Minerva anestesiologica
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Minerva anestesiologica · Jul 2000
Randomized Controlled Trial Comparative Study Clinical TrialA prospective, randomized comparison of dexketoprofen, ketoprofen or paracetamol for postoperative analgesia after outpatient knee arthroscopy.
This prospective, randomized study was conducted to evaluate the quality of postoperative pain relief when using dexketoprofen, ketoprofen, or paracetamol after outpatient knee arthroscopy. ⋯ This prospective, randomized study demonstrated that in outpatients receiving arthroscopic knee surgery, the use of 75 mg/day dexketoprofen was as effective and safe as 150 mg/day racemate ketoprofen, with a better pain relief during motion compared to 2 g/day paracetamol when patients were discharged from the day-surgery unit.
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Minerva anestesiologica · Jun 2000
Randomized Controlled Trial Comparative Study Clinical Trial[Laryngeal mask vs tracheal tube in pediatric anesthesia in the presence of upper respiratory tract infection].
The aim of this report is to assess the incidence of postoperative respiratory complications in patients recently suffering from inflammation of the upper respiratory tract in whom a LMA or an uncuffed orotracheal tube have been used. ⋯ The frequency of ARE increases significantly in URI patients with both LMA and the tracheal tube, but with the former is far lower than with the latter. Despite the appearance of only minor and transient complications, it is confirmed that the tracheal intubation is an additional risk factor as a result of the mechanical airway simulation. In recent URI, it would seem appropriate to avoid tracheal intubation, if possible, preferring the LMA.
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Minerva anestesiologica · Jun 2000
Clinical Trial[Post-intubation subglottal stenosis in children: risk factors and prevention in pediatric intensive care].
Endotracheal intubation (EI) may result in significant injury to the larynx and trachea; subglottic stenosis is the most dangerous consequence of this injury in the pediatric age. It is well known that there are potential risk factors for post-intubation subglottic stenosis, and namely the underlying disease requiring EI, the age and body weight at EI, the duration and number of EI, the absence of sedation and the occurrence of infectious, hypotensive or hypoxic events during the period of EI and the traumatic EI. On the basis of our data an attempt is made to understand which factors are more important in the pathogenesis of this complication and whether post-intubation subglottic stenosis is a preventable complication of EI in children. ⋯ Prevention of post-intubation subglottic stenosis is possible through a better management of the EI and of the child with a tracheal tube. Sedation of intubated children and skill in the EI technique and in the tube size selection are very important. Many intubations can be avoided with a better attention to the tube fixation and to extubation criteria. Some children at high risk for this complication can be identified.
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The Bispectral Index or "BIS" is a single number, composed from different EEG features, using multivariate statistical methods. It was designed for monitoring the depth of hypnosis during anaesthesia and sedation. ⋯ Unlike univariate measures, such as Spectral Edge Frequency or Median Frequency, the Bispectral Index is drug independent and changes with increasing doses of hypnotics in an almost linear way. Though sophisticated technology, the A-2000 BIS monitor and the BIS sensor are easy to use and also allow non-experts to monitor the depth of hypnosis and sedation on a routine basis.
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Due to pharmacokinetic and pharmacodynamic reasons, the elderly are at particular risk of incurring unwanted side effects of drugs commonly used in anaesthesia. The bispectral index (BIS) is an EEG-derived value that measures the sedative component of the anaesthetic state. The BIS could be useful in guiding titration of anaesthetic drugs in the elderly. ⋯ The BIS is a useful guidance for titration of anaesthetic drugs in the elderly. The presence of senile dementia may be a confounding factor in the interpretation of the BIS values during anaesthesia.