Minerva anestesiologica最新文献

{"title":"Maximum extension and regression rate of cutaneous sensory block obtained with the external oblique intercostal block or the modified thoracoabdominal nerves block through perichondrial approach in patients undergoing laparoscopic cholecystectomy.","authors":"Caner Genc, Serkan Tulgar, Can Akgun, Mehmet A Avci, Busra Yesilyurt, Busra Yildiz, Alessandro DE Cassai","doi":"10.23736/S0375-9393.24.18213-2","DOIUrl":"10.23736/S0375-9393.24.18213-2","url":null,"abstract":"<p><strong>Background: </strong>Several studies demonstrate that both external oblique ıntercostal block (EOIB) and modified thoracoabdominal nerves block through perichondrial approach (M-TAPA) contribute to analgesia in the anterior abdomen by targeting the thoracoabdominal nerves through distinct pathways. However, the sensory assessment and dermatomal analysis remain poorly understood.</p><p><strong>Methods: </strong>This prospective observational study aimed to determine the sensory assessment and dermatomal regression rate of EOIB and M-TAPA in patients undergoing laparoscopic cholecystectomy. The study included a total of 24 patients, with 12 patients in each group. Blocks were performed bilaterally, administering 25 mL of bupivacaine 0.25% for each side, resulting in a total volume of 50 mL. The anterior abdominal wall was vertically partitioned into the midabdomen, left-lateral abdomen, and right-lateral abdomen, and horizontally divided into the epigastric, umbilical, and hypogastric regions. Sensory block was assessed at the 45^th minute with cold stimulus and pinprick. Subsequent evaluations were at intervals of 6, 10, 14, 18, 22, and 24 hours.</p><p><strong>Results: </strong>The blocked area percentile with cold sensation in the anterior abdomen was 43.07% (36.67-55.74) with EOIB, 40.49% (34.05-43.67) with M-TAPA (P=0.3219). When the region above the intertubercular plane was examined with cold sensation, EOIB covered 55.92% (46.75-62.07), and M-TAPA covered 49.60% (40.39-54.03) of the epigastric and umbilical areas. Assessment of the midabdominal portion of the anterior abdomen revealed that the blocked area percentile was statistically significantly higher in the M-TAPA group with both cold sensation and pinprick. At 45 minutes, the percentage of blocked dermatomes was 100% between T7-T8 in the EOIB group and between T7-T10 in the M-TAPA group. Both groups exhibited lower success rates in dermatomes T5 and T12, with no sensory block within the L1 dermatome, and cutaneous dermatomal block status either absent or negligible after 24 hours. All trocar entries were located within the cutaneous sensory block for both blocks, except for trocar C, which was located most laterally.</p><p><strong>Conclusions: </strong>Bilateral EOIB and M-TAPA produce a comparable sensory cutaneous block in the anterior abdomen, particularly in the umbilical and epigastric regions. Additionally, the midabdominal cutaneous blocked area was greater in patients undergoing M-TAPA, suggesting a more consistent distribution along the anterior cutaneous branches of the thoracoabdominal nerves.</p>","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":"90 11","pages":"979-988"},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142639022","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":"Which place for hyperbaric oxygen therapy in Intensive Care Unit and operating room?","authors":"Sylvain Diop, Quentin Marion, Ariane Roujansky, Roman Mounier","doi":"10.23736/S0375-9393.24.18259-4","DOIUrl":"10.23736/S0375-9393.24.18259-4","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":"1054-1056"},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141759740","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":"Individualized positive end-expiratory pressure in laparoscopic surgery: a randomized controlled trial.","authors":"Muqiao Cheng, Fengying Xu, Wei Wang, Weiwei Li, Ran Xia, Haiying Ji, Shunan Lv, Xueyin Shi, Chengmi Zhang","doi":"10.23736/S0375-9393.24.18209-0","DOIUrl":"10.23736/S0375-9393.24.18209-0","url":null,"abstract":"<p><strong>Background: </strong>The reduction in functional residual capacity (FRC) is a significant pathological factor in the development of postoperative pulmonary complications. Appropriate positive end-expiratory pressure (PEEP) is critical to preserve FRC during mechanical ventilation. Our previous study suggests that using driving pressure-guided PEEP can reduce postoperative pulmonary complications. In this study, we hypothesize that individualized PEEP can increase immediate postoperative FRC and improve lung ventilation.</p><p><strong>Methods: </strong>This single-centered, randomized controlled trial included a total of 91 patients scheduled for laparoscopic surgery for colorectal carcinoma. Patients were randomly assigned to receive individualized PEEP guided by minimum driving pressure or a fixed PEEP of six cmH<inf>2</inf>O. The primary outcome was postoperative FRC. Secondary outcomes included the incidence of postoperative pulmonary complications, postoperative Oxygenation Index, alveolar-arterial oxygen tension difference (P<inf>A-a</inf>O<inf>2</inf>), intrapulmonary shunt (Q<inf>S</inf>/Q<inf>T</inf>), and Respiratory Index, as well as lung ventilation measured by electrical impedance tomography.</p><p><strong>Results: </strong>The median value of PEEP in the individualized group was 14 cmH<inf>2</inf>O, with an interquartile range of 12-14 cmH<inf>2</inf>O. The postoperative FRC was significantly higher in the individualized PEEP group than that in the PEEP six cmH<inf>2</inf>O group (32.8 [12.8] vs. 25.0 [12.6] mL/kg, P=0.004). Patients receiving driving pressure-guided PEEP also had significantly higher Oxygenation Index, better ventilation distribution, and lower PA-aO<inf>2</inf>, Q<inf>S</inf>/Q<inf>T</inf>, and Respiratory Index.</p><p><strong>Conclusions: </strong>Driving pressure-guided PEEP can preserve postoperative FRC and provide better ventilation and oxygenation for patients undergoing laparoscopic colorectal surgery.</p>","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":"90 11","pages":"969-978"},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142639003","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":"Serratus posterior superior intercostal plane block for postoperative analgesia in clavicle surgeries: new indications for a novel block.","authors":"Engin I Turan, Sevde Işik, Abdurrahman E Baydemir, Ayça S Şahin","doi":"10.23736/S0375-9393.24.18275-2","DOIUrl":"10.23736/S0375-9393.24.18275-2","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":"1058-1060"},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141889763","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":"Combined awake intubation technique for predicted difficult airways in a patient with thyroid goiter.","authors":"Pasquale Rinaldi, Carmela Eziandio, Francesco Coletta, Maria E Porcelli, Giovanna Lauro, Antonio Tomasello, Romolo Villani","doi":"10.23736/S0375-9393.24.18262-4","DOIUrl":"10.23736/S0375-9393.24.18262-4","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":"1056-1057"},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141889747","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":"Ropivacaine and magnesium sulfate in sciatic nerve block at the popliteal level: randomized double-blind study.","authors":"Riccardo Pulitanò, Marco Giudice, Francesca LA Verde, Enrico DI Sabatino, Massimiliano Carassiti, Giuseppe Pascarella","doi":"10.23736/S0375-9393.24.18126-6","DOIUrl":"10.23736/S0375-9393.24.18126-6","url":null,"abstract":"<p><strong>Background: </strong>Following surgical procedures, over 80% of patients experience acute pain, with half of them expressing dissatisfaction with pain relief. The modern approach to surgical treatment and pain management increasingly relies on implementing multimodal analgesia, which includes the use of adjuvants in addition to long-acting local anesthetics (such as ropivacaine). This double-blind randomized study evaluated the analgesic effect of magnesium sulfate added to ropivacaine in the sciatic nerve block at the popliteal level for bunion correction surgery.</p><p><strong>Methods: </strong>In this double-blind study, fifty patients were enrolled and randomized in a 1:1 ratio to receive ropivacaine and MgSO<inf>4</inf> 200 mg or ropivacaine and physiological solution. The primary endpoint was the duration of sensory block.</p><p><strong>Results: </strong>A statistically significant difference was observed in the onset time for sensory block (9.2 minutes vs. 21.8 minutes, P<0.001) and its duration (18.2 hours vs. 13.9 hours, P<0.001) between the two groups. Between 12 and 24 hours postoperatively, the maximum NRS pain scores in the magnesium group were lower than those in the control group (IQR [range]) 2 (2-3.8 [0-6.5]) vs. 6.7 (5.6-7.9 [2.7-9.2], P<0.001). The need for additional opioids after 12-24 hours was significantly higher in patients in the physiological solution group compared to those in the magnesium group.</p><p><strong>Conclusions: </strong>Our results suggest that magnesium added to the local anesthetic extends sensory block duration, reduces postoperative pain, improves the quality of analgesia, decreases the need for additional opioids. Further studies are needed to confirm these preliminary findings.</p>","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142546342","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":"Complete anesthesia after unilateral sacral ESP block.","authors":"Andrea Sanapo, Gian M Petroni, Francesca DE Sanctis, Pierfrancesco Fusco","doi":"10.23736/S0375-9393.24.18399-X","DOIUrl":"https://doi.org/10.23736/S0375-9393.24.18399-X","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142546339","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 of ultrasound-guided lumbar plexus block: a vertebral arch root method.","authors":"Junde Han, Shanshan Yu, Wenzong Ni","doi":"10.23736/S0375-9393.24.18364-2","DOIUrl":"https://doi.org/10.23736/S0375-9393.24.18364-2","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142546268","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 ultrasound-guided bilateral rectus sheath block vs. local anesthetic infiltration in gynecologic oncology patients undergoing midline laparotomy: a triple-blinded randomized controlled trial.","authors":"Merve Bulun Yediyildiz, Hülya Yilmaz Ak, İrem Durmuş, Kübra Taşkin, Esra Keles, Banu Çevik, Murat Api","doi":"10.23736/S0375-9393.24.18302-2","DOIUrl":"10.23736/S0375-9393.24.18302-2","url":null,"abstract":"<p><strong>Background: </strong>Postoperative pain is a serious problem in gynecological oncology patients. Rectus sheath block (RSB) is increasingly utilized as a part of multimodal analgesia. The purpose of this three blinded, randomized-controlled trial is to compare the analgesic efficacy of ultrasound-guided (US-guided) bilateral rectus sheath block (BRSB) and local anesthetic wound infiltration (LAWI) application in patients undergoing midline laparotomy for gynecologic cancer.</p><p><strong>Methods: </strong>This prospective, single-center, three-blinded, randomized clinical trial enrolled a total of 60 patients who underwent surgery through a midline laparotomy. Patients were randomly allocated into two groups and were administered either LAWI or BRSB with 20 mL of 0.25% bupivacaine just after the end of surgery. Both groups were compared for Numeric Rating Scale (NRS) pain scores, time to first analgesic requirement, total tramadol consumption.</p><p><strong>Results: </strong>Fifty-five patients (BRSB=28, LAWI=27) completed the study. The BRSB group had significantly lower NRS scores at 2, 6, 12, and 24th hours (P<0.001). The median (interquartile range, IQR) NRS scores for BRSB group were 3 (3-3) at 2nd hours, 3 (2-4) at 6th hours, 3 (2-4) at 12th hours and 3 (2-3) at 24th hours. For the LAWI group, the median (IQR) NRS scores were 4 (3-4) at 2nd hours, 4 (3-5) at 6th hours, 4 (3-4) at 12th hours and 4 (3-4) at 24th hours. The BRSB group had significantly less additional tramadol consumption than the LAWI group (P<0.001).</p><p><strong>Conclusions: </strong>The US-guided BRSB is a safe and feasible technique. This technique resulted in reduced postoperative pain scores, decreased tramadol usage, and prolonged pain relief compared to LAWI.</p>","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142546340","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":"BRILMA block for analgesia in adolescent fibroadenoma excision.","authors":"Volkan Özen, Engin I Turan, Arda Ayas, Taylan Kirdan","doi":"10.23736/S0375-9393.24.18552-5","DOIUrl":"https://doi.org/10.23736/S0375-9393.24.18552-5","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142546338","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}