Minerva anestesiologica
-
Minerva anestesiologica · Apr 2021
Randomized Controlled TrialEffect of dexmedetomidine on CD4+ T cells and programmed cell death protein-1 in postoperative analgesia: a prospective, randomized, controlled study.
Surgical trauma inhibits cellular immunity. Dexmedetomidine produces opioid-sparing effect and an impact on immune response. ⋯ Dexmedetomidine increases the differentiation of Th1 and Treg cells and reduces the expression of PD-1 on CD4+ T cells. Dexmedetomidine may assist to ameliorate postoperative pain and attenuate proinflammatory response. There might be a negative correlation between pain and Th1 cells.
-
Minerva anestesiologica · Apr 2021
Low diaphragm muscle mass predicts adverse outcome in patients hospitalized for Covid-19 pneumonia: an exploratory pilot study.
The aim of this study was to evaluate whether measurement of diaphragm thickness (DT) by ultrasonography may be a clinically useful noninvasive method for identifying patients at risk of adverse outcomes defined as need of invasive mechanical ventilation or death. ⋯ Diaphragmatic ultrasound may be a valid tool to evaluate the risk of respiratory failure. Evaluating the need of mechanical ventilation treatment should be based not only on PaO
2 /FiO2 , but on a more comprehensive assessment including DT because if the lungs become less compliant a thinner diaphragm, albeit free of intrinsic abnormality, may become exhausted, thus contributing to severe respiratory failure. -
Minerva anestesiologica · Apr 2021
Effectiveness and validity of midsagittal tongue cross-sectional area and width measured by ultrasound to predict difficult airways.
Increased tongue volume measured by ultrasound has been proven to be related to difficult airways. Tongue volume is an indirect parameter and is derived from multiplying the midsagittal tongue cross-sectional area (CSA) by the tongue width. However, few studies have focused on the ability of tongue CSA and tongue width to predict difficult airways. This study aimed to investigate the predictive value of tongue CSA and tongue width for predicting difficult laryngoscopy and difficult intubation. ⋯ Ultrasonic measurement of midsagittal tongue CSA may be a valuable predictor of difficult laryngoscopy and difficult intubation. By contrast, tongue width measured by ultrasound may be a weak predictor of difficult laryngoscopy, but its predictive ability was questionable.
-
The PENG block is a recently described ultrasound-guided technique for the blockade of the sensory nerve branches to the anterior hip joint capsule. It was described as an analgesic block for the acute pain management after hip fracture, while subsequent studies expanded the original indication. The aim of this narrative review was to summarize the existing knowledge about the PENG block from the anatomical bases and to provide an up-to-date description of the technique, applications and effects. ⋯ The PENG block is a promising technique. Randomized controlled trials of high methodological quality are required to further elaborate the role of this block.