Minerva anestesiologica最新文献

{"title":"Efficacy of dexmedetomidine as a proficient measure to prevent emergence delirium among children undergoing invasive cardiac catheterization.","authors":"Sandeep Dey","doi":"10.23736/S0375-9393.25.18845-7","DOIUrl":"10.23736/S0375-9393.25.18845-7","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":"126-128"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143409061","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 estazolam plus remimazolam on attenuating preoperative anxiety and remifentanil-induced postoperative hyperalgesia in elective gynecological laparoscopic surgery: a randomized clinical trial.","authors":"Yu Huang, Rui-Jia Gao, Shi-Meng Mao, Jin-Liang Yao, Hong-Yan He, Ying Wang, Ji-Ying Feng","doi":"10.23736/S0375-9393.24.18563-X","DOIUrl":"10.23736/S0375-9393.24.18563-X","url":null,"abstract":"<p><strong>Background: </strong>Preoperative anxiety is closely related to opioid-induced hyperalgesia, and high levels of preoperative anxiety have the potential to aggravate opioid-induced hyperalgesia. We aimed to estimate the effect of estazolam, remimazolam, and their combination on preoperative anxiety and opioid-induced hyperalgesia in patients undergoing elective gynecological laparoscopic surgery.</p><p><strong>Methods: </strong>We carried out a randomized, double-blind, placebo-controlled experiment between October 2020 and April 2021. Starting on 9, October 2020,a total of 108 patients were split into four groups: (1 mg estazolam or starch was taken orally on the evening before surgery; 0.1 mg/kg remimazolam or normal saline was administered intravenously after entering the operating room) Group E received estazolam and normal saline; Group R received starch and remimazolam; participants in Group ER were given not only estazolam but also remimazolam; participants in Group C were given starch and normal saline. We recorded pain intensity at rest at 24 hours postoperatively as the primary outcome and measured pain intensity, sufentanil consumption, and adverse events within 72 hours postoperatively.</p><p><strong>Results: </strong>The mean anxiety scores were significantly lower in Groups E, R, and ER than in Group C before surgery. Compared with Group C, mean pain scores were significantly lower in Group ER at 0.5, 1, 4, 8, 24, 48, and 72 hours after surgery and lower in Groups R or E at 4, 8, and 24 hours after surgery. The mean pain scores in Group E (at 8 and 24 hours postoperatively) and Group R (at 8 hours postoperatively) were both significantly higher than those in Group ER. Moreover, the mean cumulative sufentanil consumption was significantly lower in Group ER at 0.5, 1, 4, 8, 24, 48, and 72 hours after surgery and lower in Groups E or R at 0.5 hours after surgery, compared with Group C.</p><p><strong>Conclusions: </strong>The preoperative application of estazolam, remimazolam, and their combination can relieve preoperative anxiety and postoperative pain for patients undergoing gynecological laparoscopic surgery. Moreover, the preoperative combination can also significantly reduce postoperative sufentanil consumption.</p>","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":"164-175"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256132","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":"Effects of high vs. low perioperative inspired oxygen fraction on length of hospital stay and postoperative complications: a systematic review, meta-analysis, and trial sequential analysis.","authors":"Mimi Wu, Lanlan Chang, Leying Sun, Zhao Dai, Jinhua Bo, Xin Xu","doi":"10.23736/S0375-9393.25.18649-5","DOIUrl":"https://doi.org/10.23736/S0375-9393.25.18649-5","url":null,"abstract":"<p><strong>Introduction: </strong>Prolonged length of hospital stay (LOS) and postoperative complications in surgical patients are major public health issues worldwide. Perioperative hyperoxia may increase LOS, and the incidence of cardiac, cerebral, renal, and pulmonary injury; however, the supporting clinical evidence is controversial. Therefore, the current meta-analysis included all relevant randomized controlled trials (RCTs) to investigate the effect of high and low inspired oxygen fraction (FiO<inf>2</inf>) on LOS, according to postoperative complications.</p><p><strong>Evidence acquisition: </strong>Standard published RCTs were searched from bibliographic databases to identify all evidence reporting perioperative FiO<inf>2</inf> for patients undergoing surgeries. The primary outcome was LOS, and the secondary outcomes were postoperative organ complications, surgical site infection (SSI), and postoperative mortality. The relative risk (RR) and Peto-odds ratio (Peto-OR) for dichotomous outcomes and the mean difference (MD) and standardized mean difference (SMD) for continuous outcomes were estimated using a random-effects model. Trial sequential analysis (TSA) was performed in the meta-analysis to evaluate the required information sizes and assess whether the primary outcome in our meta-analysis was conclusive.</p><p><strong>Evidence synthesis: </strong>Thirty-one RCTs with 10506 participants undergoing different surgeries were included. The LOS in the high FiO<inf>2</inf> group did not differ significantly from that in the low FiO<inf>2</inf> group (MD -0.01, 95% CI -0.10 to 0.08, P=0.81). Moreover, we found no meaningful evidence of subgroup differences in the primary outcome, in comparisons of FiO<inf>2</inf>, RCT type, surgery type, duration of oxygen inhalation or timing of oxygen inhalation. TSA results further suggested that the number of included studies was sufficient for the primary outcome. There was also no significant difference in postoperative organ complications (cardiac, cerebral, renal, and pulmonary), SSI (rate of SSI, ASEPSIS score, and ASEPSIS score > 20 cases), or postoperative mortality. For postoperative atelectasis, sensitivity analysis showed that after exclusion of one study, \"Myles 2007,\" high FiO<inf>2</inf> was associated with increased postoperative atelectasis.</p><p><strong>Conclusions: </strong>The use of low FiO<inf>2</inf> has no effect on LOS, or the incidence of cardiac, cerebral, and renal injury or postoperative mortality. Compared with low FiO<inf>2</inf>, high FiO<inf>2</inf> did not reduce SSI which was contrary to the guidelines. Meanwhile, high FiO<inf>2</inf> may increase postoperative atelectasis in surgical patients.</p>","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":"91 3","pages":"201-213"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029222","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":"Remimazolam: back to the future.","authors":"Stefano Romagnoli, Alessandro Di Filippo","doi":"10.23736/S0375-9393.24.18665-8","DOIUrl":"https://doi.org/10.23736/S0375-9393.24.18665-8","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":"91 3","pages":"136-138"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144017489","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":"Can estazolam plus remimazolam as an anxiolytic reduce remifentanil-induced postoperative hyperalgesia?","authors":"Ahmet Eroglu","doi":"10.23736/S0375-9393.24.18758-5","DOIUrl":"10.23736/S0375-9393.24.18758-5","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":"129-131"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143066703","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":"Analgesic efficacy of ultrasound-guided rhomboid intercostal block versus serratus plane block in modified radical mastectomy: a prospective randomized controlled study.","authors":"Dina H Alhassanin, Amr A Elbadry, Hoda A Ezz, Naglaa K Mohamed","doi":"10.23736/S0375-9393.24.18334-4","DOIUrl":"10.23736/S0375-9393.24.18334-4","url":null,"abstract":"<p><strong>Background: </strong>This research aimed to assess the analgesic efficacy of ultrasound-guided rhomboid intercostal block (RIB) or serratus plane block (SPB) versus IV opioid among modified radical mastectomy (MRM) patients.</p><p><strong>Methods: </strong>One hundred and five female patients aged 18-65 years with American Society of Anesthesiologists (ASA) physical status II-III scheduled for unilateral MRM were randomly allocated into three equal groups: 1) control group (received IV basal analgesia); 2) SPB group (received ipsilateral SPB); and 3) RIB group (received ipsilateral RIB).</p><p><strong>Results: </strong>Visual Analogue Scale (VAS) was significantly increased in control group compared to SPB group at Post-Anesthesia Care Unit (PACU) (1 [1-2], 0 [0-1]), 2 h (4 [3-4], 0 [0-1]), and 4 h (3 [3-4], 2 [1-2]) postoperative in control and SPB groups, respectively; and in comparison with RIB group at PACU (0 [0-1]), 2 h (1 [0-1]), 4 h, (1 [1-2]), 6 h (1 [1-2]), and 8 h (2 [1-2]), postoperative. VAS was significantly increased in SPB group at 6 h (4 [3-4]), and 8 h (4 [3.25-4]), compared to RIB group with P<0.0001. Time of first analgesic requirement (minutes) was significantly delayed in RIB (720 [480-720]) and SPB (360 [360-360]) groups in comparison with control group (60 [60-120]) and in RIB group in comparison with SPB group. The total postoperative 24 h morphine consumption (mg) was significantly increased in control group (15.69±1.64) when compared to SPB (9.6±1.42) and RIB (6.51±1.36) groups and in SPB group when compared to RIB group.</p><p><strong>Conclusions: </strong>Both rhomboid intercostal and serratus anterior plane blocks were efficient for analgesia after modified radical mastectomy. However, RIB had better analgesic efficacy compared to SPB.</p>","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":"155-163"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716609","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":"Uncontrolled donation after circulatory death and the Tuscany example: a call to action for Italian regions to strive for better outcomes.","authors":"Luigi Vetrugno, Enrico Boero","doi":"10.23736/S0375-9393.25.18873-1","DOIUrl":"https://doi.org/10.23736/S0375-9393.25.18873-1","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":"91 3","pages":"132-135"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144033396","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":"147-154"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","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":"Centralized monitored anesthesia care by nurse anesthetist for cataract and glaucoma surgery in a 1:3 ratio: a non-inferiority study.","authors":"Simon Clariot, Jean-Marie Moures, Lucia Lopes, Damien Gatinel, Eric Gabison, Georges Nicolaos, Laurence Salomon, Jean-Michel Devys","doi":"10.23736/S0375-9393.24.18455-6","DOIUrl":"10.23736/S0375-9393.24.18455-6","url":null,"abstract":"<p><strong>Background: </strong>Minor Ophthalmic Procedures (MOP), especially cataract or glaucoma surgery, are considered low risk. However, in France, anesthesia must be monitored continuously and carried out by an anesthetist or a nurse anesthetist (NA). The aim was to assess whether an externalized monitored anesthesia care (MAC) would be non-inferior to an individual MAC inside the OR regarding the incidence of severe hypertension, bradycardia, hypoxemia, and surgeon satisfaction.</p><p><strong>Methods: </strong>We performed a monocentric randomized, non-inferiority trial. Adults undergoing MOP with topical or locoregional anesthesia were randomly assigned to externalized MAC (the NA monitored simultaneously up to 3 patients with a screen monitor repeating the inside monitor) or inside MAC. The primary endpoint was a composite of per-operative complications defined as a blood pressure >200 mmHg, pulse rate <45/min, pulse oximetry <85%, or surgeon satisfaction regarding patient security <3/10. Secondary endpoints included patient and surgeons' overall satisfaction, re-operation within 24 hours, and nurses' overall satisfaction.</p><p><strong>Results: </strong>A total of 900 patients were enrolled (450 in both groups). The externalized MAC was non-inferior to inside MAC as event occurred in 29 patients (6.4%) and 26 patients (5.8%), respectively (adjusted difference - 0.7%). Patient agitation assessed by the surgeon was lower with the inside MAC (adjusted mean difference -0.33; 95%CI -0.61 to -0.04).</p><p><strong>Conclusions: </strong>Among patients undergoing MOP with topical or locoregional anesthesia, an externalized MAC strategy with a 1:3 NA-to-patient ratio were non-inferior to an inside monitoring on the incidence of severe hypertension, bradycardia, hypoxemia and surgeon satisfaction regarding patient safety.</p>","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":"176-183"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142770646","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":"Why the fascial blocks have to become dynamic.","authors":"Pierfrancesco Fusco, Emanuele Nazzarro","doi":"10.23736/S0375-9393.25.18886-X","DOIUrl":"https://doi.org/10.23736/S0375-9393.25.18886-X","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":"91 3","pages":"123-125"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003947","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}