Anesthesiology and Perioperative Science最新文献

{"title":"Adjuvants and rebound pain following peripheral nerve block in adult surgical patients: a systematic review and network meta-analysis of randomized controlled trials","authors":"Xiaodan Yang,&nbsp;Bin Su,&nbsp;Yupei Chen,&nbsp;Jianjun Yang,&nbsp;He Huang,&nbsp;Bing Chen,&nbsp;Pain Group of the Chinese Society of Anesthesiology","doi":"10.1007/s44254-025-00111-8","DOIUrl":"10.1007/s44254-025-00111-8","url":null,"abstract":"<div><h3>Purpose</h3><p>Rebound pain occurs when peripheral nerve blocks (PNBs) subside and this hampers patient recovery after surgery. This study aims to determine the most effective adjuvant to mitigate rebound pain in adult surgical patients.</p><h3>Methods</h3><p>A comprehensive search was conducted for randomized controlled trials (RCTs) that reported rebound pain and utilized perineurally (PN) or intravenously (IV) administered adjuvants. We used multiple databases, including PubMed, Web of Science, the Cochrane Library, Embase, CNKI, Wanfang Data, SinoMed and Chinese medical journals from their inception until September 30, 2024. The primary outcome measured was the incidence of rebound pain. A network meta-analysis was performed using a frequentist approach.</p><h3>Results</h3><p>The meta-analysis included three RCTs examining ketamine/esketamine, eight evaluating dexamethasone and one assessing tropisetron. Compared to no adjuvant, IV dexamethasone was found to significantly reduce the incidence of rebound pain (odds ratio [OR] = 0.13, 95% confidence interval [CI]: 0.05, 0.35) and postoperative nausea and vomiting (PONV; OR = 0.33, 95% CI: 0.12, 0.85), while also prolonging the time to onset of rebound pain (mean difference [MD] = 3.95 h, 95% CI: 1.36, 6.53). PN dexamethasone extended the time to onset of rebound pain (MD = 6.57 h, 95% CI: 3.20, 9.93) but did not significantly reduce the incidence of rebound pain or PONV. Ketamine/esketamine was associated with a reduction in the incidence of rebound pain (OR = 0.30, 95% CI: 0.10, 0.89) but did not affect PONV. According to the rank order of surface under the cumulative ranking curve analysis, IV dexamethasone exhibited the lowest incidence of rebound pain and PONV compared to PN dexamethasone, ketamine/esketamine, tropisetron and no adjuvant. PN dexamethasone was most effective in prolonging the onset of rebound pain compared to IV dexamethasone, tropisetron and no adjuvant. The overall quality of evidence was rated as low or very low.</p><h3>Conclusion</h3><p>Current evidence, albeit of low quality, indicates that IV dexamethasone is the most effective adjuvant for the prevention of rebound pain, while PN dexamethasone is optimal for delaying its onset. Therefore, a combined approach utilizing both IV and PN dexamethasone following PNB may represent an effective strategy for managing rebound pain in adult surgical patients.</p></div>","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"3 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-025-00111-8.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145144978","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":"Placement and management of Erector Spinae Plane catheters for pain management in children with spina bifida presenting for major reconstruction of the lower urinary tract. A simple approach to a complex population","authors":"Robert P. Moore,&nbsp;Megan A. Brockel,&nbsp;Nicholas E. Burjek","doi":"10.1007/s44254-025-00110-9","DOIUrl":"10.1007/s44254-025-00110-9","url":null,"abstract":"","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"3 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-025-00110-9.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145143838","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":"Clinical utilization of bronchoscopy in the ICU: indications, complications, and perspectives","authors":"Daniela Cuéllar-Mendoza,&nbsp;Orlando R. Pérez-Nieto,&nbsp;Gabriela A. Bautista-Aguilar,&nbsp;David A. Trejo-Osornio,&nbsp;Carlos A. Zamorano-León,&nbsp;Ernesto Deloya-Tomas,&nbsp;Jesús Salvador Sánchez-Díaz,&nbsp;Marian Elizabeth Phinder-Puente","doi":"10.1007/s44254-025-00108-3","DOIUrl":"10.1007/s44254-025-00108-3","url":null,"abstract":"","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"3 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-025-00108-3.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145143920","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":"Parasympathetic tone in perioperative and critical care setting: is it a matter?","authors":"Yuann Lu,&nbsp;Jiashi Sun,&nbsp;Qian Chen,&nbsp;Daqing Ma","doi":"10.1007/s44254-025-00109-2","DOIUrl":"10.1007/s44254-025-00109-2","url":null,"abstract":"","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"3 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-025-00109-2.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145164211","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":"Peripheral VA-ECMO: from Evolving Indications to Perioperative Implications","authors":"Ngan Hoang Kim Trieu,&nbsp;Huy Minh Pham,&nbsp;Dai Quang Huynh,&nbsp;Linh Thanh Tran,&nbsp;Ngoc Tu Nguyen,&nbsp;Anh Tuan Mai,&nbsp;Thao Thi Ngoc Pham","doi":"10.1007/s44254-025-00106-5","DOIUrl":"10.1007/s44254-025-00106-5","url":null,"abstract":"<div><p>Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is a form of extracorporeal circulation that provides cardiopulmonary support in cardiogenic shock unresponsive to conventional therapy. Historically, VA-ECMO was limited to the operating room and primarily used to manage postcardiotomy cardiogenic shock cases. However, with advances in ECMO technology and a better understanding of patient selection criteria, VA-ECMO has expanded its role as a temporary and adaptable intervention in cardiogenic shock of diverse etiologies. This review provides an updated overview of the indications for peripheral VA-ECMO, discussing how recent studies have enhanced our understanding of when VA-ECMO should be considered. In addition, we discuss the feasibility of surgery during VA-ECMO support to improve perioperative planning and tailored anesthetic strategies following ECMO-related physiologic and pharmacological changes.</p></div>","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"3 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-025-00106-5.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145162120","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":"Rethinking evolution and application of artificial intelligence for perioperative medicine","authors":"Yaqiang Wang,&nbsp;Xuechao Hao,&nbsp;Ruihao Zhou,&nbsp;Guo Chen,&nbsp;Tao Zhu","doi":"10.1007/s44254-025-00105-6","DOIUrl":"10.1007/s44254-025-00105-6","url":null,"abstract":"","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"3 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-025-00105-6.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145171498","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":"Artificial intelligence in anesthesia and perioperative medicine","authors":"Qin Fei,&nbsp;Yufeng Zhang,&nbsp;Chao Liu,&nbsp;Jigen Zheng,&nbsp;Qiang Fu","doi":"10.1007/s44254-025-00107-4","DOIUrl":"10.1007/s44254-025-00107-4","url":null,"abstract":"<div><p>The rapid development of artificial intelligence (AI) technology, in particular AlphaFold, has greatly improved protein structure prediction and design, reshaped protein biology and expanded research directions in anesthesiology and perioperative medicine. AI relies on deep learning to accurately model key proteins, such as G protein-coupled receptors, to aid drug development. In perioperative medicine, AI improves individualized treatment, patient safety and postoperative recovery through biomarker identification and anesthetic protocol optimization. In addition, AI accelerates anesthetic drug discovery, optimizes drug screening, toxicity prediction and clinical trials to improve the efficiency of research and development. Whilst data interpretation and diversity remain challenges, the continued advancement of AI in the fields of precision medicine and perioperative management will promote the development of individualized anesthesia and precision medicine.</p></div>","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"3 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-025-00107-4.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145169946","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":"Association of nociception index with postoperative immune status: a prospective observational study","authors":"Yanling Zhang,&nbsp;Anhui Zha,&nbsp;Weiyun Shen,&nbsp;Ruping Dai","doi":"10.1007/s44254-025-00104-7","DOIUrl":"10.1007/s44254-025-00104-7","url":null,"abstract":"<div><h3>Purpose</h3><p>Electroencephalography (EEG) is commonly used to assess sedation levels in general anesthesia, but its ability to indicate perioperative trauma and inflammation activation levels remains unclear. This study examines the relationship between the nociception index (NOX), an EEG-derived metric, and related immune changes in surgical patients.</p><h3>Methods</h3><p>Patients aged 18 to 75 years scheduled for elective surgery under general anesthesia, without chronic pain, hepatic or renal dysfunction, pregnancy, intensive care unit stay, and a postoperative stay of less than 1 day. We investigated the relationship between the NOX and immune-inflammatory parameters in surgical patients. NOX and bispectral index (BIS) values were recorded upon post-anesthesia care unit admission and after awakening from anesthesia. We collected immune-related indicators, including immune cell counts in routine blood tests, C-reactive protein (CRP) levels, hemoglobin, and the length of postoperative hospital stay. The association of NOX with inflammatory response from surgical stimulation and postoperative prognosis was assessed.</p><h3>Results</h3><p>A total of 100 patients were included in the analysis. NOX value is positively associated with immune-inflammatory parameters, such as the postoperative CRP level (R = 0.3313, <i>P</i> = 0.0002), changes in monocyte counts (R = 0.3078, <i>P</i> = 0.0009), and changes in hemoglobin (R = 0.4036, <i>P</i> &lt; 0.0001) before and one day after surgery, whereas the BISpro index is not associated with these parameters (All<i> P</i> &gt; 0.05). In comparison to patients with NOX values lower than the BISpro values, patients with NOX values exceeding BISpro levels showed elevated levels of immune-related indicators, such as CRP level (<i>P</i> = 0.0182), monocyte count (<i>P</i> = 0.0357), and changes in hemoglobin before and one day after surgery (<i>P</i> = 0.0234). The variation of NOX (△NOX) negatively correlates with the CRP level (R = –0.2708, <i>P</i> = 0.0073), changes in monocyte numbers (R = –0.3606, <i>P</i> = 0.0002), changes in hemoglobin (R = –0.3083, <i>P</i> &lt; 0.0001), and postoperative hospital stay (R = –0.1882, <i>P</i> = 0.0327).</p><h3>Conclusions</h3><p>Our study demonstrates that, as an EEG index, NOX and its dynamic variation may be associated with the inflammatory response induced by surgical trauma, potentially offering insights into postoperative immune status.</p><h3>Trial registration</h3><p>Registered at the Chinese Clinical Trial Registry (ChiCTR, https://www.chictr.org.cn/showproj.html?proj=199672) with No. ChiCTR2300074319.</p></div>","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"3 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-025-00104-7.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144100219","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":"Mechanisms of microbial-gut-brain axis modulation by electroconvulsive therapy in the treatment of depression","authors":"Jiaming Ji,&nbsp;Jinyan Guo,&nbsp;Jirong Yang,&nbsp;Siyang Zeng,&nbsp;Xue Han,&nbsp;Ziqing Hei,&nbsp;Weifeng Yao,&nbsp;Chaojin Chen","doi":"10.1007/s44254-025-00103-8","DOIUrl":"10.1007/s44254-025-00103-8","url":null,"abstract":"<div><h3>Purpose</h3><p>The present study aims to evaluate the effects of electroconvulsive therapy (ECT) on depressive behaviors. In addition, we explore mechanisms by which ECT alters the composition and functioning of gut microbiota through the microbiota-gut-brain axis.</p><h3>Methods</h3><p>A depression model in mice was established using chronic unpredictable mild stress. The mice were divided into three groups: control, depression, and ECT-treated. Depressive behaviors were assessed through a series of behavioral tests, including monitoring body weight, open field tests, sucrose preference and forced swim tests. Histological and microcirculatory assessments of brain and gut tissues were conducted using hematoxylin and eosin (H&amp;E) staining, Nissl staining and immunofluorescence methodology along with laser speckle contrast imaging. In addition, the inflammatory cytokines Tumor Necrosis Factor-<i>α</i> (TNF-<i>α</i>), Interleukin-6 (IL-6) and Interleukin-1<i>β</i> (IL-1<i>β</i>) were quantified in gut tissues using enzyme-linked immunosorbent assay. Metagenomic sequencing was employed to evaluate the diversity and abundance of the gut microbiota.</p><h3>Results</h3><p>ECT significantly improved depressive behaviors in mice as evidenced by increased body weight and decreased immobility time in the forced swim tests. H&amp;E staining indicated a substantial reduction in gut inflammation while Nissl staining revealed a restoration of neuronal morphology following ECT treatment. Furthermore, immunofluorescence analysis showed elevated c-Fos expression in the hippocampal region (<i>P</i> &lt; 0.05). Assessments of inflammatory cytokines demonstrated significant reductions in TNF-<i>α</i>, IL-6, and IL-1<i>β</i> levels in the ECT group. In addition, metagenomic sequencing showed that ECT enhanced gut microbiota diversity, particularly restoring the abundance of Bacteroides and Verrucomicrobia (<i>P</i> &lt; 0.05).</p><h3>Conclusion</h3><p>ECT exerts its antidepressant effects by modulating gut microbiota and enhancing the functionality of the gut-brain axis.</p></div>","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"3 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-025-00103-8.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143913812","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 innovative approach of continuous lateral parasacral ischial plane block: supine position","authors":"Peng Ye,&nbsp;Cansheng Gong,&nbsp;Jing Zhuang,&nbsp;Hanliang Fan,&nbsp;Xuan Pan,&nbsp;Xiaochun Zheng,&nbsp;Ting Zheng","doi":"10.1007/s44254-025-00101-w","DOIUrl":"10.1007/s44254-025-00101-w","url":null,"abstract":"","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"3 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-025-00101-w.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143877722","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}