Minerva anestesiologica最新文献

{"title":"A novel and feasible option for postoperative analgesia in hernia repair surgery: quadro-iliac plane block.","authors":"Tommaso Sorrentino, Carmine Pullano, Francesco Marrone","doi":"10.23736/S0375-9393.25.19017-2","DOIUrl":"10.23736/S0375-9393.25.19017-2","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":"857-858"},"PeriodicalIF":2.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031830","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 pain profiles and rebound pain following spinal anesthesia compared to general anesthesia: an observational study.","authors":"Hanns-Christian Dinges, Christian Volberg, Andrea Leibeling, Julian Maul, Philipp Benkhoff, Karl M Meggiolaro, Hinnerk Wulf, Ann-Kristin Schubert","doi":"10.23736/S0375-9393.25.19042-1","DOIUrl":"10.23736/S0375-9393.25.19042-1","url":null,"abstract":"<p><strong>Background: </strong>Excessive pain during nerve block resolution after surgery under regional anesthesia has recently been referred to as rebound pain. The objective of this study was to detect differences in postoperative pain profiles of spinal and general anesthesia.</p><p><strong>Methods: </strong>This single-center observational cohort study was conducted at University Hospital Marburg from January 2022 until July 2023. Main outcome measures were integrated pain scores (IPS), postoperative pain scores over 24 hours, cumulative morphine equivalents, and incidence of rebound pain according to the clinical definitions.</p><p><strong>Results: </strong>We enrolled 328 patients scheduled for elective orthopedic, urological or gynecological surgery receiving either spinal or general anesthesia in this study. No statistically significant differences in IPS were observed apart from the PACU interval. Regarding pain scores on the Numerical Rating Scale (NRS), we found significantly lower NRS at the PACU, but significantly higher NRS after six hours following orthopedic surgery that was conducted under spinal anesthesia, but not for the other cohorts. The morphine equivalent consumption was very low for the entire study. The incidence for rebound pain according to clinical definitions, was highest for patients in the orthopedic cohort following spinal anesthesia.</p><p><strong>Conclusions: </strong>Statistically significant and clinically relevant differences in pain scores were seen in orthopedic and orthopedic patients during the early postoperative period on resolution of spinal anesthesia. While the entity or rebound pain remains unclear, this phenomenon is a relevant problem in some clinical settings.</p>","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":"745-756"},"PeriodicalIF":2.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144742812","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":"Could mandibular profile angle or inter-pterygoid distance provide a novel method for predicting difficult laryngoscopy?","authors":"E Sule Ozdemir Sezgi, M Murat Sayin, Savaş Altinsoy","doi":"10.23736/S0375-9393.25.18712-9","DOIUrl":"https://doi.org/10.23736/S0375-9393.25.18712-9","url":null,"abstract":"<p><strong>Background: </strong>Various tests have been developed to predict difficult airway during preoperative examination, but none has presented an adequate degree of accuracy. This study investigates novel mandibular structures and angles for evaluation as potential predictor of difficult laryngoscopy.</p><p><strong>Methods: </strong>Following Ethics Committee approval, 1001 patients scheduled for elective surgeries under general anesthesia with oral intubation were included in this prospective study. Difficult laryngoscopy was defined as a Cormack-Lehane grade III or IV view. Standard predictive tests - including neck circumference, thyromental distance, sternomental distance, Modified Mallampati Test (MMT), mouth opening, and upper lip bite test - were evaluated alongside two novel parameters: the \"mandibular profile angle\" and \"inter-pterygoid distance.\"</p><p><strong>Results: </strong>The sensitivity and specificity of the Modified Mallampati Test (MMT) for predicting difficult laryngoscopy were 46% and 91%, respectively, with a positive predictive value (PPV) of 51% and a negative predictive value (NPV) of 89%. In contrast, the \"mandibular profile angle\" demonstrated a sensitivity of 83%, specificity of 86%, PPV of 55%, and NPV of 96%. The \"inter-pterygoid distance\" showed similar accuracy, with a sensitivity of 82%, specificity of 88%, PPV of 58%, and NPV of 96%. The area under the curve (AUC) values were 0.89 for the \"mandibular profile angle\" and 0.90 for the \"inter-pterygoid distance.\" The optimal cut-off for predicting difficult laryngoscopy was 107.75° for the \"mandibular profile angle\" and 13.05 cm for the \"inter-pterygoid distance.\"</p><p><strong>Conclusions: </strong>These findings suggest that using mandibular structures in preoperative assessments to anticipate and prepare for difficult laryngoscopy scenarios provides reliable threshold values that may improve patient safety and procedural outcomes. The introduction of novel measurements, specific to mandibular structure assessment, carries the potential to initiate a distinct approach in predicting difficult laryngoscopy. By integrating these measurements with existing bedside tests, a substantial enhancement in the accuracy and robustness of predictive evaluations may be reached.</p>","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":"91 9","pages":"766-775"},"PeriodicalIF":2.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113579","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":"Retrolaminar block for postoperative pain management in a pediatric patient undergoing circumcision and orchidopexy.","authors":"Engin I Turan, Selçuk Alver, Bahadır Çiftçi, Volkan Özen","doi":"10.23736/S0375-9393.25.19018-4","DOIUrl":"10.23736/S0375-9393.25.19018-4","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":"858-860"},"PeriodicalIF":2.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027751","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":"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":"776-785"},"PeriodicalIF":2.8,"publicationDate":"2025-09-01","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":"Efficacy and safety of ciprofol versus propofol in hysteroscopy: a systematic review and meta-analysis.","authors":"Lucas Caetano DA Silva, Vanessa Tapioca, Tathiane Gibicoski, Tatiana Souza DO Nascimento","doi":"10.23736/S0375-9393.25.18930-X","DOIUrl":"10.23736/S0375-9393.25.18930-X","url":null,"abstract":"<p><strong>Introduction: </strong>Hysteroscopy is a minimally invasive procedure for diagnosing and treating intrauterine conditions. Adverse effects such as injection pain and hypotension are common with propofol, the standard anesthetic agent. Emerging evidence suggests ciprofol may be a safer alternative, but its role in hysteroscopy remains unclear.</p><p><strong>Evidence acquisition: </strong>A systematic search of MEDLINE, Embase, Cochrane, and Web of Science was conducted, following the recommendations of the Cochrane Handbook and the PRISMA statement. The measure of association used was risk ratio (RR) or Standardized Mean Difference (SMD), with 95% Confidence Intervals (CIs), identifying randomized controlled trials (RCTs) comparing intravenous ciprofol and propofol in hysteroscopy patients aged ≥18 years. Risk Ratio (RR) and mean difference (MD) with 95% CIs were calculated using a random-effects model. Statistical analyses were performed using R software (version 4.2.2). Trial Sequential Analysis (TSA) was used to evaluate the robustness of the findings.</p><p><strong>Evidence synthesis: </strong>Four RCTs with 1512 patients (49.8% ciprofol group) showed that ciprofol was associated with a significant reduction in injection pain (RR=0.18; 95% CI: 0.06-0.51) and hypotension (RR=0.57; 95% CI: 0.49-0.67). TSA and sensitivity analyses confirmed these findings, demonstrating sufficient statistical power. Ciprofol was also associated with a reduction in hypoxemia (RR=0.54; 95% CI: 0.39-0.75) and body movement (RR=0.55; 95% CI: 0.40-0.76), with no significant differences in bradycardia, induction, or recovery time.</p><p><strong>Conclusions: </strong>This meta-analysis with TSA supports ciprofol as a safer, effective alternative to propofol for hysteroscopy, reducing key adverse effects.</p>","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":"808-816"},"PeriodicalIF":2.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732174","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":"Tuscany takes a step forward: a new law on physician-assisted suicide.","authors":"Annachiara Marra, Maria Vargas, Veronica Guidi, Giuseppe Servillo","doi":"10.23736/S0375-9393.25.19003-2","DOIUrl":"10.23736/S0375-9393.25.19003-2","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":"855-857"},"PeriodicalIF":2.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144742813","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":"Airway management: grandeur built on shaky ground.","authors":"Manuel Á Gómez-Ríos, Alfredo Abad-Gurumeta","doi":"10.23736/S0375-9393.25.19380-2","DOIUrl":"https://doi.org/10.23736/S0375-9393.25.19380-2","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":"91 9","pages":"742-744"},"PeriodicalIF":2.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113622","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":"Pregabalin for sleep quality and postoperative pain: a potential strategy for long-term recovery.","authors":"Wen-Yi Lai, Ching-Wei Chuang","doi":"10.23736/S0375-9393.25.18964-5","DOIUrl":"10.23736/S0375-9393.25.18964-5","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":"852-854"},"PeriodicalIF":2.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657787","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 continuous stellate ganglion block for refractory ventricular electrical storm.","authors":"Paolo Scimia, Andrea Angelozzi, Stefano Troili, Manuel A Conti, Giuseppe Sepolvere, Luca Gentili","doi":"10.23736/S0375-9393.25.18987-6","DOIUrl":"10.23736/S0375-9393.25.18987-6","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":"854-855"},"PeriodicalIF":2.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009266","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}