Minerva anestesiologica最新文献

{"title":"Complete anesthesia after unilateral sacral ESP block.","authors":"Andrea Sanapo, Gian M Petroni, Francesca De Sanctis, Pierfrancesco Fusco","doi":"10.23736/S0375-9393.24.18399-X","DOIUrl":"10.23736/S0375-9393.24.18399-X","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":"1166-1167"},"PeriodicalIF":2.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142546339","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":"An alternative of ultrasound-guided lumbar plexus block: a vertebral arch root method.","authors":"Junde Han, Shanshan Yu, Wenzong Ni","doi":"10.23736/S0375-9393.24.18364-2","DOIUrl":"10.23736/S0375-9393.24.18364-2","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":"1161-1162"},"PeriodicalIF":2.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142546268","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":"Impact of stellate ganglion block on postoperative gastrointestinal function.","authors":"I-Wen Chen, Chien-Ming Lin, Kuo-Chuan Hung","doi":"10.23736/S0375-9393.24.18384-8","DOIUrl":"10.23736/S0375-9393.24.18384-8","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":"1164-1165"},"PeriodicalIF":2.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142349861","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":"Assessment of the organ function as the primary intention of clinical reasoning applied to the critically ill patient.","authors":"Roberto A De Blasi","doi":"10.23736/S0375-9393.24.18474-X","DOIUrl":"10.23736/S0375-9393.24.18474-X","url":null,"abstract":"<p><p>This article examines how clinical reasoning about the critical patient is currently treated and draws attention to some critical issues already often highlighted in the literature. Traditional approaches to clinical reasoning, even when applied to critical patients, prioritize identifying structured diseases. In contrast, the critical care setting demands an alternative approach that aligns with the intensivist's goal of supporting or substituting vital organ functions. In this manuscript, we emphasized the reasons that make it primary for intensivists to obtain a diagnosis of function in order to act therapeutically. Moreover, we highlighted the challenges posed by diagnostic errors, often attributed to cognitive biases and shortcomings in clinical reasoning, which can adversely affect patient outcomes and resource utilization. We also discussed the complexities of clinical decision-making in emergency medical services, where physicians must perform rapid actions in the face of incomplete information and high uncertainty. We underscore the limitations of traditional information technology tools in facilitating practical clinical reasoning, advocating for the integration of relevant data that directly informs on organ function and pathophysiological mechanisms. This discourse emphasizes a deep understanding of physiology and pathophysiology as foundational for practical clinical reasoning in critical care. Finally, we propose a structured assessment method that prioritizes pinpointing the compromised organ function, elucidating the pathophysiological mechanism responsible, hypothesizing potential causes, and testing these hypotheses to guide therapeutic interventions. This approach aligns clinical reasoning with the intensivist's goal: supporting and restoring vital functions in the critically ill patient.</p>","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":"1151-1158"},"PeriodicalIF":2.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751176","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 postoperative awakening between ciprofol and propofol in elderly patients undergoing hip replacement surgery: a single-blind, randomized, controlled trial.","authors":"Dawei Yang, Jie Zhou, Luyu Sun, Min Li, Jianyou Zhang","doi":"10.23736/S0375-9393.24.18263-6","DOIUrl":"10.23736/S0375-9393.24.18263-6","url":null,"abstract":"<p><strong>Background: </strong>The aim of this paper was to compare the impact of continuous infusion of ciprofol versus propofol on postoperative awakening in elderly patients following hip replacement surgery.</p><p><strong>Methods: </strong>Patients were randomized into two groups (N.=45 each): the ciprofol group and the propofol group. The ciprofol group received ciprofol for anesthesia induction and maintenance, while the propofol group underwent anesthesia induction and maintenance using propofol. The primary outcome was awakening time. Secondary outcomes included spontaneous breathing recovery time, extubation time, time to modified Aldrete Score ≥9, modified observer's assessment of alertness/sedation (MOAA/S) scores, anesthetic dosage, volume of fluid replacement, urine output and administration of vasoactive drugs.</p><p><strong>Results: </strong>The Ciprofol group exhibited a significantly prolonged awakening time (11.0±6.4 min vs. 7.4±4.3 min, P=0.003), spontaneous breathing recovery time (9.9±6.3 min vs. 5.9±4.3 min, P=0.001), and extubation time (12.0 [8.0-16.0] min vs. 8.5 [6.0-11.0] min, P=0.005), and reduced requirement for intraoperative fluid replacement (728.9±254.2 mL vs. 908.3±287.5 mL, P=0.003), increased urine output (235.1±102.1 mL vs. 173.5±106.2 mL, P=0.007), decreased likelihood of vasoactive drug administration (15/30 vs. 28/14, P=0.002). No significant differences were observed between the two groups in terms of reaching a modified Aldrete Score ≥9, MOAA/S scores at 0, 5, 15, or 30 minutes post-extubation, or occurrence of adverse reactions (P>0.05). The dosage of remifentanil was significantly higher in the ciprofol group [5.4 (2.7-7.4) μg·kg^-1·h^-1 vs. 3.4 (1.9-4.3) μg·kg^-1·h^-1, P=0.004], with a mean maintenance dose of ciprofol at 0.8 mg·kg^-1·h^-1 (range: 0.5 to 1.2 mg·kg^-1·h^-1).</p><p><strong>Conclusions: </strong>Compared to propofol, the administration of ciprofol in elderly patients following hip replacement surgery is associated with prolonged awakening time, spontaneous breathing recovery time, and extubation. The average intravenous maintenance dosage of ciprofol in geriatric patients under general anesthesia was 0.8 mg·kg^-1·h^-1.</p>","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":"1074-1081"},"PeriodicalIF":2.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142769989","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":"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":"1118-1130"},"PeriodicalIF":2.9,"publicationDate":"2024-12-01","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":"The GRIM Test could be useful in detecting fabricated data.","authors":"Alessandro De Cassai, Giulia Aviani Fulvio, Anna Bordin, Elia Citton, Paolo Navalesi","doi":"10.23736/S0375-9393.24.18328-9","DOIUrl":"10.23736/S0375-9393.24.18328-9","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":"1160-1161"},"PeriodicalIF":2.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141855994","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":"10.23736/S0375-9393.24.18314-9","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":"1159-1160"},"PeriodicalIF":2.9,"publicationDate":"2024-12-01","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":"Renal resistive index assessment by intraoperative transesophageal echocardiography is associated with acute kidney injury after cardiac surgery: a prospective observational study.","authors":"Richa Dhawan, Kristin Trela, Joshua M Junge, Daniel Viox, Kristen E Wroblewski, Mark A Chaney","doi":"10.23736/S0375-9393.24.18464-7","DOIUrl":"10.23736/S0375-9393.24.18464-7","url":null,"abstract":"<p><strong>Background: </strong>Acute kidney injury (AKI) is a major health burden after cardiac surgery. Renal vasoconstriction and venous congestion can be assessed via transesophageal echocardiography (TEE). The primary objective is to determine feasibility of measuring intraoperative Renal resistive index (RRI) and portal vein pulsatility fraction (PF) by TEE. The secondary objectives are to determine the association between RRI and/or PF and postoperative AKI, Intensive Care Unit (ICU) length of stay, hospital length of stay, and 30-day mortality.</p><p><strong>Methods: </strong>This is a prospective observational study at a single center University setting in adult patients undergoing elective cardiac surgery. Intraoperative RRI and PF measurements were obtained prior to CPB, after CPB, and after chest closure.</p><p><strong>Results: </strong>Eighty patients met eligibility criteria and consented. Overall feasibility rate was 91% (73/80), RRI measured in 96% (77/80) and PF measured in 94% (75/80). Further analyses was conducted in 69 patients. RRI prior to CPB significantly correlated with AKI ([OR][95% CI] 2.15 [1.07-4.33], P=0.03) with an AUC of 0.68 ([95%CI] 0.55-0.81, P=0.02). Post-chest closure RRI>0.75 significantly correlated with AKI ([OR][95% CI] 3.54 [1.18-10.62], P=0.02). Combination of the three timepoints significantly associated with AKI ([AUC][95% CI] 0.71 [0.58-0.84], P=0.007). PF did not significantly correlate with AKI.</p><p><strong>Conclusions: </strong>This study demonstrates high feasibility for obtaining intraoperative TEE measurement of RRI and PF and significant correlation between postoperative AKI with pre CPB RRI, post chest closure RRI, and the combination of RRI at the three timepoints.</p>","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":"1108-1117"},"PeriodicalIF":2.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716717","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":"Prehabilitation for Chilean frail elderly people - pre-surgical conditioning protocol - to reduce the length of stay: randomized control trial.","authors":"Victor Contreras, María F Elgueta, Detlef Balde, Paula Astaburuaga, Marcela Carrasco, Juan C Pedemonte, María N Nicoletti, Rene Medina Diaz, Sebastián Franco, Raul Agurto, Catherin Vivanco, Constanza Figueroa, Mirelly Alamos, Valeria Cuzmar Benítez, Benjamin Vargas, Benjamin Barraza, Claudio Rematal, Luis I Cortinez","doi":"10.23736/S0375-9393.24.18245-4","DOIUrl":"https://doi.org/10.23736/S0375-9393.24.18245-4","url":null,"abstract":"<p><strong>Background: </strong>Frail elderly patients have a higher risk of postoperative morbidity and mortality. Prehabilitation is a potential intervention for optimizing postoperative outcomes in frail patients. We studied the impact of a prehabilitation program on length of stay (LOS) in frail elderly patients undergoing elective surgery.</p><p><strong>Methods: </strong>An RCT study was conducted. Frail patients scheduled for elective surgery were randomized to receive either pre-surgical conditioning protocol (PCP) or standard preoperative care. PCP included nursing, anesthetic, and geriatric assessment, nutritional intervention, and physical training for 4-weeks preoperatively. A nurse followed both groups until discharge criteria were met. The primary outcome was postoperative LOS. Secondary outcomes were nutritional status, preoperative frailty status (frailty phenotype-FP) after PCP, and postoperative complications up to three months categorized according to the Clavien-Dindo Classification. Means and medians between the control and intervention groups were compared, with statistical significance set at α=5%.</p><p><strong>Results: </strong>Thirty-four patients were to intervention and Thirty-seven to the control group. In the intervention group, adherence to prehabilitation was 90%. The median LOS after surgery was three days in both groups, without finding statistically significant differences between groups (P=0.754), although there was a trend towards lower LOS in the urologic surgery subgroup. We found a significant reduction in frailty status after PCP (FP<inf>pre</inf>=2.4±0.5 and FP<inf>post</inf>=1.7±0.5, P<0.001). Nutritional status significantly improved in frail patients after prehabilitation (MNA<inf>basal</inf>=9.0±2.5 and MNA<inf>post</inf>=10.6±2.6), P=0.028. The intervention group had less severe postoperative complications, which were not statistically significant.</p><p><strong>Conclusions: </strong>The PCP conducted both in-person and online, for older frail patients undergoing elective colorectal and urological surgery was not associated with shorter LOS. However, frailty status significantly improved after completing PCP.</p>","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":"90 12","pages":"1098-1107"},"PeriodicalIF":2.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143008274","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}