Minerva anestesiologica
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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.
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Minerva anestesiologica · Sep 2024
Comment Letter Case ReportsBilateral erector spinae plane block for percutaneous portal vein embolization.
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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.