Minerva anestesiologica
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Minerva anestesiologica · Oct 2022
ReviewAnatomical changes of the ligamentum flavum and the epidural space after spinal surgery: a retrospective magnetic resonance imaging study.
Anatomical changes of the ligamentum flavum (LF) and epidural space (ES) after spinal surgery may affect the loss-of-resistance during interlaminar epidural procedure and distribution of drug administered into the ES. This study aims to investigate clinically relevant anatomical changes of the LF and ES after spinal surgery. ⋯ For epidural anesthesia in patients who have previously undergone spinal surgery, it is reasonable to select a needle insertion site other than the level of spinal surgery.
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Minerva anestesiologica · Oct 2022
Meta AnalysisA systematic review and meta-analysis of three risk factors for chronic postsurgical pain: age, sex and preoperative pain.
Chronic postsurgical pain (CPSP) is a common and disabling postoperative complication. Several risk factors for CPSP have been established, but it is unclear whether they are significant for any type of surgery. This systematic review aimed to assess the risk of CPSP related to three known preoperative risk factors "age, sex and preoperative pain" in the adult population after any type of elective non-obstetrical surgery. ⋯ This systematic review confirms that younger age, female sex, and preoperative pain are associated with higher risk of developing CPSP in any type of elective non-obstetrical surgery. However, effect sizes are small and quality of evidence low-moderate only, limiting comparisons of different types of surgery.
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Minerva anestesiologica · Oct 2022
Older adults with severe coronavirus disease 2019 admitted to intensive care unit: prevalence, characteristics and risk factors for mortality.
Although older adults are at high risk for severe coronavirus disease 2019 (COVID-19) requiring intensive care unit (ICU) admission, age is often used as a selection criterion in case of ICU beds scarcity. We sought to compare the proportion, clinical features and mortality between patients ≥70 years old and younger ICU patients with COVID-19. ⋯ When age is not used as criterion for admission to COVID ICU, patients ≥70 years old represent a considerable proportion and, compared to younger ones, they have higher mortality. Age, severity of illness and CCI, and certain comorbidities are independent risk factors for mortality.