Minerva anestesiologica
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Minerva anestesiologica · Apr 2024
Meta AnalysisThe effects of prophylactic use of esketamine on postoperative depression and quality of life: a meta-analysis.
The aim of this systemic review and meta-analysis was to assess the impact of prophylactic use of esketamine on postoperative depression and quality of life in patients. ⋯ Prophylactic use of esketamine during the preoperative and anesthesia period has shown significant benefits in improving postoperative quality of life. It can effectively alleviate postoperative depression, anxiety, and chronic pain, as well as enhance sleep quality.
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Minerva anestesiologica · Apr 2024
Meta AnalysisThe efficacy of Perfusion Index for identifying failed nerve block in patients receiving upper extremity surgery: a meta-analysis.
Nerve block success is commonly assessed through a variety of techniques, including testing sensations for temperature over the relevant dermatomes and evaluating pain response (e.g., pin-prick). This meta-analysis aimed to investigate the diagnostic efficacy of Perfusion Index (PI) in identifying failed nerve blocks in patients undergoing upper extremity surgery. ⋯ Our meta-analysis confirmed that the PI values and ratios are promising objective predictors of nerve block failure. The simplicity of these techniques supports their feasibility for routine clinical practice. Further studies focusing on different patient populations, such as pregnant women or the elderly, are needed to validate and expand upon our findings.
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Minerva anestesiologica · Apr 2024
Review GuidelineOpioid-free anesthesia: a practical guide for teaching and implementation.
Opioid-free anesthesia (OFA) represents an innovative approach that prioritizes patient safety, reduces the risks associated with opioid use, and seeks to enhance recovery. Few descriptions regarding the practical and implementation aspects exist. This review serves as a practical guide on OFA teaching and application. ⋯ Whilst opioids still have an important place in pain management, they have brought harms that we cannot ignore. Evidence for using opioid-sparing and OFA techniques continues to emerge and there is a need to personalize more approaches. In this review, we provide evidence-based, relatively simple methods that can be used in implementing and delivering OFA.
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Minerva anestesiologica · Apr 2024
Multicenter StudyImproving the performance of the Cleveland Clinic Score for predicting acute kidney injury after cardiac surgery: a prospective multicenter cohort study.
Cardiac surgery-associated acute kidney injury (CSA-AKI) is associated with high short- and long-term mortality rates. The prediction of CSA-AKI is crucial for early detection and treatment. Current predictive models may be improved by potentially useful preoperative and intraoperative information. ⋯ The addition of baseline hemoglobin, eGFR, HbA
1c , and nadir intraoperative hemoglobin may be useful for improving the discrimination of the clinical predictive risk scores for AKI.