Minerva anestesiologica最新文献

{"title":"Effectiveness of ChatGPT-4 in predicting the human decision to send patients to the postoperative intensive care unit: a prospective multicentric study.","authors":"Engin I Turan, Abdurrahman E Baydemir, Ayça S Şahin, Funda G Özcan","doi":"10.23736/S0375-9393.24.18587-2","DOIUrl":"10.23736/S0375-9393.24.18587-2","url":null,"abstract":"<p><strong>Background: </strong>Postoperative ICU admission is crucial in surgical patient management, impacting morbidity and mortality outcomes. Traditional prediction methods, such as the ASA physical status classification, are subjective and prone to variability. This study evaluates the effectiveness of ChatGPT-4 in predicting postoperative ICU admission needs using comprehensive preoperative patient data.</p><p><strong>Methods: </strong>In this prospective multicentric study, data from 406 patients aged 18 and older were analyzed. Patients requiring emergency surgery and those with insufficient information were excluded. Preoperative data, including demographics, medical history, laboratory results, and imaging findings, were collected and anonymized. ChatGPT-4 was configured to predict ICU admission needs based on this data. The model's predictions were compared with actual ICU admissions using Chi-Square, confusion matrix, and one-sample t-tests.</p><p><strong>Results: </strong>ChatGPT-4 model predicted 128 patients for ward care and 278 for ICU admission. Among the predicted ICU cases, 160 were correctly identified as ICU, while 118 were observed to need ward care. The overall accuracy of the model was 0.645, with a specificity of 0.464, sensitivity of 0.860, and an F1 score of 0.690. A Chi-square Test revealed a significant result (P=0.000).</p><p><strong>Conclusions: </strong>The findings demonstrate that ChatGPT-4 can effectively predict postoperative ICU needs, providing a valuable tool for clinical decision-making. While the model showed strong agreement with actual ICU admissions, refinement is needed to improve the accuracy of ICU stay duration predictions. Integrating AI in preoperative assessments could enhance objectivity and efficiency, contributing to optimized patient care and resource allocation. Further validation across diverse patient populations is recommended.</p>","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":"259-267"},"PeriodicalIF":2.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143720530","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 effect of sacral erector spinae plane block on the quality of recovery after total hip arthroplasty: a prospective, randomized, controlled, multicenter study.","authors":"Muhammed H Satici, Mahmut S Tutar, Yasin Tire, Orhan Binici, Osman Çiçekler, Elif Korkmaz, Oğuzhan Pekince, Betül Kozanhan","doi":"10.23736/S0375-9393.24.18353-8","DOIUrl":"10.23736/S0375-9393.24.18353-8","url":null,"abstract":"<p><strong>Background: </strong>Total hip arthroplasty, commonly performed to alleviate hip pain and enhance functionality in elderly patients, requires effective postoperative pain management to reduce opioid consumption and its associated side effects. A novel regional anaesthesia technique, the sacral erector spinae plane block, has the potential to enhance the quality of postoperative recovery significantly.</p><p><strong>Methods: </strong>This prospective, randomized, controlled multicenter study investigated the effects of the sacral erector spinae plane block on recovery quality in patients undergoing total hip arthroplasty. The study comprised 50 patients, divided into Group S (patients receiving patients receiving sacral erector spinae plane block [S-ESPB]) and Group C (patients getting just multimodal analgesia). The primary outcome measured was the Quality of Recovery-15 score 24 hours post-surgery. Secondary outcomes included postoperative numerical rating scale scores (A score of 0 indicates no pain, while 10 indicates the most severe pain), total consumption of rescue analgesics, time to first rescue analgesic administration, patient satisfaction, time to first ambulation, the occurrence of complications, and the need for antiemetics.</p><p><strong>Results: </strong>Group S had markedly higher quality of recovery-15 scores compared to Group C (Group S: median 117 percentiles [97-121]; Group C: median 89 percentiles [75-96]; P<0.001). Group S scored higher in postoperative pain, physical comfort, support, emotional state, and general quality of recovery-15 (P<0.001). Nevertheless, the physical independence category ratings were comparable across both groups (P=0.286).</p><p><strong>Conclusions: </strong>Sacral erector spinae plane block is a promising analgesic technique that enhances postoperative recovery and patient comfort in total hip arthroplasty.</p>","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":"278-285"},"PeriodicalIF":2.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569060","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":"Ultrasonography versus conventional palpation for epidural analgesia in pediatrics undergoing midabdominal urological operations: a randomized clinical trial.","authors":"Mohamed A Tolba, Mohammed Abaalkhayl, Ahmed A Shabaan, Sameh M El-Sherbiny, Maha A Abo-Zeid","doi":"10.23736/S0375-9393.24.18414-3","DOIUrl":"10.23736/S0375-9393.24.18414-3","url":null,"abstract":"<p><strong>Background: </strong>Epidural block may be facilitated by ultrasound (US), particularly in pediatrics. Our goal was to compare pre-procedural US with traditional palpation for epidural block in pediatrics undergoing midabdominal urological procedures.</p><p><strong>Methods: </strong>A total of 110 patients (one to 12 years of age) with physical status Class I and II were enrolled in this study. Patients were randomly assigned to two equal groups (US and palpation; 55 subjects in each group) using the permuted block randomization method with randomly selected block sizes of four and six. Study subjects and outcomes evaluators were blinded to the study group. The primary outcome was the rate of successful epidural block at the first needle pass.</p><p><strong>Results: </strong>There was a significant increase in success rate of the epidural block at the first needle pass in US group compared with the palpation group, 80% and 47.3% respectively, 95% Confidence Interval (2.379-8.35), P value ˂0.001. The epidural space detection time was significantly shorter in the US group compared to the palpation group. No procedural complications (unintentional vascular puncture and epidural puncture) occurred in the two groups.</p><p><strong>Conclusions: </strong>Preprocedural US facilitated epidural block in pediatrics undergoing mid-abdominal urological operations compared with conventional techniques.</p>","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":"296-305"},"PeriodicalIF":2.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716770","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 tension capnothorax on respiratory mechanics and individualized PEEP during robotic-assisted thoracic surgery: a prospective pilot observational study.","authors":"Álvaro Buñuel, Ricard Navarro-Ripoll, Stefano Italiano, Manuel López-Baamonde, Enric Barbeta, Robert Gatherer, Carlos Ferrando","doi":"10.23736/S0375-9393.24.18632-4","DOIUrl":"https://doi.org/10.23736/S0375-9393.24.18632-4","url":null,"abstract":"<p><strong>Background: </strong>Tension capnothorax during robotic-assisted thoracic surgery (RATS) might promote intraoperative atelectasis, which predisposes to ventilation-induced lung injury (VILI). Lung-protective mechanical ventilation including recruitment maneuver (RM) and individualized positive-end expiratory pressure (iPEEP) minimizes VILI. This study examines the effects of capnothorax on respiratory mechanics (respiratory system compliance, Crs), and the potential differences in the iPEEP before-and-after capnothorax.</p><p><strong>Methods: </strong>This is a prospective, observational pilot study enrolling patients scheduled for RATS using continuous tension capnothorax. The effects of capnothorax were analyzed with respiratory mechanics and volumetric capnography at different time points. The primary outcome were differences in Crs just before-and-after capnothorax. We also tested the iPEEP before-and-after capnothorax. After a RM, a PEEP titration trial was used to indentify the iPEEP.</p><p><strong>Results: </strong>A total of 30 patients were included in the analysis. The application of capnothorax significantly impaired respiratory system mechanics, as shown by a decreased in Crs from 40 (7) to 21 (8) mL/cmH<inf>2</inf>O, P<0.001) and an increase in driving pressure (DP) from 8 (3) to 16 (5) cmH<inf>2</inf>O, P<0.001. A non-significantly increase was shown for dead spaces. RM + iPEEP significantly improved Crs from 21 (8) to 43 (8) mL/cmH<inf>2</inf>O and DP from 16 (5) to 8 (2) cmH<inf>2</inf>O (P<0.001). iPEEP before capnothorax was 6 (2) cmH<inf>2</inf>O, which increased to 12 (4) cmH<inf>2</inf>O, P<0.001 after it.</p><p><strong>Conclusions: </strong>Tension capnothorax during RATS impairs respiratory system mechanics and increases iPEEP requirements to maintain an open-lung condition. Individualized PEEP after CO<inf>2</inf> insufflation restores respiratory system mechanics and alveolar dead space.</p>","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753482","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 perioperative analgesia in hip fractures surgery: quadro-iliac plane block.","authors":"Francesco Marrone, Tommaso Sorrentino, Carmine Pullano, Serkan Tulgar","doi":"10.23736/S0375-9393.25.18801-9","DOIUrl":"https://doi.org/10.23736/S0375-9393.25.18801-9","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143720524","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":"Peripheral nerve block for acute limb ischemia related to shock in critical care settings: report of a preliminary experience.","authors":"Sylvain Diop, Camille Wirth, Jacques Thes, Olaf Mercier, Maïra Gaillard, François Stephan, Thibaut Genty","doi":"10.23736/S0375-9393.25.18916-5","DOIUrl":"https://doi.org/10.23736/S0375-9393.25.18916-5","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143720534","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":"Robotic thoracic surgery: clear benefits, hidden harms.","authors":"Alberto Fogagnolo, Savino Spadaro","doi":"10.23736/S0375-9393.25.18931-1","DOIUrl":"https://doi.org/10.23736/S0375-9393.25.18931-1","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143720537","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":"Comparison of safety and efficacy of commonly used sedatives in bronchoscopy examination: a Bayesian network meta-analysis of randomized controlled trials.","authors":"Weiying Chen, Feng Chen, Xiaodan Luo, Dongmei Li, Hong Li, Fuhai Bai","doi":"10.23736/S0375-9393.24.18426-X","DOIUrl":"https://doi.org/10.23736/S0375-9393.24.18426-X","url":null,"abstract":"<p><strong>Introduction: </strong>Propofol, dexmedetomidine, midazolam, and remimazolam are widely used for sedation during bronchoscopy. The purpose of this network meta-analysis was to compare the safety and efficacy of these four sedative drugs for bronchoscopy.</p><p><strong>Evidence acquisition: </strong>PubMed, Embase, Cochrane Libary, and Wed of Science databases were systematically searched to collect randomized controlled trials (RCTs) of propofol, dexmedetomidine, midazolam, and remimazolam for bronchoscopy from the inception of the database to December 25, 2023. The search strategy we used was (sedative subject terms or sedative free terms) AND (bronchoscopy subject terms or bronchoscopy free terms), without language restrictions. The included studies were randomized controlled trials. Two authors independently searched the databases, selected studies, and extracted data.</p><p><strong>Evidence synthesis: </strong>Eleven RCTs and 1,076 patients were finally included. The results showed that in terms of hypoxemia, compared to midazolam (RR=0.156, 95% CI [0.031, 0.677]), placebo (RR=1.109, 95% Cl [0.014, 0.977]), propofol (RR=0.112, 95% Cl [0.021, 0.553]), and remimazolam (RR=0.104, 95% Cl [0.012, 0.991]), dexmedetomidine significantly reduced the occurrence of hypoxemia (P<0.05). A surface under the cumulative ranking curve (SUCRA) value indicated a higher ranking of a treatment plan, suggesting that the treatment plan is more advantageous. In terms of hypoxemia, the SUCRA ranking was as follows: dexmedetomidine (98%) > midazolam (57%) > placebo (33%) > remimazolam (32%) > propofol (30%). In terms of arrhythmia, the SUCRA ranking was as follows: dexmedetomidine (89%) > placebo (44%) > remimazolam (42%) > midazolam (40%) > propofol (35%). In terms of bronchoscopy time, the SUCRA ranking was as follows: propofol (68%) > remimazolam (67%) > midazolam (66%) > dexmedetomidine (37%) > placebo (12%).</p><p><strong>Conclusions: </strong>Compared to midazolam, remimazolam, and propofol, dexmedetomidine significantly reduced the occurrence of hypoxemia and arrhythmia during bronchoscopy. Additionally, bronchoscopy procedures performed under propofol sedation exhibited the shortest operating time.</p>","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657786","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":"https://doi.org/10.23736/S0375-9393.25.18964-5","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-19","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":"Tailoring postoperative physiologic monitoring: lessons learned from hypoxaemia monitoring after bariatric surgery in patients with obstructive sleep apnoea.","authors":"Andrea DE Gasperi","doi":"10.23736/S0375-9393.25.18928-1","DOIUrl":"https://doi.org/10.23736/S0375-9393.25.18928-1","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625021","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}