1. Influence of hypnosis and acupuncture on perioperative complicationsJasmina Markovič Božič, Meta Gradišar, Mihela Petovar, Polona Mušič, Nina Pirc, Joseph Meyerson, Maks Tušak, Andrej Lapoša, Matej Tušak, Alenka Spindler-Vesel, 2025, izvirni znanstveni članek Povzetek: Background: This randomised, single-centre study and original research manuscript aimed to evaluate whether perioperative hypnosis and acupuncture can reduce postoperative nausea and vomiting (PONV), opioid use, and other complications in spinal surgery compared to standard pharmacological management. Methods: In total, 60 patients undergoing spinal surgery were divided into three groups regarding antiemetic prevention: Hypnosis and acupuncture (HG), hypnosis, acupuncture, and antiemetic (HAG), and standard control with antiemetic (CG). Hypnosis was performed one day before surgery, or patients received premedication with midazolam on the day of surgery. Anaesthesia was induced and maintained with propofol and remifentanil. Acupuncture was performed bilaterally at points LI4 and PC6 after induction of anaesthesia. Postoperatively, the consumption of opioids and antiemetics, satisfaction and well-being, length of stay and complications were recorded. Results: In all groups, additional opioids were administered in the first hour after surgery (p = 0.4). In the ICU, only one patient in the HAG and two patients in the CG and HG required additional analgesics (p = 0.8). Overall satisfaction (9/9/0 vs. 10/6/4 vs. 9/7/3; p = 0.4) and well-being scores (10/8/0 vs. 13/5/2 vs. 13/5/1; p = 0.5) were high across all groups, with no significant differences. Two patients in CG experienced mild complications. The length of hospitalisation was similar (3 days in CG vs. 4 days in HAG and HG (p = 0.7). Only one patient in the HG required antiemetics; none were needed in CG or HAG (p = 0.4). Conclusions: Within the constraints of this exploratory single-centre trial, hypnosis appeared to provide anxiolytic benefits comparable to benzodiazepines, and intraoperative acupuncture did not increase PONV despite reduced pharmacological prophylaxis. No significant differences were detected in opioid and antiemetic consumption. Larger, adequately powered studies are needed to confirm these findings and optimise the timing and modality of non-pharmacological interventions.
Ključne besede: spinal surgery, anaesthesia, antiemetic, acupuncture, hypnosis
Objavljeno v DiRROS: 05.01.2026; Ogledov: 554; Prenosov: 216
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2. The role of intraoperative monitoring in target selection in deep brain stimulation : a single centre studySandro Ibrulj, Dejan Georgiev, Žiga Samsa, Polona Mušič, Mitja Benedičič, Maja Trošt, 2025, izvirni znanstveni članek Povzetek: Introduction Intraoperative microelectrode recording (MER) and intraoperative test stimulation may provide vital information for optimal electrode placement and clinical outcome in movement disorders patients treated with deep brain stimulation (DBS). The aims of this retrospective study were to determine (i) how often the planned (imaging based) placements of electrodes were changed due to MER and intraoperative test stimulation in Parkinson’s disease (PD), dystonia and essential tremor (ET) patients; (ii) whether the frequency of repositioning changed over time; (iii) whether patients’ age or disease duration (in PD) influenced the frequency of repositioning. Methods Data on the planned and the final placement of 141 electrodes in 72 consecutive DBS treated patients (52 PD, 11 dystonia, 9 ET) was collected over the first 8 years of DBS implementation in a single center. An association between the rate of electrode repositioning and the patients’ age, disease duration and the time/year of implementation was explored. Results Analysis of all targets showed a change in final electrode placement in 39.7 % (56/141); 39.8 % (41/103) in PD, 40.9 % (9/22) in dystonia and 37.5 % (6/16) in ET. Annual analysis showed a decrease in rate of repositioning between the centre’s first and eighth year (p = 0.013) of implementation. No correlation was found between electrode repositioning rate and patient age (p = 0.42) nor disease duration (p = 0.09) in PD. Conclusion This retrospective analysis confirms the benefit of MER and intraoperative test stimulation during DBS surgery in determining the final electrode position during the early / initial period of implementing the procedure. Our findings show a learning curve in successful preoperative planning in our centre achieved through experience.
Ključne besede: deep brain stimulation, intraoperative monitoringa, asleep DBS
Objavljeno v DiRROS: 02.12.2025; Ogledov: 787; Prenosov: 257
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3. Crystalloids vs. colloids for fluid optimization in patients undergoing brain tumour surgeryJasmina Markovič Božič, Božidar Visočnik, Polona Mušič, Iztok Potočnik, Alenka Spindler-Vesel, 2022, izvirni znanstveni članek Povzetek: Background. This randomised, double-blinded, single-centre study prospectively investigated the impact of goal directed therapy and fluid optimization with crystalloids or colloids on perioperative complications in patients un-dergoing brain tumour surgery. Main aim of the study was to investigate the impact of fluid type on postoperative complications.Patients and methods. 80 patients were allocated into two equal groups to be optimised with either crystalloids (n = 40) or colloids (n = 40). Invasive hemodynamic monitoring was used to adjust and maintain mean arterial pressure and cerebral oxygenation within the baseline values (± 20%) and stroke volume variation (SVV) ≤ 10%. Postoperative complications from different organ systems were monitored during the first 15 days after surgery. Hospital stay was also recorded.Results. Crystalloid group received significantly more fluids (p = 0.003) and phenylephrine (p = 0.02) compared to colloid group. This did not have any significant impact on perioperative complications and hospital stay, since no dif-ferences between groups were observed. Conclusions. Either crystalloids or colloids could be used for fluid optimization in brain tumour surgery. If protocol-ised perioperative haemodynamic management is used, the type of fluid does not have significant impact on the outcome.
Objavljeno v DiRROS: 25.07.2024; Ogledov: 1262; Prenosov: 362
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