Anesthesia and pain medicine最新文献

Permissive strategies in intensive care units (ICUs): actual trends? 重症监护病房（icu）的宽松策略：实际趋势？

Anesthesia and pain medicine Pub Date : 2025-01-15 DOI: 10.17085/apm.24103

Rudin Domi, Filadelfo Coniglione, Gentian Huti, Krenar Lilaj

引用次数: 0

Transforaminal lumbar epidural injection of dexmedetomidine versus magnesium sulfate combined with dexamethasone for lower limb radicular pain management: a randomized, clinical trial. 经椎间孔腰椎硬膜外注射右美托咪定与硫酸镁联合地塞米松治疗下肢神经根性疼痛：一项随机临床试验

Anesthesia and pain medicine Pub Date : 2025-01-02 DOI: 10.17085/apm.24125

Mina Maher Raouf, Gehan Ibrahim Abdelrazek Salem, Fady Adib Abdel Malek, Tamer Youssef Elie Hamawy, Sadik Abdel-Maseeh Sadik, Mohammad Awad Elsaed

{"title":"Transforaminal lumbar epidural injection of dexmedetomidine versus magnesium sulfate combined with dexamethasone for lower limb radicular pain management: a randomized, clinical trial.","authors":"Mina Maher Raouf, Gehan Ibrahim Abdelrazek Salem, Fady Adib Abdel Malek, Tamer Youssef Elie Hamawy, Sadik Abdel-Maseeh Sadik, Mohammad Awad Elsaed","doi":"10.17085/apm.24125","DOIUrl":"https://doi.org/10.17085/apm.24125","url":null,"abstract":"Background: Epidural steroid injections are frequently used to treat chronic radicular pain of a discogenic origin; however, their efficacy remains limited. Magnesium sulfate and dexmedetomidine are emerging adjuvants with the potential to enhance the effectiveness and prolong the therapeutic duration of steroid injections.Methods: In this randomized, double-blind study, 90 patients with unilateral lower limb radiculopathy due to lumbar disc prolapse who did not respond to conservative treatment for 12 weeks were assigned to three groups. The control group received dexamethasone (4 mg), lidocaine 2% (40 mg), and saline. The magnesium group received magnesium sulfate (200 mg) with dexamethasone and lidocaine. The dexmedetomidine group received dexmedetomidine (50 mcg), dexamethasone, lidocaine, and saline. Pain intensity was assessed using the visual analog scale at 1 week and 1, 3, and 6 months post-treatment. Secondary outcomes included the Modified Oswestry Disability Index (MODI), analgesic consumption, and procedure-related complications.Results: Both magnesium and dexmedetomidine significantly reduced pain, disability, and analgesic consumption for up to 3 months. By 6 months, the magnesium group demonstrated significant improvement in pain scores and MODI and a decline in ibuprofen use compared to the control and dexmedetomidine groups.Conclusions: Magnesium significantly reduced pain intensity, disability, and analgesic consumption over a 6-month observation period.","PeriodicalId":101360,"journal":{"name":"Anesthesia and pain medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985716","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}

引用次数: 0

Targeted nutritional strategies in postoperative care. 术后护理中的针对性营养策略。

Anesthesia and pain medicine Pub Date : 2025-01-01 Epub Date: 2025-01-15 DOI: 10.17085/apm.24067

Hye Jin Ham, Jeongmin Kim

{"title":"Targeted nutritional strategies in postoperative care.","authors":"Hye Jin Ham, Jeongmin Kim","doi":"10.17085/apm.24067","DOIUrl":"10.17085/apm.24067","url":null,"abstract":"Immunonutrition, which uses specific nutrients to modulate the immune response, has emerged as a vital adjunct to perioperative care. Surgery-induced stress triggers immune responses that can lead to complications, such as infections and delayed wound healing. Traditional nutritional support often overlooks the immunological needs of surgical patients. Immunonutrition addresses this oversight by providing key nutrients, such as arginine, omega-3 fatty acids, glutamine, nucleotides, and antioxidants (vitamins C and E) to enhance immune function and support tissue repair. This review examined the efficacy and safety of immunonutrition in surgical settings, guided by the recommendations of the American Society for Parenteral and Enteral Nutrition and the European Society for Clinical Nutrition and Metabolism. Both organizations recommend immunonutrition for high-risk or malnourished patients undergoing major surgery and support its use in reducing complications and improving recovery. The key nutrients in immunonutrition aim to improve immune cell function, reduce inflammation, and enhance wound healing. Clinical studies and meta-analyses have demonstrated that immunonutrition lowers the infection rate, shortens the length of hospital stay, and accelerates recovery. Challenges hindering the clinical application of immunonutrition include cost, logistics, and a lack of standardized and personalized protocols. Future studies should focus on biomarker-driven approaches, pharmacogenomics, and innovative nutrient formulations. Addressing these issues will help to integrate immunonutrition into clinical practice, ultimately improving surgical outcomes and patient recovery.","PeriodicalId":101360,"journal":{"name":"Anesthesia and pain medicine","volume":" ","pages":"34-45"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834873/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985721","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}

引用次数: 0

Effects of immediate extubation in the operating room on long-term outcomes in living donor liver transplantation: a retrospective cohort study.

Anesthesia and pain medicine Pub Date : 2025-01-01 Epub Date: 2025-01-24 DOI: 10.17085/apm.24042

Jung-Pil Yoon, Ji-Uk Yoon, Hye-Jin Kim, Seyeon Park, Yeong Min Yoo, Hong-Sik Shon, Da Eun Lee, Eun-Jung Kim, Hee Young Kim

{"title":"Effects of immediate extubation in the operating room on long-term outcomes in living donor liver transplantation: a retrospective cohort study.","authors":"Jung-Pil Yoon, Ji-Uk Yoon, Hye-Jin Kim, Seyeon Park, Yeong Min Yoo, Hong-Sik Shon, Da Eun Lee, Eun-Jung Kim, Hee Young Kim","doi":"10.17085/apm.24042","DOIUrl":"10.17085/apm.24042","url":null,"abstract":"Background: Living-donor liver transplantation (LDLT) is a viable alternative to deceased-donor liver transplantation. Enhanced recovery after surgery protocols that include early extubation offer short-term benefits; however, the effect of immediate extubation in the operating room (OR) on long-term outcomes in patients undergoing LDLT remains unknown. We hypothesized that immediate OR extubation is associated with improved long-term outcomes in patients undergoing LDLT.Methods: This retrospective cohort study included 205 patients who underwent LDLT. The patients were classified based on the extubation location as OREX (those extubated in the OR) or NOREX (those extubated in the intensive care unit [ICU]). The primary outcome was overall survival (OS), while secondary outcomes included ICU stay, hospital stay duration, and various postoperative outcomes.Results: Among the 205 patients, 98 (47.8%) underwent extubation in the OR after LDLT. Univariate analysis revealed that OR extubation did not significantly affect OS (hazard ratio [HR]: 0.50, 95% confidence interval [CI]: 0.24-1.05; P = 0.066). Furthermore, multivariate analysis revealed no statistically significant association between OR extubation and OS (HR: 0.79, 95% CI: 0.35-1.80; P = 0.580). However, OR extubation was significantly associated with a lower incidence of 30-day composite complications and shorter ICU and hospital stays. Multivariate analysis indicated that higher preoperative platelet counts, increased serum creatinine levels, and a longer surgery duration were associated with poorer OS.Conclusions: Immediate OR extubation following LDLT surgery was associated with fewer 30-day composite complications and shorter ICU and hospital stays; however, it did not significantly improve OS compared with ICU extubation.","PeriodicalId":101360,"journal":{"name":"Anesthesia and pain medicine","volume":"20 1","pages":"50-60"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834885/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143384837","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}

引用次数: 0

Dexmedetomidine versus hyaluronidase along with lumbar transforaminal epidural steroid injection in failed back surgery: a randomized double-blind clinical trial. 右美托咪定与透明质酸酶联合经椎间孔硬膜外类固醇注射治疗失败背部手术：一项随机双盲临床试验

Anesthesia and pain medicine Pub Date : 2025-01-01 Epub Date: 2024-11-27 DOI: 10.17085/apm.24094

Mina Maher Raouf, Sherry Shehata Kyriacos, Manal Hassanein, Gehan Ibrahim Abdel-Razek Salem, Amira Elsonbaty, Sadik Abdel-Maseeh Sadik, Mohammad Awad

{"title":"Dexmedetomidine versus hyaluronidase along with lumbar transforaminal epidural steroid injection in failed back surgery: a randomized double-blind clinical trial.","authors":"Mina Maher Raouf, Sherry Shehata Kyriacos, Manal Hassanein, Gehan Ibrahim Abdel-Razek Salem, Amira Elsonbaty, Sadik Abdel-Maseeh Sadik, Mohammad Awad","doi":"10.17085/apm.24094","DOIUrl":"10.17085/apm.24094","url":null,"abstract":"Background: Failed back surgery syndrome is a common problem faced by chronic pain management specialists. Steroid-only epidural injections have modest efficacy because of excessive scarring. Epidural hyaluronidase (HA), functions as a depolymerizing agent, successfully breaking down adhesions and collagen bundles, whereas dexmedetomidine (DEX) helps to reduce inflammation.Methods: The current study is a randomized, double blind, clinical trial. The study cohort included population with persistent (> 6 months) back and/or radicular lower limb pain after laminectomy. Group I (HA group) received bupivacaine 0.5% (5 mg), triamcinolone 40 mg, sterile saline (2 ml), and HA (1500 IU) instilled in 1 mL of distilled water. Group II (DEX group) received bupivacaine 0.5% (5 mg), triamcinolone 40 mg (1 ml), DEX (0.5 mcg/kg), and sterile saline (2 ml).Results: Both groups showed significant reductions in VAS scores at all follow-ups compared to the pre-injection values. At 6 months, the DEX group experienced a significantly greater reduction in pain scores than the HA group (P = 0.003). In terms of the MODI, both groups showed significant reductions in disability scores at all follow-ups relative to the pre-injection values. The DEX group showed greater improvement in MODI values than the HA group. No significant complications were reported.Conclusions: Both DEX and HA yielded significant improvements in pain and disability scores compared with pre-injection levels. The DEX group showed a more substantial and long-term reduction in both pain scores and disability index than the HA group.","PeriodicalId":101360,"journal":{"name":"Anesthesia and pain medicine","volume":" ","pages":"61-71"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834887/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985500","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}

引用次数: 0

Effect of patient position on the success rate of placing triple-cuffed double lumen endotracheal tubes: a two-center interventional observational study. 患者体位对放置三层袖带双腔气管导管成功率的影响：一项双中心介入观察研究。

Anesthesia and pain medicine Pub Date : 2025-01-01 Epub Date: 2024-07-23 DOI: 10.17085/apm.24084

Dong Kyu Lee, Tae-Yop Kim, Jongwon Yun, Seongkyun Cho, Hansu Bae

{"title":"Effect of patient position on the success rate of placing triple-cuffed double lumen endotracheal tubes: a two-center interventional observational study.","authors":"Dong Kyu Lee, Tae-Yop Kim, Jongwon Yun, Seongkyun Cho, Hansu Bae","doi":"10.17085/apm.24084","DOIUrl":"10.17085/apm.24084","url":null,"abstract":"Background: Double-lumen endotracheal tubes (DLT) are essential for one-lung ventilation during thoracic surgery. Bronchoscopy is crucial for correct placement of a DLT to avoid complications such as hypoxemia. This study evaluated the effectiveness of the triple-cuffed DLT (tcDLT) in the supine and lateral positions for correct placement without bronchoscopic guidance.Methods: This prospective observational study included 167 patients scheduled for elective thoracic surgery requiring one-lung ventilation. The incidence of successful placement of left-sided tcDLTs was compared between the supine and lateral decubitus positions under bronchoscopic surveillance. Successful tcDLT placement was defined as the placement of the proximal end of the bronchial cuff within 5 mm of the carina.Results: Among 153 patients who completed the study, the successful tcDLT placement rate in the lateral position (70.6%) was significantly higher than that in the supine position (50.3%). The rate of difference was 20.3% (95% confidence interval [CI], 10.6-29.9%). The extended successful placement rate, including slightly deeper placements, showed no significant differences between the positions (88.9%; 95% CI, 83.9-93.9% in supine, 86.3%; 95% CI, 80.8-91.7% in lateral).Conclusions: tcDLT facilitates correct tube placement in both the supine and lateral positions, with a higher lateral success rate. This finding supports the idea that tcDLTs offer a reliable alternative for lung separation when bronchoscopy is not feasible.","PeriodicalId":101360,"journal":{"name":"Anesthesia and pain medicine","volume":" ","pages":"78-85"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141753800","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}

引用次数: 0

Perineural catheters for continuous peripheral nerve blocks: a narrative review.

Anesthesia and pain medicine Pub Date : 2025-01-01 Epub Date: 2025-01-25 DOI: 10.17085/apm.24192

Seokha Yoo, Hansol Kim, Jin-Tae Kim

引用次数: 0

Neuromuscular transmission monitoring using acceleromyography in a patient with Charcot-Marie-Tooth disease. 用加速肌图监测腓骨肌萎缩症患者的神经肌肉传递。

Anesthesia and pain medicine Pub Date : 2025-01-01 Epub Date: 2025-01-02 DOI: 10.17085/apm.24114

Hidemi Ishido, Yuzo Iseki, Keisuke Yoshida, Masahiro Murakawa

引用次数: 0

A survey of anesthesiologists aged 60 years and older in Korea: current status, challenges, and future strategies.

Anesthesia and pain medicine Pub Date : 2025-01-01 Epub Date: 2025-01-25 DOI: 10.17085/apm.24053

Won Uk Koh, Shamin Ara Sultana, Jong Ho Kim, So Young Lim, Sang Woo Kim, Sung Mi Hwang, Youngsuk Kwon, Jae Jun Lee, Hong Seuk Yang

{"title":"A survey of anesthesiologists aged 60 years and older in Korea: current status, challenges, and future strategies.","authors":"Won Uk Koh, Shamin Ara Sultana, Jong Ho Kim, So Young Lim, Sang Woo Kim, Sung Mi Hwang, Youngsuk Kwon, Jae Jun Lee, Hong Seuk Yang","doi":"10.17085/apm.24053","DOIUrl":"10.17085/apm.24053","url":null,"abstract":"Background: As the global population ages, medical professionals are also aging. This study investigates the status of Korean anesthesiologists over the age of 60.Methods: Anesthesiologists aged 60 and older, residing and working in Korea, were invited to participate in this study via e-mail from February to March 2021 and by mail from June to August 2021. The survey consisted of 40 questions covering 10 topics, including health status, residence, work style, and economic status. Depending on the type of question, answers were ranked on a scale of 1, 2, and 3, with the most preferred response being selected.Results: A total of 63 responses were received, resulting in a response rate of 26.5%. Among the respondents, 56 were currently practicing as anesthesiologists and reported satisfaction with their clinical practice and life status. On average, they treated 24 patients per day without experiencing significant discomfort or inconvenience in their roles as senior physicians. Twenty-four respondents acknowledged physical discomfort related to aging, and nine expressed cautions regarding age-related changes. Fifty-two respondents indicated that reeducation for advanced medical practice as anesthesiologists was necessary.Conclusions: Senior anesthesiologists in Korea are primarily working in secondary and tertiary hospitals and are satisfied with their current life status. A comprehensive evaluation of reeducation programs for advanced clinical practice and retirement strategies for senior anesthesiologists is needed to address the growing number of aging physicians in the workforce.","PeriodicalId":101360,"journal":{"name":"Anesthesia and pain medicine","volume":"20 1","pages":"86-97"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834875/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143384859","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}

引用次数: 0

A message from the Editor-in-Chief and Editorial Board, 2024: journal metrics and statistics, and appreciation to reviewers.

Anesthesia and pain medicine Pub Date : 2025-01-01 Epub Date: 2025-01-25 DOI: 10.17085/apm.25202

Jun Hyun Kim, Hyun Kang

引用次数: 0