Minerva anestesiologica
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Minerva anestesiologica · Oct 2022
Randomized Controlled TrialDuloxetine role in reducing opioid consumption after thoracotomy: a prospective, randomized, double -blinded, placebo - controlled pilot trial.
Exploration of the thoracic cavity through a thoracotomy incision for thoracic malignancies is accompanied by severe, excruciating acute postoperative pain. The objective of this study is to evaluate the efficacy of perioperative duloxetine when given as part of a multimodal analgesia in reducing the dose of opioids needed to treat acute postoperative pain after thoracotomy. ⋯ Oral duloxetine used perioperatively during thoracic surgery may play an important role as multimodal analgesia for acute postoperative pain without any added side effects.
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Minerva anestesiologica · Oct 2022
Meta AnalysisA systematic review and meta-analysis of three risk factors for chronic postsurgical pain: age, sex and preoperative pain.
Chronic postsurgical pain (CPSP) is a common and disabling postoperative complication. Several risk factors for CPSP have been established, but it is unclear whether they are significant for any type of surgery. This systematic review aimed to assess the risk of CPSP related to three known preoperative risk factors "age, sex and preoperative pain" in the adult population after any type of elective non-obstetrical surgery. ⋯ This systematic review confirms that younger age, female sex, and preoperative pain are associated with higher risk of developing CPSP in any type of elective non-obstetrical surgery. However, effect sizes are small and quality of evidence low-moderate only, limiting comparisons of different types of surgery.
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Minerva anestesiologica · Oct 2022
Meta AnalysisThe effects of exposure to severe hyperoxemia on neurological outcome and mortality after cardiac arrest.
Hyperoxemia during cardiac arrest (CA) may increase chances of successful resuscitation. However, episodes of severe hyperoxemia after intensive care unit admission occurs frequently (up to 60%), and these have been associated with higher mortality in CA patients. The impact of severe hyperoxemia on neurological outcome is more unclear. ⋯ Severe hyperoxemia is associated with worse neurological outcome and lower survival in CA survivors admitted to intensive care unit. Clinical efforts should be made to avoid severe hyperoxemia during at least the first 36 hours after cardiac arrest.
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Minerva anestesiologica · Oct 2022
ReviewAnatomical changes of the ligamentum flavum and the epidural space after spinal surgery: a retrospective magnetic resonance imaging study.
Anatomical changes of the ligamentum flavum (LF) and epidural space (ES) after spinal surgery may affect the loss-of-resistance during interlaminar epidural procedure and distribution of drug administered into the ES. This study aims to investigate clinically relevant anatomical changes of the LF and ES after spinal surgery. ⋯ For epidural anesthesia in patients who have previously undergone spinal surgery, it is reasonable to select a needle insertion site other than the level of spinal surgery.