Minerva anestesiologica
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Minerva anestesiologica · Jul 2023
Meta AnalysisSafety and efficacy of the combination of esketamine and propofol in procedural sedation/analgesia: a systematic review and meta-analysis.
This review and meta-analysis of randomized controlled trials (RCTs) assessed the side effects and efficacy of esketamine combined with propofol in procedural sedation and analgesia. ⋯ Esketamine combined with propofol has an advantage in reducing the incidence of hypotension and bradycardia during procedural sedation and analgesia, but it may increase the risk of agitation in the recovery phase. More studies of high quality are needed before the widespread adoption of the combination of esketamine and propofol.
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Minerva anestesiologica · Jul 2023
The effect of off-hours hip surgery on patients' outcomes: a RECORD-compliant retrospective, propensity score-matched cohort study.
Off-hours working may have negative impacts on the performance of clinicians, leading to possible adverse outcomes of patients. We aimed to explore the impact of off-hours hip surgery on early postoperative outcomes. ⋯ Off-hours hip surgery was associated with adverse early postoperative prognosis, suggesting that more attention should be paid to off-hours hip surgery.
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Minerva anestesiologica · Jul 2023
Randomized Controlled TrialProlonged continuous wound infusion of local anesthetic and steroid after major abdominal surgery to reduce opioid consumption: a randomized, double-blind trial.
Continuous wound infusion (CWI) is effective for post-operative pain management, but the effect of prolonged infusions and the use of steroids in the infused mixture have never been addressed. We investigate the effect of prolonged CWI with ropivacaine 0.2% (R) over seven days and methylprednisolone (Mp) 1 mg/kg infused in the wound in the first 24 hours. ⋯ Prolonged infusion with R-Mp is safe and effective but did not reduce opioid consumption in the seven days after surgery or PPSP prevalence.
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Minerva anestesiologica · Jul 2023
ReviewTherapeutic potentials of mesenchymal stromal cells-derived extracellular vesicles in liver failure and marginal liver graft rehabilitation: a scoping review.
Liver failure includes distinct subgroups of diseases: Acute liver failure (ALF) without preexisting cirrhosis, acute-on-chronic liver failure (ACLF) (severe form of cirrhosis associated with organ failures and excess mortality), and liver fibrosis (LF). Inflammation plays a key role in ALF, LF, and more specifically in ACLF for which we have currently no treatment other than liver transplantation (LT). The increasing incidence of marginal liver grafts and the shortage of liver grafts require us to consider strategies to increase the quantity and quality of available liver grafts. ⋯ In LF, MSC-EVs demonstrated anti-fibrotic properties associated with liver tissue regeneration. Normothermic-machine perfusion (NMP) combined with MSC-EVs represents an attractive therapy to improve liver regeneration before LT. Our review suggests a growing interest in MSC-EVs in liver failure and gives an appealing insight into their development to rehabilitate marginal liver grafts through NMP.
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Minerva anestesiologica · Jul 2023
Observational StudyProspective analysis on carotid endarterectomy: intermediate-deep ultrasound-guided cervical blockade versus general anesthesia.
The best regional anesthesia plan with the best clinical results for Carotid endarterectomy (CEA) has not been defined yet. ⋯ Although the use of intermediate-deep cervical plexus blockade for CEA confers similar neurologic stability as GA does, there is a difference on the hemodynamic behaviour due to the differences in vasoactive drug consumption. Loco-regional techniques provide a better postoperative pain control and shorten in-hospital length of stay.