Minerva anestesiologica
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Minerva anestesiologica · May 2012
Randomized Controlled Trial Comparative StudyA randomized controlled study to assess patients' understanding of and consenting for clinical trials using two different consent form presentations.
Informed consent is the ethical basis for clinical research. The physical appearance of the consent document may influence patients' willingness to carefully read the consent document. We therefore tested the hypothesis that presentation of consent documents in an enhanced format improves patients' attention, understanding and therefore willingness to consent for clinical research. ⋯ Consent forms in an enhanced format (i.e., printed on fine paper and presented in a folio) did not improve patients' understanding or willingness to consent to participate in clinical trials.
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Minerva anestesiologica · May 2012
Randomized Controlled Trial Comparative StudyPain relief after total hip replacement: oral CR oxycodone plus IV paracetamol versus epidural levobupivacaine and sufentanil. A randomized controlled trial.
We tested the hypothesis that pain relief after total hip replacement (THR) can be obtained with a multimodal approach using oral controlled release (CR) oxycodone plus IV paracetamol. ⋯ Oral CR oxycodone plus IV paracetamol was as effective as epidural levobupivacaine and sufentanil for postoperative pain relief after THR.
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Minerva anestesiologica · May 2012
Efficacy of functional hemodynamic parameters in predicting fluid responsiveness with pulse power analysis in surgical patients.
In this study we quantify the ability of dynamic cardiovascular parameters measured by the PulseCO™ algorithm of the LiDCO™plus monitor to predict the response to a fluid challenge in post-operative patients. ⋯ Thirty-one patients were enrolled, and received protocol-based fluid challenges. Twelve (38%) responded by demonstrating an increase in stroke volume of >15%. Heart rate (HR) and central venous pressure (CVP) were not statistically different between responders and non-responders. Mean arterial pressure (mAP), systolic pressure variation (SPV), pulse pressure variation (PPV) and stroke volume variation (SVV) were statistically different between responders and non-responders. Parameters with a ROC area under the curve (AUC) significantly >0.5 included SPV 0.70 (0.52-0.88) P=0.046, PPV 0.87 (0.76-0.99) P<0.0002 and SVV 0.84 (0.71-0.96) P=0.0005. The best cut-off values (sensitivity and specificity) to predict fluid were SPV >9 mmHg (73%, 76%), PPV >13% (83%, 74%) and SVV >12.5% (75%, 83%). ROC analysis did not show the AUC to be significantly >0.5 for HR, mAP and CVP CONCLUSION: Dynamic indices measured by PulseCO™ (LiDCO) have a high sensitivity and specificity in predicting fluid responsiveness in sedated and mechanically ventilated patients. A cut-off value for PPV of 13% is the most sensitive and specific indicator of fluid responsiveness.
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Minerva anestesiologica · May 2012
ReviewAnesthetic concerns for robotic-assisted laparoscopic radical prostatectomy.
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, respiratory and hemodynamic homeostasis. ⋯ Close coordination between the anesthesia and surgical teams is required for a successful surgery. This review will discuss the anesthetic concerns and perioperative management of patients presenting for RALP.