that produce symptoms of pain and disability, which worsen the quality of life of a patient. Pain management specialists must be aware of these biomechanical changes brought by spinal surgeries, as well as of the symptoms associated with pain after surgery, to reach an appropriate diagnosis and provide an adequate treatment. ⋯ It is necessary to perform studies with a population sample comprising patients with adjacent segment syndrome after spinal surgery, since almost all treatments applied in this group are extrapolated from those used in patients with pain originating in the same area but who have not previously undergone spine surgery. Therefore, we consider necessary for pain physicians to understand the underlying biomechanics, promote the diagnosis of this condition, and analyze possible treatments in patients with adjacent segment disease to alleviate their pain and improve their quality of life.
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Minerva anestesiologica · Apr 2022
Randomized Controlled TrialAdductor canal block performed 20 hours after total knee arthroplasty to improve postoperative analgesia and functional recovery: a double-blind randomized controlled clinical trial.
The goal of postoperative pain protocols in total knee arthroplasty (TKA) is to get pain free patients throughout severe pain period without impairing walking ability. The aim of the study was to investigate if an adductor canal block performed 20 hours after TKA, in patients treated with systemic analgesia and intraoperative local infiltration anesthesia (LIA), improves postoperative pain and functional outcomes. ⋯ An adductor canal block done 20 hours after total knee arthroplasty reduces pain and opioid requirements without increasing the risk of falls. An optimal pain control, especially at movement was not achieved.