Minerva anestesiologica
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Minerva anestesiologica · Mar 2008
Comparative StudyComparing the efficacy and safety of continuous epidural analgesia in abdominal and urological surgery between two opioids with different kinetic properties: morphine and sufentanyl.
Ample evidence is now available showing the analgesic efficacy of a local anaesthetic-opioid combination to control postoperative pain. This retrospective study aimed to analyze any improvement in the ability of sufentanyl, a highly lipophilic opioid, and morphine, a poorly lipophilic opioid, to control postoperative pain at rest and in motion when combined with ropivacaine 0.2%. ⋯ Both protocols providing a combination of a local anaesthetic and an opioid demonstrated an excellent safety and efficacy profile. The differing lipophilicity of the opioids did not cause any clinically or statistically significant differences in terms of efficacy or safety, other than a reduced onset time of sufentanyl, ensuring better pain control upon waking. We therefore believe that morphine should be the standard opioid for neuraxial use, although these results must be confirmed in the setting of a randomized controlled clinical trial.
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Minerva anestesiologica · Mar 2008
Assisted sedation: a safe and easy method for pain-free percutaneous vertebroplasty.
This study was performed to describe a method of assisted sedation for percutaneous vertebroplasty (PVP). ⋯ Assisted sedation is a safe and easy method for pain free PVP procedures. Age is an important factor to titrate propofol dose. However, it is noteworthy that no adverse effects were observed independent of age and physical status.
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There is substantial national and international variation in the conduct of anesthesia for ophthalmic surgical procedures. Ophthalmic regional anesthetic techniques include traditional needle-based blocks, such as intraconal or extraconal injections; sub-Tenon's blocks which can be accomplished with needles, but are more commonly performed with blunt cannulae; and topical anesthesia. Needle-based techniques are generally safe although rare, serious sight- and life-threatening complications may occur. ⋯ Currently there is no absolutely safe ophthalmic regional block. It is essential that those who are involved in the care of ophthalmic patients have a thorough knowledge of the approaches employed and their associated risks and benefits. This review article outlines the relevant anatomy, commonly used techniques and their safe performance.