Minerva anestesiologica
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Minerva anestesiologica · Nov 2024
Practice GuidelineRecommendations for fast-track extubation in adult cardiac surgery patients: a consensus statement.
Enhanced recovery after cardiac surgery in selected low-risk patients, has the potential to improve outcomes and reduce the burden of healthcare costs. Anesthesia-related challenges play a major role in the successful implementation of Enhanced Recovery After Surgery (ERAS) protocols, with particular emphasis placed on fast-track extubation. Acknowledging the importance of this practice, the Italian Association of Cardiac Anesthesiologists and Intensive Care (ITACTAIC) has advocated for an initiative to establish a consensus offering practical recommendations for fast-track extubation after adult cardiac surgery. ⋯ In the first consensus document ever published by a scientific society addressing practical recommendations for fast-track extubation post-cardiac surgery, the authors identified sixteen interventions commonly associated with fast-track extubation in selected adult cardiac surgery patients.
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Minerva anestesiologica · Nov 2024
Meta Analysis Comparative StudyCiprofol versus propofol for adult sedation in gastrointestinal endoscopic procedures: a systematic review and meta-analysis.
Although propofol is widely preferred as a sedative agent in gastrointestinal endoscopy, its use is commonly associated with hemodynamic adverse events. New sedatives, such as ciprofol, are emerging with promising results. Thus, we aimed to perform a systematic review and meta-analysis to compare efficacy-, safety-, and satisfaction-related outcomes between ciprofol and propofol for adult sedation in gastrointestinal endoscopy. ⋯ This systematic review and meta-analysis demonstrated similar clinical efficacy and better safety profile of ciprofol compared with propofol for adult sedation in gastrointestinal endoscopies. Furthermore, patient satisfaction scores were higher with ciprofol.
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Minerva anestesiologica · Nov 2024
ReviewMultimodal analgesic strategies in polytraumatized patients.
In recent years, the resuscitation of trauma patients has improved; however, pain related to trauma remains associated with systemic complications. In trauma patients, pain should be considered a vital sign, and its control is crucial for reducing complications, improving patient satisfaction, and enhancing the quality of life. ⋯ In this review, we offer the reader an updated general framework of the various approaches available for pain treatment in polytraumatized patients, with a focus on the opportunities presented by regional anesthesia. We will examine different types of locoregional anesthesia blocks and describe ultrasonographic execution techniques.
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Lumbar and sacral tattoos are popular amongst all ages. Some physicians are concerned that passing a needle through a pigmented area during lumbar puncture may deposit toxic material into the central nervous system, resulting in late complications. ⋯ There is insufficient evidence to endorse placement of a needle through a tattoo into the neuraxis before it is completely healed. The Fermi paradox 'absence of evidence is not evidence of absence of effect' still holds in light of emerging evidence that tattoos may be linked to lymphoma.