Minerva anestesiologica最新文献

{"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}

{"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":"https://doi.org/10.23736/S0375-9393.25.19017-2","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-07","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":"A fascial compartment plus \"cup-shaped\" blocks provide surgical anesthesia for the excision of a huge mass at the posterior cervico-occipital region.","authors":"Peiqi Shao, Songchao Xu, Huili Li, Ruijuan Guo, Yun Wang","doi":"10.23736/S0375-9393.25.18741-5","DOIUrl":"10.23736/S0375-9393.25.18741-5","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":"476-477"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143502315","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 pericapsular nerve block on the quality of recovery after shoulder arthroscopy.","authors":"Muhammed H Satici, Mahmut S Tutar, Betül Kozanhan, Yasin Tire, Büşra A Acar, Ahmet Yildirim, Evren Büyükfirat, Nuray Altay","doi":"10.23736/S0375-9393.24.18461-1","DOIUrl":"10.23736/S0375-9393.24.18461-1","url":null,"abstract":"<p><strong>Background: </strong>Shoulder arthroscopy, a standard orthopedic procedure, often results in severe postoperative pain, leading to high opioid consumption and delayed recovery. Various analgesic methods, including peripheral nerve blocks, manage this pain. The pericapsular nerve group block is a relatively new technique whose efficacy in shoulder surgeries has yet to be extensively studied. This study aimed to assess the impact of the pericapsular nerve group block on postoperative recovery quality following shoulder arthroscopy, as measured by the Quality of Recovery-15 score.</p><p><strong>Methods: </strong>A randomized, prospective, controlled, multicenter study was conducted with 60 patients undergoing unilateral shoulder arthroscopy. Participants were allocated to either Group P (patients receiving the pericapsular nerve group block and multimodal analgesia) or Group C (patients receiving only multimodal analgesia). The primary outcome measured was the Quality of Recovery-15 score 24 hours post-surgery. Secondary outcomes included postoperative numeric rating scale scores, the requirement for rescue analgesia, time to first rescue analgesia, postoperative complications, the necessity for antiemetics, and patient satisfaction.</p><p><strong>Results: </strong>The median Quality of Recovery-15 score was significantly higher in Group P compared to Group C (120±10 vs. 89±11; P<0.001). Additionally, Group P exhibited lower pain scores at rest and during movement, a decreased need for rescue analgesia, and an extended duration before the first rescue analgesia was required. Postoperative nausea and vomiting were less common in Group P, and patient satisfaction scores were notably higher in this group.</p><p><strong>Conclusions: </strong>The pericapsular nerve group block significantly enhances postoperative recovery quality, reduces pain and opioid consumption, and improves patient satisfaction without significant complications.</p>","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":"395-403"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142624056","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":"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":"385-394"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","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}