Minerva anestesiologica
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Minerva anestesiologica · Sep 2024
Meta AnalysisAssociation between elevated preoperative VE/VCO2 slope and increased mortality following major surgery: a meta-analysis.
The relationship between preoperative VE/VCO
2 slope and mortality in adults undergoing major surgery is not well-established. ⋯ Elevated preoperative VE/V CO2 slope is associated with an increased risk of postoperative short- and long-term mortality in adults undergoing major surgery. -
Minerva anestesiologica · Sep 2024
Meta Analysis Comparative StudyRemimazolam versus propofol for endoscopy sedation in elderly patients: a systematic review, meta-analysis and trial sequential analysis.
Procedural sedation is crucial in gastrointestinal endoscopy, where propofol is commonly used but may lead to cardiovascular and respiratory side effects. Remimazolam, a new drug, offers advantages such as rapid onset and recovery. The sedation protocols for this population vary, requiring tailored titration of sedatives. The comparative safety of these drugs in elderly patients undergoing procedural sedation remains unclear, as previous studies primarily focus on the general population. We aimed to compare the safety profiles of remimazolam and propofol in this context. in elderly patients undergoing procedural sedation for gastrointestinal endoscopy. ⋯ Our findings suggest that in elderly patients having gastrointestinal endoscopy, remimazolam could be safer than propofol. This population may benefit from remimazolam's lower risk of adverse events, notably hypoxemia and respiratory depression.
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Minerva anestesiologica · Sep 2024
Comment Observational StudyBehavioral training and mirroring techniques to prepare for elective anesthesia in children with autism spectrum disorder: a prospective evaluation of implemented program.
Children with autism spectrum disorder (ASD) often require multiple interventions receiving general anesthesia during their lifetimes. However, a single negative experience may trigger and/or aggravate anxiety and subsequent development of unwanted behavior. This monocentric study assessed the compliance with mask induction of children with ASD who followed a preoperative preparation using behavioral training with positive reinforcement technique and use of mirroring technique. ⋯ The use of behavioral and mirroring techniques implemented as a preparation program for children with ASD could facilitate mask induction of anesthesia. Such a preparation achieves good to excellent compliance in almost 60% of patients.
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Minerva anestesiologica · Sep 2024
Comment Letter Comparative StudyComparison of shoulder anterior capsular block and interscalene brachial plexus blocks: reply to Dr. Shakeri.
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Minerva anestesiologica · Sep 2024
ReviewHas the role of troponin as a biomarker of cardiac complications after non-cardiac surgery been fully understood?
Myocardial injury after non-cardiac surgery is a major issue with a rate of almost 20%, as suggested by the literature. Guidelines recommend screening patients undergoing non-cardiac surgery who have at least one cardiovascular risk factor. Clinical trials are characterized by a high degree of heterogeneity. ⋯ Troponin elevation can be a result of patient-related factors and comorbidities, including age, chronic renal failure, and inflammatory status. Currently, there is no effective strategy to prevent perioperative myocardial injury, and there are no therapeutic options that significantly improve the outcome of patients with myocardial injury. We have focused on this topic and on perioperative myocardial injury to highlight the areas of research that remain unexplored.