Minerva anestesiologica
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Minerva anestesiologica · Oct 2008
Thromboembolic prophylaxis in head trauma and multiple-trauma patients.
The association between trauma and venous thromboembolism (VTE) is well recognized. VTE consists mainly of deep venous thrombosis (DVT) and pulmonary embolism, a complication that leads to mortality in nearly 50% of cases. Without thromboprophylaxis, the risk of DVT exceeds 50%, but even with routine use of prophylaxis,one third of patients may develop DVT. ⋯ Mechanical VTE prophylaxis by graduated compression stockings or intermittent pneumatic compression provides suboptimal protection, and its use is recommended only in combination with LMWH prophylaxis unless active bleeding is not controlled. The routine use of VTE prophylaxis in trauma patients is a standard of care. The use of LMWH, started once primary hemostasis has been accomplished, is safe, efficacious and cost-effective in the majority of trauma patients, including TBI patients.
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Minerva anestesiologica · Sep 2008
Randomized Controlled Trial Comparative StudyDexmedetomidine-based versus fentanyl-based total intravenous anesthesia for lumbar laminectomy.
The present study was designed to show the effects of dexmedetomidine infusion with loading dosage on perioperative hemodynamics, propofol consumption, and postoperative recovery when used for general anesthesia in patients undergoing spinal laminectomy. ⋯ In conclusion, propofol-dexmedetomidine is suitable for patients undergoing elective spinal laminectomy and provides stable perioperative hemodynamic responses. Propofol-fentanyl medication requires a higher dosage of postoperative analgesics and causes frequent postoperative nausea and vomiting compared with propofol-dexmedetomidine.
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Minerva anestesiologica · Sep 2008
Randomized Controlled Trial Comparative StudyA prospective, randomized, double-blind comparison between parecoxib and ketorolac for early postoperative analgesia following nasal surgery.
The aim of this prospective, randomized, double-blind study was to compare the efficacy of parecoxibfor postoperative analgesia after endoscopic turbinate and sinus surgery, with the non-selective non-steroid anti-inflammatory drug (NSAID), ketorolac. ⋯ In patients undergoing endoscopic nasal surgery and local infiltration with 1% mepivacaine, parecoxib administered before discontinuing general anesthesia is as effective in treating early postoperative pain as ketorolac.
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The aim of this study was to identify Greek anesthesiologists' difficult airway management practices, as well as the availability of equipment and familiarity with different airway management techniques. ⋯ There are shortfalls in various areas of airway management in Greece, in particular with the availability of modern airway devices and training in fibrescopic intubation.
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Minerva anestesiologica · Sep 2008
Intensive care after elective surgery: a survey on 30-day postoperative mortality and morbidity.
Postoperative admission to the surgical intensive care unit (S-ICU) is routinely planned in order to prevent and treat early complications. Currently, limited studies have been conducted on this topic, and as such, early morbidity and mortality in patients undergoing postoperative intensive care were investigated. ⋯ The first 48 hours after surgery is a critical period in high-risk patients, and a stay in the S-ICU should be seriously considered. Planned admission to the S-ICU may effectively decrease postoperative mortality, as suggested by the highly significant difference between expected and observed deaths following S-ICU admission.