Anesthesia and pain medicine最新文献_第2页

Treatment of severe pain in a patient with a cervical spinal cord injury at C5-7 level using an intrathecal targeted drug delivery system - A case report. 鞘内靶向给药系统治疗C5-7节段颈脊髓损伤患者剧烈疼痛1例报告

Anesthesia and pain medicine Pub Date : 2025-04-01 Epub Date: 2025-04-30 DOI: 10.17085/apm.24151

Yeong-Min Yoo, Ji-Eun Jung, Hyun-Jin Kim, Hyeon-Soo Park, Hye-Jin Kim, Gyeong-Jo Byeon

引用次数: 0

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。

Anesthesia and pain medicine Pub Date : 2025-04-01 Epub Date: 2025-04-30 DOI: 10.17085/apm.24142

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

{"title":"Pathway from anterior suprascapular nerve block to the phrenic nerve: a cadaveric dye study.","authors":"Sandeep Diwan, Deepika Sathe, Anjali Sabnis, Prakash Mane, Anju Gupta","doi":"10.17085/apm.24142","DOIUrl":"https://doi.org/10.17085/apm.24142","url":null,"abstract":"Background: Anterior suprascapular nerve block is widely used for postoperative shoulder pain management. Although cadaveric studies show the spread and smudging of the phrenic nerve, our cadaveric injection investigation was conducted to investigate the pathway of diffusion of the dye toward the phrenic nerve from a more distal injection at the suprascapular nerve.Methods: We injected 5 ml of 0.1% methylene blue dye into the proximal portion of the suprascapular nerve (infra-omohyoid in the posterior triangle) in 12 neck specimens from six cadavers. Following meticulous dissection, we assessed the spread of the dye along the brachial plexus to the nerve roots and traced the phrenic nerve for staining.Results: The phrenic nerve was stained in 41.7% of the cases, the inferior trunk of the brachial plexus was unstained in all cases (100%), and the posterior division and suprascapular nerve were stained in all cases (100%). The nerves to the subclavius, dorsal aspect of the superior trunk, and C5 and C6 roots were stained in all cases. Anterior division of the superior trunk was observed in 75% of the specimens. The dye-spread pathway along the brachial plexus was dorsal, sparing the ventral aspect.Conclusions: Our study demonstrated that the dye-spread pathway from the suprascapular nerve at the infra-omohyoid level to the phrenic nerve is dorsal to the brachial plexus.","PeriodicalId":101360,"journal":{"name":"Anesthesia and pain medicine","volume":"20 2","pages":"175-182"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12066203/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045666","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

Evolution of pain management in lung cancer surgery: from opioid-based to personalized analgesia. 肺癌手术中疼痛管理的演变：从阿片类药物到个性化镇痛。

Anesthesia and pain medicine Pub Date : 2025-04-01 Epub Date: 2025-04-30 DOI: 10.17085/apm.25240

Wonjung Hwang

{"title":"Evolution of pain management in lung cancer surgery: from opioid-based to personalized analgesia.","authors":"Wonjung Hwang","doi":"10.17085/apm.25240","DOIUrl":"https://doi.org/10.17085/apm.25240","url":null,"abstract":"Pain management in lung cancer resection has undergone a paradigm shift from opioid-centric approaches to multimodal analgesia, and more recently, personalized strategies that integrate the principles of precision medicine. Historically, opioids have been the mainstay of perioperative analgesia. However, concerns regarding opioid-related adverse effects, including respiratory depression, immunosuppression, and potential oncologic implications, have driven the adoption of opioid-sparing techniques. Current strategies emphasize multimodal analgesia, combining nonsteroidal antiinflammatory drugs, acetaminophen, regional anesthesia, and adjunctive agents to enhance pain control while minimizing opioid exposure. However, growing evidence suggests that perioperative analgesics may differentially influence tumor biology depending on molecular and genetic factors, necessitating a more tailored approach. This has led to the emergence of precision oncoanesthesia, which aims to integrate tumor-specific genomic insights into perioperative pain management. Although promising, the clinical implementation of precision oncoanesthesia remains in its early stages, with key challenges including the lack of large-scale prospective studies, limited real- time genomic profiling in anesthetic planning, and variability in patient responses to analgesics. Future research should focus on identifying biomarkers that predict individual responses to perioperative analgesia and establishing evidence-based guidelines for precision- based pain management. By evolving beyond traditional opioid reliance and standard analgesic protocols, perioperative pain management in lung cancer surgery can align with emerging precision medicine approaches, ensuring effective pain control and optimized oncologic outcomes.","PeriodicalId":101360,"journal":{"name":"Anesthesia and pain medicine","volume":"20 2","pages":"109-120"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12066207/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061833","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

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

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

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

Effects of immediate extubation in the operating room on long-term outcomes in living donor liver transplantation: a retrospective cohort study. 即时拔管对活体肝移植长期预后的影响：一项回顾性队列研究。

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

Perineural catheters for continuous peripheral nerve blocks: a narrative review. 连续周围神经阻滞的神经周围导尿管：叙述回顾。

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

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

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