Water-electrolyte homeostasis and its basic regulatory hormones have been studied in 36 patients with neurosurgical brain pathology during surgical interventions performed under balanced anesthesia (sodium hydroxybutyrate combined with NLA drugs). The study has revealed 3 types of reactions in hormones regulating water-electrolyte homeostasis: type I--a decrease in vasopressin (VP) concentration and renin-angiotensin-aldosterone system (RAAS) activity; type II--VP increase and RAAS activation; type III--an increase in VP content and RAAS disbalance. It has been shown that type I reaction is accompanied by marked osmotic disturbances. The impact of sodium hydroxybutyrate on RAAS is manifested in aldosterone secretion suppression.
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Br J Anaesth
January 2025
Department of Anaesthesiology, Critical Care and Pain Medicine, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy. Electronic address:
There is a complex association between postoperative pain and postoperative delirium, which highlights the need for a more balanced approach to pain management that considers various risk factors. We emphasise the importance of comprehensive documentation and standardised monitoring to improve detection and management of postoperative delirium, ultimately enhancing patient outcomes. We advocate for a precision anaesthesia approach, which tailors care to individual patient profiles, as a potential solution to address these challenges.
View Article and Find Full Text PDFSurg Today
January 2025
Division of Surgery, Istituto Auxologico Italiano IRCCS (Istituto di Ricovero e Cura a Carattere Scientifico), Milan, Italy.
Purposes: We analyzed the acute-phase response in unilateral thyroidectomy by comparing the transoral endoscopic thyroidectomy vestibular approach (TOEVA) with the minimally invasive video-assisted thyroidectomy (MIVAT).
Methods: Patients were randomly assigned to undergo either TOEVA or MIVAT, after we obtained their written informed consent to participate in this study. Blood count, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), interleukin-1β (IL-1β), IL-6 and tumor necrosis factor (TNF-) were measured before surgery and then 4, 24, and 48 h after surgery.
PLoS One
December 2024
Department of Medicine, Division of Nephrology and Hypertension, Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, NY, United States of America.
Acute kidney injury (AKI) incidence after neurosurgical operations has been reported as 10-14%. The literature regarding the incidence of nosocomial acute kidney disease (AKD) following neurosurgery is scarce. This retrospective, single-center, observational study aimed to assess the impact of different anaesthetics on development of postoperative AKI and persistent AKD in neurosurgical patients.
View Article and Find Full Text PDFEur J Med Res
December 2024
Department of Anesthesiology and Reanimation, Faculty of Medicine, Osmangazi University, Büyükdere Mh, Odunpazarı, 26040, Eskişehir, Turkey.
Background: Ophthalmic procedures are increasingly being performed under regional anesthesia techniques such as peribulbar and incisionless sub-Tenon's blocks. The aim is to compare peribulbar block with incisionless sub-Tenon's block in terms of perioperative complications in patients who underwent cataract and vitreoretinal surgeries.
Methods: The patients who underwent cataract or vitroretinal surgery under peribulbar block or incisionless sub-Tenon's block were included in the study.
J Cardiothorac Vasc Anesth
December 2024
Division of Cardiac Surgery, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy; Division of Cardiac Surgery, Santa Maria Hospital, GVM Care & Research, Bari, Italy. Electronic address:
Objectives: To investigate the impact of systemic inflammatory response syndrome (SIRS) on 30-day mortality following cardiac surgery and develop a machine learning model to predict SIRS.
Design: Retrospective cohort study.
Setting: Single tertiary care hospital.
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