Anesthesia and pain medicine最新文献

Assessment of changes in lung aeration and diaphragmatic function using ultrasonography in laparoscopic abdominal surgery: a prospective observational study. 应用超声评估腹腔镜腹部手术中肺通气和膈功能的变化：一项前瞻性观察研究。

IF 3.2

Anesthesia and pain medicine Pub Date : 2026-04-24 DOI: 10.17085/apm.25248

Divya Sethi, Stuti Prajapati, Garima Garg

{"title":"Assessment of changes in lung aeration and diaphragmatic function using ultrasonography in laparoscopic abdominal surgery: a prospective observational study.","authors":"Divya Sethi, Stuti Prajapati, Garima Garg","doi":"10.17085/apm.25248","DOIUrl":"https://doi.org/10.17085/apm.25248","url":null,"abstract":"Background: A few studies investigating the perioperative use of lung ultrasound (LUS) have shown loss of lung aeration with decline in diaphragmatic function after general anesthesia. We aimed to measure changes in lung aeration and diaphragmatic functions using LUS in patients undergoing elective laparoscopic cholecystectomy.Methods: Forty patients of American Society of Anesthesiologists I/II undergoing elective laparoscopic cholecystectomy under general anesthesia were enrolled. For all patients, LUS examination was performed at 5 time points: preoperative room, after intubation, after deflation of pneumoperitoneum, 30 min after extubation, and 24 h post-extubation. The aeration loss was assessed using the modified LUS score. The diaphragmatic excursion was also evaluated preoperatively, and at 30 min and 24 h post-extubation.Results: A progressive increase in modified LUS score was seen after intubation, after deflation of pneumoperitoneum, 30 min postoperative, after extubation and 24 h post-extubation at postoperative anesthesia care unit (PACU) as compared to preoperative room (P < 0.0001). The maximum modified LUS score was observed postoperatively after 30 min: 8 (5, 10) and 24 h post-extubation in PACU: 8 (4.25, 11.0). No significant change in the diaphragmatic excursion or respiratory complications was observed.Conclusions: Our study found a progressive loss of lung aeration after the induction of general anesthesia in laparoscopic cholecystectomy, extending up to the 24-h perioperative period. However, diaphragmatic excursion remained unchanged. The study also suggests that LUS is a valuable tool for detecting perioperative atelectasis and quantifying the aeration loss.","PeriodicalId":101360,"journal":{"name":"Anesthesia and pain medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147794036","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

A scoping review approach for synthesizing and mapping research in anesthesia and pain medicine. 麻醉与疼痛药物合成与图谱研究的范围综述方法。

IF 3.2

Anesthesia and pain medicine Pub Date : 2026-04-24 DOI: 10.17085/apm.25402

Hyun-Ju Seo

引用次数: 0

Transcranial Doppler ultrasonography in geriatric anesthesia: moving toward personalized brain protection strategies. 经颅多普勒超声在老年麻醉：走向个性化的脑保护策略。

IF 3.2

Anesthesia and pain medicine Pub Date : 2026-04-06 DOI: 10.17085/apm.25383

Lan Ge, Taotao Xing

{"title":"Transcranial Doppler ultrasonography in geriatric anesthesia: moving toward personalized brain protection strategies.","authors":"Lan Ge, Taotao Xing","doi":"10.17085/apm.25383","DOIUrl":"https://doi.org/10.17085/apm.25383","url":null,"abstract":"The increasing volume of geriatric surgical procedures presents a critical challenge: protecting the aging brain from perioperative complications such as postoperative delirium and postoperative cognitive dysfunction. Conventional anesthetic management, which relies primarily on systemic parameters like blood pressure, often overlooks age-related vulnerabilities, including impaired cerebral autoregulation and reduced cerebrovascular reserve. Transcranial Doppler ultrasonography (TCD) offers a valuable solution by providing real-time, noninvasive assessment of cerebral hemodynamics. This modality enables dynamic monitoring of key indicators, such as mean flow velocity and pulsatility index, to detect cerebral hypoperfusion, microembolic events, and blood flow variability-all of which represent significant risk factors for neurological injury. A major advantage of TCD lies in its capacity to guide individualized blood pressure management. By determining each patient's optimal mean arterial pressure, TCD assists clinicians in preventing both hypotension and hypertension, thereby surpassing the limitations of a one-size-fits-all approach. Despite remaining challenges-such as operator dependence and the need for larger-scale validation studies-the future of TCD appears promising. Integration with robotic systems and artificial intelligence is expected to improve automation and reliability. Ultimately, TCD is likely to become an integral component of multimodal intraoperative monitoring, facilitating a data-driven, brain-centered anesthetic strategy that enhances the safety and well-being of elderly surgical patients.","PeriodicalId":101360,"journal":{"name":"Anesthesia and pain medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147625105","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

Utility of real-time ultrasound-guided spinal anesthesia in severe ankylosing spondylitis - A case report. 实时超声引导下脊柱麻醉在重度强直性脊柱炎中的应用- 1例报告。

IF 3.2

Anesthesia and pain medicine Pub Date : 2026-04-06 DOI: 10.17085/apm.25392

Jedniphat Intrapongpan, Hyungtae Kim, Hajung Kim, Won Uk Koh, Se-Ung Park, Yoojeong Kwak, Jaedo Lee

{"title":"Utility of real-time ultrasound-guided spinal anesthesia in severe ankylosing spondylitis - A case report.","authors":"Jedniphat Intrapongpan, Hyungtae Kim, Hajung Kim, Won Uk Koh, Se-Ung Park, Yoojeong Kwak, Jaedo Lee","doi":"10.17085/apm.25392","DOIUrl":"https://doi.org/10.17085/apm.25392","url":null,"abstract":"Background: Ankylosing spondylitis (AS) distorts the neuraxial anatomy and can complicate airway management. However, patients with severe AS are often considered unsuitable for spinal anesthesia, and attempts are typically avoided. We report a case of successful real-time ultrasound-guided spinal anesthesia in a patient with severe AS.Case: A 73-year-old man with severe AS and restrictive lung impairment presented with a femoral neck fracture and was scheduled for bipolar hemiarthroplasty. Cervical flexion deformity and whole spine ankylosis predicted difficult airway and hindered spinal anesthesia. Preprocedural ultrasound in the paramedian sagittal oblique view identified a single, small L3-4 interlaminar space. Real-time ultrasound guidance enabled intrathecal needle advancement and successful spinal anesthesia with uneventful intraoperative and immediate postoperative courses.Conclusions: Real-time ultrasound-guided spinal anesthesia can overcome severe anatomical distortion in patients with AS.","PeriodicalId":101360,"journal":{"name":"Anesthesia and pain medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147625106","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

Response to: Comment on "Clinical roles of point-of-care ultrasonography in airway management". 回复：关于“现场超声检查在气道管理中的临床作用”的评论。

IF 3.2

Anesthesia and pain medicine Pub Date : 2026-01-01 Epub Date: 2026-01-30 DOI: 10.17085/apm.25514

Hyungseok Seo, Chung-Sik Oh, Geun Joo Choi, Jung-Bin Park

引用次数: 0

Frailty assessment in perioperative geriatric patients: a narrative review. 围手术期老年患者的衰弱评估：叙述性回顾。

IF 3.2

Anesthesia and pain medicine Pub Date : 2026-01-01 Epub Date: 2026-01-30 DOI: 10.17085/apm.25480

Tae-Yun Sung, Chung-Sik Oh

{"title":"Frailty assessment in perioperative geriatric patients: a narrative review.","authors":"Tae-Yun Sung, Chung-Sik Oh","doi":"10.17085/apm.25480","DOIUrl":"10.17085/apm.25480","url":null,"abstract":"Frailty is increasingly recognized as a major determinant of perioperative risk in the geriatric population. It is characterized by reduced physiological reserve and impaired stress tolerance and arises from multisystem dysregulation involving chronic inflammation, neuroendocrine changes, sarcopenia, and organ dysfunction. Unlike chronological aging, frailty reflects biological vulnerability independent of comorbidity or disability and is strongly associated with postoperative complications, prolonged hospitalization, cognitive decline, and mortality. Therefore, early and systematic frailty assessment is essential to optimize perioperative management, support clinical decision-making, and implement tailored interventions. Multiple validated frailty assessment strategies exist, ranging from phenotypic models such as the Fried Frailty Phenotype to deficit accumulation tools such as the Frailty Index (FI). Practical bedside instruments, including the Clinical Frailty Scale, Edmonton Frail Scale, fatigue, resistance, ambulation, illnesses, loss of weight (FRAIL) questionnaire, modified FI, and disease-specific screening tools, enable rapid detection in clinical settings. Frailty assessment should be performed early and efficiently to facilitate targeted prehabilitation, nutritional optimization, and cognitive support, all of which have been associated with improved functional outcomes. It also informs individualized anesthetic strategies, including drug titration, hemodynamic stabilization, lung-protective ventilation, and delirium prevention. However, barriers to implementation-such as limited clinician awareness, time constraints, and lack of standardized protocols-continue to hinder routine use. Future integration may be accelerated by artificial intelligence, telemedicine, and digital monitoring technologies to enhance geriatric anesthesia. This review provides a comprehensive overview of frailty in geriatric patients, highlighting its definition, pathophysiology, assessment methods, and clinical impact.","PeriodicalId":101360,"journal":{"name":"Anesthesia and pain medicine","volume":"21 1","pages":"51-66"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12890551/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146159946","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

Intraoperative lactate level and lactate clearance is associated with long-term mortality in liver transplant recipients. 肝移植受者术中乳酸水平和乳酸清除率与长期死亡率相关。

IF 3.2

Anesthesia and pain medicine Pub Date : 2026-01-01 Epub Date: 2025-11-17 DOI: 10.17085/apm.25331

Akira Katayama, Ezeldeen Abuelkasem, Marianne M Ligon, Yaroslava Longhitano, David W Wang

{"title":"Intraoperative lactate level and lactate clearance is associated with long-term mortality in liver transplant recipients.","authors":"Akira Katayama, Ezeldeen Abuelkasem, Marianne M Ligon, Yaroslava Longhitano, David W Wang","doi":"10.17085/apm.25331","DOIUrl":"10.17085/apm.25331","url":null,"abstract":"Background: Hyperlactatemia has been associated with poor outcomes in various clinical settings including liver transplantation (LT). However, the impact of intraoperative lactate levels and lactate clearance on long-term mortality in LT recipients remains unclear.Methods: We retrospectively reviewed data from 1,067 patients who underwent LT. All lactate data measured intraoperatively were used to calculate the time-weighted average lactate (TWAL) method. Lactate clearance was calculated as the difference between lactate levels immediately after reperfusion and at the end of surgery. Multivariable analyses were performed to identify independent predictors of mortality after LT.Results: Higher lactate group showed significantly worse survival at 30-days, 1-year, and 3-years (P = 0.01, P < 0.001, and P < 0.001, respectively), and lactate clearance was significantly lower in non-survivors (P = 0.003, P = 0.003, and P = 0.002, respectively). Multivariable analyses revealed that the TWAL was independently associated with each mortality timepoint (hazard ratio [HR], 1.41, 95% confidence interval [CI], 1.19-1.67; P < 0.001, HR, 1.29, 95% CI, 1.17-1.42; P < 0.001, HR, 1.20, 95% CI, 1.10-1.30; and P < 0.001, respectively). Furthermore, lactate clearance was also an independent predictor for each mortality timepoint (HR, 0.69, 95% CI, 0.60-0.80; P < 0.001, HR, 0.80, 95% CI, 0.73-0.88; P < 0.001, and HR, 0.83, 95% CI, 0.77-0.90; P < 0.001, respectively).Conclusions: Both intraoperative lactate level and lactate clearance were independently associated with mortality after LT. Intraoperative lactate monitoring may help predict both short- and long-term mortality in LT recipients.","PeriodicalId":101360,"journal":{"name":"Anesthesia and pain medicine","volume":"21 1","pages":"72-82"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12890539/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146159969","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

Corrigendum to: Pathway from anterior suprascapular nerve block to the phrenic nerve: a cadaveric dye study. 从肩胛前上神经阻滞到膈神经的通路：尸体染色研究。

IF 3.2

Anesthesia and pain medicine Pub Date : 2026-01-01 Epub Date: 2026-01-30 DOI: 10.17085/apm.24142.e1

Sandeep Diwan, Deepika Sathe, Anjali Sabnis, Prakash Mane, Anju Gupta

引用次数: 0

A message from the Editor-in-Chief and Editorial Board, 2025: journal metrics and statistics, and appreciation to reviewers. 总编辑和编辑委员会的信息，2025：期刊指标和统计，以及对审稿人的感谢。

IF 3.2

Anesthesia and pain medicine Pub Date : 2026-01-01 Epub Date: 2026-01-30 DOI: 10.17085/apm.26515

Jun Hyun Kim, Hyun Kang

引用次数: 0

Grip strength as a simple method to predict postoperative delirium after lower extremity surgery in the elderly: a prospective diagnostic evaluation. 握力作为预测老年人下肢手术后谵妄的简单方法：一项前瞻性诊断评估。

IF 3.2

Anesthesia and pain medicine Pub Date : 2026-01-01 Epub Date: 2025-11-24 DOI: 10.17085/apm.25254

Hyo Sung Kim, Seok Kyeong Oh, Young Sung Kim, Hyun Ah Lee

{"title":"Grip strength as a simple method to predict postoperative delirium after lower extremity surgery in the elderly: a prospective diagnostic evaluation.","authors":"Hyo Sung Kim, Seok Kyeong Oh, Young Sung Kim, Hyun Ah Lee","doi":"10.17085/apm.25254","DOIUrl":"10.17085/apm.25254","url":null,"abstract":"Background: Grip strength (GS), an indicator of sarcopenia, declines with age and is associated with frailty, which increases the risk of postoperative delirium (POD). Assessing frailty in patients undergoing lower extremity surgery is challenging owing to limited mobility. We investigated whether GS, a simple screening tool, can independently predict POD and aimed to determine the most appropriate criteria for low GS in the Korean population.Methods: This prospective study included patients aged ≥ 65 years undergoing lower extremity surgery. Preoperative GS was measured, and sarcopenia was diagnosed according to the Asian Working Group for Sarcopenia (AWGS) cut-offs and three other established criteria for GS weakness. POD was assessed with the Confusion Assessment Method for the Intensive Care Unit. Receiver operating characteristic (ROC) curves were used to evaluate the sensitivity and specificity of low GS in predicting POD. Logistic regression analysis was performed to identify variables independently associated with POD.Results: GS was measured in 150 patients with a median age of 73 years. POD was diagnosed in 17 patients (11.3%), 13 of whom had low GS. Among the four sarcopenia criteria, the AWGS showed the highest area under the ROC curve (0.796). Of the variables analyzed-including age, American Society of Anesthesiologists class, body weight, intraoperative opioid use, and postoperative pain-only low GS was identified as an independent predictor of POD (odds ratio: 15.543, P < 0.001).Conclusions: GS is a simple, reliable measure that may serve as an independent predictor of POD in elderly undergoing lower extremity surgery.","PeriodicalId":101360,"journal":{"name":"Anesthesia and pain medicine","volume":"21 1","pages":"101-110"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12890543/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146159970","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