A year in review in Minerva Anestesiologica 2019. Anesthesia, analgesia, and perioperative medicine

Innovations in anesthesia and perioperative pain management have animated the debate the last year

Messages from the RICALOR Study

WOS: 000386760400001PubMed: 26959384Nowadays, regional anesthesia (RA) techniques used for both anesthesia and postoperative analgesia procedures have become increasingly widespread. While the introduction of ultrasonography (USG) for use as a part of these techniques has increased the interest in RA, visualizing anatomic structures during the procedure has also provided a considerable advantage regarding the safety of RA techniques. However, it does not seem possible to advocate that the use of USG can completely eliminate complications 1,2. For this reason, it is important to report complications associated with RA in order to safely perform future procedures and to develop novel technologies

In vitro antimicrobial activity of commonly used vasoactive drugs

WOS: 000384952700087PubMed: 27687422Study Objective: Microbial contamination during preparation of the infusion drugs is an important issue in intensive care units. Objective of this study was to investigate in vitro antimicrobial properties of commonly used vasoactive drugs. Design: Prospective study. Setting: Clinical microbiology laboratory of a university hospital. Measurements: Growth of the microorganisms Staphylococcus aureus, Staphylococcus epidermidis, Escherichia coli, Pseudomonas aeruginosa, and Candida albicans in saline dilutions of adrenaline at 1, 10, and 100 mu g/mL; noradrenaline at 1, 10, and 100 mu g/mL; and dopamine at 0.1, 1, and 10 mg/mL concentrations was investigated. Each drug solution and saline were analyzed with a digital pH meter. Main Results: Saline dilutions of adrenaline, noradrenaline, and dopamine at clinically used concentrations decreased microbial growth. The highest concentration doses of adrenaline, noradrenaline, and dopamine used in the study had significant antimicrobial effect when compared to the low and moderate doses. This effect was shown with the all microorganisms. S aureus, S epidermidis, and C albicans were more sensitive; on the other hand, E coli and P aeruginosa were more resistant against the effect of the drug dilutions. Conclusions: To limit microbial growth in case of contamination of the drug solution, it is advisable to use more concentrated dilutions of adrenaline, noradrenaline, and dopamine used in clinical practice. (C) 2016 Elsevier Inc. All rights reserved

In vitro antimicrobial activity of commonly used vasoactive drugs

WOS: 000384952700087PubMed: 27687422Study Objective: Microbial contamination during preparation of the infusion drugs is an important issue in intensive care units. Objective of this study was to investigate in vitro antimicrobial properties of commonly used vasoactive drugs. Design: Prospective study. Setting: Clinical microbiology laboratory of a university hospital. Measurements: Growth of the microorganisms Staphylococcus aureus, Staphylococcus epidermidis, Escherichia coli, Pseudomonas aeruginosa, and Candida albicans in saline dilutions of adrenaline at 1, 10, and 100 mu g/mL; noradrenaline at 1, 10, and 100 mu g/mL; and dopamine at 0.1, 1, and 10 mg/mL concentrations was investigated. Each drug solution and saline were analyzed with a digital pH meter. Main Results: Saline dilutions of adrenaline, noradrenaline, and dopamine at clinically used concentrations decreased microbial growth. The highest concentration doses of adrenaline, noradrenaline, and dopamine used in the study had significant antimicrobial effect when compared to the low and moderate doses. This effect was shown with the all microorganisms. S aureus, S epidermidis, and C albicans were more sensitive; on the other hand, E coli and P aeruginosa were more resistant against the effect of the drug dilutions. Conclusions: To limit microbial growth in case of contamination of the drug solution, it is advisable to use more concentrated dilutions of adrenaline, noradrenaline, and dopamine used in clinical practice. (C) 2016 Elsevier Inc. All rights reserved

Caudal block in adults: new horizons with ultrasound

WOS: 000330202000005PubMed: 23839326Caudal block is the most common technique that performed in pediatric patients. It can be used especially for pospoperative analgesia in surgeries mainly below the umbilicus with high success rate

Segmental epidural anesthesia for percutaneous kyphoplasty: comparison with general anesthesia

WOS: 000393331000032PubMed: 28081331Background/aim: This is a feasibility study evaluating whether segmental epidural anesthesia is an alternative anesthetic approach to general anesthesia for percutaneous kyphoplasty. Materials and methods: After ethics committee approval was obtained, 52 ASA class I-III patients scheduled for elective, single-level percutaneous kyphoplasty were recruited. The patients were divided into two equal groups. In Group E (Group Epidural) segmental epidural anesthesia was performed using the loss of resistance technique with saline. In Group G (Group Control) general anesthesia was performed. Hemodynamic parameters, intraoperative and postoperative analgesic requirements, visual analogue scale (VAS) scores, length of stay in the postanesthesia care unit (PACU), and complications were recorded. Results: Hemodynamics were similar between the two groups. Postoperative analgesic requirement was significantly higher in Group G than in Group E (P < 0.004). VAS scores were significantly lower in Group E than in Group G (P < 0.05). Time to first pain experience at the first postoperative 4 h was significantly longer and length of stay in the PACU was significantly shorter in Group E than in Group G (P < 0.001). Conclusion: Segmental epidural anesthesia is a safe anesthetic technique for percutaneous kyphoplasty. This technique offered advantages over general anesthesia in terms of postoperative analgesia, analgesic consumption, early recovery, and short PACU stay. Therefore, it should be considered a suitable anesthetic technique in patients undergoing single level percutaneous kyphoplasty

Regional anesthesia for postoperative pain control (vol 2014, 309606, 2014)

Erturk, Engin/0000-0002-5864-1754; Apan, Alparslan/0000-0001-9660-3276WOS: 000352372400001PubMed: 25861646