Minerva anestesiologica最新文献

{"title":"The prognostic role of Neurologic Pupil Index in COVID-19 patients: a retrospective study.","authors":"Andrea Garone, Elisa Gouvea Bogossian, Caterina Peratoner, Andrea Minini, Giuseppina Giannì, Ernesto Migliorino, Katia Donadello, Fabio S Taccone, Lorenzo Peluso","doi":"10.23736/S0375-9393.24.18074-1","DOIUrl":"https://doi.org/10.23736/S0375-9393.24.18074-1","url":null,"abstract":"<p><strong>Background: </strong>Neurological complications have been observed in approximately 30% of hospitalized COVID-19 patients. The aim of this study was to evaluate whether early assessment of the Neurological Pupil Index (NPi^TM) derived from an automated pupillometry could predict mortality in critically ill COVID-19 patients.</p><p><strong>Methods: </strong>Retrospective cohort study of adult critically ill COVID-19 patients admitted to the intensive care unit of a University Hospital; patients without NPi measurement were excluded. The worst NPi (i.e. lowest value from one eye) was collected daily and then computed over the first five days of assessment. Mortality was assessed at hospital discharge. The secondary endpoint involved assessing differences in neurological assessments between patients who developed neurological complications and those who did not.</p><p><strong>Results: </strong>A total of 217 patients were included over the study period (median age 61 [50-68] years), 70% were males. A total of 97 patients (45%) died during the hospital stay. Among all patients, 35 (16%) experienced neurological complications. Non-survivors showed significantly a lower overall NPi (3.0 [2.0-4.1] vs. 3.4 [2.7-4.2]; P=0.04) than survivors. At multivariate logistic regression NPi was not significantly associated with in-hospital mortality. Moreover, no differences in different NPi measurements were observed between patients with and without neurological complications.</p><p><strong>Conclusions: </strong>In this study, NPi values were not independent predictor of mortality and neurological complications in critically ill COVID-19 patients.</p>","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":"90 10","pages":"892-900"},"PeriodicalIF":2.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142391734","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 hemodynamic effects of remimazolam and propofol during general anesthesia: a systematic review and meta-analysis.","authors":"Bruno M Wegner, Gustavo M Wegner, Luigi W Spagnol, Luis A Costa, Valentine W Spagnol, Daniel F Paiva","doi":"10.23736/S0375-9393.24.18041-8","DOIUrl":"10.23736/S0375-9393.24.18041-8","url":null,"abstract":"<p><strong>Introduction: </strong>The need for safe anesthetic agents with minimal side effects has led to the development of remimazolam, a new benzodiazepine designed to be an alternative to the commonly used drug propofol, which has significant hemodynamic effects. This study aims to compare the hemodynamic effects of remimazolam with propofol during general anesthesia.</p><p><strong>Evidence acquisition: </strong>A systematic search was conducted in Embase, Web of Science, Cochrane Library, Scopus, and PubMed databases on 13/02/2023, following the recommendations of Cochrane Handbook and the PRISMA statement. The measure of association used was Risk Ratio (RR) or standardized mean difference, with 95% confidence intervals (CI) and 95% Prediction intervals (PI). An additional search was conducted on 04/09/2023. A Trial Sequential Analysis and a GRADE (Grading of Recommendations Assessment, Development and Evaluation) evidence table were conducted based on the editor's recommendation.</p><p><strong>Evidence synthesis: </strong>After applying eligibility criteria and removing duplicates, 16 randomized clinical trials comprising 1951 patients were included in the meta-analysis. Significant associations favoring remimazolam over propofol were observed in the following aspects: intraoperative hypotension events (RR=0.47; 95% CI=0.41 to 0.54; 95% PI=0.40 to 0.55); frequency of vasoactive drug administration (RR=0.54; 95% CI=0.46 to 0.64; 95% PI=0.41 to 0.74); intraoperative bradycardia (RR=0.39; 95% CI=0.27 to 0.57; 95% PI=0.26 to 0.66); mean arterial pressure at induction (MD=7.77; 95% CI=6.00 to 9.55; 95% PI=4.39 to 11.15); heart rate at induction (MD=6.40; 95% CI=4.07 to 8.73; 95% PI=0.33 to 12.48); and heart rate at intubation (MD=6.06; 95% CI=2.33 to 9.78; 95% PI=-5.59 to 17.71).</p><p><strong>Conclusions: </strong>This study provides evidence that remimazolam induces fewer cardiorespiratory depressant effects and has a more favorable side effect profile compared to propofol during general anaesthesia.</p>","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":"901-911"},"PeriodicalIF":2.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141889748","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":"Is the femoral nerve affected by iliopsoas block? A cadaveric volume study.","authors":"Yunus O Atalay, Bahar Tekin, Gamze Ansen, Elif K Koc, Tumay U Yanaral, Bayram U Sakul, Haci A Alici","doi":"10.23736/S0375-9393.24.18452-0","DOIUrl":"https://doi.org/10.23736/S0375-9393.24.18452-0","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142349862","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":"Understanding opioid free anesthesia through trials: a PICO tassonomy.","authors":"Stefano Skurzak, Antonella Marzullo","doi":"10.23736/S0375-9393.24.18448-9","DOIUrl":"https://doi.org/10.23736/S0375-9393.24.18448-9","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":"90 10","pages":"839-841"},"PeriodicalIF":2.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142391735","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":"Factors affecting decision-making process in organ donation in Italy.","authors":"Francesca Leonardis, Roberto Cacciola","doi":"10.23736/S0375-9393.24.18278-8","DOIUrl":"10.23736/S0375-9393.24.18278-8","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":"842-844"},"PeriodicalIF":2.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141559118","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":"Mitochondrial abnormalities in septic cardiomyopathy.","authors":"Fang Jin, Li-Jun Liu","doi":"10.23736/S0375-9393.24.18045-5","DOIUrl":"10.23736/S0375-9393.24.18045-5","url":null,"abstract":"<p><p>Septic cardiomyopathy is a common complication in patients with sepsis, and is one of the indicators of poor prognosis. Its pathogenesis is complex, involving calcium ion imbalance in cardiomyocytes, nitric oxide (NO) synthesis disorder, mitochondrial abnormalities and immune inflammatory reaction, especially mitochondrial abnormalities. In this paper, the mechanism of mitochondrial abnormalities causing septic cardiomyopathy was discussed from the aspects of mitochondrial structure change, mitochondrial energy metabolism disorder, redox imbalance, mitochondrial calcium overload, mitochondrial biosynthesis and autophagy abnormalities.</p>","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":"922-930"},"PeriodicalIF":2.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141759738","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":"Understanding the anatomy of pelvic fascia: implications for regional anesthesia.","authors":"Peiqi Shao, Zhangran Ai, Huili Li, Ruijuan Guo, Yun Wang","doi":"10.23736/S0375-9393.24.18290-9","DOIUrl":"https://doi.org/10.23736/S0375-9393.24.18290-9","url":null,"abstract":"<p><p>The fascia, a continuous structure around the whole body across various anatomical locations, remains underexplored in regional anesthesia. The pelvic fascia is a particularly controversial and complicated anatomical structure. It holds significant relevance not only for surgeons but also in the realms of regional anesthesia and pain management. Many regional nerve blocking techniques in the pelvis are closely related to fascial anatomy, such as fascia iliaca compartment block, circum-psoas block, inferior hypogastric plexus block, and ganglion impar block. The continuity of fascia and interfascial spaces profoundly influences both the efficacy of blockades and the incidence of complications. A thorough understanding of pelvic fascia anatomy is crucial for understanding the potential pathways and barriers for spread of local anesthetics, enhancing analgesia, and minimizing side effects. Currently, a systematic discussion of pelvic fascia from the perspective of regional anesthesia and pain therapy is notably absent. This narrative review aims to consolidate knowledge on the anatomy of pelvic fascia pertinent to regional anesthesia and pain management, detailing relevant pelvic nerves, and associated peripheral nerve blocking techniques.</p>","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142349866","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":"Magnesium sulfate infusion for emergence agitation in adult patients after general anesthesia: a systematic review and meta-analysis of randomized controlled trials.","authors":"Lucas R DE Freitas, Suzany L Martins, Pedro L Alencar, Vitor R Moraes, Gabriel D Condeixa, Mariana Gaya DA Costa","doi":"10.23736/S0375-9393.24.18221-1","DOIUrl":"https://doi.org/10.23736/S0375-9393.24.18221-1","url":null,"abstract":"<p><strong>Introduction: </strong>Emergence agitation following general anesthesia poses significant risks to both patients and medical staff. While extensive research has explored the efficacy of magnesium sulfate (MgSO4) in managing pediatric emergence agitation, its effectiveness in adults remains uncertain. Therefore, this meta-analysis seeks to evaluate the efficacy of MgSO4 in mitigating emergence agitation following general anesthesia in adult populations.</p><p><strong>Evidence acquisition: </strong>A systematic search was conducted across PubMed, Embase, Cochrane Library, and Web of Science databases to identify randomized controlled trials (RCTs) comparing MgSO4 or placebo infusion during surgical procedures involving adult patients under general anesthesia. Key outcomes assessed included the incidence of emergence agitation, agitation severity scores, extubation duration, and postoperative nausea and vomiting (PONV). Statistical analyses were conducted using Review Manager 5.4.1 (Cochrane, London, UK), with heterogeneity evaluated using I2 statistics. Significance was defined at P<0.05 for Odds Ratios (OR), mean differences (MD), and standard mean differences (SMD).</p><p><strong>Evidence synthesis: </strong>Five RCTs encompassing 605 participants were included. MgSO4 resulted in a lower emergence agitation incidence (OR=0.29 [95% CI: 0.12;0.72]; P=0.007). There were no significant differences between groups for patient's agitation severity scores (SMD=-0.69 [95% CI: -1.82; 0.44]; P=0.23), extubation time (MD=1.16 [95% CI: -1.06; 3.37]; P=0.30), or PONV incidence (OR=0.52 [95% CI: 0.15-1.76]; P=0.29).</p><p><strong>Conclusions: </strong>Magnesium sulfate infusion during general anesthesia was associated with lower incidence of emergence agitation in adults. However, no significant differences were observed regarding emergence agitation severity scores, PONV, or extubation time.</p>","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142349863","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 quadro-iliac plane block in single level lumbar discectomies: a case series for novel block.","authors":"Engin I Turan, Cansu Aslan, Kübranur Berber, Onur Sarban, Ayça S Şahin","doi":"10.23736/S0375-9393.24.18314-9","DOIUrl":"https://doi.org/10.23736/S0375-9393.24.18314-9","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142290879","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 systemic lidocaine infusion on optic nerve sheath diameter during laparoscopic hysterectomy: a randomized controlled study.","authors":"Osama M Rehab, Mohammed S Elsharkawy, Doha M Bakr, Adel A Hassan","doi":"10.23736/S0375-9393.24.18204-1","DOIUrl":"10.23736/S0375-9393.24.18204-1","url":null,"abstract":"<p><strong>Background: </strong>During laparoscopic hysterectomy (LH), the elevation of intra-abdominal and intra-thoracic pressures due to pneumoperitoneum (PP) results in an increase in intracranial pressure (ICP). The Trendelenburg position (TP) is an accentuating factor. This trial aimed to assess the effect of intravenous (IV) lidocaine infusion on optic nerve sheath diameter (ONSD), a widely accepted surrogate measure for ICP, during PP and TP.</p><p><strong>Methods: </strong>A randomized, placebo-controlled study was conducted on 66 patients scheduled for LH, equally divided into a lidocaine group and a saline group. ONSD, the primary outcome, was recorded before induction (T1), before PP initiation in the supine position (T2), five minutes (T3), 30 minutes (T4), and 60 minutes (T5) after PP and TP, and five minutes after termination of PP in the supine position (T6). Secondary outcomes included numerical rating scale (NRS) scores at arrival to the post-anesthesia care unit (PACU), 6, 12, and 24 hours after surgery, and postoperative adverse effects.</p><p><strong>Results: </strong>ONSD at T4 and T5 was significantly lower in the lidocaine group than in the saline group (T4: 4.94±0.43 mm vs. 5.27±0.37 mm; P =0.003, T5: 5.08±0.46 vs. 5.41±0.38 mm; P =0.004). The lidocaine group had significantly lower NRS values than the saline group only at PACU arrival (median [Q1-Q3]: 5 [4-6] vs. 6 [5-6.25]; P =0.016). Fewer patients in the lidocaine group experienced postoperative headache (P =0.029).</p><p><strong>Conclusions: </strong>IV lidocaine during LH can attenuate the ONSD distension, decrease pain scores at PACU arrival, and reduce the incidence of postoperative headache.</p>","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":"90 9","pages":"727-738"},"PeriodicalIF":2.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142290907","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}