Minerva anestesiologica最新文献

{"title":"Depression and anxiety among older surgical patients with cognitive impairment: a multicenter longitudinal cohort study.","authors":"Eric Cheuk, Ellene Yan, Yasmin Alhamdah, Aparna Saripella, Leif E Lovblom, Jean Wong, Frances Chung","doi":"10.23736/S0375-9393.26.19892-7","DOIUrl":"https://doi.org/10.23736/S0375-9393.26.19892-7","url":null,"abstract":"<p><strong>Background: </strong>Cognitive impairment (CI), depression, and anxiety are underrecognized yet frequently co-existing conditions linked to poor surgical outcomes in older patients. We examined: 1) the prevalence and perioperative trajectory of depression/anxiety in patients with and without CI; 2) preoperative patient-reported outcome measures; and 3) postoperative outcomes associated with depression/anxiety.</p><p><strong>Methods: </strong>This study included 369 surgical patients (≥65 years) from two academic tertiary care hospitals. CI was assessed with the Ascertain Dementia Eight preoperatively, while depression/anxiety was measured using the Patient Health Questionnaire-4 preoperatively, at 30-, and 90 days postoperatively. The trajectory of depression/anxiety in CI versus no-CI patients was analyzed with linear mixed-effects models.</p><p><strong>Results: </strong>Preoperatively, 28% of patients had depression/anxiety, 13% had CI, and 8% had co-existing depression/anxiety and CI. Those with depression/anxiety were more likely to have co-existing CI than those without depression/anxiety (29% vs. 6%; P<0.001). Patients that screened positive for preoperative CI experienced significantly worse psychological symptoms at all times compared to those without CI. Among those with preoperative CI, mean psychological symptoms remained above screening thresholds for depression/anxiety at all time points and significantly worsened at 90 days post-surgery compared to baseline levels. Patients with depression/anxiety reported significantly worse preoperative health, including greater pain and functional disability, as well as worse quality of life and sleep.</p><p><strong>Conclusions: </strong>Given greater psychological burden in those with CI, screening for both conditions may enable early identification of patients at higher risk for poor outcomes. This approach may ultimately enhance risk stratification and optimization of perioperative care in older adults.</p>","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149195340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serratus posterior superior intercostal plane block for analgesia in cervical disc surgery: sensory mapping and functional assessment.","authors":"Mehmet G Taflan, Elif Sarikaya Özel","doi":"10.23736/S0375-9393.26.20575-8","DOIUrl":"https://doi.org/10.23736/S0375-9393.26.20575-8","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149195359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimal volumes of early oral fluid intake in the post-anesthesia care unit for patients not under postoperative fasting orders: a meta-analysis and trial sequential analysis of clinical recovery and safety outcomes.","authors":"Fang Chen, Na Zhou, Kai Lv, Zihao Xue, Haiou Qi","doi":"10.23736/S0375-9393.26.20157-8","DOIUrl":"https://doi.org/10.23736/S0375-9393.26.20157-8","url":null,"abstract":"<p><strong>Introduction: </strong>Postoperative recovery in the post-anaesthesia care unit (PACU) is frequently complicated by thirst, oropharyngeal dryness, and postoperative nausea and vomiting (PONV). Early oral fluid intake has been proposed to alleviate these discomforts. However, its optimal timing and volume remain uncertain. We conducted a systematic review and meta-analysis with trial sequential analysis (TSA) to evaluate the safety and clinical outcomes of PACU-initiated early oral fluid intake in adults after general anaesthesia, focusing on administered fluid volume.</p><p><strong>Methods: </strong>We systematically searched PubMed/MEDLINE, Embase, CENTRAL, Ovid, Web of Science, and Wanfang Database for studies published from January 2014 to December 2024. Eligible studies enrolled adults (≥18 years) recovering in the PACU after general anaesthesia who received early oral fluid intake versus delayed intake or standard fasting. Primary outcome was PONV incidence. Secondary outcomes included thirst alleviation, oropharyngeal discomfort, patient satisfaction, time to PACU discharge, and gastrointestinal recovery. Subgroup analyses by fluid volume and timing were considered exploratory. Two reviewers independently screened studies, extracted data, and assessed risk of bias. Random-effects models were used. TSA and GRADE were applied to the primary outcome.</p><p><strong>Results: </strong>Thirteen studies (11 randomised controlled trials, 2 non-randomised studies) involving 4,528 adults were included. Early oral fluid intake significantly reduced PONV incidence (RR 0.60, 95% CI 0.50 to 0.73; moderate certainty). TSA indicated that the cumulative evidence crossed the trial sequential monitoring boundary, supporting the robustness of this finding. Exploratory subgroup analyses suggested that volumes of 20-49 mL and 100-199 mL were associated with lower PONV. Early oral intake also shortened time to first flatus (MD -3.27 hours; low certainty). Evidence for thirst alleviation, patient satisfaction, oropharyngeal discomfort, and PACU discharge time was of very low certainty owing to substantial heterogeneity and imprecision. No aspiration events were observed, although trials were not powered to exclude rare adverse events.</p><p><strong>Conclusions: </strong>PACU-initiated early oral fluid intake appears feasible and was associated with reduced PONV in appropriately selected adults after general anaesthesia. Evidence for secondary outcomes remains limited by heterogeneity and risk of bias. Larger, standardized trials are needed to define optimal timing and volume and to strengthen evidence for patient-reported and recovery outcomes.</p>","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149183206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rhomboid intercostal plane block as an analgesic technique in a patient undergoing minimally invasive cardiac surgery.","authors":"Nur N Yucal, Kübra Cebeci, Funda Gümüş Özcan, Nihan Kayalar","doi":"10.23736/S0375-9393.26.20357-7","DOIUrl":"https://doi.org/10.23736/S0375-9393.26.20357-7","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149183200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The first pediatric organ donation after circulatory determination of death in Italy: facing challenges.","authors":"Eleonora Calabrò, Alvise Tosoni, Luca Marchetto, Daria Gaffo, Alberto D'Amico, Demetrio Pittarello, Nicola Berto, Vladimiro Vida, Angela Amigoni, Claudia M Bonardi","doi":"10.23736/S0375-9393.26.20225-0","DOIUrl":"https://doi.org/10.23736/S0375-9393.26.20225-0","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149183202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recurrent transient isolated hand motor episodes following ultrasound-guided interscalene block: local anesthetic systemic toxicity or a localized motor phenomenon?","authors":"Hülya T Söner","doi":"10.23736/S0375-9393.26.20412-1","DOIUrl":"https://doi.org/10.23736/S0375-9393.26.20412-1","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148906436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep lumbar erector spinae plane block for postoperative analgesia in pediatric laparoscopic surgery: a two-patient case series.","authors":"Volkan Özen, Engin I Turan, Merve Şahin, Selçuk Alver, Bahadır Çiftçi","doi":"10.23736/S0375-9393.26.20497-2","DOIUrl":"https://doi.org/10.23736/S0375-9393.26.20497-2","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148906488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combined interfascial plane blocks for Nuss bar removal: dermatomal sensory mapping and analgesic outcomes.","authors":"Volkan Özen, Engin I Turan, Bahadir Çiftçi, Selçuk Alver, Kübra Demir, Ayça S Şahin","doi":"10.23736/S0375-9393.26.20223-7","DOIUrl":"https://doi.org/10.23736/S0375-9393.26.20223-7","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intraoperative hemodynamic patterns during hypotension prediction index-guided care: a high-resolution secondary analysis of the HYT trial.","authors":"Javier Ripollés-Melchor, Ángel V Espinosa, César Aldecoa, Begoña Quintana-Villamandos, María J Colomina, Rosalía Navarro-Pérez, Ignacio Fernández-López, Alfredo Abad-Gurumeta, Juan V Lorente, Ane Abad-Motos, Laura Carrasco-Sánchez, Eva Rivas, Paula Fernández-Valdes-Bango, Rachel Budithi, Andrés Zorrilla-Vaca, M Ignacio Monge-García","doi":"10.23736/S0375-9393.26.20113-X","DOIUrl":"https://doi.org/10.23736/S0375-9393.26.20113-X","url":null,"abstract":"<p><strong>Background: </strong>Although the Hypotension Prediction Index (HPI) reduces intraoperative hypotension, improvements in patient-centered outcomes remain inconsistent. We performed a high-resolution signal analysis to describe the coexistence of arterial pressure, preload-related hemodynamic signals, and algorithm-derived hypotension risk during surgery.</p><p><strong>Methods: </strong>We conducted a retrospective high-resolution signal analysis (20-second intervals) of 181 patients from the multicenter HYT trial. We quantified hypotension (mean arterial pressure [MAP] <65 mmHg), preload-dependent physiology (stroke volume variation [SVV] >13%), and their temporal relationship with HPI-derived risk signals. Patients were classified into four descriptive groups based on combinations of MAP and SVV burden.</p><p><strong>Results: </strong>Overall hypotension exposure was low (median 1.3% of monitored time), whereas preload-dependent physiology was more frequent (approximately 10%) and often persisted during periods classified as low hypotension risk (HPI <80). SVV >13% preceded hypotensive events significantly earlier than HPI alerts (median 8.7 vs. 1.8 minutes; P=0.0119). Higher vasopressor burden was observed in patients with preserved MAP despite sustained SVV elevation.</p><p><strong>Conclusions: </strong>During HPI-guided care, preserved arterial pressure frequently coexists with sustained preload-dependent hemodynamic signals. These findings describe patterns of pressure and preload-related signal behavior during algorithm-guided hemodynamic management and should be interpreted as hypothesis-generating.</p>","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Opioid-free multimodal analgesia with bilateral ultrasound-guided M-TAPA block in an extremely-low-birth-weight infant with respiratory distress syndrome undergoing major abdominal surgery.","authors":"Volkan Özen, Selcuk Alver, Engin I Turan, Bahadır Ciftci","doi":"10.23736/S0375-9393.26.20442-X","DOIUrl":"https://doi.org/10.23736/S0375-9393.26.20442-X","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}