Articles: postoperative.
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Minerva anestesiologica · Dec 2016
Randomized Controlled Trial Comparative StudyComparison of the Macintosh, GlideScope®, Airtraq®, and King VisionTM laryngoscopes in routine airway management.
We hypothesized that the use of the channeled King Vision™ and Airtraq® would shorten the time for tracheal intubation compared with the Macintosh or GlideScope® laryngoscopes in patients with normal airways. ⋯ The King Vision™ and Airtraq® require longer intubation times, as primary outcome, and cause less sore throat than the Macintosh and GlideScope® when used by anesthesiologists with limited experience in patients with normal airways. Our conclusion is difficult to extrapolate to the expert anesthesiologists who are using videolaryngoscopes on a regular basis.
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Propofol is a short-acting, intravenous sedative-hypnotic agent that is widely used for the induction and maintenance of general anesthesia and sedation. An uncommon adverse effect of propofol is green discoloration of the urine, which has been reported not only under general anesthesia but also with sedation. Although it is assumed that the phenolic derivatives of propofol can cause green discoloration of the urine, the actual origin remains unknown. The aim of this report was to identify the origin of the green discoloration of the urine using liquid chromatography-mass spectrometry (LC-MS). ⋯ We experienced a case of a patient with green discoloration of the urine after general anesthesia using propofol. Although LC-MS analysis showed 2 unique peaks in the green urine at 490 and 590 nm, obvious causes were not revealed.
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Minerva anestesiologica · Dec 2016
ReviewThe aging digestive tract. What should we anesthesiologists know about it?
At present, elderly individuals represent approximately 18.5% of the European population and account for about 23% of surgical procedures performed. This patient population is at a higher risk for perioperative complications and adverse postoperative outcome. This narrative review highlights our current knowledge about physiological changes in the aging gut and the implications for anesthesiologists. ⋯ Healthy aging appears to be associated with modest slowing of gastric emptying, but this does not demand prolonged preoperative fasting. The physiological changes associated with polypharmacy also make elderly patients a risk group for pulmonary aspiration during anesthesia. Further research is needed to determine the effects of commonly used anesthetic agents on the pharyngo-gastrointestinal tract in elderly patients.
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Minerva anestesiologica · Dec 2016
Randomized Controlled TrialContinuous epidural versus wound infusion plus single morphine bolus as postoperative analgesia in open abdominal aortic aneurysm repair: a randomized non-inferiority trial.
We compared a bundle of interventions including wound infiltration and continuous infusion with local anesthetics plus a single morphine bolus (CWI-M) with continuous epidural infusion (CEI) as postoperative analgesia. ⋯ CWI-M was comparable to CEI in in postoperative pain control, but it was associated with higher need of rescue systemic opiates and with a worse early pain control.