Anesthesiology and Perioperative Science最新文献

{"title":"Correction: Analysis of sleep deprivation-associated Homer1 gene and protein acting on synaptic plasticity by bioinformatics and animal experiments","authors":"Yun Li, Lina Zhao, Qi Zhou, Xizhe Zhang, Jiannan Song, Xinyi Wang, Chenyi Yang, Haiyun Wang","doi":"10.1007/s44254-023-00026-2","DOIUrl":"10.1007/s44254-023-00026-2","url":null,"abstract":"","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"1 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-023-00026-2.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76776383","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":"Congenitally corrected transposition of great arteries: anaesthesia management for a double heart valve replacement","authors":"Bingling Dai,&nbsp;Xiang Liu,&nbsp;Xiang Zhao,&nbsp;Evelyne Bischof,&nbsp;Jiajun Ding,&nbsp;Huihong Lu","doi":"10.1007/s44254-023-00025-3","DOIUrl":"10.1007/s44254-023-00025-3","url":null,"abstract":"<div><h3>Purpose</h3><p>Congenitally corrected transposition of the great arteries (ccTGA) is a rare disease that is complicated by a variety of tachyarrhythmias or atrioventricular blocks and cardiac malformations. Anesthesia management is a challenge, especially in ccTGA patients with complications. Herein, we reported a case of ccTGA.</p><h3>Methods</h3><p>Multimodal general anesthesia combined with transversus thoracic muscle plane block (TTMPB), use of low-dose opioids and adjuvant medications, lung protective ventilation, use of vasoactive drugs and close perioperative monitoring were employed for the peri-operative management of this patient.</p><h3>Results</h3><p>The patient was safely returned to the ward and did not develop serious complications. Fourteen days after surgery, the patient recovered well and was discharged.</p><h3>Conclusions</h3><p>For patients undergoing a secondary cardiac surgery for ccTGA, preoperative evaluation of etiology of ccTGA is very important. Anesthesia management based on the surgical method and intraoperative vital signs and the postoperative real-time monitoring are also crucial for the post-operative recovery of these patients.</p></div>","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"1 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-023-00025-3.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77040383","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 use of gabapentinoids in pediatric patients","authors":"Nicholas E. Burjek,&nbsp;Michael Hafeman,&nbsp;David Guthrie,&nbsp;Amruta Desai,&nbsp;Zhaosheng Jin,&nbsp;Megan Brockel,&nbsp;Robert Moore","doi":"10.1007/s44254-023-00024-4","DOIUrl":"10.1007/s44254-023-00024-4","url":null,"abstract":"<div><p>Effective management of pediatric perioperative pain is typically goal-directed and multimodal, requiring various imperfect agents in combination to provide analgesia and support recovery. Gabapentinoids are one such class of agents often used in pediatric analgesic and enhanced recovery pathways. In adults, gabapentinoids have been associated with a modest reduction in pain scores but are often avoided due to undesired side effects. Children may be less susceptible to these unwanted effects, and the reduction in pain, agitation, and post-operative nausea and vomiting seen with these medications may confer significant benefit. While further studies are needed, to date there is no evidence to suggest a significantly increased risk of adverse effects in generally healthy children treated with gabapentinoids in the perioperative period. Although current evidence does not support their indiscriminate use, there appears to be a subset of pediatric surgical patients who stand to benefit from perioperative gabapentinoids. Pediatric use should not be abandoned, but rather further investigated to support thoughtful goal-directed application.</p><h3>Graphical Abstract</h3>\u0000 <div><figure><div><div><picture><source><img></source></picture></div></div></figure></div>\u0000 </div>","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"1 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-023-00024-4.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89745263","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":"Cerebral haemodynamics, anaesthesia and the frail brain","authors":"Samuel C. Barnes,&nbsp;Lucy C. Beishon,&nbsp;Md Tanvir Hasan,&nbsp;Thompson G. Robinson,&nbsp;Jatinder S. Minhas","doi":"10.1007/s44254-023-00020-8","DOIUrl":"10.1007/s44254-023-00020-8","url":null,"abstract":"","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"1 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-023-00020-8.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79171545","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":"Allergic and other adverse reactions to drugs used in anesthesia and surgery","authors":"Brian A. Baldo","doi":"10.1007/s44254-023-00018-2","DOIUrl":"10.1007/s44254-023-00018-2","url":null,"abstract":"&lt;div&gt;&lt;p&gt;The list of drugs patients may be exposed to during the perioperative and postoperative periods is potentially extensive. It includes induction agents, neuromuscular blocking drugs (NMBDs), opioids, antibiotics, sugammadex, colloids, local anesthetics, polypeptides, antifibrinolytic agents, heparin and related anticoagulants, blue dyes, chlorhexidine, and a range of other agents depending on several factors related to individual patients’ clinical condition and progress in the postoperative recovery period. To avoid poor or ultrarapid metabolizers to a particular drug (for example tramadol and codeine) or possible adverse drug reactions (ADRs), some drugs may need to be avoided during or after surgery. This will be the case for patients with a history of anaphylaxis or other adverse events/intolerances to a known drug. Other drugs may be ceased for a period before surgery, e.g., anticoagulants that increase the chance of bleeding; diuretics for patients with acute renal failure; antihypertensives relative to kidney injury after major vascular surgery; and serotonergic drugs that together with some opioids may rarely induce serotonin toxicity. Studies of germline variations shown by genotyping and phenotyping to identify a predisposition of genetic factors to ADRs offer an increasingly important approach to individualize drug therapy. Studies of associations of human leukocyte antigen (HLA) genes with some serious delayed immune-mediated reactions are ongoing and variations of drug-metabolizing cytochrome CYP450 enzymes, P-glycoprotein, and catechol-&lt;i&gt;O&lt;/i&gt;-methyltransferase show promise for the assessment of ADRs and non-responses to drugs, particularly opioids and other analgesics. Surveys of ADRs from an increasing number of institutions often cover small numbers of patients, are retrospective in nature, fail to clearly identify culprit drugs, and do not adequately distinguish immune-mediated from non-immune-mediated anaphylactoid reactions. From the many surveys undertaken, the large list of agents identified during and after anesthesia and surgery are examined for their ADR involvement. Drugs are classified into those most often involved, (NMBD and antibiotics); drugs that are becoming more frequently implicated, namely antibiotics (particularly teicoplanin), and blue dyes; those becoming less frequently involved; and drugs more rarely involved in perioperative, and postoperative adverse reactions but still important and necessary to keep in mind for the occasional potential sensitive patient. Clinicians should be aware of the similarities between drug-induced true allergic type I IgE/FcεRI- and pseudoallergic MRGPRX2-mediated ADRs, the clinical features of each, and their distinguishing characteristics. Procedures for identifying MRGPRX2 agonists and diagnosing and distinguishing pseudoallergic from allergic reaction mechanisms are discussed.&lt;/p&gt;&lt;h3&gt;Graphical Abstract&lt;/h3&gt;\u0000 &lt;div&gt;&lt;figure&gt;&lt;div&gt;&lt;div&gt;&lt;picture&gt;&lt;source&gt;&lt;i","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"1 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-023-00018-2.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84616684","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":"Red hair and pain sensitivity: insights into genomics of pain?","authors":"Hannah R. Williams,&nbsp;Jaideep J. Pandit","doi":"10.1007/s44254-023-00017-3","DOIUrl":"10.1007/s44254-023-00017-3","url":null,"abstract":"<div><h3>Purpose</h3><p>To present a review of insights gained from investigating the question as to whether red haired individuals have altered sensitivity to pain.</p><h3>Methods</h3><p>A narrative review of the literature.</p><h3>Results</h3><p>Anecdotal observations from anaesthesiologists have suggested that individuals with red hair require more analgesia on average than members of the general population. This observation has been confirmed and the redheaded phenotype is associated with an altered sensitivity to pain across a wide range of different pain types. Through the use of mouse models, a central mechanism for this altered pain sensitivity has been proposed involving both the melanocortin and opioid receptor systems, despite the causative mutation for this phenotype occurring in melanocortin 1 receptors (MC1Rs) on peripheral melanocytes.</p><h3>Conclusions</h3><p>Understanding the endocrine imbalance caused by this loss of function mutation helps us to further explore the mechanisms behind pain sensitivity. It also facilitates a discussion about how pharmacogenomics can be exploited to personalise and subsequently optimise treatment.</p><h3>Graphical Abstract</h3>\u0000 <div><figure><div><div><picture><source><img></source></picture></div></div></figure></div>\u0000 </div>","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"1 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-023-00017-3.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72632353","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 serious video game—EmergenCSim™—for novice anesthesia trainees to learn how to perform general anesthesia for emergency cesarean delivery: a randomized controlled trial","authors":"Allison J. Lee,&nbsp;Stephanie Goodman,&nbsp;Beatriz Corradini,&nbsp;Sophie Cohn,&nbsp;Madhabi Chatterji,&nbsp;Ruth Landau","doi":"10.1007/s44254-023-00016-4","DOIUrl":"10.1007/s44254-023-00016-4","url":null,"abstract":"<div><h3>Purpose</h3><p>We developed EmergenCSim™, a serious game (SG) with an embedded assessment, to teach and assess performing general anesthesia for cesarean delivery. We hypothesized that first-year anesthesiology trainees (CA-1) playing EmergenCSim™ would yield superior knowledge scores versus controls, and EmergenCSim™ and high-fidelity simulation (HFS) assessments would correlate.</p><h3>Methods</h3><p>This was a single-blinded, longitudinal randomized experiment. Following a lecture (week 3), trainees took a multiple-choice question (MCQ) test (week 4) and were randomized to play EmergenCSim™ (<i>N</i> = 26) or a non-content specific SG (<i>N</i> = 23). Participants repeated the MCQ test (week 8). Between month 3 and 12, all repeated the MCQ test, played EmergenCSim™ and participated in HFS of an identical scenario. HFS performance was rated using a behavior checklist.</p><h3>Results</h3><p>There was no significant change in mean MCQ scores over time between groups F (2, 94) = 0.870, <i>p</i> = 0.42, and no main effect on MCQ scores, F (1, 47) = 1.110, <i>p</i> = 0.20. There was significant three-way interaction between time, gender and group, F (2, 90) = 3.042, <i>p</i> = 0.053, and significant two-way interaction between gender and time on MCQ scores, F (2, 94) = 107.77, <i>p</i> = 0.036; outcomes improved over time among males. There was no group difference in HFS checklist and SG scores. Both instruments demonstrated good internal consistency reliability but non-significant score correlation.</p><h3>Conclusions</h3><p>Playing EmergenCSim™ once did not improve MCQ scores; nonetheless scores slightly improved among males over time, suggesting gender may impact learning outcomes with SGs.</p></div>","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"1 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-023-00016-4.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77378405","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 bilateral superficial cervical plexus block on postoperative pain, nausea, and vomiting in thyroid surgery: a systematic review and meta-analysis","authors":"Yujing Cai,&nbsp;Lidan Nong,&nbsp;Haifeng Li,&nbsp;Quehua Luo,&nbsp;Yi Zhu,&nbsp;Haihua Shu","doi":"10.1007/s44254-023-00012-8","DOIUrl":"10.1007/s44254-023-00012-8","url":null,"abstract":"<div><p>Bilateral superficial cervical plexus block (BSCPB) is widely used in thyroid surgery. However, its ability to reduce patients’ perioperative pain remains controversial. Therefore, this study aimed to investigate the value of using BSCPB perioperatively for thyroid surgery by conducting a systematic review and meta-analysis of relevant clinical studies. In this systematic review and meta-analysis, we conducted comprehensive searches in the PubMed, Embase, and Cochrane Library databases to collect all randomized controlled trials (RCTs) that used BSCPB for thyroid surgery. The included studies were then analyzed for heterogeneity using the chi-square test, and studies with large heterogeneity were subjected to subgroup or sensitivity analyses. Treatment effects were measured using odds ratio (OR) or weighted mean difference (WMD) and 95% confidence interval (CI). A total of 19 RCTs with 1,365 patients who underwent thyroid surgery (713 and 652 patients in the BSCPB and control groups, respectively) were included in this systematic review. Most of the studies reported that cervical plexus blocks were used preoperatively, and the main drugs used were 0.25–0.75% ropivacaine or bupivacaine. The BSCPB procedure could significantly reduce visual analog scale scores in the immediate (WMD: −1.12, 95% <i>CI</i>: −1.51 to −0.73, <i>P</i> &lt; <i>0.00001</i>), 6-h (WMD: −1.06, 95% <i>CI</i>: −1.60 to −0.53, <i>P</i> = <i>0.0001</i>) and 24-h (WMD: −0.87, 95% <i>CI</i>: −1.29 to −0.45, <i>P</i> &lt; <i>0.0001</i>) postoperative period and also reduce opioid requirements for patients in the post-anesthesia care unit (50.99% vs 72.92%, OR: 0.3, 95% <i>CI</i>: 0.17 to 0.52, <i>P</i> &lt; <i>0.0001</i>) and in the wards (39.80% vs 59.79%, OR: 0.27, 95% <i>CI</i>: 0.12 to 0.59, <i>P</i> = <i>0.001</i>). Additionally, BSCPB reduced the incidence of postoperative nausea and vomiting (OR: 0.50, 95% <i>CI</i>: 0.29 to 0.87, <i>P</i> = <i>0.01</i>). Due to the large heterogeneity, the results only suggest decrease use of intraoperative fentanyl and postoperative morphine in the BSCPB group. The use of BSCPB alleviates of postoperative pain, opioid requirement, and reduces incidence of postoperative nausea and vomiting in patients who have undergone thyroid surgery. More clinical studies are needed for further conclusions.</p></div>","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"1 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-023-00012-8.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72645818","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":"Stranger things: the erector spinae block, extra sensory perception, or paranormal block by proxy?","authors":"Steve Coppens,&nbsp;Aisling Ni Eochagain,&nbsp;Danny Feike Hoogma,&nbsp;Geertrui Dewinter","doi":"10.1007/s44254-023-00007-5","DOIUrl":"10.1007/s44254-023-00007-5","url":null,"abstract":"<div><p>The erector spinae plane block remains a divisive regional technique which has split the regional anesthesia community into believers and non-believers. Its main mechanism of action remains controversial and this has been pivotal in the controversy. We explore our current understanding of fascial plane blocks and erector spinae blocks as well as explore the gaps in knowledge. This opinion paper is meant to give a balanced view of the current state of this block in regard to guidelines, research and future. The viewpoint of the authors may not necessarily align with current ideas, however, hopefully will guide subsequent trials to more robust evidence.</p></div>","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"1 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-023-00007-5.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86310726","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":"Statistical fragility of reporting hemidiaphragmatic paralysis after brachial plexus blocks in randomized controlled trials: a systematic review","authors":"Quehua Luo,&nbsp;Yang Liu,&nbsp;Yi Zhu,&nbsp;Zhipeng Wang,&nbsp;Junyi Zheng,&nbsp;Weifeng Yao","doi":"10.1007/s44254-023-00006-6","DOIUrl":"10.1007/s44254-023-00006-6","url":null,"abstract":"<div><p>To characterize the fragility index (FI) of statistically significant results reported in randomized controlled trials (RCTs) investigating the incidence of hemidiaphragmatic paralysis (HDP) after brachial plexus blocks. A systematic review of RCTs retrieved from the PubMed-Medline, Embase, and Web of Science electronic databases was conducted. All alternative RCTs published between January 2012 and October 2022 were identified. Only RCTs with two parallel arms designs, and reporting HDP as the primary outcome, statistical significance, and superiority results were selected. The FI was calculated according to Fisher’s exact test using previously described methods. In addition, the risk of bias was evaluated using the Cochrane Risk-of-Bias tool for randomized trials. The 23 RCTs that fulfilled the inclusion criteria had a median FI of 4 (interquartile range [IQR]2–8) and a median Fragility Quotient of 0.077 (IQR 0.038- 0.129). However, in 13 (56.5%) trials, the calculated FI value was ≤ 4. In 3/23 (13.0%) trials, the number of patients who dropped-out exceeded the FI value. Most trials (91.3%) had an overall low risk of bias. This systematic review revealed that the statistical results of RCTs investing HDP after brachial plexus blocks have tended to be fragile in the past decade. The FI should be an important aid in the interpretation of clinical results in combination with the P-value, particularly when statistically significant results are dependent on a small number of events. Future RCTs with larger sample sizes are needed to obtain more robust results in this field.</p></div>","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"1 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-023-00006-6.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85661245","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}