Minerva anestesiologica
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Minerva anestesiologica · Apr 2024
Short-term effects of small volume saline infusion on acid base equilibrium in critically ill patients.
Short-term acid-base effects of 0.9% saline solution infusion are not well described. Aim of this study was to assess the effects of a fluid challenge with 0.9% saline in critically ill patients according to the Stewart's approach, which allows a precise determination of acid base equilibrium. ⋯ The infusion of 0.9% saline reduced strong ion difference by increasing plasma chloride concentration, with no effect on pH due to concomitant albumin dilution. Saline non-responders, characterized by the ability to excrete the sodium excess, were more likely to suffer the acidifying effects of saline infusion, while renal function did not affect the acid-base response to saline infusion.
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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
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. -
Minerva anestesiologica · Apr 2024
Editorial Comment LetterLights and shadows on the use of adjuvants in fascial block.
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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.