Minerva anestesiologica最新文献

{"title":"Efficacy of percutaneous cryoneurolysis for pain management of rib fractures.","authors":"Van S Smith Iii, Se Y Cheon, Jade A Tom Yew, Aiden B DE Witt, Shahab Ahmadzadeh, Sam N Amarasinghe, Jibin Mathew, Sahar Shekoohi, Alaa Abd-Elsayed, Alan D Kaye","doi":"10.23736/S0375-9393.26.19686-2","DOIUrl":"10.23736/S0375-9393.26.19686-2","url":null,"abstract":"<p><p>Rib fractures are a common injury with several etiologies. Various techniques for managing pain with rib fractures have evolved over the past few decades. Pain control is key in reducing further complications of this traumatic injury. In this regard, cryoneurolysis is a form of interventional pain management that involves applying freezing temperatures to disrupt the signaling pathways of nerves, hence reducing pain. Alternative forms of pain management, such as cryoneurolysis, are being studied to find less invasive techniques and to reduce dependence on opioids and other potentially addictive forms of analgesia. The present investigation focuses on the overall efficacy of cryoneurolysis in pain management of rib fractures. In this review, we discuss the clinical significance of rib fractures, the mechanism and outcome of cryoneurolysis, and the safety profile of cryoneurolysis in clinical treatment.</p>","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":"92 7-8","pages":"718-725"},"PeriodicalIF":3.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148562506","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 fascial plane blocks for analgesia in pregnancy.","authors":"Francesco Marrone, Simona Lolli, Saverio Paventi, Lorenza Sbucafratta, Pierfrancesco Fusco, Burhan Dost","doi":"10.23736/S0375-9393.26.19920-9","DOIUrl":"10.23736/S0375-9393.26.19920-9","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":"773-776"},"PeriodicalIF":3.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147307625","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 propofol-remifentanil target-controlled infusion with lidocaine versus neuromuscular blockade for laryngoscopy.","authors":"Zi-Yi He, Tao Huang, An-Yi Lu, Ning Wang, Gao-Feng Zhao, Min Liao","doi":"10.23736/S0375-9393.26.19549-2","DOIUrl":"10.23736/S0375-9393.26.19549-2","url":null,"abstract":"<p><strong>Background: </strong>To assess the preliminary efficacy and safety of neuromuscular blocking agent (NMBA)-free anesthesia compared with standard NMBA-based protocols during tracheal intubation and postoperative recovery in patients undergoing elective suspension laryngoscopy for vocal cord polypectomy.</p><p><strong>Methods: </strong>In this single-center pilot randomized controlled trial, 43 patients classified as American Society of Anesthesiologists physical status I-II were randomized to receive either intravenous cisatracurium (NMBA group, N.=23) or topical 2% lidocaine (NMBA-free group, N.=20). A standardized propofol-remifentanil target-controlled infusion was administered to both groups. Surgeon satisfaction with intubation conditions was evaluated as the primary outcome, while extubation time, hemodynamic stability, and perioperative complications were recorded as secondary outcomes.</p><p><strong>Results: </strong>The NMBA-free group demonstrated comparable intubation conditions (satisfaction: 100% vs. 95.7%, P=0.31) and faster recovery profiles than the NMBA group. Specifically, extubation time was reduced by 39% (15.1±3.82 vs. 24.87±9.04 minutes; 95% CI, -13.99 to -5.55 minutes; P<0.001), and time to post-anesthesia care unit discharge decreased by 27% (33.35±7.20 vs. 45.57±13.10 minutes; 95% CI, -18.66 to -5.78 minutes; P<0.001). No laryngospasm or major complications occurred. The NMBA-free approach also provided better hemodynamic stability, as indicated by differences in mean arterial pressure (P=0.012), peripheral oxygen saturation (P=0.048), and heart rate variability (P=0.004).</p><p><strong>Conclusions: </strong>This exploratory trial provides preliminary evidence that propofol-remifentanil TCI combined with topical lidocaine enables safe NMBA-free anesthesia for brief suspension laryngoscopy, with recovery outcomes consistent with enhanced recovery after surgery principles.</p>","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":"672-682"},"PeriodicalIF":3.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148211815","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":"Early initiation of extracorporeal membrane oxygenation to prevent grey matter loss in severe acute respiratory distress syndrome.","authors":"Tomasz Czarnik, Ryszard Gawda","doi":"10.23736/S0375-9393.26.20252-3","DOIUrl":"10.23736/S0375-9393.26.20252-3","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":"92 7-8","pages":"659-661"},"PeriodicalIF":3.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148562525","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":"Early intraperitoneal ropivacaine for acute pain relief after ambulatory laparoscopic cholecystectomy: a randomized controlled trial.","authors":"Benjamin Javillier, Mehdi Scohy, Margaux Mestdag, Simon Lacroix, Raphaël Rubay, Nicolas Terwagne, Frédéric Pierard, Eric Deflandre","doi":"10.23736/S0375-9393.25.19652-1","DOIUrl":"10.23736/S0375-9393.25.19652-1","url":null,"abstract":"<p><strong>Background: </strong>Intraperitoneal local anesthetic may reduce early postoperative pain after laparoscopic surgery, but evidence in ambulatory settings is inconsistent.</p><p><strong>Methods: </strong>Prospective, randomized, double-blind, placebo-controlled trial including 113 adults undergoing ambulatory laparoscopic cholecystectomy. After pneumoperitoneum and before surgical manipulation, patients received 20 mL 0.25% ropivacaine or saline intraperitoneally. Primary outcomes - VAS pain at 0, 4, 6, 12 h and opioid use in the recovery room. Pain was analyzed with a linear mixed-effects model. Chronic pain was assessed at three and six months.</p><p><strong>Results: </strong>Ropivacaine lowered VAS at 0 h (3.1±2.4 vs. 5.1±2.6), 4 h (1.5±1.8 vs. 2.8±2.3) and 6 h (1.7±1.7 vs. 3.5±2.6; all P<0.001). Group×time interaction was significant (P=0.008). Opioid consumption was reduced (mean difference -3.3 mg piritramide; 95% CI -5.0 to -1.6; P<0.001). No difference at 12 h or in chronic pain at three-six months; no serious adverse events.</p><p><strong>Conclusions: </strong>Early intraperitoneal ropivacaine improves immediate postoperative analgesia and reduces opioids after ambulatory laparoscopic cholecystectomy. It is a simple, safe adjunct to multimodal analgesia.</p>","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":"692-697"},"PeriodicalIF":3.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147468439","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 adding phenylephrine infusion to goal-directed fluid therapy on postoperative quality of recovery in elderly patients undergoing laparoscopic gastrointestinal surgery: a randomized controlled trial.","authors":"Xiangwen Lu, Xinyang Xiong, Na Zhang, Lei Shen, Dunyi Qi","doi":"10.23736/S0375-9393.26.19696-5","DOIUrl":"10.23736/S0375-9393.26.19696-5","url":null,"abstract":"<p><strong>Background: </strong>Goal-directed fluid therapy (GDFT) guided by pulse pressure variation (PPV) is an established strategy to optimize perioperative fluid management in elderly surgical patients. However, its efficacy may be limited by age-related decline in vascular compliance. This study aimed to investigate whether supplementing PPV-guided GDFT with a continuous low-dose phenylephrine infusion could improve the quality of postoperative recovery in this population.</p><p><strong>Methods: </strong>Ninety-four elderly patients scheduled for elective laparoscopic gastrointestinal surgery were randomized to either PPV-guided GDFT with phenylephrine (GP group, N.=46) or GDFT alone (G group, N.=48). Following anesthesia induction, the GP group received a continuous phenylephrine infusion (0.2~0.25 μg/kg/min), while the G group received normal saline at an equivalent rate. Both groups used a PPV threshold of ≥13% to guide fluid administration. The primary outcome was the 24-hour postoperative QoR-15 score. Secondary outcomes included QoR-15 scores at 48 hours and seven days, intraoperative variables, recovery markers, and laboratory results.</p><p><strong>Results: </strong>Baseline characteristics showed no statistical differences between G group and GP group (P>0.05).GP group demonstrated notably higher 24-h (103.46±4.17 vs. 93.10±2.90) and 48-h (117.00±3.43 vs. 108.08±3.04) QoR-15 total scores, along with superior performance in multiple subitems (P<0.001). Additionally, GP group received less intraoperative fluid (1825 [1550.0-2250.0] vs. 2250 [1862.5-2500.0] mL, P=0.002) and exhibited shorter time to first flatus (38.3±6.0 vs. 59.0±12.5 h) and hospital stay (14.2±2.7 vs. 17.0±4.4 d), with all these differences statistically significant (P<0.001). No disparities were observed in renal parameters, lactate levels, or postoperative complications (P>0.05).</p><p><strong>Conclusions: </strong>For elderly laparoscopic gastrointestinal surgery patients, PPV-guided GDFT combined with phenylephrine improved early recovery, accelerated gastrointestinal function, shortened hospital stay, without added circulatory or renal risks.</p>","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":"662-671"},"PeriodicalIF":3.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147775988","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":"Highlights from the July-August 2026 issue.","authors":"Franco Cavaliere","doi":"10.23736/S0375-9393.26.20466-2","DOIUrl":"https://doi.org/10.23736/S0375-9393.26.20466-2","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":"92 7-8","pages":"653-655"},"PeriodicalIF":3.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148562431","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":"Early implementation of an artificial intelligence content labeling system in perioperative care: experience in the second stage of EU-AI Act implementation.","authors":"Elena G Bignami, Valentina Bellini, Michele Russo","doi":"10.23736/S0375-9393.26.19911-8","DOIUrl":"10.23736/S0375-9393.26.19911-8","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":"767-770"},"PeriodicalIF":3.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147284422","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":"Veno-venous extracorporeal membrane oxygenation for severe respiratory failure and hypothermia after cold water drowning-induced cardiac arrest.","authors":"Elena Caporossi, Elisa Bergamini Viola, Irene Tomasella, Enrico Mattiello, Marcello Ceola Graziadei, Alessandro Russo, Lorenzo Peluso, Leonardo Gottin","doi":"10.23736/S0375-9393.26.19854-X","DOIUrl":"10.23736/S0375-9393.26.19854-X","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":"762-764"},"PeriodicalIF":3.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147307677","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":"Beyond the intersection point: the \"double circle\" technique for puncture site identification in ultrasound-assisted spinal anesthesia.","authors":"Massimiliano Ricci, Giuseppe Pascarella, Francesca Gargano, Fabio Costa, Massimiliano Carassiti","doi":"10.23736/S0375-9393.26.19856-3","DOIUrl":"10.23736/S0375-9393.26.19856-3","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":"764-766"},"PeriodicalIF":3.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147378134","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}