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Povzetek: Neurocognitive decline during the perioperative period represents a risk of significant complications, including dementia and death. The aim of our study was to observe the change in biomarkers of neuroinflammation in optimized anesthesia without clinical signs of perioperative neurocognitive decline. Observational study included high-risk surgical patients who underwent large intestinal resections. Balanced anaesthesia was used to maximize cerebral protection. The release of NSE, protein S-100, matrix metalloproteinase-9 (MMP-9) and other biomarkers of cerebral injury were measured in serum samples using immunochemical methods during and after surgery. Profiles of proteins MMP-9 and S-100 showed perioperative increase, which was in accordance with intraoperative cerebral injury. Despite the increase, the S-100 and NSE plasma levels remained within normal range. The study highlights the perioperative expression of proteins MMP-9 and S-100, which might be useful as biomarkers of cerebral injury in the context of balanced anesthesia during major abdominal surgery.
Ključne besede: biomarkers, abdominal cancer surgery, anaesthesia
Objavljeno v DiRROS: 27.02.2026; Ogledov: 308; Prenosov: 152
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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: 552; Prenosov: 213
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Povzetek: Aim: This prospective pilot anatomical study aimed to develop an ultrasoundguided transversus abdominis plane (TAP) block technique that desensitises cranial and mid-abdominal wall in grower pigs. We hypothesised that a fourpoint TAP approach would be more efficient than a three-point TAP in staining relevant nerves of the cranial and mid-abdominal wall. Methods: In phase I, the ultrasound anatomy of the abdominal wall musculature was examined on three pig cadavers (two piglets and one fattening pig) and the ultrasound localization of the needle in the corresponding interfascial plane was practised. In phase II, a three-point TAP injection was performed in three freshly euthanized cadavers of grower pigs. A 1% methylene blue solution (0.3 mL/ kg per injection point) was injected between the transversus abdominis and internal oblique muscle. In phase III, methylene blue solution was injected at four points (0.2 mL/kg per injection point) in four anaesthetized grower pigs prior to euthanasia. Positive nerve staining was defined as continuous staining of at least 1 cm of the nerve length. Binary variables (positive/negative) were used for nerve staining assessment. Results: The four-point TAP technique with a lower injection volume stained more nerves than the three-point technique with a higher injection volume, i.e., 69% of the observed nerves from the eighth-last thoracic to the third lumbar nerve were stained with the four-point TAP technique. The nerves in the centre were stained with a higher success rate, while the eighth-last thoracic and the second lumbar nerve were stained with less success (1/8 and 3/8, respectively). The third lumbar nerve was not stained. Conclusion: The four-point TAP technique could be used as part of a multimodal analgesia approach for cranial and mid-abdominal surgery in pigs, but live animal studies are needed to evaluate the clinical applicability and efficacy of desensitisation.
Ključne besede: abdominal surgery, cadaveric anatomical study, pig, regional anaesthesia, transversus abdominis plane block, methylene blue
Objavljeno v DiRROS: 09.12.2025; Ogledov: 937; Prenosov: 235
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