Abstract:
:The aim of these recommendations is the revision of data published in 2002 in the "SIAARTI Recommendations for acute postoperative pain treatment". In this version, the SIAARTI Study Group for acute and chronic pain decided to grade evidence based on the "modified Delphi" method with 5 levels of recommendation strength. Analgesia is a fundamental right of the patient. The appropriate management of postoperative pain (POP) is known to significantly reduce perioperative morbidity, including the incidence of postoperative complications, hospital stay and costs, especially in high-risk patients (ASA III-V), those undergoing major surgery and those hospitalized in a critical unit (Level A). Therefore, the treatment of POP represents a high-priority institutional objective, as well as an integral part of the treatment plan for "perioperative disease", which includes analgesia, early mobilization, early enteral nutrition and active physiokinesitherapy (Level A). In order to improve an ACUTE PAIN SERVICE organization, we recommend: --a plan for pain management that includes adequate preoperative evaluation, pain measurement, organization of existing resources, identification and training of involved personnel in order to assure multimodal analgesia, early mobilization, early enteral nutrition and active physiokinesitherapy (Level A); --the implementation of an Acute Pain Service, a multidisciplinary structure which includes an anesthetist (team coordinator), surgeons, nurses, physiotherapists and eventually other specialists; --referring to high-quality indicators in establishing an APS and considering the following key points in its organization (Level C): --service adoption; --identifying a referring anesthetist who is on call 24 hours a day; --patient care during the night and weekend; --sharing, drafting and updating written therapeutic protocols; --continuous medical education; --systematic pain assessment; --data collection regarding the efficacy and safety of the implemented protocols; --at least one audit per year. --a preoperative evaluation, including all the necessary information for the management of postoperative analgesia (Level C); --to adequately inform the patient about the risks and benefits of drugs and procedures used to obtain the maximum efficacy from the administered treatments (Level D). We describe pharmacological and loco-regional techniques with special attention to day surgery and difficult populations. Risk management pathways must be the reference for early identification and treatment of adverse events and chronic pain development.
journal_name
Minerva Anestesioljournal_title
Minerva anestesiologicaauthors
Savoia G,Alampi D,Amantea B,Ambrosio F,Arcioni R,Berti M,Bettelli G,Bertini L,Bosco M,Casati A,Castelletti I,Carassiti M,Coluzzi F,Costantini A,Danelli G,Evangelista M,Finco G,Gatti A,Gravino E,Launo C,Loreto M,subject
Has Abstractpub_date
2010-08-01 00:00:00pages
657-67issue
8eissn
0375-9393issn
1827-1596pii
R02105687journal_volume
76pub_type
杂志文章,实务指引abstract:BACKGROUND:The effort to decrease hospital stays and to increase operating room efficacy has become an important consideration in the practice of anesthesia. METHODS:Fifty-three patients who underwent shoulder rotator cuff repair in the sitting position were divided into four groups according to the anesthesia techniq...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2001-09-01 00:00:00
abstract:INTRODUCTION:The study aimed to compare Bispectral Index (BIS) and non-BIS anesthetic protocols on postoperative recovery outcomes. EVIDENCE ACQUISITION:Medline, PubMed, Cochrane, EMBASE, and Google Scholar databases were searched until January 21, 2016. EVIDENCE SYNTHESIS:Twenty-six studies were included with a tota...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:10.23736/S0375-9393.17.12033-X
更新日期:2018-02-01 00:00:00
abstract:AIM:The aim of this paper is to describe the anesthesiological management and the outcome of beating heart revascularization. METHODS:A prospective study has been performed in a tertiary teaching hospital on 100 consecutive patients undergoing off-pump coronary artery revascularization. The main features of anesthetic...
journal_title:Minerva anestesiologica
pub_type: 临床试验,杂志文章
doi:
更新日期:2006-10-01 00:00:00
abstract::Sepsis is a condition at high risk for the patients to develop organ(s) or system dysfunction/failure and represent a very limiting process for survival. Researchers and clinicians proposed standardization of terminology for sepsis and related problems to improve communication and to evaluate the efficacy of preventiv...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:1999-07-01 00:00:00
abstract:BACKGROUND:High-volume low-pressure (HVLP) endotracheal tube (ETT) cuffs for critically ill patients often deflate during the course of mechanical ventilation. We performed an in-vitro study to comprehensively assess HVLP cuff deflation dynamics and potential preventive measures. METHODS:We evaluated 24-hour deflation...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:10.23736/S0375-9393.19.13133-1
更新日期:2019-08-01 00:00:00
abstract::Neuraxial block for labor analgesia is widely accepted and highly effective. Much progress has been achieved in terms of providing safer and more efficacious analgesia. Emphasis has been placed on maternal autonomy and individualization of therapy. The introduction of the combined spinal-epidural technique in the labo...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2008-03-01 00:00:00
abstract::We herein evaluated the analgesic effectiveness of low doses of buprenorphine with or without a primer and the practicality and usefulness of a constant flow disposable infusion set (Infusor Baxter 2 ml/h). Our series consists of 300 patients, seen between January 1992 and December 1993, randomly distributed in three ...
journal_title:Minerva anestesiologica
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1994-10-01 00:00:00
abstract:BACKGROUND:Thrombocytopenia is associated with worse outcomes in critically ill patients. The clinical relevance of other platelets indices is less studied. We investigated the ability of the platelets distribution width (PDW) and the mean platelet volume (MPV) to predict mortality in critically ill patients. We hypoth...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:10.23736/S0375-9393.20.14528-0
更新日期:2020-09-22 00:00:00
abstract::The authors describe a case of prolonged neuromuscular blockade following suxamethonlum in a patient with a normal cholinesterase activity and dibucaine number > or = 75%. In this case a peripheral nerve stimulator and capnography allowed neuromuscular blockade evaluation and fresh frozen plasma infusion led to a norm...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1995-01-01 00:00:00
abstract::The authors review the advantages and disadvantages of general and regional anesthesia in bad clinical conditions. The purpose of this study was to evaluate the efficacy of Blended Anesthesia (association of general anesthesia with a regional technique) in 25 patients belonging to ASA classes II-III-IV, undergoing sur...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1993-04-01 00:00:00
abstract:BACKGROUND:There is an equipoise regarding closed-loop ventilation modes and the ability to reduce workload for providers. On one hand some settings are managed by the ventilator but on another hand the automatic mode introduces new settings for the user. METHODS:This randomized controlled trial compared the number of...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,随机对照试验
doi:10.23736/S0375-9393.17.11963-2
更新日期:2018-01-01 00:00:00
abstract::Ahead of Print article withdrawn by publisher Blood brain barrier disruption (BBBD) is a novel technique for treating central nervous system lymphoma. This technique depends on the disruption of the tight junctions between endothelial cells (which represent the blood brain barrier) by intra-arterial injection of manni...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2011-10-21 00:00:00
abstract::Data concerning antibiotic therapy in italian ICUs are presented. These data were not directly measured: they have been derived from a previous study on costs of intensive care treatments. 78% of 1065 patients received antibiotic therapy. Empirical therapy was started in 82% of septic patients. 93% of septic patients ...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2001-04-01 00:00:00
abstract:AIM:The aim of this study was to evaluate and compare the parameters for mechanical respiration in pediatric patients undergoing controlled ventilation with a laryngeal mask (LM) and an uncuffed orotracheal tube. METHODS:The study examined 100 ASA 1 patients undergoing general anesthesia with myoresolution and mechani...
journal_title:Minerva anestesiologica
pub_type: 临床试验,杂志文章
doi:
更新日期:2000-01-01 00:00:00
abstract::Clinical neurophysiology is both an extension of clinical examination and an integration of neuroimaging. It plays a role in diagnosis, prognosis and monitoring in the Intensive Care Unit (ICU). Electroencephalography (EEG) and somatosensory evoked potentials (SEPs) are the most informative neurophysiological tests. B...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2012-09-01 00:00:00
abstract::Oxygen supply to all tissues is possible only in a condition of adequate blood circulation. Oxygen demand is the driving force that is responsive of hemodynamic adjustment. The human body acts on four modulators (intravascular volume, inotropy, vasoactivity, chrono-tropy) in order to adjust the hemodynamic state. Hemo...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2006-06-01 00:00:00
abstract::The overall use of allogeneic blood transfusions in clinical practice remains relatively high and still varies widely among centres and practitioners. Moreover, allogeneic blood transfusions have historically been linked with risks and complications: some of them (e.g. transfusion reactions and transmission of pathoge...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2015-10-01 00:00:00
abstract:BACKGROUND:The analysis of the arterial pulse contour obtained by means of a non-invasive device (Finapres) seems to be an ideal method to measure cardiac output (CO). An individual calibration factor (Z) dimensionally equal to aortic impedence is the necessary pre-requisite to calculate CO by pulse contour analysis. T...
journal_title:Minerva anestesiologica
pub_type: 临床试验,杂志文章
doi:
更新日期:1998-03-01 00:00:00
abstract::A multimodal, rehabilitative, fast discharge approach to abdominal aortic surgery is analyzed. The approach was developed in two phases during the years 1997-2000: in the first phase (1997) patients had thoracic epidural anesthesia plus TIVA and analgesia. They had improvement of the classical surrogate outcomes and a...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2001-09-01 00:00:00
abstract::The bulbar hypotonizing activity of Althesin in eye surgery has been assessed. The anaesthetic was then utilized in the induction and maintenance of narcosis in cryoextraction operations on the crystalline lens. In the 50 narcoses examined, a mean decrease in ocular tone of 30% was noted with respect to basal value fi...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1980-02-01 00:00:00
abstract::This article describes the clinical history of a patient admitted to the Emergency Room after severe infrascapular pain unaffected by breathing or postural changes. After thoracic CT a type B aortic dissection was diagnosed. On admission to the CCU, the patient's blood pressure was still high (210/120 mmHg). Sodium ni...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2007-09-01 00:00:00
abstract:BACKGROUND:The efficacy of an ultrasound guided transmuscular quadratus lumborum block (QLB) for perioperative analgesia of the upper and lower abdomen remain debatable. The purpose of this study was to compare the cutaneous sensory blocked area (CSBA) between QLB blocks performed at the L2 vs. L4 levels. METHODS:Twen...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,随机对照试验
doi:10.23736/S0375-9393.19.13656-5
更新日期:2019-12-01 00:00:00
abstract::The authors compared the efficacy of ketorolac trometamin (30 mg i.m. every 6 hours) and buprenorphine (0.3 mg i.m. every 12 hours) in the treatment of pain following cholecystectomy. Ketorolac was found to be equally efficacious in comparison to buprenorphine and caused fewer side effects. ...
journal_title:Minerva anestesiologica
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1993-03-01 00:00:00
abstract:BACKGROUND:This study aimed to determine the accuracy of commonly used preoperative difficult airway indices as predictors of difficult mask ventilation (DMV) in obese patients (BMI >30 kg/m2). METHODS:In 309 consecutive obese patients undergoing general surgery, the modified Mallampati test, patient's Height/Thyromen...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2014-02-01 00:00:00
abstract::Cardiovascular response to laryngoscopy and tracheal intubation may be harmful in surgical patients with cardiovascular and cerebral diseases. The efficacy of intravenous lidocaine on attenuating the hemodynamic changes remains controversial. This systematic review aims to determine the efficacy of lidocaine versus pl...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,meta分析,评审
doi:
更新日期:2013-12-01 00:00:00
abstract::Results obtained with Althesin as anaesthetic in 100 patient subjected to urological surgery are presented. The continuous perfusion of Althesin gave a level of stable and flexible anaesthesia that, like the return to consciousness, was particularly appreciated by aged patients. Stress is laid on the fact that the har...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1980-02-01 00:00:00
abstract:BACKGROUND:Today, most of the pre-emptive hemodynamic optimization algorithms are based on variables associated with invasive techniques like arterial cannulation. The non-invasive Nexfin™ technology is able to estimate continuous Cardiac Index (CI) and pulse pressure variation (PPV). However, the efficiency of an earl...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,随机对照试验
doi:
更新日期:2016-11-01 00:00:00
abstract:BACKGROUND:Cost reduction is an important issue in medicine today, especially when considering ICUs, since they account for a large percentage of all hospital expenditure. Through a retrospective analysis of the data regarding the expenses incurred during the years 1996-97, we have been able to evaluate the total costs...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2000-11-01 00:00:00
abstract:INTRODUCTION:Recent data found that perioperative goal directed therapy (GDT) was effective only in higher control mortality rates (>20%) with a relatively high heterogeneity that limited the strength of evidence. The aim of the present meta-analysis was to clearly understand which high risk patients may benefit of GDT...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,meta分析
doi:
更新日期:2016-11-01 00:00:00
abstract::The authors briefly discuss the advantages and limits of sedation in critically ill patients. They also focus the importance of an individualized sedative approach which provides pain relief and modulates stress response, allowing patients to be easily arousable and cooperative as necessary. ...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2002-04-01 00:00:00