Minerva anestesiologica最新文献

{"title":"Modified thoracoabdominal nerves block through perichondrial approach block for pediatric kidney transplantation.","authors":"Volkan Özen, Engin I Turan, Beyzanur Aydoğdu, Ayça S Şahin","doi":"10.23736/S0375-9393.24.18617-8","DOIUrl":"https://doi.org/10.23736/S0375-9393.24.18617-8","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864878","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":"Quadro-iliac plane block for lumbar multi-level instrumentation surgery: far away from the surgical area.","authors":"Bahadir Ciftci, Ahmet Cetinkal, Selcuk Alver, Ali Ahiskalioglu","doi":"10.23736/S0375-9393.24.18680-4","DOIUrl":"https://doi.org/10.23736/S0375-9393.24.18680-4","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142801274","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":"Awake veno-venous extracorporeal membrane oxygenation: practical aspects and considerations.","authors":"Gianluca Paternoster, Pietro Bertini, Fabio Sangalli, Sabino Scolletta","doi":"10.23736/S0375-9393.24.18228-4","DOIUrl":"https://doi.org/10.23736/S0375-9393.24.18228-4","url":null,"abstract":"<p><p>Veno-venous extracorporeal membrane oxygenation (ECMO) is a life-saving technique in the armamentarium of critical care medicine. It involves extracorporeal blood circulation outside the body, providing temporary respiratory support while allowing the lungs to heal. Traditionally, patients undergoing ECMO require sedation to minimize discomfort and facilitate mechanical ventilation. The \"awake ECMO\" concept emerged as a promising strategy to mitigate sedation-related complications and facilitate early mobilization in critically ill patients. In this article, we describe the potential advantages of awake ECMO and its role in preserving respiratory muscle function, enhancing rehabilitation prospects, and improving patient outcomes.</p>","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142801248","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":"A randomized clinical trial comparing different combination of peripheral nerve blocks for intraoperative analgesia in patients on antithrombotic drugs undergoing hip fracture surgery: pericapsular nerve group (PENG) block versus femoral and obturator nerve block.","authors":"Francesca Gargano, Sabrina Migliorelli, Giuseppe Pascarella, Fabio Costa, Alessandro Strumia, Alice Bellezze, Alessandro Ruggiero, Massimiliano Carassiti","doi":"10.23736/S0375-9393.24.18534-3","DOIUrl":"https://doi.org/10.23736/S0375-9393.24.18534-3","url":null,"abstract":"<p><strong>Background: </strong>Locoregional anesthesia is commonly used in orthopedic trauma surgery, particularly in elderly patients. We conducted a prospective, monocentric, randomized controlled trial to evaluate the anesthetic and analgesic efficacy of pericapsular nerve group (PENG) block in patients on antithrombotic drugs undergoing hip fracture surgery, comparing it with femoral and obturator nerve block (FNB+ONB).</p><p><strong>Methods: </strong>Forty patients were randomly allocated to receive a PENG block or FNB and ONB, both combined with wound infiltration (WI). The main outcome was pain, assessed using a Numeric Rating Scale (NRS) 30 minutes after the block, in Post Anesthesia Care Unit (PACU) and in the postoperative 6, 12 and 24 hours. Secondary outcomes included intra and postoperative analgesic requirement, need to increase the level of sedation and postoperative complications.</p><p><strong>Results: </strong>We observed, except for 12 hours post-surgery, higher NRS values for PENG group compared to FNB + ONB group, with a median (IQR) NRS of 3 (2-4) vs. 2 (1-3.25) 30 minutes after the block, 1.5 (0-3.25) vs. 0 (0-1.25) at PACU, 1.5 (0-2) vs. 1 (0-2.25) at 6 hours, 1.5 (0-2) vs. 2 (1-2) at 12 hours, and 2 (0-2) vs. 1.5 (0-2) at 24 hours. Despite this, no result was statistically significant; all P>0.05. No differences were observed as regards other secondary outcomes.</p><p><strong>Conclusions: </strong>Our results suggest that PENG block is not inferior to FNB + ONB as anesthetic and analgesic technique in patients on antithrombotic drugs undergoing hip fracture surgery.</p>","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142801244","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":"Comparison of two approaches to quadratus lumborum block for postoperative analgesia in radical cystectomy: a randomized clinical trial.","authors":"Ghada M Aboelfadl, Abdelraheem M Elawamy, Ahmed H Othman, Hassan M Abdelbaky, Ahmed M Aboelfadl, Marwa M Abdelrady","doi":"10.23736/S0375-9393.24.18332-0","DOIUrl":"https://doi.org/10.23736/S0375-9393.24.18332-0","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to evaluate the analgesic effects following radical cystectomy using two ultrasound guided QLB techniques: anterior and intramuscular.</p><p><strong>Methods: </strong>Sixty patients aged 40-60 years old with ASA I, II were considered for this study. They were divided into two equal groups. Bilateral ultrasound guided QLB was performed via either the anterior (QLBa) or intramuscular (QLBi) approach with 2.5 mg/kg of 0.25% bupivacaine diluted to 20 mL of normal saline after surgery. The primary outcome was the time to the first request for analgesia, while the secondary outcomes were the dose of postoperative morphine consumption, numerical rating scale (NRS) at rest and on movement, Bromage Scale, adverse events, and patient satisfaction.</p><p><strong>Results: </strong>The mean time to first request for analgesia was significantly prolonged in group QLBa (14.7±1.33 hours) compared to group QLBi (9.8±0.72 hours) (P<0.001). NRS either at rest or on movement were not statistically significant until 6 hours postoperatively. At 10, 12, and 14 h, Group QLBi had a significantly higher NRS Score at rest and on movement (P<0.001). Group QLBa had a significantly lower total morphine consumption (5.37±0.49 mg) compared to Group QLBi (6.4±0.77 mg) (P<0.001). The QLBa had higher patient satisfaction than the QLBi.</p><p><strong>Conclusions: </strong>Compared with QLBi, bilateral ultrasound guided QLBa provided a longer time to the first analgesic request, less postoperative opioid consumption, lower NRS at rest and on movement, and higher patients' satisfaction after radical cystectomy under general anesthesia.</p>","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142801264","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":"Clinical application and progress in preoxygenation techniques.","authors":"Chunling Yan, Xiaolu Sun, Yanxia Sun, Mingzhang Zuo, Zhen Hua","doi":"10.23736/S0375-9393.24.18355-1","DOIUrl":"https://doi.org/10.23736/S0375-9393.24.18355-1","url":null,"abstract":"<p><strong>Introduction: </strong>Airway management is often a life-saving procedure for patients. However, during airway management, difficult ventilation and difficult intubation are not always predictable. Preoxygenation, a crucial technique to improve oxygen reserves, plays a vital role in preventing hypoxemia during anesthesia induction. Preoxygenation technology and equipment are not monolithic. With the development of preoxygenation equipment and technology, the effect of preoxygenation has been improved, and it can be applied to different clinical settings.</p><p><strong>Evidence acquisition: </strong>We conducted a literature search (PubMed and Scopus) in October 2023 with a starting date of January 1985, repeated in August 2024, to identify relevant articles. Key search terms included: 'preoxygenation,' 'high-flow nasal oxygenation,' 'non-invasive ventilation,' 'obese patients,' 'pediatric patients,' and 'elderly patients.'</p><p><strong>Evidence synthesis: </strong>The abstracts of identified articles were assessed for relevance, along with screening of their references for further relevant publications. A full-text review of 219 articles was undertaken, of which 77 were included in the final review.</p><p><strong>Conclusions: </strong>Preoxygenation is really effective, and different preoxygenation equipment and technology can be applied in different clinical settings to improve the oxygen reserve of patients, thereby ensuring patient safety and improving patient outcome.</p>","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142801251","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":"New insights into the use of dexamethasone-dexmedetomidine as perineural adjuvants in peripheral nerve and fascial blocks: an up-to-date narrative review.","authors":"Francesco Marrone, Pierfrancesco Fusco, Eros Pilia, Laura B Colantonio, Carmine Pullano","doi":"10.23736/S0375-9393.24.18476-3","DOIUrl":"https://doi.org/10.23736/S0375-9393.24.18476-3","url":null,"abstract":"<p><p>The discovery of the mechanism of action of local anesthetics, involving the blocking of sodium ion channels is considered a milestone in anesthesia. Potentially lethal toxic effects occur in the case of intravascular injection of local anesthetic (LA) or in case of exceeding dosages, as a result of systemic reabsorption. Attempts to prevent these life-threatening events have been made by developing novel LA and by adding adjuvants. The aim of this up-to-date review was to provide the newest insights on the two adjuvants dexamethasone and dexmedetomidine for regional anesthesia. The addition of perineural dexamethasone-dexmedetomidine combination has shown a faster onset, longer duration of action and increased intensity of neuronal blockade of regional anesthesia compared to perineural single adjunct. This is consistent with clinical studies (trials, observational studies and reports) of a marked prolongation of the local anesthetic effect. Nevertheless, further studies are needed to ascertain the full potential of this technique and all possible associated risks.</p>","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142801270","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":"Ultrasound-guided bilateral erector spinae plane block in the management of postoperative analgesia in living liver donors: a randomized, prospective study.","authors":"Tumay Uludag Yanaral, Hande Gungor, Ayşe Ince, Erkan C Celik, Onur Yaprak, Yunus O Atalay, Bahadir Ciftci, Pelin Karaaslan","doi":"10.23736/S0375-9393.24.18085-6","DOIUrl":"https://doi.org/10.23736/S0375-9393.24.18085-6","url":null,"abstract":"<p><strong>Background: </strong>Living donor hepatectomy is a procedure associated with notable postoperative pain, impacting patient recovery and satisfaction. Addressing this challenge, we aimed to examine the effect of ultrasound-guided bilateral erector spinae plane block (ESPB) in postoperative analgesia management of patients undergoing living donor hepatectomy for liver transplantation.</p><p><strong>Methods: </strong>A single-center prospective, randomized, controlled study was conducted on ASA I-II patients aged 18-65 who underwent elective living donor hepatectomy. Participants were randomized into ESPB (N.=20) and control (N.=21) groups. ESPB was performed under ultrasound guidance with 0.25% bupivacaine (20 mL bilaterally) at T7-T9 levels. The control group received no block. Postoperative analgesia included IV acetaminophen, opioids, alongside fentanyl patient-controlled analgesia. Pain intensity was assessed using Numeric Rating Scale (NRS) at various time intervals. Primary outcome was to compare postoperative opioid consumption levels and secondary outcomes were to evaluate postoperative pain scores, requirement of rescue analgesia, and opioid-related side effects.</p><p><strong>Results: </strong>Patients in ESBP group exhibited lower total fentanyl consumption (P=0.023) and lower meperidine use for rescue analgesia (P=0.001) compared to controls. While static pain scores showed no significant difference, Group ESPB reported lower dynamic pain scores in the immediate postoperative period (P=0.047). The incidence of nausea was lower in Group ESPB (6 vs. 17, P=0.002) with no observed complications.</p><p><strong>Conclusions: </strong>ESPB displayed promise in effectively managing post-living donor hepatectomy pain, resulting in decreased opioid consumption, improved pain relief, and reduced rescue analgesia requirements. This technique holds potential to enhance recovery and patient satisfaction following donor hepatectomy.</p>","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142770155","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":"Centralized monitored anesthesia care by nurse anesthetist for cataract and glaucoma surgery in a 1:3 ratio: a non-inferiority study.","authors":"Simon Clariot, Jean-Marie Moures, Lucia Lopes, Damien Gatinel, Eric Gabison, Georges Nicolaos, Laurence Salomon, Jean-Michel Devys","doi":"10.23736/S0375-9393.24.18455-6","DOIUrl":"https://doi.org/10.23736/S0375-9393.24.18455-6","url":null,"abstract":"<p><strong>Background: </strong>Minor Ophthalmic Procedures (MOP), especially cataract or glaucoma surgery, are considered low risk. However, in France, anesthesia must be monitored continuously and carried out by an anesthetist or a nurse anesthetist (NA). The aim was to assess whether an externalized monitored anesthesia care (MAC) would be non-inferior to an individual MAC inside the OR regarding the incidence of severe hypertension, bradycardia, hypoxemia, and surgeon satisfaction.</p><p><strong>Methods: </strong>We performed a monocentric randomized, non-inferiority trial. Adults undergoing MOP with topical or locoregional anesthesia were randomly assigned to externalized MAC (the NA monitored simultaneously up to 3 patients with a screen monitor repeating the inside monitor) or inside MAC. The primary endpoint was a composite of per-operative complications defined as a blood pressure >200 mmHg, pulse rate <45/min, pulse oximetry <85%, or surgeon satisfaction regarding patient security <3/10. Secondary endpoints included patient and surgeons' overall satisfaction, re-operation within 24 hours, and nurses' overall satisfaction.</p><p><strong>Results: </strong>A total of 900 patients were enrolled (450 in both groups). The externalized MAC was non-inferior to inside MAC as event occurred in 29 patients (6.4%) and 26 patients (5.8%), respectively (adjusted difference - 0.7%). Patient agitation assessed by the surgeon was lower with the inside MAC (adjusted mean difference -0.33; 95%CI -0.61 to -0.04).</p><p><strong>Conclusions: </strong>Among patients undergoing MOP with topical or locoregional anesthesia, an externalized MAC strategy with a 1:3 NA-to-patient ratio were non-inferior to an inside monitoring on the incidence of severe hypertension, bradycardia, hypoxemia and surgeon satisfaction regarding patient safety.</p>","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142770646","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":"Survival difference in patients treated with extracorporeal membrane oxygenation in COVID-19 vs. non-COVID ARDS: a systematic review and meta-analysis.","authors":"Pietro Bertini, Alberto Marabotti, Fabio Sangalli, Gianluca Paternoster","doi":"10.23736/S0375-9393.24.18219-3","DOIUrl":"https://doi.org/10.23736/S0375-9393.24.18219-3","url":null,"abstract":"<p><strong>Introduction: </strong>The COVID-19 pandemic has emphasized the need for effective management of severe acute respiratory distress syndrome (ARDS) using veno-venous extracorporeal membrane oxygenation (VV-ECMO). This meta-analysis aims to compare the effectiveness and outcomes of ECMO in patients with COVID-19 ARDS versus those with non-COVID ARDS, assessing its role in different respiratory virus infections.</p><p><strong>Evidence acquisition: </strong>A systematic search was conducted in PubMed, Web of Science, and other relevant databases up to June 30, 2023, to identify studies comparing ECMO use in COVID-19 and non-COVID ARDS cases. This analysis adheres to PRISMA guidelines, with studies rigorously selected based on predefined inclusion and exclusion criteria and assessed for bias using validated tools.</p><p><strong>Evidence synthesis: </strong>The meta-analysis included 24 studies with 2,121 patients, revealing that non-COVID ARDS patients treated with ECMO had a lower mortality risk compared to those with COVID-19 ARDS. Specifically, the overall pooled risk difference in survival was -0.11 (95% CI: -0.17 to -0.05, P<0.001), indicating a statistically significant advantage for non-COVID patients. The standardized mean difference for ECMO duration was significantly longer in COVID-19 patients (SMD=0.70, 95% CI: 0.32 to 1.08, P<0.001), reflecting more prolonged treatment needs.</p><p><strong>Conclusions: </strong>ECMO serves as a vital intervention in severe ARDS, with differential effectiveness observed between COVID-19 and non-COVID patients. The study's findings underline the need for precise patient selection and tailored ECMO application across different viral etiologies. These insights are crucial for enhancing clinical strategies and resource allocation during ongoing and future pandemics.</p>","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142770190","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}