Anesthesiology and Perioperative Science最新文献

{"title":"Patients' perception of the duration of analgesia provided by intrathecal bupivacaine/morphine after laparoscopic colorectal surgery: a prospective cohort study","authors":"Joost L. C. Lokin,&nbsp;Claudia Savelkoul,&nbsp;Ramon R. J. P. van Eekeren,&nbsp;Mark V. Koning","doi":"10.1007/s44254-024-00054-6","DOIUrl":"10.1007/s44254-024-00054-6","url":null,"abstract":"<div><h3>Purpose</h3><p>The addition of intrathecal morphine to general anesthesia for laparoscopic colorectal surgery is an effective method of providing analgesia. However, the analgesia duration of approximately 24 hours poses the risk of rebound pain on the second postoperative day. Therefore, this study aimed to investigate the patients' perception on postoperative pain management using the International Pain Outcomes questionnaire on both the first and second postoperative day.</p><h3>Methods</h3><p>This prospective single-center cohort study was conducted between November 2020 and March 2021 and included forty patients. The primary outcome was a difference in postoperative pain on the first and second postoperative day. Secondary outcomes included opioid consumption, interference of pain with activities, side effects, and patients’ perception and satisfaction with pain treatment.</p><h3>Results</h3><p>The intensity of postoperative pain did not increase on the second postoperative day NRS [numeric rating scale] 5 (2–7 [0–10]) vs 5 (3–7 [1–10]), <i>p</i>=0.414), but the percentage of time spent in severe pain increased (20% (10-40 [0-90]) vs 30% (20-50 [0-80]), <i>p</i>=0.010). There was no difference in opioid consumption (6 mg (0–12) [0–42] vs 6 mg (0–12) [0–29], <i>p</i>=0.914). Pruritis (NRS 2 (0–6 [0–10]) vs 0 (0–3 [0–8]), <i>p</i>=0.001) and dizziness (NRS 2 (0–7 [0–10]) vs 0 (0–2 [0–9]), <i>p</i>=0.002) decreased on the second postoperative day. Patients reported high satisfaction during the first two days after surgery (NRS 8 (7–9) [0–10] vs 8 (7–9) [0–10], <i>p</i>=0.395).</p><h3>Conclusion</h3><p>Intrathecal morphine is a suitable analgesic modality in laparoscopic colorectal surgery within an enhanced recovery after surgery program, without causing important rebound pain. Pain scores, however, may be further reduced by adding non-opioid analgesics.</p></div>","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"2 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-024-00054-6.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140697654","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":"Listen to the kidney when he is calling for you: the potential role of perioperative urine biochemistry monitoring to detect early AKI development in elective surgical patients","authors":"Alexandre Toledo Maciel,&nbsp;on behalf of the Imed Group of Investigators","doi":"10.1007/s44254-024-00057-3","DOIUrl":"10.1007/s44254-024-00057-3","url":null,"abstract":"","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"2 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-024-00057-3.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140701814","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 recent research progress in neurobiological characteristics and pain regulation of the cerebrospinal fluid-contacting nucleus","authors":"Jingqiu Wei,&nbsp;He Liu,&nbsp;Fang Zhou,&nbsp;Xianfu Lu,&nbsp;Hongxing Zhang,&nbsp;Licai Zhang","doi":"10.1007/s44254-024-00051-9","DOIUrl":"10.1007/s44254-024-00051-9","url":null,"abstract":"<div><p>The ependymal epithelium forms the cerebrospinal fluid barrier, separating the brain and spinal cord from the cerebrospinal fluid. However, in specific regions of the central nervous system, there are neurons that directly interface with the cerebrospinal fluid, including neuronal bodies, dendrites, or axons, This constitutes what is referred to as the \"cerebrospinal fluid contacting neurons system (CSF-CNS)\". The research team led by Professor Zhang has successfully utilized cholera toxin subunit B coupled horseradish peroxidase complex (CB-HRP) to selectively label the specialized neuron system that interfaces with cerebrospinal fluid, pioneeringly designating it as the \"cerebrospinal fluid-contacting nucleus\", commonly referred to as the \"CSF-contacting nucleus\". For the first time, the discovery of the CSF-contacting nucleus provides compelling morphological evidence for the existence of a distinct neural structure within the brain parenchyma that establishes a connection with the cerebrospinal fluid, thereby suggesting its potential significance in facilitating material and information exchange between the brain parenchyma and cerebrospinal fluid. After conducting a comprehensive series of studies on the morphological structure, material expression, gene analysis and functional aspects of the CSF-contacting nucleus in rodents and non-human primates, it has been revealed that there are fibrous connections between the CSF-contacting nucleus and the cerebral cortex and subcortical nuclei being involved in the regulatory mechanisms of pain, cognition, learning and memory, emotion, addiction, stress and anxiety responses, visceral activity, olfaction, vision processing and perception, auditory processing, perception, motor control and coordination, homeostasis regulation including maintenance of body energy and fluid balance, as well as the control of sleep–wake cycles and synchronization of biological rhythms. Current experiments have confirmed that the CSF-contacting nucleus is related to pain, morphine dependence and withdrawal, learning and memory, as well as stress. This present article offers a comprehensive review of the neurobiological characteristics and recent advancements in pain regulation of the CSF-contacting nucleus. The aim is to provide novel insights into the investigation of pain regulation within bidirectional regulatory pathway between the brain and cerebrospinal fluid, with a specific focus on elucidating the role of the CSF-contacting nucleus as a bridge structure. Additionally, the objective of this research is to propose innovative strategies for pain management and associated disorders in the future.</p></div>","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"2 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-024-00051-9.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140728526","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":"Effect of ultrasound-guided recruitment maneuver on atelectasis: a systematic review and meta-analysis of randomized controlled trials","authors":"Yi Xu,&nbsp;Yang Han,&nbsp;Huijia Zhuang,&nbsp;Fei Fei,&nbsp;Tingting Zheng,&nbsp;Hai Yu","doi":"10.1007/s44254-024-00056-4","DOIUrl":"10.1007/s44254-024-00056-4","url":null,"abstract":"<div><p>To summarize the existing evidence on the effects of ultrasound-guided recruitment maneuver (RM) during perioperative period on atelectasis, oxygenation and other clinical outcomes in adult patients undergoing abdominal surgery. In this systematic review and meta-analysis, PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, and WanFang databases were searched from inception to May 2023 for relevant randomized controlled trials (RCTs) comparing the perioperative use of ultrasound-guided RM with a control group in adult patients undergoing abdominal surgery. The primary outcome was the incidence of early postoperative atelectasis (within 24 h after surgery). A total of 12 RCTs with 895 patients were included. The ultrasound-guided RM significantly reduced the incidence of postoperative atelectasis (RR [risk ratio]: 0.44, 95% <i>CI</i> [confidence interval]: 0.34 to 0.57, <i>P</i> &lt; 0.001), with a median fragility index of 4. Prespecified subgroup analyses demonstrated the consistent findings. Additionally, ultrasound-guided RM could decrease postoperative lung ultrasound score (MD [mean difference]: − 3.02, 95% <i>CI</i>: − 3.98 to − 2.06, <i>P</i> &lt; 0.001), reduce the incidence of postoperative hypoxemia (RR: 0.32, 95% <i>CI</i>: 0.18 to 0.56, <i>P</i> &lt; 0.001), improve postoperative oxygenation index (MD: 45.23 mmHg, 95% <i>CI</i>: 26.54 to 63.92 mmHg, <i>P</i> &lt; 0.001), and shorten post-anesthesia care unit (MD: − 1.89 min, 95% <i>CI</i>: − 3.14 to − 0.63 min, <i>P</i> = 0.003) and hospital length of stay (MD: − 0.17 days, 95% <i>CI</i>: − 0.30 to − 0.03 days, <i>P</i> = 0.02). However, there was no significant difference in the incidence of atelectasis at the end of surgery between two groups (RR: 0.99, 95% <i>CI</i>: 0.86 to 1.14, <i>P</i> = 0.89). The use of ultrasound-guided RM perioperatively reduced the risk of atelectasis and improve oxygenation after abdominal surgery. Strategies to reduce the development of perioperative atelectasis are presented to highlight areas for future research.</p></div>","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"2 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-024-00056-4.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140733136","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":"Anesthesia for lung transplantation in children under 12 years of age: a single center experience of China","authors":"Shengjie Yuan,&nbsp;Yan Zhou,&nbsp;Jingyu Chen,&nbsp;Xin Zhang,&nbsp;Guilong Wang","doi":"10.1007/s44254-024-00050-w","DOIUrl":"10.1007/s44254-024-00050-w","url":null,"abstract":"<div><h3>Purpose</h3><p>This study aims to provide a comprehensive overview of anesthesia management strategies employed in pediatric lung transplantation.</p><h3>Methods</h3><p>A retrospective analysis was conducted on data from 14 pediatric patients who underwent lung transplantation at the Wuxi Center between September 2019 and November 2022. Patient demographics, surgical particulars, airway management, utilization of extracorporeal support, fluid administration, blood gas and electrolyte profiles, and postoperative outcomes were systematically documented and subsequently summarized.</p><h3>Results</h3><p>Of the 14 patients, 7 received extracorporeal membrane oxygenation (ECMO) and 1 received cardiopulmonary bypass (CPB). The average operation time was 303 ± 53 min, with the median extubation time of 26 h. The entirety of pediatric lung transplant procedures was executed successfully, resulting in the discharge of thirteen patients postoperatively. Regrettably, one patient died due to infectious shock on the fourth postoperative day.</p><h3>Conclusion</h3><p>The achievement of successful pediatric lung transplantation necessitates effective perioperative anesthesia management, with a focal emphasis on circulatory control. Real-time measurements serve as the cornerstone for decision-making. Proactive administration of vasoactive agents is integral to sustaining hemodynamic stability. The judicious assessment of ECMO necessity is paramount, favoring central ECMO during the surgical intervention.</p></div>","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"2 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-024-00050-w.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140755094","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":"Further innovation is required to enhance risk prediction of postoperative pulmonary complications—comment on Anesthesiol Perioper Sci. 2023;1(4):34","authors":"Zyad J. Carr","doi":"10.1007/s44254-024-00053-7","DOIUrl":"10.1007/s44254-024-00053-7","url":null,"abstract":"","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"2 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-024-00053-7.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140375036","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":"Folic acid ameliorated sevoflurane exposure-induced decrease in differentiation capacity of oligodendrocyte precursor cells","authors":"Lingling Shi,&nbsp;Zhengjie Miao,&nbsp;Yanyong Cheng,&nbsp;Lei Zhang","doi":"10.1007/s44254-024-00058-2","DOIUrl":"10.1007/s44254-024-00058-2","url":null,"abstract":"","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"2 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-024-00058-2.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140377900","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 taurine or taurolidine supplementation on clinical outcomes: A systematic review with meta-analysis","authors":"Kwok M. Ho,&nbsp;Yusra Harahsheh","doi":"10.1007/s44254-024-00055-5","DOIUrl":"10.1007/s44254-024-00055-5","url":null,"abstract":"<div><p>Taurine is a conditionally essential amino acid that has been reported to have antioxidative and immunomodulatory effects either directly or through its interactions with gut microbiome. Although taurine has been widely used as a health supplement and also for treatment of congestive heart failure in Japan, its roles in the perioperative setting have not been well characterized. The purpose of this systematic review and meta-analysis was to assess whether oral or intravenous taurine, or its derivatives such as taurolidine, can offer benefits compared to placebo in the perioperative setting. Non-randomized studies, trials assessed topical taurine or taurolidine, or trials did not report clinical outcomes were excluded. Six randomized-controlled-trials (RCTs) involving a total of 596 adult surgical patients, in PubMed, MEDLINE and EMBASE databases on September 14, 2023 were identified and meta-analyzed using a fixed-effect model. Biases were assessed by reporting individual trial elements. Taurine or taurolidine (which is readily metabolized by hydrolysis to taurine) supplementation was associated with a reduction in all-cause infection (5 trials: pooled odds ratio (OR) 0.59; 95% confidence interval (CI) 0.38–0.92; <i>p</i> = 0.020) but not delirium (2 trials: OR 0.63, 95% CI 0.38–1.04; <i>p</i> = 0.071) or mortality (4 trials: OR 0.82, 95% CI 0.43–1.58; <i>p</i> = 0.557) compared to placebo. Using the ‘trim and fill’ technique to adjust for publication bias did not change the favorable effect of taurine on risk of infection (OR 0.61, 95% CI 0.40–0.95). Because the number of studies included was small, the promising benefits of taurine on risks of perioperative infection should be confirmed by adequately-powered RCTs.</p></div>","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"2 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-024-00055-5.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140383444","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":"Reproducibility of heart rate recovery measures across differing modalities and intensities of submaximal exercise in healthy volunteers: A healthy volunteer study","authors":"Haroon Minhas,&nbsp;Christopher Morton,&nbsp;Martin Shaw,&nbsp;Ben Shelley","doi":"10.1007/s44254-023-00042-2","DOIUrl":"10.1007/s44254-023-00042-2","url":null,"abstract":"<div><h3>Purpose</h3><p>Submaximal exercise tests (SET) are an easier to conduct and less physically demanding alternative to cardiopulmonary exercise testing for assessment of pre-operative fitness. Assessment of heart rate recovery (HRR) following SETs offers an easily obtained marker of vagal reactivation and sympathetic withdrawal and therefore provides an indication of an individual’s fitness. This study sought to assess the reproducibility of HRR across different workloads and modalities of SET.</p><h3>Methods</h3><p>Thirty-four healthy volunteers were recruited to undergo two SETs at 40% and 60% of their predicted maximal workload. A second group of thirty-one healthy volunteers were recruited to undergo three SETs of differing modalities; Cycle ergometry, Step and Shuttle Walk tests. HRR was quantified using the conventional indices HRR1 and HRR2 (calculated as heart rate (HR) on exercise cessation minus HR at 1 and 2 min of rest) and a novel area under the HRR vs. time curve (HRR_AUC) method. Reproducibility of results was assessed using intra-class correlation coefficient (ICC) and limits of agreements.</p><h3>Results</h3><p>The results showed that HRR1 and HRR2 were poorly reproducible across differing workloads and exercise modalities (ICC &lt; 0.45 for all comparisons) whereas HRR_AUC proved to be at least moderately reproducible (ICC &gt; 0.52 for all comparisons).</p><h3>Conclusions</h3><p>These results suggest that HRR_AUC may be a superior way of quantifying HRR following SETs, adding objectivity to SET results. Quantifying HRR_AUC could prove to have useful clinical applications for pre-operative risk assessment, assessing fitness to undergo treatment and monitoring disease progression.</p></div>","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-023-00042-2.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140428455","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":"A review of intraoperative protective ventilation","authors":"Yuanyuan Zou, Zhiyun Liu, Qing Miao, Jingxiang Wu","doi":"10.1007/s44254-023-00048-w","DOIUrl":"https://doi.org/10.1007/s44254-023-00048-w","url":null,"abstract":"","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"76 S18","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139798999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}