Minerva anestesiologica
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Minerva anestesiologica · Jun 2023
Randomized Controlled TrialComparison of ultrasound-guided erector spinae plane block and thoracic paravertebral block for postoperative analgesia after laparoscopic nephrectomy: a randomized controlled non-inferiority clinical trial.
Thoracic paravertebral block offers effective analgesia after laparoscopic nephrectomy but has potential severe complication risks. Erector spinae plane block has been described for analgesia after abdominal surgery. However, there are no prospective randomized trials determining if ultrasound-guided erector spinae plane block is non-inferior to thoracic paravertebral block in terms of analgesia after abdominal surgeries including laparoscopic nephrectomy. ⋯ This study demonstrates that erector spinae plane block provides non-inferior analgesia for pain at rest within 24 postoperative hours in comparison to thoracic paravertebral block for laparoscopic nephrectomy.
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Minerva anestesiologica · Jun 2023
ReviewThe efficacy of 5HT3-receptor antagonists in postoperative nausea and vomiting: the role of pharmacogenetics.
Genetic variants may affect drug efficacy on postoperative nausea and vomiting (PONV). The understanding of these mechanisms will help to identify the surgical patients who might benefit from specific prophylactic and therapeutic antiemetic treatment. The aim of the present review was to investigate gene polymorphisms that influence 5-hydroxytryptamine (serotonin) type 3 receptor antagonists (5HT3RA) efficacy in PONV. ⋯ This review highlights that inefficacy of a specific drug in managing PONV could be attributed to specific genetic profiles and patients would possibly benefit from a drug switch.
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Minerva anestesiologica · Jun 2023
ReviewPathophysiology of COVID-19 pneumonia and respiratory treatment.
COVID-19 pandemic has seen an unprecedented number of patients presenting with acute respiratory distress syndrome to the intensive care units all over the world. Between August and November 2022, we performed research on PubMed screening all publications on COVID-19 disease and respiratory failure and its treatment. ⋯ The mainstay of the disease is the frequent presence of severe hypoxemia associated - at least at the beginning - to a near normal lung mechanics and PaCO
2 tension. The management of symptomatic patients, progressing through these temporal phases, is not possible without understanding the pathophysiology underlying the respiratory manifestation. -
Minerva anestesiologica · Jun 2023
A prediction model for difficult intubation using skeletal features in patients affected by apnea-hypopnea syndrome.
Obstructive sleep apnea-hypopnea syndrome (OSAHS) has been linked to increased risk of perioperative morbidity and mortality because of difficult intubation (DI). However, there is a lack of clinically validated tools to identify OSAHS patients who are likely to have an increased the risk of DI. ⋯ Our study developed and externally validated a DI prediction model using skeletal features in OSAHS patients. The final model had an NPV of nearly 95%, suggesting that a simple nomogram including only five predictors was quite helpful for ruling out the presence of difficult intubation in OSAHS patients who underwent elective surgery.
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Minerva anestesiologica · Jun 2023
A protocol based on Hypotension probability indicator vs. standard care to prevent intraoperative hypotension during supratentorial brain surgery: a prospective randomized pilot trial.
To test the hypothesis that Hypotension probability indicator (HPI) driven hemodynamic protocol use may decrease the exposition to hypotension (mean arterial pressure below 65 mmHg) during supratentorial intracranial procedures. ⋯ In this pilot trial, the HPI-based protocol decreased the incidence of hypotension during the anesthesia maintenance but non-significant trends among secondary outcomes were also documented. Larger trials are needed to confirm our findings.