Minerva anestesiologica
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Minerva anestesiologica · Feb 2020
Randomized Controlled TrialEffect of quadratus lumborum block on postoperative analgesic requirements in pediatric patients: a randomized controlled double blinded study.
Quadratus lumborum block (QLB) is a newly-defined trunk block performed with local anesthetic injection by imaging the abdominal muscles with ultrasonography (US) guidance; thus, analgesia is expected to be ensured from the T7-L1 dermatomal segment level. In the study, the aim was making the comparison between the quadratus lumborum block and the intravenous analgesia with tramadol on postoperative analgesic effect in pediatric patients undergoing lower abdominal surgery. ⋯ In conclusion, we believe QLB1 provides effective analgesia in the postoperative period for lower abdominal surgery in pediatric patients.
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Minerva anestesiologica · Feb 2020
ReviewUncontrolled donation after circulatory death and liver transplantation: evidence and unresolved issues.
This review aimed at summarizing the available evidence on liver transplantation from uncontrolled donation after circulatory death (uDCD) on differences in protocols, donor management, in and ex vivo perfusion techniques from center to center. Uncontrolled DCDs represent a unique, complex model of ischemia-reperfusion injury, so far not completely understood. Nevertheless, results on liver transplantation from uDCDs are promising in terms of long-term graft survival. ⋯ Values and kinetics of transaminanes during normothermic regional perfusion (nRP) should not considered absolute contraindication at least for ex vivo perfusion. Intraoperative evaluation at organ recovery remains pivotal since macroscopic alterations (i.e. hepatic rupture, an abnormal appearance of gall bladder and choledocus) still represent contraindications for organ retrieval. Concerning ex vivo perfusion, the debate is still open, since the choice of type of machine perfusion (mainly hypothermic vs. normothermic) varies from center to center, mainly relying to the single center experience (especially in controlled DCD), surgeons' believes and/or criteria translated from animal models.
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Minerva anestesiologica · Feb 2020
Randomized Controlled TrialRandomized controlled trial of acupuncture to prevent emergence delirium in children undergoing myringotomy tube placement.
Myringotomy tube placement is a pediatric procedure frequently performed under inhalational anesthesia without intravenous line placement. Emergence delirium is common following sevoflurane anesthesia, and can lead to patient harm and escalation of nursing care. Our goal was to determine if intraoperative acupuncture, compared to standard of care, reduces emergence delirium in children undergoing myringotomy tube placement. ⋯ Intraoperative acupuncture at HT7 and ear Shen Men did not reduce PAED scores after myringotomy tube placement. Based on these data, it is therefore unlikely that a larger study of the same design would demonstrate a significant effect of intraoperative acupuncture on emergence delirium after brief sevoflurane anesthesia. However, other acupuncture points or techniques could be considered.
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Minerva anestesiologica · Feb 2020
Randomized Controlled TrialRespiratory and hemodynamic effects of three different sedative regimens for drug induced sleep endoscopy in sleep apnea patients. A prospective randomized study.
Drug induced sleep endoscopy (DISE) has emerged as a promising tool for customizing the adequate surgical approach to relieve airway obstruction in sleep apnea patients. We aimed to compare propofol, dexmedetomidine or ketofol with regards their efficacy and safety for sedation in patients with obstructive sleep apnea (OSA) undergoing DISE procedure. ⋯ Dexmedetomidine and ketofol provided a safe respiratory profile compared to propofol during DISE without significant hemodynamic adverse events.
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Minerva anestesiologica · Feb 2020
Regional air trapping in acute exacerbation of obstructive lung diseases measured with electrical impedance tomography: a feasibility study.
Since bronchial abnormalities often exhibit spatial non-uniformity which may be not correctly assessed by conventional global lung function measures, regional information may help to characterize the disease progress. We hypothesized that regional air trapping during mechanical ventilation could be characterized by regional end-expiratory flow (EEF) derived from electrical impedance tomography (EIT). ⋯ Regional EEF characterizes air trapping and intrinsic PEEP, which could provide diagnostic information for monitoring the disease progress during treatment.