Minerva anestesiologica最新文献

{"title":"Predicting surgical anesthesia for shoulder surgery: a sensorimotor scale for shoulder blocks.","authors":"Julián Aliste, Daniela Bravo, Sebastián Layera, Germán Aguilera, Hans Erpel, Álvaro Jara, Diego Mora, De Q Tran","doi":"10.23736/S0375-9393.25.19031-7","DOIUrl":"10.23736/S0375-9393.25.19031-7","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":"860-862"},"PeriodicalIF":2.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144002550","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":"Sevoflurane sedation as an alternative for awake fiberoptic intubation in difficult airway patients: a randomized controlled trial.","authors":"Marwa A Abogabal, Mohamed Z Wfa, Laila A El-Ahwal","doi":"10.23736/S0375-9393.25.18997-9","DOIUrl":"10.23736/S0375-9393.25.18997-9","url":null,"abstract":"<p><strong>Background: </strong>Fiberoptic intubation is recommended for difficult airways, but traditional awake techniques can cause patient discomfort. This study compared sevoflurane sedation to conventional awake fiberoptic intubation (AFOI) in difficult airway patients.</p><p><strong>Methods: </strong>Seventy participants with difficult airways were involved in an open label randomized controlled trail. Patients were randomized to undergo fiberoptic intubation under either sevoflurane sedation with 2% with a gradual increase in concentration while maintaining spontaneous breathing (group I) or AFOI with airway nerve blocks with bilateral superior laryngeal nerve blocks and transtracheal instillation using 2% plain lidocaine (2 ml each) (group II).</p><p><strong>Results: </strong>Group I had a substantially reduced intubation time (4.51±1.09 vs. 6.74±1.09 minutes, P<0.001). Group I showed better hemodynamic stability and superior intubation scores, with less coughing (P=0.003) and limb movement (P<0.001). Patient comfort was higher in group I than in group II (74.29 vs. 31.43%, P=0.021). Group I had higher patient satisfaction, 91.43% vs. 68.57% in group II (P=0.034) and fewer complications, including airway obstruction (40% vs. 71.43%, P=0.008) and cough (25.71% vs. 62.86%, P=0.002).</p><p><strong>Conclusions: </strong>Sevoflurane sedation appears to be an effective alternative to AFOI in difficult airway patients, offering shorter intubation times, improved hemodynamic stability, better intubation conditions, and higher patient satisfaction.</p>","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":"757-765"},"PeriodicalIF":2.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675265","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":"Association between intraoperative end tidal carbon dioxide levels and postoperative nausea and vomiting: a systematic review and meta-analysis.","authors":"Thrivikrama P Tantry, Shraddha Nuliyalu, Madhura Rao, Neha Aras, Harish Karanth, Madhusudan Upadya, Dinesh Kadam","doi":"10.23736/S0375-9393.25.18941-4","DOIUrl":"https://doi.org/10.23736/S0375-9393.25.18941-4","url":null,"abstract":"<p><strong>Introduction: </strong>The relationship between intraoperative end-tidal carbon dioxide (EtCO<inf>2</inf>) levels and postoperative nausea and vomiting (PONV) has gained research interest. This meta-analysis aims to elucidate the relationship between intraoperative EtCO<inf>2</inf> levels and PONV incidence through a systematic review and synthesis of available evidence, thereby addressing the existing knowledge gap in the perioperative care.</p><p><strong>Evidence acquisition: </strong>We conducted a meta-analysis of randomized controlled trials (RCTs) to investigate this association, examining PONV incidence, nausea scores, and rescue antiemetic use. Our analysis included 10 RCTs (N.=1860), comparing EtCO<inf>2</inf> levels of <35 vs. ≥35 mmHg and <40 vs. ≥40 mmHg. In the random-effects statistical models, pooled risk/odds ratios (RR/ORs) or mean differences (MDs), 95%CIs, and P values were estimated for endpoints.</p><p><strong>Evidence synthesis: </strong>In the first comparison (seven trials, N.=475), the RR for PONV incidence with higher EtCO<inf>2</inf> (≥35 mmHg) was 0.80 (95%CI, 0.35-1.84, P=0.60, I²=72%). In the second, (six trials, N.=1639), the RR for PONV with higher EtCO<inf>2</inf> (≥40 mmHg) was 0.82 (95% CI, 0.67-1.00, P=0.051, I²=0%). For other outcomes, nausea scores with high EtCO<inf>2</inf> (≥40 mmHg) showed a MD of 0.94 (95%CI: -1.55-3.43, P=0.46, N.=456). Rescue antiemetic use showed no significant reduction with hypercapnia (OR, 0.48, 95%CI: 0.21-1.06, P=0.07, N.=548). Meta-regression analysis revealed no significant associations between PONV incidence and predictors including age, BMI, laparoscopic surgery, female gender, surgery duration, and intraoperative EtCO<inf>2</inf> values (for EtCO<inf>2</inf>, meta-regression P=0.278).</p><p><strong>Conclusions: </strong>The analysis does not provide strong evidence that EtCO<inf>2</inf> levels are a key factor in influencing PONV incidence, even when the available covariates or the factors examined. Further large-scale, well-designed studies are needed to clarify this relationship and explore potential interactions with other PONV risk factors.</p>","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":"91 9","pages":"817-827"},"PeriodicalIF":2.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113562","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 midpoint-transverse process to pleura block for lipoma excision in a two-year-old child.","authors":"Volkan Özen, Engin I Turan, Bahadır Çiftçi, Hicret S Kaya, Ayça S Şahin","doi":"10.23736/S0375-9393.25.19419-4","DOIUrl":"https://doi.org/10.23736/S0375-9393.25.19419-4","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144794892","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":"Respectful engagement as moral duty: reply to Mazzon et al.","authors":"Enrico Furlan, Alberto Giannini","doi":"10.23736/S0375-9393.25.19386-3","DOIUrl":"https://doi.org/10.23736/S0375-9393.25.19386-3","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144784654","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":"Continuous fascia iliaca compartment block for therapy-resistant postoperative joint stiffness of the knee.","authors":"Ergun Mendes, Melih Civan","doi":"10.23736/S0375-9393.25.19370-X","DOIUrl":"https://doi.org/10.23736/S0375-9393.25.19370-X","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144784652","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 between the ultrasound guided pericapsular nerve group block and anterior quadratus lumborum block in elderly patients undergoing total hip replacement surgeries: a randomized controlled clinical trial.","authors":"Ahmed Elshall, Osama Asaad, Bassant M Abdelhamid, Alaa F Abd Elbadei, Mohamed A Ollaek","doi":"10.23736/S0375-9393.25.18883-4","DOIUrl":"https://doi.org/10.23736/S0375-9393.25.18883-4","url":null,"abstract":"<p><strong>Background: </strong>To compare the safety and efficacy of ultrasound-guided pericapsular nerve group (PENG) block and anterior quadratus lumborum block (AQLB) in elderly patients undergoing total hip arthroplasty (THA).</p><p><strong>Methods: </strong>This randomized, controlled trial included 93 patients aged 65 years or older with traumatic hip fractures, scheduled for elective unilateral THA under general anesthesia. Patients were randomized into three groups: PENG group (N.=31), AQLB group (N.=31), and a control group (N.=31), which received only opioid analgesia. The primary outcome was total morphine consumption within the first 24 hours postoperatively. Secondary outcomes included intraoperative fentanyl use, time to first rescue analgesia, block failure rate, pain scores at rest and during movement, motor recovery (muscle strength and hip flexion), time to first ambulation, and length of hospital stay. Additional assessments involved intraoperative hemodynamic monitoring, block-related and morphine-related complications, as well as block performance time and duration of surgery.</p><p><strong>Results: </strong>The AQLB group showed the least total morphine consumption (median 6.0 mg), followed by the PENG group (median 8.0 mg), with a significant difference between the two groups (P=0.035). Both PENG and AQLB groups showed a significantly lower total morphine consumption than the control group (median=12.0 mg). The Numeric Pain Rating Scale at rest showed significant differences between \"AQLB versus Control\" till 4 hours postoperative, and between \"PENG versus Control\" at all-time points except at 6, 8, and 18 hours. The AQLB group showed the lowest scores for the manual muscle test for the quadriceps and Iliopsoas muscles and for the range of motion with significant differences between AQLB and PENG. Furthermore, the time to first walk was significantly longer among the AQLB group (median 24 h) in comparison to the PENG group (median 8 h). The PENG displayed the shortest hospital stay period (2.13 days), followed by the control group (2.94 days), and then the AQLB group (3.16 days), with significant differences.</p><p><strong>Conclusions: </strong>While the PENG block facilitated earlier mobilization and shorter hospital stays, the AQLB offered superior analgesia and reduced opioid consumption. Both techniques proved effective, with the choice depending on clinical priorities such as pain control versus early recovery.</p>","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144784651","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":"Comparative analysis of large language models and clinician responses in patient blood management knowledge.","authors":"Felix Tran, Patrick Meybohm, Lea V Blum, Vanessa Neef, Jan A Kloka, Florian Rumpf, Tobias E Haas, Sebastian Hottenrott, Philipp Helmer, Peter Kranke, Benedikt Schmid, Denana Mehic, Kai Zacharowski, Suma Choorapoikayil","doi":"10.23736/S0375-9393.25.19014-7","DOIUrl":"https://doi.org/10.23736/S0375-9393.25.19014-7","url":null,"abstract":"<p><strong>Background: </strong>Large language models (LLMs) are increasingly used in the medical field and have the potential to reduce workload and improve treatment procedures in clinical practice. This study evaluates the capabilities of LLMs to answer common questions related to patient blood management (PBM) and compares their performance to the expertise of clinicians from two university hospitals.</p><p><strong>Methods: </strong>To evaluate the performance of ChatGPT-3.5, ChatGPT-4o, and Google Gemini in answering PBM-related questions, we used a representative sample of 40 questions (30 single-choice and 10 frequently asked patient questions) and compared their responses to those of clinicians. The accuracy and interrater reliability of the answers were analyzed.</p><p><strong>Results: </strong>For PBM knowledge-based questions, the proportion of correct answers was 96.4% (95% CI: 93.6-98.0%) for ChatGPT-4o, 81.3% (95% CI: 77.0-85.7%) for ChatGPT-3.5, and 84.0% (95% CI: 79.4-87.7%) for Google Gemini. Clinicians (N.=82) provided correct answers to 76.5% (95% CI: 74.7-78.1%) of the questions. For frequently asked patient questions, the proportion of correct answers was 100% for ChatGPT-4o, 95.5% (95% CI: 91.4-99.6%) for ChatGPT-3.5 and 91.7% (95% CI: 86.0-97.4%) for Google Gemini. Clinicians provided correct answers to 62.0% (95% CI: 58.7-65.3%) of the questions. Across the categories -anemia management, iron supplementation, cell salvage, principles of PBM, and blood transfusion- ChatGPT-4o achieved the highest scores, providing the most correct answers.</p><p><strong>Conclusions: </strong>LLMs show strong potential for delivering accurate and comprehensive responses to common PBM-related questions. However, it remains essential for clinicians and patients to verify responses, particularly in critical situations.</p>","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144784650","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":"Post-extubation pulmonary edema following laparoscopic appendicectomy in a young patient.","authors":"Pasquale Rinaldi, Martina Mariani, Simone Alfieri, Romolo Villani, Maria Notaro","doi":"10.23736/S0375-9393.25.19347-4","DOIUrl":"https://doi.org/10.23736/S0375-9393.25.19347-4","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144784653","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 subtransverse interligamentary plane block in a pediatric patient undergoing dorsal mass excision.","authors":"Volkan Özen, Engin I Turan, Bahadir Çiftçi, Selçuk Alver, Betül Gözübüyük, Ayça S Şahin","doi":"10.23736/S0375-9393.25.19389-9","DOIUrl":"https://doi.org/10.23736/S0375-9393.25.19389-9","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144760509","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}