Minerva anestesiologica最新文献

{"title":"Quadro-iliac plane block in inguinal hernia surgery.","authors":"Muhammed H Satici, Nuray Altay","doi":"10.23736/S0375-9393.25.18739-7","DOIUrl":"https://doi.org/10.23736/S0375-9393.25.18739-7","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441341","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 dexmedetomidine as a proficient measure to prevent emergence delirium among children undergoing invasive cardiac catheterization.","authors":"Sandeep Dey","doi":"10.23736/S0375-9393.25.18845-7","DOIUrl":"https://doi.org/10.23736/S0375-9393.25.18845-7","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143409061","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":"Performance of Shock Index as a predictor of severe postpartum hemorrhage following cesarean section under spinal anesthesia: a retrospective cohort study.","authors":"Valentina DE Giorgis, Myriam Brebion, Lauranne Ossé, Xavier Repessé, Ann-Marie Crowe, Gilles Orliaguet, Hawa Keita","doi":"10.23736/S0375-9393.24.18468-4","DOIUrl":"https://doi.org/10.23736/S0375-9393.24.18468-4","url":null,"abstract":"<p><strong>Background: </strong>An early diagnosis of a postpartum hemorrhage (PPH) can be challenging. The Shock Index (SI), the ratio of heart rate to systolic blood pressure, appears to be a useful indicator for the early diagnosis of severe PPH after vaginal delivery. Our primary aim was to evaluate if the SI has a predictive value for severe PPH following cesarean section (C-section) under spinal anesthesia (SA) and its best predictive threshold.</p><p><strong>Methods: </strong>Retrospective single-center trial including women scheduled for C-section under SA with prevention of maternal hypotension by phenylephrine, and complicated by PPH between 2019 and 2021. Women were divided into two groups: non-severe PPH (blood loss <1000 mL) versus severe PPH (blood loss ≥1000 mL). SI was calculated and compared between the groups at four different time points: T0: prior to C-section; T1: at incision; T2: 15 minutes from start of PPH; T3: end of PPH management. Using receiver operating characteristic curve, we calculated the area under the curve (AUC) and the best diagnostic threshold (sensitivity and specificity) for predicting severe PPH.</p><p><strong>Results: </strong>Overall, 129 patients were included, 26 (20.2%) with severe PPH. Median SI was significantly higher at T2 in the severe PPH group (1.14 (1.10-1.25) versus 1.0 (0.85-1.10), P<0.001), but not at other times of management. An SI value of ≥1.17 was the best threshold with an AUC of 0.81 (95% CI 0.72 to 0.90), a sensitivity of 0.42 and a specificity of 0.88.</p><p><strong>Conclusions: </strong>SI may be an early indicator of severe PPH during C-section under SA.</p>","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256136","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":"Real-time ultrasound-guided neuraxial puncture in elderly patients: a randomized controlled trial comparing paramedian transverse and parasagittal approaches.","authors":"Marwan S Rizk, Amro F Khalili, Thuraya H Hajali, Ali H Berjaoui, Kelly E Merheb, Nada A Sadek, Elie B Geara, Mohamad F El-Khatib, Marie T Aouad","doi":"10.23736/S0375-9393.24.18450-7","DOIUrl":"https://doi.org/10.23736/S0375-9393.24.18450-7","url":null,"abstract":"<p><strong>Background: </strong>Historically, spinal anesthesia has been performed using anatomical landmarks. This study aimed to compare the efficacy and procedural outcomes of real-time ultrasound-guided parasagittal oblique (RTU-PO) and real-time ultrasound-guided paramedian transverse (RTU-PT) approaches in elderly patients undergoing elective surgery under spinal anesthesia.</p><p><strong>Methods: </strong>Seventy-seven elderly patients scheduled for elective surgery under spinal anesthesia were enrolled in this study. Patients were randomized to receive spinal anesthesia using either RTU-PO (38 patients) or RTU-PT (39 patients) technique. The primary measure outcome was the rate of successful dural puncture at the first attempt in both groups. The secondary outcomes included the overall success rate of spinal anesthesia, time to identify the posterior complex on ultrasound, time to perform spinal anesthesia, total procedural time, number of needle redirections and passes, number of separate skin punctures, patients' satisfaction, and incidences of complications in both groups.</p><p><strong>Results: </strong>Baseline demographic and anatomical characteristics were not different between the two groups. The incidence of successful spinal anesthesia at first attempt was 60.5% with RTU-PO and 56.4% with RTU-PT (P=0.71). All other secondary outcomes were comparable between the two groups except for the time to identify posterior complex that was higher in the RTU-PT versus the RTU-PO group (36±18 vs. 20±11 seconds; P=0.0001).</p><p><strong>Conclusions: </strong>In elderly patients undergoing elective surgeries under spinal anesthesia, the RTU-PO and the RTU-PT techniques are comparable in almost all aspects.</p>","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256204","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":"Effect of estazolam plus remimazolam on attenuating preoperative anxiety and remifentanil-induced postoperative hyperalgesia in elective gynecological laparoscopic surgery: a randomized clinical trial.","authors":"Yu Huang, Rui-Jia Gao, Shi-Meng Mao, Jin-Liang Yao, Hong-Yan He, Ying Wang, Ji-Ying Feng","doi":"10.23736/S0375-9393.24.18563-X","DOIUrl":"https://doi.org/10.23736/S0375-9393.24.18563-X","url":null,"abstract":"<p><strong>Background: </strong>Preoperative anxiety is closely related to opioid-induced hyperalgesia, and high levels of preoperative anxiety have the potential to aggravate opioid-induced hyperalgesia. We aimed to estimate the effect of estazolam, remimazolam, and their combination on preoperative anxiety and opioid-induced hyperalgesia in patients undergoing elective gynecological laparoscopic surgery.</p><p><strong>Methods: </strong>We carried out a randomized, double-blind, placebo-controlled experiment between October 2020 and April 2021. Starting on 9, October 2020,a total of 108 patients were split into four groups: (1 mg estazolam or starch was taken orally on the evening before surgery; 0.1 mg/kg remimazolam or normal saline was administered intravenously after entering the operating room) Group E received estazolam and normal saline; Group R received starch and remimazolam; participants in Group ER were given not only estazolam but also remimazolam; participants in Group C were given starch and normal saline. We recorded pain intensity at rest at 24 hours postoperatively as the primary outcome and measured pain intensity, sufentanil consumption, and adverse events within 72 hours postoperatively.</p><p><strong>Results: </strong>The mean anxiety scores were significantly lower in Groups E, R, and ER than in Group C before surgery. Compared with Group C, mean pain scores were significantly lower in Group ER at 0.5, 1, 4, 8, 24, 48, and 72 hours after surgery and lower in Groups R or E at 4, 8, and 24 hours after surgery. The mean pain scores in Group E (at 8 and 24 hours postoperatively) and Group R (at 8 hours postoperatively) were both significantly higher than those in Group ER. Moreover, the mean cumulative sufentanil consumption was significantly lower in Group ER at 0.5, 1, 4, 8, 24, 48, and 72 hours after surgery and lower in Groups E or R at 0.5 hours after surgery, compared with Group C.</p><p><strong>Conclusions: </strong>The preoperative application of estazolam, remimazolam, and their combination can relieve preoperative anxiety and postoperative pain for patients undergoing gynecological laparoscopic surgery. Moreover, the preoperative combination can also significantly reduce postoperative sufentanil consumption.</p>","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256132","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":"Serum Dickkopf-3 as a biomarker for predicting acute kidney injury in postoperative intensive care patients.","authors":"Yao Sun, Zengli Xiao, Huiying Zhao, Youzhong An","doi":"10.23736/S0375-9393.24.18677-4","DOIUrl":"https://doi.org/10.23736/S0375-9393.24.18677-4","url":null,"abstract":"<p><strong>Background: </strong>Acute kidney injury (AKI) is a common and significant complication in the Intensive Care Unit (ICU), affecting more than half of all patients admitted. This condition is associated with increased morbidity and mortality, underscoring the urgent need for accurate and specific biomarkers to enable early diagnosis and intervention. Dickkopf-3 (DKK3) has emerged as a promising candidate biomarker for renal injury.</p><p><strong>Methods: </strong>We conducted a single-center, prospective cohort study from March 1 to July 1, 2023, enrolling 166 non-cardiac postoperative patients admitted to the ICU. Serum and urinary DKK3 levels were quantified using enzyme-linked immunosorbent assay (ELISA) kits. A multifactorial logistic regression model was constructed, incorporating changes in serum creatinine (ΔScr), cystatin C (CysC), serum DKK3 levels, and the serum DKK3 to urine DKK3 ratio.</p><p><strong>Results: </strong>Elevated serum DKK3 levels were significantly associated with an increased incidence of AKI and a composite outcome of adverse events (AKI or death). The multifactorial logistic regression model exhibited excellent performance, with an area under the receiver operating characteristic curve (AUC) of 0.98. Decision curve analysis (DCA) demonstrated a net clinical benefit of utilizing serum DKK3 levels to guide treatment decisions, particularly at higher risk thresholds.</p><p><strong>Conclusions: </strong>Serum DKK3 is a robust diagnostic biomarker for AKI, effectively stratifying patients based on protein levels. The predictive model that incorporates DKK3 provides a valuable tool for clinical decision-making in the ICU setting. Further validation in larger and more diverse populations is warranted.</p>","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256223","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":"An alternative sonographic approach to infraspinatus-teres minor interfascial plane block: make it easy.","authors":"Ali Ahiskalioglu, Yunus E Karapinar, Yusuf Dagci, Ahmet M Yayik, Bahadir Ciftci, Serkan Tulgar","doi":"10.23736/S0375-9393.24.18697-X","DOIUrl":"https://doi.org/10.23736/S0375-9393.24.18697-X","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256129","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":"Foot movements during the maintenance phase of propofol-remifentanil anesthesia due to ankle clonus.","authors":"Toshiyuki Yano, Tomoki Takahashi","doi":"10.23736/S0375-9393.24.18725-1","DOIUrl":"https://doi.org/10.23736/S0375-9393.24.18725-1","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256135","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":"Risk stratification for postoperative hypoxemia among bariatric surgery patients.","authors":"Naveen Perisetla, Jose Malavet, Christopher Popiolek, Giorgio Melloni, Ashley Mooney, Maha Balouch, Peter Wu, Jeffrey Weiss, John Hodgson, Enrico Camporesi","doi":"10.23736/S0375-9393.24.18595-1","DOIUrl":"https://doi.org/10.23736/S0375-9393.24.18595-1","url":null,"abstract":"<p><strong>Background: </strong>Patients with obesity, especially those suffering from obstructive sleep apnea (OSA), are prone to postoperative respiratory hypoxemia. The PRODIGY (prediction of opioid-induced respiratory depression in patients monitored by capnography) Score is used to predict respiratory complications that factor in sleep-disordered breathing. Data on the impact of OSA on the frequency and timing of postoperative desaturation trends after bariatric surgery are lacking.</p><p><strong>Methods: </strong>This cohort study included 195 patients who underwent robotic-assisted bariatric surgery between June 2022 and December 2023. Patients underwent were classified by OSA status (yes/no) and PRODIGY Risk Score (high/intermediate/low). All patients received low or opioid sparing anesthesia and were continuously monitored postoperatively using the Masimo Rad-97 device (Masimo, Irvine, CA, USA). Postoperative monitoring averaged 14.5 hours, including tracking several variables and SpO<inf>2</inf> values. We documented desaturations and opioid usage in 2-hour intervals. Patients also underwent 30-day postoperative follow up. Descriptive statistics were analyzed based on OSA status and PRODIGY scores using Student's t-test, ANOVA, and Fisher's Exact Test.</p><p><strong>Results: </strong>Most study patients (57.4%) had OSA, were significantly older, and were predominantly female. Patients with OSA had substantially more prolonged exposure to SpO<inf>2</inf> ranges between 80-95% and experienced more frequent desaturation events between 10 and 14 hours after Post-Anesthesia Care Unit (PACU) discharge. Patients with high PRODIGY scores (>15) had significantly more desaturation events compared to intermediate and low-score groups.</p><p><strong>Conclusions: </strong>Postoperative desaturation rates are significantly higher among patients with OSA with high PRODIGY scores, especially in the delayed postoperative period. Continuous extended postoperative monitoring is warranted for these high-risk patients after bariatric surgery.</p>","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189816","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 pediatric epidural anesthesia: benefits, barriers, and future directions.","authors":"Freda Richa, Nadine El Hage","doi":"10.23736/S0375-9393.24.18766-4","DOIUrl":"https://doi.org/10.23736/S0375-9393.24.18766-4","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189829","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}