Minerva anestesiologica
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Minerva anestesiologica · Jan 2024
ReviewHow anesthesiology can deal with innovation and new technologies?
Innovation and new technologies have always impacted significantly the anesthesiology practice all along the perioperative course, as it is recognized as one of the most transformative medical specialties specifically regarding patient's safety. Beside a number of major changes in procedures, equipment, training, and organization that aggregated to establish a strong safety culture with effective practices, anesthesiology is also a stakeholder in disruptive innovation. The present review is not exhaustive and aims to provide an overview on how innovation could change and improve anesthesiology practices through some examples as telemedicine (TM), machine learning and artificial intelligence (AI). ⋯ Clinical workflow could be facilitated and accelerated with mobile devices and applications, assuming that these tools should remain at the service of patients and care providers. Care providers and patients connections have improved, thanks to these digital and innovative transformations, without replacing existing relationships between them. It also should give time back to physicians and nurses to better spend it in the perioperative care, and to provide "personalized" medicine keeping a high level of standard of care.
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Minerva anestesiologica · Jan 2024
Epidural vs. systemic analgesia in the Intensive Care Unit: retrospective study of patient outcomes.
Patients admitted to the Intensive Care Unit (ICU) often experience acute pain. Causes include major surgery, multisystem trauma, and pancreatitis. Most ICU patients who require pain management are treated with systemic analgesia, usually intravenous opioids. This study compared the rate of pain and delirium scores, as well as mortality and morbidity between ICU patients treated with systemic vs. epidural analgesia. ⋯ Epidural analgesia reduced the number of delirium events and was associated with a shorter ICU stay, fewer ventilation days and a lower mortality rate. Further research is needed to confirm these findings.
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Minerva anestesiologica · Jan 2024
Randomized Controlled TrialPositive end-expiratory pressure during one-lung ventilation for preventing atelectasis after video-assisted thoracoscopic surgery: a triple-arm, randomized controlled trial.
There is little evidence regarding the benefits of lung-protective ventilation in patients undergoing one-lung ventilation for thoracic surgery. This study aimed to determine the optimal level of positive end-expiratory pressure (PEEP) during one-lung ventilation for minimizing postoperative atelectasis through lung ultrasonography. ⋯ Although the optimal level of PEEP during one-lung ventilation was not determined, the application of higher PEEP can prevent aeration loss in the ventilated lung after video-assisted thoracoscopic surgery under one-lung ventilation.
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Minerva anestesiologica · Jan 2024
Factors to consider for fascial plane blocks' success in acute and chronic pain management.
The outcome of fascial plane blocks (FPBs) has a certain variability that may depend on many factors, which can be divided into three main categories: operator-related, patient-related and drug-related. Operator-related factors include personal skills, choice of needle and injection modalities. ⋯ In this article, we investigated all the factors that may influence the outcome of FPBs from a generic perspective, without focusing on any specific technique. Also, we provided suggestions to optimize techniques for everyday practitioners and insights to researchers for future studies.