Abstract：
:Chronic musculoskeletal pain is a highly prevalent condition that is commonly encountered in both general and specialist practice. Nonetheless, it still represents a significant challenge to the practitioners because of the lack of substantial evidence-based guidance. This review aimed to summarize the main pathophysiological mechanisms of chronic pain offering a mechanism-oriented approach to diagnosis and management. We believe that a basic knowledge of the physical signs and symptoms of these mechanisms could empower the clinician to choose appropriate medication and identify high-risk pain patients. Central sensitization and neuropathic features may arise in previously nociceptive and inflammatory pain syndromes. Central sensitization is a functional remodeling of the spinal cord, where light touch afferents are recruited by nociceptive second-order neurons. Neuropathic features include both negative signs, such as reduced perception of vibration and touch, and positive symptoms, such as paroxysmal electric shock pain, due to ectopic discharge. These phenomena are the neurobiological basis of the commonly defined refractory chronic pain. Early detection and specific treatment of these mechanisms are required in order to restrain the reinforcement of pronociceptive remodeling of the nervous system.
journal_name
Minerva Anestesioljournal_title
Minerva anestesiologicaauthors
Finco G,Evangelista M,Sardo Sdoi
10.23736/S0375-9393.20.14573-5subject
Has Abstractpub_date
2020-12-01 00:00:00pages
1321-1330issue
12eissn
0375-9393issn
1827-1596pii
S0375-9393.20.14573-5journal_volume
86pub_type
杂志文章abstract：:Drugs used in anesthesia do not always produce the expected neurophysiological results. By studying those cases in which the reappearance of intraoperative awareness is most common, an attempt was made to estimate how many and which levels of cerebral function could be identified. Four levels were recognised: awarenes...
journal_title：Minerva anestesiologica
pub_type： 杂志文章
doi：
更新日期：1990-05-01 00:00:00
abstract：BACKGROUND:To compare the anaesthetic epidural effects of levobupivacaine plus fentanyl versus bupivacaine plus fentanyl in patients undergoing lower limb surgery. METHODS:A single blind, randomised, prospective, multicentre study was designed to compare both therapies. The study was conducted in 10 tertiary hospitals...
journal_title：Minerva anestesiologica
pub_type： 杂志文章,多中心研究,随机对照试验
doi：
更新日期：2008-07-01 00:00:00
abstract：AIM:The study compares the intraoperative effects of combined versus general anesthesia during major liver surgery. METHODS:In this prospective randomized study, 70 patients were divided into 2 group of 35 subjects. Group A received general anesthesia (thiopentone, fentanyl, vecuronium, sevoflurane in a closed circuit...
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：2003-12-01 00:00:00
abstract：:Twenty eight elderly patients scheduled for urologic surgery were randomly assigned to receive in a double blind fashion subarachnoid hyperbaric bupivacaine 15 mg with the addition of 50 micrograms (group A, n = 7), 25 micrograms (group B, n = 7), 12.5 micrograms (group C, n = 7), of fentanyl or 1 ml of saline (group ...
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：1991-04-01 00:00:00
abstract：:Known for two centuries, positive pressure non invasive mechanical ventilation (VMNPP) has been widely applied in acute respiratory failure (IRA) only in the last ten years. The fact that VMNPP is able to improve gas exchange by avoiding endotracheal intubation and its complications is the most attractive aspect in bo...
journal_title：Minerva anestesiologica
pub_type： 历史文章,杂志文章,评审
doi：
更新日期：2000-10-01 00:00:00
abstract：:On the basis of experience of 25 patients subjected to suspension laryngoscopy and bronchoscopy, it is shown that the technique of anaesthesiology conduction adopted responds to the needs of the anaesthesist and the laryngoscopist. Althesin in particular has been found to possess the requisites for this type of diagno...
journal_title：Minerva anestesiologica
pub_type： 杂志文章
doi：
更新日期：1981-01-01 00:00:00
abstract：BACKGROUND:A short hospital stay is nowadays desirable and affordable for a wide range of surgical pathology, respecting safety of care and home discharge. In the present study, the Authors investigated the use of TIVA with propofol/remifentanil during microsurgical vertebral disc resection to maintain a controlled vas...
journal_title：Minerva anestesiologica
pub_type： 临床试验,杂志文章
doi：
更新日期：2002-09-01 00:00:00
abstract：BACKGROUND:Anaesthesia drugs cause the cutaneous vasodilatation that produces core temperature lowering at the beginning of general anaesthesia; when the thermal threshold for vasoconstriction is reached the cutaneous heat losses are decreased. Furthermore, the soda lime begins to produce water and heat after 40 minute...
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：1995-09-01 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：:109 patients who suffered from an episode of acute respiratory failure, necessitated mechanical ventilation (MV) in a general Intensive Care Unit (ICU) and admitted to our Respiratory Intermediate Intensive Unit (RIIU), were retrospectively evaluated for outcome and weaning success. The patients, 69 +/- 9 years old, p...
journal_title：Minerva anestesiologica
pub_type： 杂志文章,评审
doi：
更新日期：1996-03-01 00:00:00
abstract：:In this study we compared the efficacy of a reduced dose of medium term neuromuscular blocking agents atracurium (0.20 mg/kg) and vecuronium (0.04 mg/kg) in short-term (8-10 min) pediatric surgery. Eighty-four children (ASA I and II) undergoing adenotonsillectomy were selected for this study. Their average age was 56 ...
journal_title：Minerva anestesiologica
pub_type： 杂志文章
doi：
更新日期：1993-03-01 00:00:00
abstract：:Arrhythmias are common in hospitalized patients and during surgery. We present a case of positional atrial arrhythmia related to a peripherally inserted central catheter (PICC). There are other documented case reports of ventricular tachycardia precipitated by body position changes with a PICC. The immediate correctio...
journal_title：Minerva anestesiologica
pub_type： 杂志文章
doi：
更新日期：2009-07-01 00:00:00
abstract：BACKGROUND:Patient-ventilator asynchronies are challenging during pediatric mechanical ventilation. We hypothesized that monitoring the electrical activity of the diaphragm (EAdi) together with the "standard" airway opening pressure (Pao) and flow-time waveforms during pressure support ventilation would improve the abi...
journal_title：Minerva anestesiologica
pub_type： 杂志文章
doi：10.23736/S0375-9393.20.14543-7
更新日期：2020-08-04 00:00:00
abstract：:With the first generation of ventilators, it was often necessary to sedate patients to avoid dyssynchrony between patient and ventilator. The standard treatment of patients in need of mechanical ventilation has therefore traditionally included sedation. Modern ventilators are able to simulate the patients breathing ef...
journal_title：Minerva anestesiologica
pub_type： 杂志文章,评审
doi：
更新日期：2011-01-01 00:00:00
abstract：:An account is given of the employment of althesin as an induction and maintenance anaesthetic. It is free of the drawbacks observed with thiopentone induction, and has negligible haemodynamic and respiratory effects. Its association with leptophen permitted excellent analgesia at minimal leptophen doses, without secon...
journal_title：Minerva anestesiologica
pub_type： 杂志文章
doi：
更新日期：1980-02-01 00:00:00
abstract：BACKGROUND:The Zero-Heat-Flux technology of the SpotOn® sensor to measure core temperature has been validated in vascular and cardiac surgery. Our aim was to assess its validity in gynecological surgery in terms of time of measurement, thermic status (hypo-, normo-, or hyperthermia) and the use of different warming dev...
journal_title：Minerva anestesiologica
pub_type： 杂志文章
doi：10.23736/S0375-9393.18.12188-2
更新日期：2019-04-01 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：:Fifty patients undergoing cardiac surgery suffering from coronary artery disease and valvular incompetence or stenosis, were randomly divided into two groups of 25 patients to compare the plasmapheresis effects on bleeding, transfusion requirements, economicity and paramedical staff compliance versus intraoperative au...
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：1995-07-01 00:00:00
abstract：BACKGROUND:Studies on pregnant women undergoing cesarean delivery or elderly men scheduled for prostate brachytherapy have demonstrated the predictive value of heart rate variability (HRV) analysis for hypotension during spinal anesthesia. We conducted a prospective observational study to investigate if preoperative HR...
journal_title：Minerva anestesiologica
pub_type： 杂志文章
doi：
更新日期：2015-07-01 00:00:00
abstract：BACKGROUND:Acute normovolaemic anemia (ANA) frequently occurs during cardiopulmonary bypass (CPB) and major surgeries. We investigated whether fluids (with different compositions) used to replace blood elicit any degree of systemic or lung inflammatory response. METHODS:We evaluated systemic and pulmonary inflammatory...
journal_title：Minerva anestesiologica
pub_type： 杂志文章
doi：
更新日期：2013-10-01 00:00:00
abstract：AIM:The aim of the paper was to examine the attitudes of the health care workers (HCW) of five Italian Hospitals towards intensive supports, in the hypothesis that a large involvement could help to solve the problems of a more adequate management of vital supports. METHODS: DESIGN:Hospital HCWs' attitudes towards car...
journal_title：Minerva anestesiologica
pub_type： 杂志文章
doi：
更新日期：2007-03-01 00:00:00
abstract：AIM:High-flow-oxygen-therapy is provided by various techniques and patient interfaces, resulting in various inspired-fraction of oxygen (FiO2) and airway-pressure levels. However, tracheal measurements have never been performed. METHODS:Three oxygen-delivery-devices were evaluated: 1) standard-high-flow-oxygen-facemas...
journal_title：Minerva anestesiologica
pub_type： 临床试验,杂志文章
doi：
更新日期：2013-12-01 00:00:00
abstract：:Despite consistent improvement in its treatment, amatoxin poisoning still extolls an elevated overall mortality, ranging between 10 and 15%, which approaches 100% when severe (grade 3-4 encephalopathy) hepatic failure supervened. Therefore, the proper treatment of intoxication by amatoxin containing mushrooms, and par...
journal_title：Minerva anestesiologica
pub_type： 杂志文章
doi：
更新日期：1991-06-01 00:00:00
abstract：BACKGROUND:In this study, the level and the variation of a number of hormone and metabolic parameters during brain death treatment in potential organ donors have been monitored. METHODS:Thirty-nine consecutive brain-dead patients were enrolled in 3 Intensive Care Units of Regional Hospitals of the North of Italy. All ...
journal_title：Minerva anestesiologica
pub_type： 临床试验,杂志文章
doi：
更新日期：1999-10-01 00:00:00
abstract：BACKGROUND:The coronary sinus oxygen saturation (SO2) can affect the oxygen saturation of the superior vena cava (superior cava SO2) and the pulmonary artery (pulmonary artery SO2), causing a gradient between the latter two (ΔSO2), as has been observed in different physiological and pathological conditions. The objecti...
journal_title：Minerva anestesiologica
pub_type： 杂志文章
doi：
更新日期：2011-06-01 00:00:00
abstract：:Two cases of Paraquat poisoning of anticonservative origin are described. A brief account of the chemical composition and mechanism of action of Paraquat is followed by a discussion of the clinical and therapeutic features of the two cases. The anatomopathological findings obtained from lung specimens examined during ...
journal_title：Minerva anestesiologica
pub_type： 杂志文章
doi：
更新日期：1979-12-01 00:00:00
abstract：:The authors report the case of a patient suffering from central sleep apnea (CSA) who underwent neurosurgery for ventriculo-peritoneal derivation under general anesthesia. Given the risk of postoperative hypoventilation in CSA, intraoperative anesthesia was induced using remifentanyl, an opiate with a plasma half-life...
journal_title：Minerva anestesiologica
pub_type： 杂志文章
doi：
更新日期：1999-09-01 00:00:00
abstract：BACKGROUND:Traumatic brain injury (TBI) and subarachnoid hemorrhage (SAH) are the most common causes of severe acute brain injury in younger Intensive Care Unit (ICU) patients. Dysglycemia (abnormal peak glycemia, glycemic variability, mean glycemia, nadir glycemia) is common in these patients but its comparative outco...
journal_title：Minerva anestesiologica
pub_type： 杂志文章
doi：10.23736/S0375-9393.19.13307-X
更新日期：2019-08-01 00:00:00
abstract：BACKGROUND:Pneumonia is the primary source of sepsis and is significantly associated with mortality. However, only a few studies focus on its clinical characteristics and outcomes. METHODS:We evaluated 500 intensive care unit patients who met severe sepsis or septic shock criteria, dividing them into two distinct grou...
journal_title：Minerva anestesiologica
pub_type： 杂志文章,多中心研究
doi：
更新日期：2013-12-01 00:00:00
abstract：OBJECTIVE:To evaluate the effectiveness of two cardiac output measurement methods based on a modified Fick equation, that calculate the O2 consumption (VO2) dividing the CO2 production (VCO2) by a fixed respiratory quotient (RQ). DESIGN:Comparative study. SETTING:One 5 beds general intensive care unit in a 500 beds g...
journal_title：Minerva anestesiologica
pub_type： 临床试验,杂志文章
doi：
更新日期：1995-05-01 00:00:00
