Minerva anestesiologica
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Minerva anestesiologica · Sep 2024
Randomized Controlled TrialEffect of systemic lidocaine infusion on optic nerve sheath diameter during laparoscopic hysterectomy: a randomized controlled study.
During laparoscopic hysterectomy (LH), the elevation of intra-abdominal and intra-thoracic pressures due to pneumoperitoneum (PP) results in an increase in intracranial pressure (ICP). The Trendelenburg position (TP) is an accentuating factor. This trial aimed to assess the effect of intravenous (IV) lidocaine infusion on optic nerve sheath diameter (ONSD), a widely accepted surrogate measure for ICP, during PP and TP. ⋯ IV lidocaine during LH can attenuate the ONSD distension, decrease pain scores at PACU arrival, and reduce the incidence of postoperative headache.
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Minerva anestesiologica · Sep 2024
ReviewThe clinical value of nonpharmacological interventions for preventing postoperative delirium: a narrative review.
Postoperative delirium (POD) is a prevalent perioperative complication among elderly individuals and is a cause of significant detrimental consequences for both individuals and society. Pharmacological and nonpharmacological prevention methods/therapies have been proposed to mitigate the risk of POD. Nevertheless, the efficacy of pharmacological interventions is controversial, and some of them cause side effects. ⋯ The former is aimed at increasing cognitive reserve, thus decreasing the incidence rate of POD. Noncognitive interventions, including sensory stimuli (music therapy, odor enrichment), improving sleep disturbances, physical activity, acupuncture and transcranial magnetic/direct current stimulation, are aimed at decreasing the risk factors for POD. This review provides a comprehensive overview of recently reported nonpharmacological mono-component interventions for preventing POD and briefly describes their clinical value.
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Brain dysfunction is a frequent complication of sepsis. Most likely, sepsis-associated brain dysfunction (SABD) results from the interaction between multiple factors: neurodegeneration due to microglial activation, altered neurotransmission, neuroinflammation and impairment of cerebral macro- and microcirculation. ⋯ Disorders of brain perfusion and CBF regulation are frequently observed in humans with sepsis, and intracranial hemodynamics monitoring can potentially be useful in clinical management of septic patients. The aim of this review is to provide an update of the current knowledge on alterations in brain hemodynamics associated with sepsis, along with physiological and methodological considerations intended to help the reader navigate the diverse results from published literature and a practical guide to apply non-invasive intracranial hemodynamics monitoring to septic patients in clinical practice.
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Minerva anestesiologica · Sep 2024
Randomized Controlled Trial Comparative StudyA comparative analysis of elevated endotracheal tube cuff pressure incidence in laparoscopic abdominal surgery: saline versus air inflation.
Endotracheal intubation is a frequently performed procedure in anesthesia practice, and ensuring the correct inflation of the cuff is essential for maintaining the airway seal. Overinflation of endotracheal tube (ETT) cuffs can lead to complications, such as postoperative sore throat. This study aimed to compare the incidence of elevated ETT cuff pressure between saline and air inflation in elective laparoscopic abdominal surgery. ⋯ Inflating ETT cuffs with saline instead of air during laparoscopic abdominal surgeries led to a reduced requirement for interventions in maintaining pressure. This indicates that the use of saline inflation may significantly lower the risk of high cuff pressure and related complications.
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Minerva anestesiologica · Sep 2024
Randomized Controlled TrialSelective ultrasound-guided nerve root block improves outcomes for discectomy in patients with cervical disc disease: a randomized, controlled, single-blinded study.
We hypothesized that ultrasound-guided selective nerve root block could play a role in the prediction of clinical outcomes in patients with multilevel cervical disease following selective anterior cervical discectomy and fusion. ⋯ In patients with multilevel cervical disease, ultrasound-guided selective nerve root block is an excellent, safe, non-radiating, and reliable test to determine the appropriate level for operation.