Minerva anestesiologica最新文献

{"title":"Fast but safe: speeding up clinical pathways in solid organ transplantation. An overview.","authors":"Alexandra Anderson, Gianni Biancofiore, Anabel Blasi, Hong Liang, Christine Nguyen-Buckley, Fuat H Saner, Gebhard Wagener","doi":"10.23736/S0375-9393.26.19708-9","DOIUrl":"10.23736/S0375-9393.26.19708-9","url":null,"abstract":"<p><p>Clinical pathways such as fast-track and enhanced recovery after surgery protocols have become integrated into transplant anesthesiology care in recent decades. These clinical pathways aim to improve patient outcomes through use of standardized, evidence-based perioperative interventions. In this paper we define the concepts of fast-track and ERAS in the context of transplant anesthesiology and review the origins of these concepts. Next, we discuss clinical pathways in three areas of transplantation: liver transplantation, kidney transplantation, and thoracic organ transplantation. In this expert opinion paper, we review current evidence and recommendations regarding fast-track and ERAS in these areas of transplantation and describe opportunities for future research and guideline development.</p>","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":"904-914"},"PeriodicalIF":3.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148150569","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 delirium and the limits of EEG monitoring without goal-directed anesthetic management.","authors":"Olga DE LA Varga-Martínez, Rosalía Navarro Pérez, Rocío López Herrero, Nekane Romero-García, Jorge Almoguera Fernández, Marta Alonso Fernández, María Artiaga-Candia, Ángel Becerra-Bolaños, Natalia Bugueño, Amparo Casasempere Sanus, Laura Contreras-López, Marta DE LA Rosa-Estadella, Iria DE LA Torre Riveiro, Gustavo Illodo Miramontes, Elena Del Val Peciña, Carla Delgado Martí, Laura Edo Cebollada, Ricardo Fernández Fernández, Jorge Fernández Rodríguez, Carolina Ferrer Gómez, Marta Giné Servén, Estefanía Gómez Pesquera, Almudena González Pereira, Ane Guereca Gala, Aurora Herrera Soto, Maria E Infantes Morales, José M Marcos-Vidal, Alberto Martínez Ruiz, Beatriz Martínez-Rafael, Adrián Matute González, Laura Pariente Juste, Ainhoa Renedo Fernández, Ángel A Rodríguez Álvarez, María A Rodríguez Conesa, Cristina Sánchez González, Cristina Tobar Gonzalo, Lorena Varela Rodríguez, Rita Veloso DE Sousa, María F Muñoz-Moreno, Gabriel Escudero Gómez, Antonio Rodríguez Calvo, María Heredia Rodríguez, José I García Sánchez, Felipe Rocha García, Pablo González Montes, Patricia Cid Boo, Leticia Narváez Rodríguez, Guadalupe Población García, Beneharo Darias-Delbey, Luis Á Gómez Arredondo, Diana M Narváez Cubillos, Raquel Fernández-García, Adrián Martínez López, Alma M Espinosa Moreno, José Ramírez-Esteban, Rodrigo Poves-Álvarez, Marina Varela Duran, Rafael Badenes, Eduardo Tamayo","doi":"10.23736/S0375-9393.26.19737-5","DOIUrl":"10.23736/S0375-9393.26.19737-5","url":null,"abstract":"<p><strong>Background: </strong>Postoperative delirium (POD) remains a major cause of morbidity after surgery. Understanding its relationship with anesthetic depth and EEG monitoring could optimize perioperative management and improve patient recovery. This study aimed to determine whether intraoperative monitoring of anesthetic depth using integrated EEG is associated with a reduced incidence of POD.</p><p><strong>Methods: </strong>Observational multicentre study conducted across 43 hospitals. 1,690 adults (≥18 years) undergoing surgery under general anesthesia were included. The primary outcome was the incidence of POD at 48 hours post-surgery, comparing patients who received intraoperative EEG-based anesthetic depth monitoring with those who did not. POD diagnosis was based on established clinical criteria. In addition, a cross-sectional survey was administered to participating anesthesiologists to assess patterns of EEG monitor use, target ranges, training, and perceptions regarding its role in delirium prevention.</p><p><strong>Results: </strong>POD occurred in 4.25% (61/1434) of patients who received EEG monitoring and in 1.56% (4/256) of those without (P=0.833). Logistic regression identified age as significantly associated with POD (OR 1.06, 95% CI: 1.04-1.09, P<0.001), while neither EEG monitoring (OR 2.66, 95% CI: 0.95-7.45, P=0.063) nor sex (OR 1.15, 95% CI: 0.69-1.91, P=0.586) were independent predictors. In a survey involving 493 anesthesiologists, a widespread use of EEG monitoring was observed in clinical practice (61% use it consistently, and 35% frequently), with the most common target range being 40-60 (82.6%). The vast majority of respondents (96.7%) perceived a potential benefit in delirium prevention. However, only 35.2% had received formal training, and the application of goal-directed, protocolized EEG monitoring remained heterogeneous.</p><p><strong>Conclusions: </strong>In real-world clinical practice, intraoperative anesthetic depth monitoring was not associated with a lower incidence of POD at 48 hours. Heterogeneous, non-protocolized use and lack of structured training may limit its effectiveness. These findings should be considered hypothesis-generating and highlight the need for implementation strategies and goal-directed use.</p>","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":"845-857"},"PeriodicalIF":3.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147840215","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":"The peritoneum is not a membrane, and our evidence base is not good enough.","authors":"Yunus O Atalay","doi":"10.23736/S0375-9393.26.20358-9","DOIUrl":"https://doi.org/10.23736/S0375-9393.26.20358-9","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148663938","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":"Warm saline infiltration of the posterior rectus sheath for chronic abdominal wall pain: a clinical extension of the deep rectus sheath paradigm.","authors":"Chiara Maggiani, Pierfrancesco Fusco, Fabrizio Fattorini, Francesco Marrone, Walter Ciaschi","doi":"10.23736/S0375-9393.26.20241-9","DOIUrl":"https://doi.org/10.23736/S0375-9393.26.20241-9","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664113","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":"Dexmedetomidine target-controlled infusion for craniotomy in a patient with brain tumor and giant bullous emphysema.","authors":"Rositsa G Tanova, Alexander V Stratev, Petar A Karazapryanov, Krasimir Z Minkin","doi":"10.23736/S0375-9393.26.20463-7","DOIUrl":"https://doi.org/10.23736/S0375-9393.26.20463-7","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148663846","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":"Effectiveness of preoperative management of alcohol use disorders in surgical patients: a systematic review and meta-analysis.","authors":"Shirley Fan, Robin Hong, Apple Geng, Sarah Bilgasem, Majid Nabipoor, Aparna Saripella, Nethmi Rajapakse, Marina Englesakis, Frances Chung","doi":"10.23736/S0375-9393.26.20025-1","DOIUrl":"https://doi.org/10.23736/S0375-9393.26.20025-1","url":null,"abstract":"<p><strong>Background: </strong>Alcohol use disorders (AUD) are associated with significant health risks in surgical patients, including increased in postoperative morbidity and mortality. Treatment of alcohol use disorders prevents adverse organ dysfunction and reduces postoperative complications. This systematic review and meta-analysis aim to assess the effectiveness of existing preoperative alcohol use disorder interventions on postoperative outcomes.</p><p><strong>Methods: </strong>MEDLINE, Embase, and Cochrane databases were searched for English-language studies involving adults undergoing surgery. Eligible studies compared preoperative alcohol use disorder interventions with no intervention and reported postoperative outcomes, including postoperative complications, length of stay, alcohol recidivism, and mortality.</p><p><strong>Results: </strong>Twenty-one studies (N.=2602) were included. Eighteen studies used non-pharmacological interventions, one utilized pharmacological monotherapy, and two provided combined interventions. At 1-year and greater than 5-year follow-ups, the intervention groups had a significant reduction in participants who relapsed to alcohol drinking (1-year follow-up: RR: 0.59; 95% CI: 0.37-0.95; 5-year follow-up: RR: 0.53; 95% CI: 0.33-0.85, respectively). No significant pooled effects were found for postoperative complications, length of hospital stay, or mortality.</p><p><strong>Conclusions: </strong>Preoperative interventions for alcohol use disorders reduce alcohol relapse in liver transplant populations. Given the strong link between preoperative alcohol use and postoperative risks, additional research on preoperative alcohol cessation interventions is needed.</p>","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148430635","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":"Combining ultrasound-guided serratus anterior plane block and serratus-intercostal plane block for postoperative analgesia in minimally invasive coronary artery bypass surgery.","authors":"Selçuk Alver, Tarık Umutoğlu, Erdoğan Öztürk, Hasan Karabulut, Engin I Turan, Bahadır Çiftçi","doi":"10.23736/S0375-9393.26.20222-5","DOIUrl":"10.23736/S0375-9393.26.20222-5","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148405029","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":"MRI-guided interfascial plane block selection for radical debridement in pediatric hip infection.","authors":"Sandeep Diwan, Anju Gupta, Dipal D Shah, Ganesh Bhong","doi":"10.23736/S0375-9393.26.20183-9","DOIUrl":"10.23736/S0375-9393.26.20183-9","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148405048","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":"Resolution of MRI-related positional myofascial shoulder pain after serratus posterior superior intercostal plane block in a patient undergoing modified radical mastectomy.","authors":"Yusuf Alan, Onur Gunes, Mursel Ekinci","doi":"10.23736/S0375-9393.26.20306-1","DOIUrl":"10.23736/S0375-9393.26.20306-1","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148405041","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":"Reducing healthcare-associated infections in critically ill children with burn injury.","authors":"Ivonne Portaccio, Sonia Mensi, Federica Tosi, Tony C Morena, Enzo Picconi, Orazio Genovese, Giorgio Conti, Tiziana Pagliarini, Giuseppe Spaltro, Marco Piastra","doi":"10.23736/S0375-9393.26.20364-4","DOIUrl":"10.23736/S0375-9393.26.20364-4","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148405074","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}