Minerva anestesiologica
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Minerva anestesiologica · Sep 2023
ReviewRecommendations and considerations for speeding the collapse of the non-ventilated lung during single-lung ventilation in thoracoscopic surgery: a literature review.
Video-assisted thoracoscopic thoracic surgery has the advantages of less physical damage, less postoperative pain, and a rapid recovery. Therefore, it is widely used in the clinic. The quality of nonventilated lung collapse is the key point of thoracoscopic surgery. ⋯ Therefore, it is important to achieve good lung collapse as soon as possible after opening the pleura. Over the past two decades, there have been reports of advances in research on the physiological mechanism of lung collapse and several kinds of techniques for speeding up lung collapse. This review will inform the advances of each technique, make recommendations for reasonable implementation and discuss their controversies and considerations.
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Minerva anestesiologica · Sep 2023
Randomized Controlled TrialTransversus abdominis plane block versus caudal block with bupivacaine and dexmedetomidine for unilateral inguinal hernia repair in pediatric patients: a randomized clinical trial.
This study compared the transversus abdominis plane (TAP) block with bupivacaine and dexmedetomidine to the same mixture in the caudal block in delivering postoperative analgesia in children after unilateral inguinal hernia surgery. ⋯ The TAP block and caudal block provide good postoperative analgesia in children undergoing unilateral inguinal hernia repair. Adding dexmedetomidine to the TAP block was superior to the caudal block in terms of extending the length of the initial analgesic request, lowering analgesic requirement, and lowering pain scores without causing substantial adverse effects.
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Minerva anestesiologica · Sep 2023
Impact of immunosuppressive regimen on ICU acquired pneumonia in critically ill COVID-19.
Immunosuppressors (IS) such as Dexamethasone (DXM), Tocilizumab, and high-dose methylprednisolone boli (HDMB), are used in COVID-19-related acute respiratory distress syndrome (ARDS). This study aimed to determine whether COVID-19 ARDS-related combined IS therapy was associated with an increased incidence of ICU-acquired pneumonia (IAP). ⋯ In critically ill COVID-19, HDMB significantly increases the risk of IAP whereas DXM alone, nor in combination with tocilizumab, did not.
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Minerva anestesiologica · Sep 2023
Anesthetic concerns for robotic-assisted laparoscopic radical prostatectomy: an update.
The anesthetic concerns of patients undergoing robotic-assisted laparoscopic radical prostatectomy (RALP) are primarily related to the use of pneumoperitoneum in the steep Trendelenburg position. This combination will affect cerebrovascular, ocular, respiratory, and hemodynamic homeostasis. ⋯ Close coordination between the anesthesia and surgical teams is required for a successful surgery. This updated review will discuss the anesthetic concerns and perioperative management of patients presenting for RALP.