Minerva anestesiologica
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Minerva anestesiologica · May 2020
Meta AnalysisLidocaine for postoperative sore throat: a meta-analysis of randomized controlled trials.
Postoperative sore throat (POST) is a common complication after tracheal intubation. Various studies have examined the efficacy of interventions using lidocaine to prevent POST. Here, we present a meta-analysis assessing their efficacy. ⋯ This meta-analysis indicated that intracuff lidocaine and intravenous lidocaine are effective in preventing POST. In addition, intracuff lidocaine was associated with reducing the risk of both cough and hoarseness.
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Minerva anestesiologica · May 2020
Randomized Controlled TrialChanges in plasma volume before and after major abdominal surgery following stroke volume variation-guided fluid therapy: a randomized controlled trial.
The aim of intraoperative fluid therapy is to avoid both hypovolemia and hypervolemia; however, the patient's exact volume status is difficult to determine during surgery. Fluid optimization guided by stroke volume variation (SVV) has been widely used in patients undergoing major open abdominal surgery. The aim of this study was to evaluate the changes in plasma volume before and after surgery following SVV-guided fluid therapy. ⋯ Fluid administration during surgery to maintain SVV below 13% was effective for maintaining the preoperative plasma volume until the end of surgery in patients undergoing major open stomach or colorectal surgery. This result supports the validity of SVV-guided fluid therapy, which maintains the SVV value below 13%, in terms of maintaining patient volume status.
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Minerva anestesiologica · May 2020
Nutrition deficit during intensive care stay: incidence, predisposing factors and outcomes.
Adequate nutrition support during intensive care has several benefits including lower amount of infectious complications, improved wound healing, shorter length of stay (LOS) and decreased morbidity. The aim of the present study was to survey the adequacy of nutrition throughout Intensive Care Unit (ICU) stay and to examine various factors associated to cumulative nutrition inadequacy during ICU stay. ⋯ The majority of ICU patients did not reach 60% of nutrition adequacy. Nutrition inadequacy was a common finding throughout the study population. Nutrition inadequacy might be partially avoidable since adequacy less than 60% was related to underprescription and failure to administer the prescribed nutrition. Bolus enteral nutrition might be an efficient method to deliver energy in ICU setting.
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Minerva anestesiologica · May 2020
Sedation in digestive endoscopy: innovations for an old technique.
Patient complexity, along with duration, number and invasiveness of procedures, increase every year in digestive endoscopy; so deep sedation, analgesia or general anesthesia requests are rising. The need for a safe, flexible, low cost and high-profile service play a central role in drugs, devices and monitoring development. The patient's degree of comfort and anxiety are also critical. ⋯ Nevertheless, these short and at low risk procedures can induce cognitive impairment. Currently, only anesthesiologists seem to have the competences to maintain high levels of safety by an appropriate evaluation and sedatives' choice, and a detailed protocol should be present in each gastrointestinal endoscopy department. In conclusion, the role of the anesthetist should be to supervise endoscopy activities at every level.