Minerva anestesiologica
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Minerva anestesiologica · Jan 2009
Randomized Controlled Trial Comparative StudyProspective randomized, blind comparison of ropivacaine and levobupivacaine for superficial plexus anesthesia in carotid endoarterectomy.
The authors performed a study to evaluate if the onset time, duration of sensory block, and quality of postoperative analgesia in superficial cervical plexus anesthesia with 0.5% levobupivacaine (1 mg/kg) was greater than 0.75% ropivacaine (1.5 mg/kg). ⋯ No beneficial effect was noted in the quality of nerve block or patient's satisfaction for 0.5% levobupivacaine when compared to 0.75% ropivacaine.
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The noble gas xenon exerts favorable anesthetic properties along with remarkable hemodynamic stability in healthy patients undergoing elective surgery. Recent investigations documented that it does not prolong the duration of widely used neuromuscular blocking agents, including mivacurium and rocuronium. Some studies also suggest reduced neurocognitive compromise in the very early phase after general anesthesia. ⋯ Results from in vitro studies and various animal models have consistently demonstrated organoprotective properties of xenon, mainly in settings of ischemia and reperfusion injury. Interestingly, these effects have frequently been observed at subanesthetic concentrations and seem to be synergistic when used in combination with therapeutic hypothermia. Future studies will have to prove whether the high costs of xenon administration might be outweighed by its ability to substantially reduce the sequelae of myocardial and cerebral ischemia.
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Minerva anestesiologica · Jan 2009
The 2008 international guidelines for management of severe sepsis and septic shock: merits and weaknesses.
The Guidelines are intended to provide standard guidance for the care of patients by grouping evidence-based interventions into bundles that can be easily used by clinicians to improve patient outcome. The 2008 International guidelines for management of severe sepsis and septic shock is a large and extraordinary update of the literature offered by current leaders in the field. ⋯ Furthermore, they can change if new participants take part in the process. By considering the merits and weaknesses of practice guidelines, we conclude that guidelines cannot replace a physician's judgments, but rather should be a starting point for more robust and proficient scientific evidence.
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Minerva anestesiologica · Dec 2008
Randomized Controlled TrialSpinal anesthesia for transurethral resection operations: bupivacaine versus levobupivacaine.
This study tested the hypothesis that 0.5% levobupivacaine might be a good alternative to 0.5% plain bupivacaine for local spinal anesthesia during transurethral resection (TUR) operations. ⋯ Administration of 0.5% levobupivacaine may be a good alternative to 0.5% plain bupivacaine for local spinal anesthesia during TUR operations.