Anesthesiology and Perioperative Science最新文献

{"title":"Efficacy of sevoflurane flush out and activated charcoal filtration—a bench study","authors":"Maximilian Mörtl,&nbsp;Daniel Schwaiger,&nbsp;Wolfgang Lederer,&nbsp;Florentin Weiss,&nbsp;Anesu Chawaguta,&nbsp;Helmut Wiesenhofer,&nbsp;Chris A. Mayhew,&nbsp;Veronika Ruzsanyi","doi":"10.1007/s44254-024-00072-4","DOIUrl":"10.1007/s44254-024-00072-4","url":null,"abstract":"<div><h3>Purpose</h3><p>A bench study to assess the elimination of sevoflurane from an anesthetic workstation using three different processing methods.</p><h3>Methods</h3><p>Sevoflurane concentrations from samples of the inspiratory breathing hose and air samples from within the investigation room were assessed during predetermined flush out intervals using Gas Chromatography-Ion Mobility Spectrometry. The primary objective was to determine the time to reach concentrations below 5 ppm_v.</p><h3>Results</h3><p>Reduction of sevoflurane volume concentrations below a threshold of 5 ppm_v was achieved within the first minute after removal of the vaporizer and the complete exchange of the soda and the breathing system and within the 15 min measurement interval after inclusion of two activated charcoal filters without a 90 s of flushing and without changing of the breathing hoses as required by the manufacturer.</p><h3>Conclusions</h3><p>Complete removal of the vaporizer and an exchange of the soda and the ventilation unit most quickly reduced sevoflurane concentrations, but the total processing interval may exceed 30 min. Inserted activated charcoal filters without a previous 90 s of flushing and without changing the breathing hoses followed by flushing only with raised fresh gas flow allow ventilation below trigger threshold to be reached within due time.\u0000</p></div>","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"2 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-024-00072-4.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142409516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of opioids on hospital stay and mortality in patients undergoing abdominal surgeries","authors":"Lucas Maia,&nbsp;Isabella Chaves,&nbsp;Heitor Medeiros,&nbsp;Glauco Francisco Silva,&nbsp;Wallace Andrino da Silva","doi":"10.1007/s44254-024-00071-5","DOIUrl":"10.1007/s44254-024-00071-5","url":null,"abstract":"<div><h3>Purpose</h3><p>Postoperative pain management is a critical aspect of surgical care, significantly influencing patient recovery and outcomes. This study aims to evaluate the impact of opioid use on hospital stay and mortality rates among patients undergoing abdominal surgeries in Brazil, where healthcare disparities may affect postoperative outcomes.</p><h3>Methods</h3><p>This observational cross-sectional study was conducted at the University Hospital Onofre Lopes in Natal, Brazil. We included 385 patients aged 18 years or older who underwent abdominal surgery in 2023. Data were collected from medical records, focusing on analgesic therapy, opioid types, dosages, and patient demographics. Statistical analyses were performed using JAMOVI software.</p><h3>Results</h3><p>Opioid consumption was prevalent among the cohort, with 89.6% of patients receiving opioids postoperatively. Tramadol was the most frequently administered opioid, followed by nalbuphine and morphine. Patients treated with morphine had a significantly extended median hospital stay (15.5 days) compared to those receiving tramadol or nalbuphine (2 days). Morphine use was also associated with a higher mortality rate, with these patients being 16 times more likely to die compared to those on weaker opioids. Older age and extended hospital stays were additional risk factors for increased mortality.</p><h3>Conclusion</h3><p>Opioids were used extensively in this cohort as the main analgesic drug for postoperative pain management after abdominal surgeries. Use was associated with prolonged hospital stay and higher probability of death.</p></div>","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"2 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-024-00071-5.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142414053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrospective study of the efficacy of methylprednisolone vs. triamcinolone in lumbar epidural steroid injections for the treatment of low back pain due to degenerative disc disease","authors":"Zachary R. Higgins,&nbsp;Shuchita Garg,&nbsp;Timothy Burroughs,&nbsp;Katherine A. Qualls,&nbsp;Jun-Ming Zhang,&nbsp;Judith A. Strong","doi":"10.1007/s44254-024-00069-z","DOIUrl":"10.1007/s44254-024-00069-z","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;p&gt;A common low back pain treatment is epidural injection of corticosteroids. The nominal target of anti-inflammatory corticosteroid drugs is the glucocorticoid receptor (GR). In vitro studies show many clinically used steroids also activate the mineralocorticoid receptor (MR) with substantial potency. Based on preclinical studies, this may have pro-inflammatory and pro-nociceptive effects that counter the desired GR effects. Of two outpatient pain clinics associated with the University of Cincinnati Department of Anesthesiology, one primarily used methylprednisolone while the other used mainly triamcinolone for epidural steroid injections. We hypothesized that triamcinolone would give better outcomes because in vitro, ratio of MR/GR potency is about 10 fold less favorable for methylprednisolone.&lt;/p&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;p&gt;We conducted a retrospective chart review of adults receiving lumbar epidural steroid injection for low back pain due to degenerative disc disease at the two pain clinics. For subjects treated at the first clinic, we obtained basic demographics, smoking history, 2 primary outcomes (patient-rated percent improvement in pain levels, and injection outcome rated as poor, partial, or good), and pain ratings (0–10 scale) before and after injection. For analysis, a subset of subjects from the second clinic was matched as closely as possible (sex, age, race, and ethnicity) to those from the first clinic.&lt;/p&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;p&gt;Eighty-six subjects from the first clinic were identified, of whom fifty-five met inclusion criteria. Review of 83 potentially matched subjects from the second clinic yielded 37 subjects. From this combined set of subjects, 44 receiving triamcinolone and 48 receiving methylprednisolone were obtained. Matching was effective in avoiding significant differences between the two drug groups in age, weight, sex, race, and body mass index, however, the incidence of smoking (current and former) was significantly higher in the methylprednisolone group (who were primarily from clinic 1). The injection responses codified on a 0–2 scale, where 0 indicated a poor response, 1 a partial response with a second injection recommended, and 2 a good response where no further treatment was recommended at the 1 month follow up point, were not significantly different between the groups (Mann–Whitney, &lt;i&gt;p&lt;/i&gt; = 0.44) although the triamcinolone group overall had slightly better responses. However, the patient-reported percent improvement after the injection was significantly better for the triamcinolone than for methylprednisolone (60% ± 5.3 vs. 42% ± 4.9), as was the pain ratings (0–10 scale) after the injection (5.0 ± 0.5 vs. 6.3 ± 0.3). A marked demographic difference between the two clinics in smoking rates was not controlled for in subject matching but accounting for smoking status did not affect the observed differences between the two steroids.&lt;/p&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;p&gt;Differences in the two primary outcomes, pa","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"2 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-024-00069-z.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142410268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of anesthetics on mitochondrial quality control: mechanisms and clinical implications","authors":"Xuxin Tan,&nbsp;Ruixue Liu,&nbsp;Ling Dan,&nbsp;He Huang,&nbsp;Chenyang Duan","doi":"10.1007/s44254-024-00070-6","DOIUrl":"10.1007/s44254-024-00070-6","url":null,"abstract":"<div><p>Focus on the implications of common perioperative drugs for mitochondrial quality control and their subsequent impact on the overall physiological condition has been increasing. This review discusses the effects of perioperative drugs, such as intravenous and inhaled anesthetics, analgesics, local anesthetics on mitochondrial quality and their underlying mechanisms. These drugs influence mitochondrial properties, including morphology, dynamics, energy metabolism, and protein expression, thereby affecting the clinical outcomes of patients undergoing surgery. Such effects can be either protective or detrimental and are contingent upon multiple variables such as the specific drug used, dosage, application timing, and the patient's overall health status. Recognizing the effects of these perioperative drugs on mitochondrial quality control is crucial to selecting safer anesthetic protocols, reducing postoperative complications, enhancing postoperative recovery, and gaining insights into the development of innovative treatment methodologies and optimization of perioperative care.</p></div>","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"2 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-024-00070-6.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142409917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The applications and prospects of big data in perioperative anesthetic management","authors":"Yiziting Zhu,&nbsp;Xiang Liu,&nbsp;Yujie Li,&nbsp;Bin Yi","doi":"10.1007/s44254-024-00068-0","DOIUrl":"10.1007/s44254-024-00068-0","url":null,"abstract":"<div><p>Perioperative anesthetic management entails a multitude of decision-making processes within complex medical scenarios. These demand the continuous and dynamic execution of precise decisions which poses significant challenges. In the age of big data, the exponential growth in data volume from diverse sources has revolutionized many fields, including healthcare, finance, and marketing. Machine learning has emerged as a powerful tool for analyzing big data, enabling the handling of large datasets and uncovering intricate patterns and relationships. The application of big data and artificial intelligence algorithms is gradually being integrated, enabling effective task completion in various stages of perioperative management, including risk prediction, decision support, and auxiliary examination. Through in-depth analysis of big data, healthcare professionals can gain insights into patient prognoses. This review provides a comprehensive overview of the distinctive features of perioperative big data and its applications in anesthesia management during the perioperative period.</p></div>","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"2 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-024-00068-0.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142413856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Esketamine as an adjuvant to propofol sedation for gastrointestinal endoscopy","authors":"Nan Song,&nbsp;Ke Peng","doi":"10.1007/s44254-024-00067-1","DOIUrl":"10.1007/s44254-024-00067-1","url":null,"abstract":"","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"2 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-024-00067-1.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142412018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetic assessment of the causal effect of plasma metabolites and metabolic pathways on delirium","authors":"Xin He,&nbsp;XinYu Shi,&nbsp;YiNi Wang,&nbsp;Shuang Han,&nbsp;JiaYan Liu,&nbsp;Fei Yang,&nbsp;Kun Ma,&nbsp;Bai-Xiang Li","doi":"10.1007/s44254-024-00064-4","DOIUrl":"10.1007/s44254-024-00064-4","url":null,"abstract":"<div><h3>Purpose</h3><p>Delirium has a significant impact on millions of people globally and is closely linked to an unfavorable prognosis for complications. Observational studies suggest that plasma metabolites may play significant roles as markers and effectors of delirium, but causal relationships have not yet been elucidated. Based on the most recent genome-wide association study (GWAS) data, our study aims to present novel insights into the genetic relationship between delirium and plasma metabolites. This investigation offers potential clues for utilizing plasma metabolites as predictors of delirium development.</p><h3>Methods</h3><p>We performed a thorough Mendelian randomization (MR) analysis to investigate the causal relationship between 1,091 individual metabolites and 309 metabolite ratios in plasma with respect to delirium. Inverse-variance weighting (IVW) was employed as the primary estimation method, while MR-Egger and weighed median methods were utilized to assess the robustness of the results. Sensitivity analyses encompassing the MR Pleiotropy RESidual Sum and Outlier (MR-PRESSO) test, Cochran Q test, leave-one-out analysis and MR Egger intercept analysis were also undertaken. Additionally, the MR Steiger test was performed to explore any potential reverse causal effect of metabolites on delirium.</p><h3>Results</h3><p>A total of 63 types of plasma metabolites associated with delirium were detected using the IVW method (<i>p</i> &lt; 0.05). Among the known metabolites, our analysis revealed that two specific metabolites (1-palmitoyl-2-palmitoleoyl-gpc (16:0/16:1) and homovanillate) and a metabolite ratio (phosphate to oleoyl-linoleoyl-glycerol (18:1 to 18:2)) demonstrated a consistent and significant causal relationship with delirium across all analysis methods. Finally, no evidence of pleiotropy was detected in our analysis.</p><h3>Conclusions</h3><p>Our study has revealed a causal association between blood metabolites and the risk of delirium. homovanillate is known to be associated with immunity and redox, 1-palmitoyl-2-palmitoleoyl-gpc (16:0/16:1) and metabolite ratio (phosphate to oleoyl-linoleoyl-glycerol (18:1 to 18:2)) may play a role in lipid regulation. These findings may provide fresh insights into the identification of suitable diagnostic markers and potential treatment strategies focused on specific plasma metabolites in patients with delirium. However, further experiments are required to gain a comprehensive understanding of the underlying biological mechanisms involved.</p></div>","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"2 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-024-00064-4.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142411676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perioperative management strategies for Marfan syndrome during pregnancy","authors":"Li Ma,&nbsp;Zhilong Lu,&nbsp;Yi Wang,&nbsp;Kaicheng Song,&nbsp;Yixiu Zhang,&nbsp;Xinyan Liu,&nbsp;Qi Miao,&nbsp;Lijian Pei","doi":"10.1007/s44254-024-00065-3","DOIUrl":"10.1007/s44254-024-00065-3","url":null,"abstract":"","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"2 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-024-00065-3.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142409936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sleep disturbance and cognition in the elderly: a narrative review","authors":"Yuanbo Ni,&nbsp;Min Yu,&nbsp;Cunming Liu","doi":"10.1007/s44254-024-00066-2","DOIUrl":"10.1007/s44254-024-00066-2","url":null,"abstract":"<div><p>Sleep is an essential physiological process that promotes physical recovery and helps consolidate learning and memory. Common manifestations of sleep disturbances include insomnia, hypersomnia, circadian rhythm disorders, and parasomnias, all of which impair cognitive function, particularly in the elderly. Cognitive impairment is a significant factor that threatens the quality of life in the elderly, and there is currently no effective treatment for conditions such as dementia. The relationship between sleep and cognition is complex. Studies have shown that sleep disorders adversely affect cognitive function and increase the incidence of cognitive decline. This article focuses on sleep disturbances and their effects on the cognition of the elderly by reviewing research conducted over the past 20 years and describing potential mechanisms. Additionally, we explore the relationship between sleep and cognition during the perioperative period, aiming to identify strategies for optimizing perioperative sleep quality. We believe this review provides a deeper understanding of the association between sleep and cognition and offers a new perspective for perioperative management.</p></div>","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"2 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-024-00066-2.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142409873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring causal correlations between blood inflammatory cytokines and low back pain: a Mendelian randomization","authors":"Hao Tian,&nbsp;Jianxin Cheng,&nbsp;Xiaoshuai Zhao,&nbsp;Zhongyuan Xia","doi":"10.1007/s44254-024-00063-5","DOIUrl":"10.1007/s44254-024-00063-5","url":null,"abstract":"<div><h3>Purpose</h3><p>Low back pain (LBP) is a common and recurring public health problem that affects sufferers both physically and mentally and warrants further research. A succession of studies have suggested a plausible role for inflammatory cytokines in the pathogenesis of LBP. To date, there is no conclusive mechanism explaining how inflammatory cytokines affects LBP.</p><h3>Methods</h3><p>A bidirectional two-sample Mendelian randomization (MR) investigation was undertaken in two stages. The initial phase encompassed 41 inflammatory cytokines as the exposure, with LBP as the outcome, and the subsequent phase adopted the inverse approach. A total of 41 blood inflammatory cytokines were extracted from the genome-wide association study meta-analysis database, encompassing 8,293 individuals. Data pertaining to LBP were acquired from the Finnish biobank. Primary findings were computed using inverse-variance weighting (IVW), while sensitivity analyses accounting for pleiotropy and invalid instruments were conducted utilizing the weighted-median estimator, MR-Egger, and MR Pleiotropy RESidual Sum and Outlier.</p><h3>Results</h3><p>Our results suggest that higher levels of Macrophage migration inhibitory factor (MIF) as well as lower levels of C-C motif chemokine ligand 3 (CCL3) are associated with an increased risk of LBP (odds ratio [OR] = 1.134, 95% confidence interval [CI ]= 1.032–1.245, <i>P</i> = 0.009; OR = 0.887, 95% CI = 0.803–0.980, <i>P</i> = 0.018). Moreover, there was no heterogeneity and horizontal pleiotropy observed in the sensitivity analysis. In contrast, in studies of the effect of LBP on inflammatory cytokines, genetically determined LBP had no causal effect on 41 inflammatory cytokines (IVW <i>P</i> &gt; 0.05).</p><h3>Conclusions</h3><p>Our study confirms that the levels of circulating MIF and CCL3 may be regarded as valuable circulating inflammatory biomarkers for the management of LBP in clinical practice and as potential molecules for future mechanistic investigation and drug target identification.\u0000</p></div>","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"2 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-024-00063-5.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142409138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}