Minerva anestesiologica最新文献

{"title":"Lumbosacral erector spinae plane block vs. fascia iliaca block in elderly patients with hip fracture.","authors":"Lorenza Sbucafratta, Francesco Marrone","doi":"10.23736/S0375-9393.26.19938-6","DOIUrl":"10.23736/S0375-9393.26.19938-6","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":"780-782"},"PeriodicalIF":3.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147504165","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":"Efficacy of intranasal insulin in preventing postoperative delirium and its impact on insulin resistance in elderly non-cardiac surgical patients: a systematic review and meta-analysis.","authors":"Junjun Qin, Weili Zhou, Sengen Chen, Mingyue Cheng, Xiong Shen, Jiasen Ma","doi":"10.23736/S0375-9393.26.19719-3","DOIUrl":"10.23736/S0375-9393.26.19719-3","url":null,"abstract":"<p><strong>Background: </strong>Postoperative delirium (POD) is a common and serious complication in elderly patients and has been established to be associated with insulin resistance (IR), a key marker of dysregulated glucose metabolism. Therefore, this study aims to systematically evaluate the efficacy of intranasal insulin in preventing POD in elderly non-cardiac surgery patients and to further investigate whether its mechanism of action is related to the improvement of IR.</p><p><strong>Methods: </strong>A systematic literature search was conducted in PubMed, Embase, the Cochrane Library, Web of Science, China National Knowledge Infrastructure, Wan Fang Database, Chinese Scientific Journals Database and Chinese Biomedical Literature Database from inception to October 19, 2025, to identify randomized controlled trials that compared elderly patients who were administered intranasal insulin during the perioperative period with those who were not. The primary outcomes of this study were the incidence of POD and the efficacy of different insulin dosing regimens. The secondary outcome was the change in the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) values before and after surgery. Data from eligible trials were pooled to calculate the combined risk ratio (RR) or standardized mean difference (SMD).</p><p><strong>Results: </strong>Analysis of seven trials involving 778 elderly patients showed that, compared to placebo, intranasal insulin significantly reduced POD incidence on day one (RR: 0.33; 95%CI: 0.22 to 0.47; P<0.001) and its cumulative incidence over three days (RR: 0.31; 95%CI: 0.22 to 0.44; P<0.001) and five days (RR: 0.32; 95%CI 0.18 to 0.56; P<0.001). In contrast, the change in HOMA-IR across the surgery period did not differ significantly between the two groups (SMD: -0.27; 95%CI: -0.77 to 0.23; P=0.290).</p><p><strong>Conclusions: </strong>Intranasal insulin is effective in reducing the incidence of POD. This benefit is likely mediated through central nervous system glucose metabolism, rather than by reversing peripheral IR, a premise that requires validation in future trials.</p>","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":"739-749"},"PeriodicalIF":3.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147776146","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":"Role of dexmedetomidine as an adjuvant to bupivacaine in external oblique intercostal plane block for post thoracotomy pain: a randomized controlled trial.","authors":"Fatma E Aboharga, Saad A Moharam, Mohammed S Elsharkawy, Mohamed E Mahmoud, Ahmed S Elsaily, Khaled Hamama, Shaimaa W Zahra, Mohamed A Ahmed, Shady A Ismaeil","doi":"10.23736/S0375-9393.26.19565-0","DOIUrl":"10.23736/S0375-9393.26.19565-0","url":null,"abstract":"<p><strong>Background: </strong>The duration of peripheral nerve blocks is extended with dexmedetomidine, which has a beneficial impact in reducing the amount of opioid consumption and pain score during and after surgery. The external oblique intercostal plane block (EOIPB) is a new method that specifically targets the sensory nerves responsible for supplying the chest wall, providing pain relief for surgical techniques. This trial's goal was to evaluate the effectiveness of dexmedetomidine as an adjuvant in EOIPB for the management of post-thoracotomy pain (PTP).</p><p><strong>Methods: </strong>In this controlled, randomized, double-blind trial, 40 adult patients of both sexes had open thoracotomies. The patients were divided into two groups: Group D was given 29 mL of 0.25% bupivacaine and 0.5 μg/kg of dexmedetomidine diluted in one mL of saline 0.9%, and Group C (Control Group) received 29 mL of bupivacaine 0.25% plus one mL of saline 0.9%. Total morphine usage over the first 48 hours after surgery was the primary outcome. The secondary outcomes were intraoperative hemodynamics, intraoperative fentanyl consumption, total morphine intake in the first 24 hours, time to the first rescue analgesia, pain score, and the level of patient satisfaction and side effects.</p><p><strong>Results: </strong>Total amount of morphine taken in the first 24 and 48 hours postoperative was markedly reduced in Group D, in contrast to Group C (P<0.05). The first request for rescue analgesia was considerably delayed in Group D, in contrast to Group C (P<0.001). Numerical Rating Scale measurements were notably reduced at 4h, 8h, 12h, and 18h in Group D in contrast to Group C (P<0.05). Patient satisfaction was substantially greater in Group D than in Group C (P=0.041).</p><p><strong>Conclusions: </strong>The addition of dexmedetomidine to bupivacaine as an adjuvant in the EOIPB resulted in effective postoperative analgesia by lowering pain scores and the need for postoperative opioids and delaying the time of the first rescue analgesia.</p>","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":"683-691"},"PeriodicalIF":3.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147593179","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":"Extracorporeal membrane oxygenation may prevent preterm cerebral atrophy in survivors of acute respiratory distress syndrome: a pilot trial.","authors":"Lars-Olav Harnisch, Miriam Winterwerber, Sebastian Riech, Peter Hellen, Kai Kallenberg, Katharina Rosengarth, Christian Gaser, Onnen Moerer","doi":"10.23736/S0375-9393.26.19780-6","DOIUrl":"10.23736/S0375-9393.26.19780-6","url":null,"abstract":"<p><strong>Background: </strong>Individuals who survive acute respiratory distress syndrome (ARDS) often face prolonged cognitive impairments. Comparable consequences have been observed in chronic hypoxic conditions, like COPD and obstructive sleep apnea syndrome, which have been linked to reduced gray matter volume. We hypothesized that ARDS patients display similar cerebral findings, but those treated with extracorporeal membrane oxygenation (ECMO) show greater structural brain alterations than those treated conservatively, reflecting the severity of hypoxemia.</p><p><strong>Methods: </strong>Eighteen ARDS survivors, seven conservatively treated (ARDS-conv), and eleven treated with ECMO (ARDS-ECMO) were studied and compared with healthy controls. Structural magnetic resonance imaging (MRI) was analyzed using voxel-based morphometry (VBM). Total intracranial volume (TIV), gray matter (GM), white matter (WM), and cerebrospinal fluid (CSF) volumes were quantified and compared between groups.</p><p><strong>Results: </strong>ARDS patients had lower TIV than healthy controls (1516.50 mL [95% CI 1380.85-1618.72] vs. 1664.07 mL [95% CI 1558.41-1776.06], P=0.008). While intracranial volumes of GM, WM, and CSF were not different between ARDS-conv and healthy controls, CSF volume of ARDS-ECMO was lower than in healthy controls, while GM and WM were comparable. Compared to ARDS-ECMO, ARDS-conv had lower GM volumes (ARDS-conv 37.9% [95% CI 36.3-39.2] vs. ARDS-ECMO 41.4% [95% CI 39.9-43.8]; P=0.036), WM and CSF were comparable. VBM also revealed distinct clusters of reduced GM in ARDS-conv patients compared to healthy controls (TFCE, FWE-corrected P<0.05).</p><p><strong>Conclusions: </strong>ARDS survivors exhibit structural brain changes suggestive of hypoxia-related injury. ECMO treatment may mitigate gray matter loss, supporting early initiation of ECMO in severe ARDS to reduce long-term neurological sequelae. Extracorporeal membrane oxygenation may prevent preterm cerebral atrophy in survivors of acute respiratory distress syndrome: a pilot trial.</p>","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":"92 7-8","pages":"708-717"},"PeriodicalIF":3.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148562490","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":"Angiotensin II use in refractory septic shock due to Plasmodium falciparum.","authors":"Tommaso Meconi, Maddalena Pazzi, Raffaella Papa, Peggy Ruggiano, Duccio Conti","doi":"10.23736/S0375-9393.26.19936-2","DOIUrl":"10.23736/S0375-9393.26.19936-2","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":"778-779"},"PeriodicalIF":3.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147504007","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":"Efficacy of second generation capacitive-resistive non-invasive radiofrequency in improving perfusion index and attenuating lower limb painful diabetic peripheral neuropathy.","authors":"Mohamed A Nasr, Waleed I Hamimy, Bassant M Abdelhamid, Hebatullah M Abdelmageed, Mahmoud A Mahmoud","doi":"10.23736/S0375-9393.26.19660-6","DOIUrl":"10.23736/S0375-9393.26.19660-6","url":null,"abstract":"<p><strong>Background: </strong>Diabetic peripheral neuropathy is a prevalent consequence of diabetes mellitus that impairs quality of life. This study aimed to investigate the impact of second generation capacitive-resistive non-invasive radiofrequency (transfer of energy capacitive and resistive, TECAR) therapy as a non-invasive modality to increase peripheral perfusion assessed using pulse oximetry by measuring the perfusion index (PI), and to improve pain in patients with painful diabetic peripheral neuropathy (PDPN).</p><p><strong>Methods: </strong>A prospective interventional study was performed in the outpatient clinic of a tertiary care hospital. Twenty-three patients of both sexes, aged 40-70 years, with type 2 diabetes mellitus (T2DM) and PDPN in the lower limbs, with Visual Analogue Scale (VAS) ≥3 in the feet, were included in the study. All patients received 12 sessions of TECAR therapy over four weeks under PI monitoring of the big toe on the targeted side. The change in PI at the end of the first session was defined as a primary outcome. Pain scoring and analgesic effect at the end of all sessions were set as secondary outcomes.</p><p><strong>Results: </strong>PI increased significantly after each session compared to the session before VAS showed significant improvement from the third session onward, lasting for one month after the 12^th session. Tactile sensation showed significant improvement from the fourth session through the end of the sessions. By the end of the sessions, 18 patients (78.3%) achieved complete remission, with a significant Difference compared to baseline (P value <0.001). The Total Remission Rate was 82.08±11.33%.</p><p><strong>Conclusions: </strong>TECAR therapy is proposed as an effective, safe, and non-invasive approach for improving symptoms of peripheral neuropathy associated with T2DM.</p>","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":"92 7-8","pages":"698-707"},"PeriodicalIF":3.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148562455","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":"Motor-sparing multimodal analgesia with serratus posterior superior intercostal plane block in open shoulder surgery.","authors":"Onur Güneş, Emre Ulusoy, Mürsel Ekinci, Yasemin N Tekin, Ahmet Kaciroğlu, Sinan Oğuzkaya","doi":"10.23736/S0375-9393.26.19913-1","DOIUrl":"10.23736/S0375-9393.26.19913-1","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":"770-771"},"PeriodicalIF":3.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147284425","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 epidural space identification methods in orthopedic surgery: spring-loaded syringe versus loss of resistance syringe.","authors":"Hüseyin Erdoğan, Doğa Şimşek, Yasemin Sincer, Mete Manici, Yavuz Gürkan","doi":"10.23736/S0375-9393.26.19916-7","DOIUrl":"10.23736/S0375-9393.26.19916-7","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":"771-773"},"PeriodicalIF":3.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147284489","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":"Validation of the Gendolcat model for chronic postsurgical pain after cesarean section: a multicenter study.","authors":"Carles Espinós Ramírez, David Martínez-Rodríguez, Pere Castellví Obiols, Gisela Roca Amatria","doi":"10.23736/S0375-9393.26.20316-4","DOIUrl":"https://doi.org/10.23736/S0375-9393.26.20316-4","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148302273","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 opioid-free analgesia in pediatric hip surgery.","authors":"Fatma Acil","doi":"10.23736/S0375-9393.26.20234-1","DOIUrl":"https://doi.org/10.23736/S0375-9393.26.20234-1","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148295391","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}