Peiqi Shao, Songchao Xu, Huili Li, Ruijuan Guo, Yun Wang
{"title":"A fascial compartment plus \"cup-shaped\" blocks provide surgical anesthesia for the excision of a huge mass at the posterior cervico-occipital region.","authors":"Peiqi Shao, Songchao Xu, Huili Li, Ruijuan Guo, Yun Wang","doi":"10.23736/S0375-9393.25.18741-5","DOIUrl":"https://doi.org/10.23736/S0375-9393.25.18741-5","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143502315","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}
Marwan S Rizk, Amro F Khalili, Thuraya H Hajali, Ali H Berjaoui, Kelly E Merheb, Nada A Sadek, Elie B Geara, Mohamad F El-Khatib, Marie T Aouad
{"title":"Real-time ultrasound-guided neuraxial puncture in elderly patients: a randomized controlled trial comparing paramedian transverse and parasagittal approaches.","authors":"Marwan S Rizk, Amro F Khalili, Thuraya H Hajali, Ali H Berjaoui, Kelly E Merheb, Nada A Sadek, Elie B Geara, Mohamad F El-Khatib, Marie T Aouad","doi":"10.23736/S0375-9393.24.18450-7","DOIUrl":"https://doi.org/10.23736/S0375-9393.24.18450-7","url":null,"abstract":"<p><strong>Background: </strong>Historically, spinal anesthesia has been performed using anatomical landmarks. This study aimed to compare the efficacy and procedural outcomes of real-time ultrasound-guided parasagittal oblique (RTU-PO) and real-time ultrasound-guided paramedian transverse (RTU-PT) approaches in elderly patients undergoing elective surgery under spinal anesthesia.</p><p><strong>Methods: </strong>Seventy-seven elderly patients scheduled for elective surgery under spinal anesthesia were enrolled in this study. Patients were randomized to receive spinal anesthesia using either RTU-PO (38 patients) or RTU-PT (39 patients) technique. The primary measure outcome was the rate of successful dural puncture at the first attempt in both groups. The secondary outcomes included the overall success rate of spinal anesthesia, time to identify the posterior complex on ultrasound, time to perform spinal anesthesia, total procedural time, number of needle redirections and passes, number of separate skin punctures, patients' satisfaction, and incidences of complications in both groups.</p><p><strong>Results: </strong>Baseline demographic and anatomical characteristics were not different between the two groups. The incidence of successful spinal anesthesia at first attempt was 60.5% with RTU-PO and 56.4% with RTU-PT (P=0.71). All other secondary outcomes were comparable between the two groups except for the time to identify posterior complex that was higher in the RTU-PT versus the RTU-PO group (36±18 vs. 20±11 seconds; P=0.0001).</p><p><strong>Conclusions: </strong>In elderly patients undergoing elective surgeries under spinal anesthesia, the RTU-PO and the RTU-PT techniques are comparable in almost all aspects.</p>","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256204","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":"Foot movements during the maintenance phase of propofol-remifentanil anesthesia due to ankle clonus.","authors":"Toshiyuki Yano, Tomoki Takahashi","doi":"10.23736/S0375-9393.24.18725-1","DOIUrl":"https://doi.org/10.23736/S0375-9393.24.18725-1","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256135","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}
Naveen Perisetla, Jose Malavet, Christopher Popiolek, Giorgio Melloni, Ashley Mooney, Maha Balouch, Peter Wu, Jeffrey Weiss, John Hodgson, Enrico Camporesi
{"title":"Risk stratification for postoperative hypoxemia among bariatric surgery patients.","authors":"Naveen Perisetla, Jose Malavet, Christopher Popiolek, Giorgio Melloni, Ashley Mooney, Maha Balouch, Peter Wu, Jeffrey Weiss, John Hodgson, Enrico Camporesi","doi":"10.23736/S0375-9393.24.18595-1","DOIUrl":"https://doi.org/10.23736/S0375-9393.24.18595-1","url":null,"abstract":"<p><strong>Background: </strong>Patients with obesity, especially those suffering from obstructive sleep apnea (OSA), are prone to postoperative respiratory hypoxemia. The PRODIGY (prediction of opioid-induced respiratory depression in patients monitored by capnography) Score is used to predict respiratory complications that factor in sleep-disordered breathing. Data on the impact of OSA on the frequency and timing of postoperative desaturation trends after bariatric surgery are lacking.</p><p><strong>Methods: </strong>This cohort study included 195 patients who underwent robotic-assisted bariatric surgery between June 2022 and December 2023. Patients underwent were classified by OSA status (yes/no) and PRODIGY Risk Score (high/intermediate/low). All patients received low or opioid sparing anesthesia and were continuously monitored postoperatively using the Masimo Rad-97 device (Masimo, Irvine, CA, USA). Postoperative monitoring averaged 14.5 hours, including tracking several variables and SpO<inf>2</inf> values. We documented desaturations and opioid usage in 2-hour intervals. Patients also underwent 30-day postoperative follow up. Descriptive statistics were analyzed based on OSA status and PRODIGY scores using Student's t-test, ANOVA, and Fisher's Exact Test.</p><p><strong>Results: </strong>Most study patients (57.4%) had OSA, were significantly older, and were predominantly female. Patients with OSA had substantially more prolonged exposure to SpO<inf>2</inf> ranges between 80-95% and experienced more frequent desaturation events between 10 and 14 hours after Post-Anesthesia Care Unit (PACU) discharge. Patients with high PRODIGY scores (>15) had significantly more desaturation events compared to intermediate and low-score groups.</p><p><strong>Conclusions: </strong>Postoperative desaturation rates are significantly higher among patients with OSA with high PRODIGY scores, especially in the delayed postoperative period. Continuous extended postoperative monitoring is warranted for these high-risk patients after bariatric surgery.</p>","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189816","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}
Alessandro DE Cassai, Burhan Dost, Dario Bugada, Yunus E Karapinar, Müzeyyen Beldagli, Mirac S Ozkal Yalin, Ali Ahiskalioglu, Serkan Tulgar
{"title":"Modified thoracoabdominal nerves block through perichondrial approach is effective in reducing postoperative opioids requirements in patients undergoing laparoscopic cholecystectomy: a meta-analysis with trial sequential analysis.","authors":"Alessandro DE Cassai, Burhan Dost, Dario Bugada, Yunus E Karapinar, Müzeyyen Beldagli, Mirac S Ozkal Yalin, Ali Ahiskalioglu, Serkan Tulgar","doi":"10.23736/S0375-9393.24.18490-8","DOIUrl":"https://doi.org/10.23736/S0375-9393.24.18490-8","url":null,"abstract":"<p><strong>Introduction: </strong>The modified thoracoabdominal nerves block through perichondrial approach (M-TAPA) has been proposed as an effective regional anesthesia technique for reducing postoperative opioid consumption in patients undergoing laparoscopic cholecystectomy (LC). We conducted this systematic review and meta-analysis with trial sequential analysis to assess the analgesic efficacy of M-TAPA block in LC.</p><p><strong>Evidence acquisition: </strong>We searched Pubmed Central, Scopus and Cochrane Central Register of Controlled Trials (from inception to until 1 July 2024). The effects of the M-TAPA were compared with those of sham block, placebo and no intervention. Randomized controlled trials, observational and retrospective studies were included. The primary outcome was postoperative opioid consumption at 24 hours, while secondary outcomes included pain scores at 12 and 24 hours, postoperative nausea and vomiting (PONV), and rescue analgesic requirements.</p><p><strong>Evidence synthesis: </strong>This meta-analysis included six studies encompassing four randomized controlled trials, one retrospective study, and one prospective observational study, with a total of 350 patients. The analysis demonstrated a significant reduction in postoperative opioid consumption (MD -9.06; 95% CI -11.6 to -6.48, P=0.001) in the M-TAPA group. Additionally, patients receiving M-TAPA reported lower pain scores at 12 and 24 hours postoperatively. The risk of PONV was significantly reduced (OR 0.19; 95% CI 0.10 to 0.39, P=0.001), and fewer patients required rescue analgesics (OR 0.24; 95% CI 0.09 to 0.65, P=0.05).</p><p><strong>Conclusions: </strong>M-TAPA block provides superior analgesia when compared with control group in LC.</p>","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189813","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}
Gian M Petroni, Andrea Sanapo, Francesca DE Sanctis, Emanuele Nazzarro, Walter Ciaschi, Chiara Maggiani, Stefano Meloncelli, Carla Stecco, Roberto Cirocchi, Pierfrancesco Fusco
{"title":"The deep rectus sheath block plus rectus sheath block in awake laparotomy surgery in the elderly patient.","authors":"Gian M Petroni, Andrea Sanapo, Francesca DE Sanctis, Emanuele Nazzarro, Walter Ciaschi, Chiara Maggiani, Stefano Meloncelli, Carla Stecco, Roberto Cirocchi, Pierfrancesco Fusco","doi":"10.23736/S0375-9393.24.18731-7","DOIUrl":"https://doi.org/10.23736/S0375-9393.24.18731-7","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189825","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}
Océane Carpentier-Chicot, Matthieu Sarsam, Jean-Marc Baste, Thomas Clavier, Emmanuel Besnier, Marie-Mélody Dusseaux, Vincent Compere, Jean Selim
{"title":"When a right double-lumen endotracheal tube could save the day!","authors":"Océane Carpentier-Chicot, Matthieu Sarsam, Jean-Marc Baste, Thomas Clavier, Emmanuel Besnier, Marie-Mélody Dusseaux, Vincent Compere, Jean Selim","doi":"10.23736/S0375-9393.24.18753-6","DOIUrl":"https://doi.org/10.23736/S0375-9393.24.18753-6","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189833","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}
Pierfrancesco Fusco, Carla Stecco, Emanuele Nazzarro, Andrea Sanapo, Francesca DE Sanctis, Marialaura Scarcella, Chiara Maggiani, Walter Ciaschi, Alessandro DE Cassai, Gian M Petroni
{"title":"Under the fascia: technique for performing the deep rectus sheath block.","authors":"Pierfrancesco Fusco, Carla Stecco, Emanuele Nazzarro, Andrea Sanapo, Francesca DE Sanctis, Marialaura Scarcella, Chiara Maggiani, Walter Ciaschi, Alessandro DE Cassai, Gian M Petroni","doi":"10.23736/S0375-9393.25.18830-5","DOIUrl":"https://doi.org/10.23736/S0375-9393.25.18830-5","url":null,"abstract":"","PeriodicalId":18522,"journal":{"name":"Minerva anestesiologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143066808","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}