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  1. Article ; Online: Comment on "Effects of a Pragmatic Home-Based Exercise Program Concurrent With Neoadjuvant Therapy on Physical Function of Patients With Pancreatic Cancer: The PancFit Randomized Clinical Trial".

    Ghielmini, Enea M / Zingg, Urs

    Annals of surgery open : perspectives of surgical history, education, and clinical approaches

    2023  Volume 4, Issue 4, Page(s) e359

    Language English
    Publishing date 2023-11-08
    Publishing country United States
    Document type Journal Article ; Comment
    ISSN 2691-3593
    ISSN (online) 2691-3593
    DOI 10.1097/AS9.0000000000000359
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  2. Article ; Online: Erector Spinae Plane Block versus Transversus Abdominis Plane Block for Robotic Inguinal Hernia Repair: A Blinded, Active-Controlled, Randomized Trial.

    Ghielmini, Enea M / Greco, Lorenzo / Spampatti, Sebastiano / Kubli, Rahel / Saporito, Andrea / La Regina, Davide

    Pain physician

    2023  Volume 27, Issue 1, Page(s) 27–34

    Abstract: Background: Regional anesthetic nerve blocks are widely used in the treatment of pain after outpatient surgery to reduce opioid consumption. Erector spinae plane (ESP) block is a recently described technique with promising results in different scenarios. ...

    Abstract Background: Regional anesthetic nerve blocks are widely used in the treatment of pain after outpatient surgery to reduce opioid consumption. Erector spinae plane (ESP) block is a recently described technique with promising results in different scenarios.
    Objectives: To compare ESP block efficacy with the commonly used transversus abdominis plane (TAP) block in patients undergoing robot-assisted inguinal hernia repair.
    Study design: This was a randomized, blinded, active controlled, superiority trial with 2 parallel groups. The study was approved by the local ethics committee. Registration took place on; www.
    Clinicaltrials: gov with the identifier NCT04750512.
    Setting: Adults undergoing robotic inguinal hernia repair were recruited between January 2021 and April 2022 in a single referral center of southern Switzerland.
    Methods: To ensure blinding, the study employed a "double dummy" design, where all patients underwent both TAP and ESP blocks, but only one block was therapeutically active. The therapeutic block contained ropivacaine 0.2%, while the other infiltration contained placebo. The therapeutic intervention varied between groups, with one group receiving the TAP block as the active treatment and the other group receiving the ESP block as the active treatment. Computer generated 1:1 randomization determined allocation, which took place immediately prior to the intervention. As a result, blinding included patients, anesthesia, and surgery providers, outcome assessors and statistical analysts. The main outcome measure was the highest reported pain score on a Visual Analog Scale (VAS) during the 6 hours following the end of general anesthesia. Secondary outcomes included pain scores at set intervals, analgesic consumption, and complications.
    Results: A total of 50 patients (25 per arm) were enrolled and included in the analysis. The study found no significant difference in the mean maximal VAS scores between the 2 groups (TAP block 22.2, ESP block 20, difference 2.2, 95% CI is -12.1 to 16.5). Secondary endpoints, including VAS pain scores at different time points, use of rescue analgesics, time to first walk, duration of stay, and frequency of adverse events, did not show any significant differences between the 2 groups. However, post-hoc analysis suggested a more stable effect over time for the ESP block compared to the TAP block.
    Limitations: The main limitation is a higher variance in VAS scores than expected in the power calculations.
    Conclusions: ESP block was not superior to TAP block in the treatment of post-operative pain among patients undergoing robotic inguinal hernia repair.
    MeSH term(s) Adult ; Humans ; Robotics ; Hernia, Inguinal/surgery ; Robotic Surgical Procedures ; Nerve Block ; Pain ; Abdominal Muscles/surgery
    Language English
    Publishing date 2023-10-20
    Publishing country United States
    Document type Randomized Controlled Trial ; Journal Article
    ZDB-ID 2146393-1
    ISSN 2150-1149 ; 1533-3159
    ISSN (online) 2150-1149
    ISSN 1533-3159
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    Zs.A 5930: Show issues Location:
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  3. Article ; Online: Ultrasound-guided pudendal nerve block in patients undergoing open hemorrhoidectomy: a double-blind randomized controlled trial.

    Di Giuseppe, Matteo / Saporito, Andrea / La Regina, Davide / Tasciotti, Edoardo / Ghielmini, Enea / Vannelli, Alberto / Pini, Ramon / Mongelli, Francesco

    International journal of colorectal disease

    2020  Volume 35, Issue 9, Page(s) 1741–1747

    Abstract: Purpose: In this double-blind randomized trial, we aimed to compare the postoperative pain, complications, and length of hospital stay in patients undergoing open hemorrhoidectomy under spinal anesthesia with or without the pudendal nerve block.: ... ...

    Abstract Purpose: In this double-blind randomized trial, we aimed to compare the postoperative pain, complications, and length of hospital stay in patients undergoing open hemorrhoidectomy under spinal anesthesia with or without the pudendal nerve block.
    Methods: Patients undergoing Milligan-Morgan hemorrhoidectomy under spinal anesthesia were randomized to undergo a pudendal nerve block or no intervention. Postoperative pain on the visual analogue scale (VAS) at 6, 12, 24, and 48 h; opioid administration; and length of hospital stay were recorded and analyzed.
    Results: Over the study period, 49 patients were included and 23 randomized in the treatment arm. No differences in terms of age, gender, and preoperative risk factors were noted between groups. The pain on the VAS at 6, 12, 24, and 48 h was 2.8 vs. 4.6 (p = 0.046), 3.4 vs. 4.7 (p = 0.697), 1.4 vs. 3.1 (p = 0.016), and 1.0 vs. 2.1 (p = 0.288) in the treatment and control groups respectively. No differences in opioids use or complications were noted. Length of hospital stay was 1.2 vs. 1.8 days respectively (p = 0.046). No complications directly associated to the pudendal nerve block were observed. Multivariate analysis revealed that the pudendal nerve block was an independent factor reducing the postoperative pain.
    Conclusions: The ultrasound-guided pudendal nerve block in patients undergoing open hemorrhoidectomy under spinal anesthesia showed a statistically significant reduction in postoperative pain and length of hospital stay. The proposed technique appeared to be safe and feasible and may be recommendable in patients undergoing open hemorrhoidectomy.
    Trial registration: ClinicalTrials.gov Identifier: NCT04251884.
    MeSH term(s) Double-Blind Method ; Hemorrhoidectomy/adverse effects ; Hemorrhoids/surgery ; Humans ; Nerve Block ; Pain, Postoperative/drug therapy ; Pain, Postoperative/etiology ; Pudendal Nerve ; Ultrasonography, Interventional
    Language English
    Publishing date 2020-05-30
    Publishing country Germany
    Document type Journal Article ; Randomized Controlled Trial
    ZDB-ID 84975-3
    ISSN 1432-1262 ; 0179-1958
    ISSN (online) 1432-1262
    ISSN 0179-1958
    DOI 10.1007/s00384-020-03630-x
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    Zs.A 2121: Show issues Location:
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  4. Article ; Online: Sleepiness at the time of testing impairs olfactory performance.

    Ghielmini, Enea / Poryazova, Rositsa / Baumann, Christian R / Bassetti, Claudio L

    European neurology

    2013  Volume 69, Issue 1, Page(s) 58–64

    Abstract: Background: We aimed to investigate the differential roles of hypocretin versus dopamine dysfunction versus excessive daytime sleepiness (EDS) in the development of hyposmia. Olfaction in patients with Parkinson disease, restless leg syndrome, ... ...

    Abstract Background: We aimed to investigate the differential roles of hypocretin versus dopamine dysfunction versus excessive daytime sleepiness (EDS) in the development of hyposmia. Olfaction in patients with Parkinson disease, restless leg syndrome, narcolepsy with cataplexy, EDS, and healthy controls was compared.
    Methods: Sixty-six subjects participated in the study: 14 with PD, 13 with NC, 12 with RLS, 8 with EDS, and 20 healthy controls. Olfaction was tested using standardized Sniffin'Sticks test. Sleepiness was assessed using Karolinska, Stanford and Epworth sleepiness scales.
    Results: Olfactory discrimination correlated negatively with subjective momentary sleepiness. A significant deficit in olfaction was found in PD patients with respect to all other groups in all olfactory domains. No significant differences were found between the other groups.
    Conclusion: We could not confirm decreased olfaction in patients with NC. Yet the significant correlation between momentary sleepiness and olfactory function suggests that sleepiness is a potential confounding factor in the assessment of olfaction, e.g. in NC. Furthermore, our results confirm that olfaction is impaired in PD, whereas it is normal in RLS.
    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; Disorders of Excessive Somnolence/physiopathology ; Female ; Humans ; Male ; Middle Aged ; Narcolepsy/physiopathology ; Olfaction Disorders/diagnosis ; Olfaction Disorders/physiopathology ; Parkinson Disease/physiopathology ; Restless Legs Syndrome/physiopathology ; Sleep/physiology ; Smell/physiology
    Language English
    Publishing date 2013
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 209426-5
    ISSN 1421-9913 ; 0014-3022
    ISSN (online) 1421-9913
    ISSN 0014-3022
    DOI 10.1159/000337449
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 575: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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  5. Article: Sleepiness at the Time of Testing Impairs Olfactory Performance

    Ghielmini, Enea / Poryazova, Rositsa / Baumann, Christian R. / Bassetti, Claudio L.

    European Neurology

    2012  Volume 69, Issue 1, Page(s) 58–64

    Abstract: Background: We aimed to investigate the differential roles of hypocretin versus dopamine dysfunction versus excessive daytime sleepiness (EDS) in the development of hyposmia. Olfaction in patients with Parkinson disease, restless leg syndrome, narcolepsy ...

    Institution Department of Neurology, University Hospital Zurich, Zurich, and Neurocenter (EOC) of Southern Switzerland, Neurology Department, Ospedale Civico, Lugano, Switzerland
    Abstract Background: We aimed to investigate the differential roles of hypocretin versus dopamine dysfunction versus excessive daytime sleepiness (EDS) in the development of hyposmia. Olfaction in patients with Parkinson disease, restless leg syndrome, narcolepsy with cataplexy, EDS, and healthy controls was compared. Methods: Sixty-six subjects participated in the study: 14 with PD, 13 with NC, 12 with RLS, 8 with EDS, and 20 healthy controls. Olfaction was tested using standardized Sniffin’Sticks test. Sleepiness was assessed using Karolinska, Stanford and Epworth sleepiness scales. Results: Olfactory discrimination correlated negatively with subjective momentary sleepiness. A significant deficit in olfaction was found in PD patients with respect to all other groups in all olfactory domains. No significant differences were found between the other groups. Conclusion: We could not confirm decreased olfaction in patients with NC. Yet the significant correlation between momentary sleepiness and olfactory function suggests that sleepiness is a potential confounding factor in the assessment of olfaction, e.g. in NC. Furthermore, our results confirm that olfaction is impaired in PD, whereas it is normal in RLS.
    Keywords Olfactory function ; Parkinson’s disease ; Narcolepsy ; Restless legs syndrome ; Excessive daytime sleepiness
    Language English
    Publishing date 2012-11-07
    Publisher S. Karger AG
    Publishing place Basel, Switzerland
    Document type Article
    Note Original Paper
    ZDB-ID 209426-5
    ISSN 1421-9913 ; 0014-3022
    ISSN (online) 1421-9913
    ISSN 0014-3022
    DOI 10.1159/000337449
    Database Karger publisher's database

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 575: Show issues Location:
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