Minerva anestesiologica最新文献

{"title":"Sacral erector spinae plane block in a child undergoing feminizing genitoplasty due to ambiguous genitalia.","authors":"Hande Gurbuz, Umut Gunay, Mursel Ekinci","doi":"10.23736/S0375-9393.25.19144-X","DOIUrl":"https://doi.org/10.23736/S0375-9393.25.19144-X","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225905","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 rare case of neonatal high-grade AV block treated with Micra Pediatric IPG: an anesthesiology perspective.","authors":"Elena Caporossi, Elisa Bergamini Viola, Luca Tomasi, Stiljan Hoxha, Giulia Piccone, Alessandro Devigili, Leonardo Gottin","doi":"10.23736/S0375-9393.25.19227-4","DOIUrl":"https://doi.org/10.23736/S0375-9393.25.19227-4","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225890","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":"Effects of transcranial direct current stimulation on postoperative pain and opioid consumption in arthroplasty: a systematic review and meta-analysis.","authors":"Jianlei Li, Bin Shen, Jianjiang Liu, Fajia Wang","doi":"10.23736/S0375-9393.25.18744-0","DOIUrl":"https://doi.org/10.23736/S0375-9393.25.18744-0","url":null,"abstract":"<p><strong>Introduction: </strong>To evaluate the effectiveness of transcranial direct current stimulation (tDCS) on acute postoperative orthopedic pain and opioid depletion following arthroplasty.</p><p><strong>Evidence acquisition: </strong>Two independent researchers searched PubMed, EMBASE, and the Cochrane Library databases from inception to May 2024 to identify eligible randomized controlled trials (RCTs). The methodological quality and potential biases of the included studies were assessed using the Cochrane risk of bias assessment tool, and the risk of bias and robustness of the literature were evaluated through funnel plots and sensitivity analyses. Additionally, statistical analysis of relevant outcome measures was conducted using STATA 17.0.</p><p><strong>Evidence synthesis: </strong>Preliminary screening yielded 417 articles, from which 8 were selected for comprehensive analysis. Statistical analysis revealed that tDCS effectively alleviated acute postoperative pain following arthroplasty, whether during rest or movement. Additionally, tDCS was observed to reduce the consumption of opioid analgesics among patients, particularly in cases where the primary motor cortex (M1) was targeted for tDCS application.</p><p><strong>Conclusions: </strong>Based on low-level evidence, tDCS shows promise in alleviating acute postoperative pain following arthroplasty and reducing the consumption of opioid analgesics in patients after surgery. These findings suggest that tDCS could potentially serve as a valuable adjunctive therapy for managing postoperative pain in orthopedic patients, providing a possible alternative or complement to traditional analgesic methods. However, it is important to note that further research, including more RCTs, is needed to confirm and extend these findings.</p>","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225902","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":"Persistent pain and associated risk factors in previously hospitalized COVID-19 survivors: data from an Italian cross-sectional study.","authors":"Matteo Castaldo, Alessandro Viganò, Rocco Giordano, Brian D Ebbesen, Sara Guidotti, Alice Fiduccia, Carlo Pruneti, Michela DI Chiara, Natascia Caroccia, Maddalena Giannella, Paolo Pillastrini, Anna Ripamonti, César Fernández DE Las Peñas, Lars Arendt-Nielsen","doi":"10.23736/S0375-9393.25.18694-X","DOIUrl":"https://doi.org/10.23736/S0375-9393.25.18694-X","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to investigate the prevalence and the characterization of post-COVID pain in an Italian cohort of previously hospitalized COVID-19 survivors. Furthermore, the study investigated risk factors for the presence of post-COVID pain at one year after the hospitalization.</p><p><strong>Methods: </strong>Subjects who agreed to participate received a telephonic interview, and if meeting the inclusion criteria, they were scheduled for a clinical assessment for post-COVID pain characteristics. They also fulfilled several questionnaires: the Hospital Anxiety and Depression Scale (HADS), Pittsburgh Sleep Quality Index, Central Sensitization Inventory (CSI), pain detect, Tampa Scale of Kinesiophobia, and Pain Catastrophizing Scale.</p><p><strong>Results: </strong>A sample of 246 subjects was included (36.6% women, age: 60.7± 14.5 years). Post-COVID pain prevalence was 26.2% (65 subjects), with musculoskeletal pain being the most common type (40 subjects, 16.2%). The multivariate analysis revealed that the number of post-COVID symptoms (WL=0.82, P<0.001), previous musculoskeletal pain (WL=0.82, P<0.001), HADS-D (WL=0.87, P<0.001), CSI (WL=0.84, P<0.001), obesity (WL=0.83, P=0.02), and previous neuropathic pain (WL=0.82, P=0.02) were risk factors associated with the presence of post-COVID pain. The model was able to correctly classify the 75.6% of post-COVID pain subjects and explained that 23% of the developing of post-COVID pain depends on the determined risk factors.</p><p><strong>Conclusions: </strong>The results of this study confirmed that post-COVID pain may still be present 18 months one year after the hospitalization, and several risk factors may be identified. These results underline that post-COVID pain may still be affecting COVID-19 survivors after 18 months, representing a major social health problem.</p>","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144174106","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":"Postoperative stellate ganglion block reduces high-sensitivity troponin T release in patients undergoing off-pump coronary artery bypass surgery: a randomized controlled trial.","authors":"Yujie Zhu, Xiaozhe Zhu, Luyao Wang, Lei Shen, Dunyi Qi","doi":"10.23736/S0375-9393.25.18748-8","DOIUrl":"https://doi.org/10.23736/S0375-9393.25.18748-8","url":null,"abstract":"<p><strong>Background: </strong>The non-analgesic applications of stellate ganglion block (SGB) are increasingly garnering scholarly and clinical interest. This study aimed to investigate the myocardial protective effects of postoperative SGB in patients undergoing off-pump coronary artery bypass grafting (OPCABG).</p><p><strong>Methods: </strong>In this double-blind, randomized controlled trial, 62 adults scheduled for OPCABG were randomized to one of two groups: the right stellate ganglion block group (RSGB group) and the control group. Postoperation, participants had a right SGB. However, controls were not blocked. The primary outcome was serum high-sensitivity troponin T concentration measured within seven days after surgery. Secondary outcomes included postoperative hemodynamics, postoperative pain scores, postoperative incidence of atrial fibrillation, postoperative dosage of vasoactive drugs, postoperative opioid consumption, incidence of myocardial infarction, 30-day postoperative mortality, and length of hospital stay.</p><p><strong>Results: </strong>At some point after the operation, the RSGB group patients' serum high-sensitivity troponin levels were noticeably lower than the control group, with means (standard deviation [SD]) of 146.1 (49.7) vs. 207.8 (50.6) at 12 hours; 132.7 (35.6) vs. 202.6 (43.8) at 24 hours; 19.7 (9.2) vs. 41.7 (24.7) at 7 days; all P<0.001. Moreover, the RSGB group showed significantly lower pain scores, a significantly reduced postoperative rate-pressure product (RPP) value, and a substantially lower incidence of atrial fibrillation.</p><p><strong>Conclusions: </strong>In patients undergoing OPCABG, it was observed that postoperative right SGB can reduce postoperative high-sensitivity cardiac troponin T levels.</p>","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144174147","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 timing of local infiltration analgesia impacts perioperative pain management in primary total knee arthroplasty: a single-blind randomized controlled clinical trial.","authors":"Moritz Weigeldt, Jan D Wandrey, Susanne Mark, Joanna Kastelik, Michal Jagielski, Wolfgang Ertel, Carsten Perka, Michael Schäfer, Sascha Tafelski, Sascha Treskatsch","doi":"10.23736/S0375-9393.25.18743-9","DOIUrl":"https://doi.org/10.23736/S0375-9393.25.18743-9","url":null,"abstract":"<p><strong>Background: </strong>Local infiltration analgesia (LIA) for primary total knee arthroplasty (TKA) is a standard procedure that is considered safe and simple. However, there is still ambiguity in the execution, technique and timing. Starting LIA at the earliest possible time could spare intraoperative opioids and prevent postoperative sensitization.</p><p><strong>Methods: </strong>Seventy patients for elective primary TKA, randomly allocated to both study groups (LIA-early N.=35, LIA-late N.=35) were included in this randomized controlled trial comparing early LIA (administered in three steps at the start and during knee joint preparation) and late LIA (administered after femur and tibia resection and during withdrawal). The primary endpoint was intraoperative opioid consumption as measured in morphine equivalent dose (MED). Secondary endpoints included total perioperative opioid consumption until discharge, pain intensity, mobility, and length of hospital stay (LOS).</p><p><strong>Results: </strong>Intraoperative opioid consumption showed no significant difference (LIA-early: median [IQR], 2.85 [2.04-3.37] vs. LIA-late: 3.1 [2.64-3.67] mg/kg; P=0.275). On POD 1-3 cumulative postoperative MEDs (LIA-early: 0.4 [0.1-0.075] mg/kg vs. LIA-late: 1.37 [0.91-1.91] mg/kg; P=0.001, r=0.58), pain scores (P<0.001), LOS (P=0.001, r=0.61), and time to achieve 90° flexion (P=0.001, r=0.71) differed significantly favoring early LIA.</p><p><strong>Conclusions: </strong>Early compared to late LIA did not reveal significant differences in intraoperative opioid-sparing effects, but significantly reduced postoperative opioid consumption, pain scores, and time of recovery. The mechanisms behind these findings are unclear.</p>","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111351","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":"Is surgical anesthesia possible with fascial plane blocks?. Combination of serratus posterior superior intercostal plane block and rhomboid intercostal block for sole anesthetic method of scapula surgery.","authors":"Bora Bilal, Bahadır Çiftçi, Ali Ahiskalioglu, Mustafa Özdemir, Selcuk Alver, Feyza Çalişir, Serkan Tulgar","doi":"10.23736/S0375-9393.25.18863-9","DOIUrl":"https://doi.org/10.23736/S0375-9393.25.18863-9","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144005029","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":"Refractory hyperthermia and sleep disturbance following intrathecal drug delivery system implantation.","authors":"Jian Han, Huayue Liu, Jiapeng Deng, Rong Zeng, Qiong Wu, Tianyi DU, Zhenwu Zhang, Diyang Ling, Zheyin Wang, Juan Zhang","doi":"10.23736/S0375-9393.25.18926-8","DOIUrl":"https://doi.org/10.23736/S0375-9393.25.18926-8","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144002551","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":"Enhanced recovery after surgery and the role of the anesthetist, road to implementation.","authors":"Marco Rossi, Luigi Tritapepe, Roberta Monzani, Fabio Sbaraglia, Filomena Della Sala, Rachele Simonte, Duccio Conti, Edoardo DE Robertis","doi":"10.23736/S0375-9393.25.18842-1","DOIUrl":"https://doi.org/10.23736/S0375-9393.25.18842-1","url":null,"abstract":"<p><p>Enhanced recovery after surgery (ERAS) is an interdisciplinary and multimodal approach to surgical patient management. Two primary objectives of the ERAS philosophy have been the standardization of practices and the reduction of variations in treatment. A notable achievement of ERAS has been its ability to enhance and combine into bundles elements that were already well-known but disconnected in clinical practice, such as preadmission, prehabilitation, and multimodal analgesia. Key concepts of ERAS pathways include multimodal, optimization, early and minimal; while the essential principles for success are research, education, and audit. Current literature suggests that a compliance rate of over 70% is associated with better clinical outcomes and improved survival rates. However, it is not yet possible to determine which specific elements are the most critical for ERAS outcomes, nor it is easy to demonstrate which combinations of items are best suited to individual patients. Three types of barriers (cultural, organizational, and structural) can be highlighted as opponents to ERAS implementation. The concept of partial ERAS is gaining increased interest. Adhering to ERAS protocols was not easy, as it required anesthetists to step outside the confines of the operating room, both physically and culturally, and to consciously assume the role of clinical support to surgeons and their patients. Through innovation, collaboration, and advocacy for their indispensable role, anesthetists can lead the evolution of perioperative medicine, ensuring that both patients and the profession thrive in the era of precision care and rapidly changing healthcare environments.</p>","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029219","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 perioperative intravenous infusion of dexmedetomidine on the quality of early and long-term postoperative recovery in patients undergoing thoracoscopic surgery: a randomized controlled trial.","authors":"Zhibiao Xu, Li Zhang, Yuyun Liu, Yuxiang Meng, Zijie Ling, Sumin Yuan, Ziwei Li, Teng Sun, Su Liu, Linlin Zhao","doi":"10.23736/S0375-9393.25.18716-6","DOIUrl":"https://doi.org/10.23736/S0375-9393.25.18716-6","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate the effect of perioperative intravenous infusion of dexmedetomidine on the quality of early and long-term postoperative recovery in patients undergoing thoracoscopic surgery, and to further analyze its potential mechanism.</p><p><strong>Methods: </strong>A total of 80 patients were enrolled and randomized to dexmedetomidine group, which received perioperative intravenous infusion of dexmedetomidine and normal saline group, which received equivalent doses of normal saline. The primary outcome was total QoR-15 score on postoperative day 1. Secondary outcomes included total QoR-15 Score on postoperative day 2, day 3, day 7, month 1 and month 3 and the score of dimensions of QoR-15, NRS Score, incidence of moderate to severe pain, physical comfort score, hospital anxiety and depression scale score and adverse reactions on postoperative day 1, day 2, day 3, day 7, month 1 and month 3.</p><p><strong>Results: </strong>The total QoR-15 score of dexmedetomidine group on postoperative day 1 was significantly higher than that of saline group (127.1±7.3 vs. 118.4±9.3, P<0.001), the same as on postoperative day 2, day 3, day 7 and month 1 (all P<0.001). Further analysis of each dimension showed that the enhancement of total QoR-15 score on postoperative day 1, day 2, day 3 in dexmedetomidine group was mainly due to the improvement of pain and physical comfort (all P<0.0.05), which was consistent with NRS score, incidence of moderate to severe pain and physical comfort score (P<0.0.05). The increase of total QoR-15 score on day 7 was mainly due to the combined effect of pain, physical comfort, and emotional dimensions (all P<0.05). The enhancement of total QoR-15 score on postoperative month 1 was mainly due to an improvement in the emotional dimension, which was consistent with hospital anxiety and depression scale score (all P<0.05). In terms of adverse reactions, the incidence of nausea and vomiting on postoperative day 1 and day 2 was significantly reduced in the dexmedetomidine group (48.7% vs. 25.6%, 38.5% vs. 17.9%, both P<0.05), and there was no significance in other aspects (all P<0.05).</p><p><strong>Conclusions: </strong>Perioperative intravenous infusion of dexmedetomidine significantly improved the quality of recovery after thoracoscopic surgery without increasing the occurrence of adverse reactions, and the early enhancement may be mainly through the improvement of pain and physical comfort, the long-term enhancement may be mainly through the improvement of emotional state.</p>","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144007196","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}