Anesthesia and pain medicine最新文献_第4页

Epigenetics in anesthesiology: an overview and clinical relevance. 麻醉学中的表观遗传学：综述和临床相关性。

IF 3.6

Anesthesia and pain medicine Pub Date : 2026-07-01 Epub Date: 2026-07-29 DOI: 10.17085/apm.26713

Hyo-Jin Byon

{"title":"Epigenetics in anesthesiology: an overview and clinical relevance.","authors":"Hyo-Jin Byon","doi":"10.17085/apm.26713","DOIUrl":"10.17085/apm.26713","url":null,"abstract":"Epigenetics, the study of heritable changes in gene expression that occur without altering the underlying DNA sequence, has emerged as an important conceptual framework for anesthesiology. The epigenome is organized into three mechanistic tiers: cytosine methylation in DNA, chemical modification of histone proteins, and gene regulation by non-coding RNA molecules. Unlike a relatively stable genome, epigenetic patterns vary between cell types, change throughout the lifespan, and are modifiable by environmental exposures, including surgical stress and anesthetic drugs. These properties make epigenetic mechanisms particularly relevant to several problems encountered in anesthetic practice. For example, interindividual variability in responses to analgesics and anesthetics, pathophysiology of chronic pain and opioid tolerance, immune dysregulation in critical illness, and long-term cognitive consequences of perioperative exposure in vulnerable populations. This review aimed to explore the fundamental concepts of epigenetics for anesthesiologists; established roles in disease conditions relevant to anesthesiology, including pain, neurodegeneration, and inflammation; and the key considerations for designing and interpreting epigenetic research in the perioperative context. Understanding the epigenome offers both a new lens through which to view the clinical phenomena encountered daily in anesthetic practice, and a potential avenue toward more individualized, mechanism-informed patient care.","PeriodicalId":101360,"journal":{"name":"Anesthesia and pain medicine","volume":"21 3","pages":"275-284"},"PeriodicalIF":3.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13444188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148674756","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

Korean guidelines for pediatric procedural sedation. 韩国小儿程序性镇静指南。

IF 3.6

Anesthesia and pain medicine Pub Date : 2026-07-01 Epub Date: 2026-07-29 DOI: 10.17085/apm.26630

Hye-Mi Lee, Young Sung Kim, Eun-Hee Kim, Jin-Tae Kim, Seyeon Park, Yong-Hee Park, Ji-Hoon Park, Jung-Woo Shim, Chung-Sik Oh, Young-Eun Jang, Sung-Ae Cho, Eun-Young Joo, Sang-Hwan Ji, Byung Gun Lim, Hyo-Jin Byon

{"title":"Korean guidelines for pediatric procedural sedation.","authors":"Hye-Mi Lee, Young Sung Kim, Eun-Hee Kim, Jin-Tae Kim, Seyeon Park, Yong-Hee Park, Ji-Hoon Park, Jung-Woo Shim, Chung-Sik Oh, Young-Eun Jang, Sung-Ae Cho, Eun-Young Joo, Sang-Hwan Ji, Byung Gun Lim, Hyo-Jin Byon","doi":"10.17085/apm.26630","DOIUrl":"10.17085/apm.26630","url":null,"abstract":"Safe and effective pediatric sedation depends on multiple factors, including the precise selection of sedative agents, provider expertise, availability of age-appropriate monitoring equipment, and the patients' individual circumstances. These revised clinical practice guidelines, developed by the Korean Society of Pediatric Anesthesiologists, aim to promote safe and effective pediatric sedation across diverse clinical settings in Korea, thereby enhancing patient safety and standardizing care. These guidelines represent a comprehensive update to the first edition published in 2017, systematically revised through an expert consensus model to reflect the rapidly evolving clinical landscape. The revision prioritized clinical utility and consistency, incorporating the latest pharmacological and technological advancements, while optimizing the content for practical bedside use. Key recommendations cover the entire sedation continuum, including the identification of qualified providers, pre-sedation patient evaluation and fasting requirements, age-specific risk assessment, monitoring of the respiratory and cardiovascular systems, level of sedation, management of respiratory complications, and structured discharge criteria. These recommendations are intended to guide healthcare providers and guardians in sedation-related decision-making for various diagnostic and therapeutic procedures. Depending on the clinical needs and institutional limitations of the primary, secondary, and tertiary care facilities, sedation providers may apply these recommendations directly, adapt them to their specific environments, or use them as a foundational framework for internal protocols.","PeriodicalId":101360,"journal":{"name":"Anesthesia and pain medicine","volume":"21 3","pages":"296-311"},"PeriodicalIF":3.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13444186/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148674753","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

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 3.6

Anesthesia and pain medicine Pub Date : 2026-07-01 Epub 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":"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":"336-347"},"PeriodicalIF":3.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13444190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147625105","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

Preoperative and early postoperative neutrophil-to-lymphocyte ratio for predicting delirium after laparoscopic gynecologic surgery in elderly women: a retrospective cohort study with an outcome-matched nested case-control analysis and internal validation. 术前和术后早期中性粒细胞与淋巴细胞比值预测老年妇女腹腔镜妇科手术后谵妄：一项结果匹配的巢式病例对照分析和内部验证的回顾性队列研究。

IF 3.6

Anesthesia and pain medicine Pub Date : 2026-07-01 Epub Date: 2026-05-13 DOI: 10.17085/apm.25489

Hayoung Lee, Cheol Lee, Hansol Hong, Hyunjong Yu

{"title":"Preoperative and early postoperative neutrophil-to-lymphocyte ratio for predicting delirium after laparoscopic gynecologic surgery in elderly women: a retrospective cohort study with an outcome-matched nested case-control analysis and internal validation.","authors":"Hayoung Lee, Cheol Lee, Hansol Hong, Hyunjong Yu","doi":"10.17085/apm.25489","DOIUrl":"10.17085/apm.25489","url":null,"abstract":"Background: Postoperative delirium (POD) is a common complication in older surgical patients. Neutrophil-to-lymphocyte ratio (NLR) is an inexpensive marker of systemic inflammation; however, its role in predicting POD after laparoscopic gynecological surgery has not been well-characterized.Methods: POD on postoperative days 0-7 was assessed using the Confusion Assessment Method (CAM) or the CAM-intensive care unit (ICU). Inflammatory indices determined preoperatively and on postoperative day 1, including the NLR, were evaluated in a retrospective cohort (n = 356). Outcome-matched (nested case-control) 1:1 propensity score-matched cohort of patients with and without POD (111 per group) was constructed, and the associations were examined using multivariate logistic regression. Model discrimination was assessed using area under the receiver operating characteristic curve (AUC).Results: POD occurred in 111 of the 356 patients (31.2%). In the matched cohort, the preoperative NLR was higher in patients with POD than in those without POD (7.7 vs. 3.2). In multivariate analyses, both preoperative NLR (adjusted odds ratio [OR]: 1.29 per unit increase) and postoperative NLR (adjusted OR: 1.08 per unit increase) were associated with POD. AUC of the clinical prediction model was 0.68, which increased to 0.78 with the addition of preoperative NLR and to 0.84 with the inclusion of both pre- and postoperative NLR. The optimal preoperative cutoff NLR was 7.1.Conclusions: In elderly women undergoing laparoscopic gynecologic surgery, the preoperative NLR was associated with POD within 7 days postoperatively. Incorporation of the NLR into clinical prediction models may facilitate perioperative risk stratification.","PeriodicalId":101360,"journal":{"name":"Anesthesia and pain medicine","volume":" ","pages":"413-424"},"PeriodicalIF":3.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13444178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147936785","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

From visibility to influence. 从能见度到影响力。

IF 3.6

Anesthesia and pain medicine Pub Date : 2026-07-01 Epub Date: 2026-07-21 DOI: 10.17085/apm.26725

Min Kyoung Kim, Hyun Kang

引用次数: 0

Effect of respiratory acid-base balance on rocuronium-induced neuromuscular blockade and sugammadex-induced reversal in rat phrenic nerve hemidiaphragm. 呼吸酸碱平衡对罗库溴铵诱导的大鼠膈神经半膈神经肌肉阻滞和糖madex诱导的逆转的影响。

IF 3.6

Anesthesia and pain medicine Pub Date : 2026-06-04 DOI: 10.17085/apm.25370

Yong Beom Kim, Chun Gon Park, Jae-Moon Choi, Hey Ran Choi, Junyong In, Boo Keun Son, Hong Seuk Yang

{"title":"Effect of respiratory acid-base balance on rocuronium-induced neuromuscular blockade and sugammadex-induced reversal in rat phrenic nerve hemidiaphragm.","authors":"Yong Beom Kim, Chun Gon Park, Jae-Moon Choi, Hey Ran Choi, Junyong In, Boo Keun Son, Hong Seuk Yang","doi":"10.17085/apm.25370","DOIUrl":"10.17085/apm.25370","url":null,"abstract":"Background: This study utilized an ex-vivo model to examine the effect of respiratory acid-base balance on rocuronium-induced neuromuscular blockade and sugammadex-induced recovery and to assess the relationship between train-of-four (TOF) ratio and the first twitch tension of TOF (T1).Methods: After obtaining approval from the Asan Ethics Committee of the Laboratory of Animal Research, phrenic nerve-hemidiaphragm specimens were obtained from 30 adult Sprague-Dawley rats and randomly assigned to control (95% O2 + 5% CO2), respiratory alkalosis (97.5% O2 + 2.5% CO2), and acidosis (91% O2 + 9% CO2) groups, immersed in the Krebs' solution, and stimulated with TOF pattern at 20-s intervals. Rocuronium loading and booster doses were administered every 10 min until > 95% blockade T1 was achieved. Recovery was monitored using T1 and TOF ratios (TOFR) until T1 to > 95% and the TOFR to > 0.9.Results: Left shift of the dose-response curve of T1% and TOFR occurred only in the acidosis group vs the alkalosis group (P < 0.0001). The recovery progression of T1 and TOFR differed significantly between the groups (P = 0.0001). The total doses of rocuronium and sugammadex were different between the control and respiratory acidosis groups (P = 0.00318 and P = 0.00315, respectively), and between the respiratory acidosis and alkalosis groups (P = 0.0007 and P = 0.0007, respectively).Conclusions: Acid-base alterations due to CO2 changes may influence rocuronium-induced neuromuscular blockade and sugammadex-induced reversal. However, despite some inter-group differences, statistically discrete results were not obtained across the experimental groups.","PeriodicalId":101360,"journal":{"name":"Anesthesia and pain medicine","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13444183/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148414504","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

Incidence of hemidiaphragmatic paralysis in superior trunk versus interscalene block upper limb surgeries: a systematic review, meta-analysis, and trial sequential analysis. 上干半膈肌麻痹与斜角肌间阻滞上肢手术的发生率：系统回顾、荟萃分析和试验序贯分析。

IF 3.2

Anesthesia and pain medicine Pub Date : 2026-05-13 DOI: 10.17085/apm.25415

Diogo Fonseca da Cunha, João Paulo Aureliano de Carvalho, Beatriz de Olinda Ribeiro, Elias Batista da Silva Neto, Liana Maria Tôrres de Araújo Azi, Norma Sueli Pinheiro Módolo, Rodrigo Leal Alves

{"title":"Incidence of hemidiaphragmatic paralysis in superior trunk versus interscalene block upper limb surgeries: a systematic review, meta-analysis, and trial sequential analysis.","authors":"Diogo Fonseca da Cunha, João Paulo Aureliano de Carvalho, Beatriz de Olinda Ribeiro, Elias Batista da Silva Neto, Liana Maria Tôrres de Araújo Azi, Norma Sueli Pinheiro Módolo, Rodrigo Leal Alves","doi":"10.17085/apm.25415","DOIUrl":"https://doi.org/10.17085/apm.25415","url":null,"abstract":"Background: Interscalene block (ISB) is widely used for upper limb surgery but frequently causes hemidiaphragmatic paralysis (HDP). Superior trunk block (STB) has emerged as a promising alternative that preserves phrenic nerve. This study aimed to evaluate whether STB is a safer option than ISB.Methods: This systematic review and meta-analysis followed PRISMA guidelines and was registered in PROSPERO (CRD420250654685). Randomized controlled trials (RCTs) comparing STB and ISB in adults undergoing upper limb surgery and reporting HDP as the primary outcome were included. Secondary outcomes were postoperative pain, opioid consumption, motor block duration, patient satisfaction, and Horner's syndrome. Comprehensive searches were conducted through June 2025 in PubMed, Scopus, Embase, Cochrane, and Web of Science. Data were analyzed using a random-effects model in R, and trial sequential analysis was applied to assess statistical robustness.Results: Eight RCTs involving 597 patients were included. Compared with ISB, STB significantly reduced the incidence of complete HDP (risk ratio [RR], 0.10; 95% confidence interval [CI], 0.07-0.17; I2 = 0%, P < 0.001) and Horner's syndrome (RR, 0.06; 95% CI, 0.01-0.24; I2 = 0%, P < 0.001). No significant differences were observed in opioid consumption (P = 0.262), pain scores (P = 0.661), patient satisfaction on a 0-10 scale (P = 0.117), or motor block duration (P = 0.624).Conclusions: STB provides postoperative analgesia comparable to ISB while significantly reducing the incidence of HDP and Horner's syndrome, supporting its role as a safer and effective alternative for shoulder surgery.","PeriodicalId":101360,"journal":{"name":"Anesthesia and pain medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147936701","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

Prediction of postoperative desaturation and bradycardia in neonates undergoing laparoscopic inguinal hernia repair: a retrospective cohort study. 腹腔镜腹股沟疝修补术中新生儿术后去饱和和心动过缓的预测：一项回顾性队列研究。

IF 3.2

Anesthesia and pain medicine Pub Date : 2026-05-13 DOI: 10.17085/apm.25395

Sujung Park, Dongwoo Chae, Hyo-Jin Byon, Min-Soo Kim, Jeongrim Lee

{"title":"Prediction of postoperative desaturation and bradycardia in neonates undergoing laparoscopic inguinal hernia repair: a retrospective cohort study.","authors":"Sujung Park, Dongwoo Chae, Hyo-Jin Byon, Min-Soo Kim, Jeongrim Lee","doi":"10.17085/apm.25395","DOIUrl":"https://doi.org/10.17085/apm.25395","url":null,"abstract":"Background: Ex-premature infants have a high risk of postoperative apnea and bradycardia. This study aimed to develop a predictive model for postoperative desaturation and bradycardia in infants who underwent laparoscopic inguinal hernia repair (IHR) under general anesthesia based on identified risk factors.Methods: The retrospective cohort included infants who underwent laparoscopic IHR under general anesthesia at Severance Hospital in Korea between February 2013 and September 2019. Collected data included sex, gestational age (GA), postnatal age and post-conceptual age at surgery, birth weight, body weight at surgery, medical history and comorbidities, urgency of surgery, preoperative hemoglobin, anesthetic agents used, operation time, anesthesia time, intraoperative opioid dose, length of hospital stay, operation to discharge time, and postoperative ward. Feature selection was applied, and a machine learning model was developed to predict postoperative desaturation and bradycardia.Results: Three features for desaturation (cardiac comorbidities, GA, and body weight at surgery) and two features for bradycardia (GA and cardiac comorbidities) were selected for multivariate logistic regression analysis. Cardiac comorbidities were the most significant predictor for desaturation and bradycardia with odds ratios (95% confidence intervals) of 5.112 (1.881-13.888) and 26.597 (3.190-221.850), respectively.Conclusions: Preterm infants with cardiac comorbidities and lower GA may be more susceptible to postoperative desaturation or bradycardia.","PeriodicalId":101360,"journal":{"name":"Anesthesia and pain medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147936680","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

Point-of-care ultrasound for the prediction of fluid responsiveness in off-pump coronary artery bypass grafting surgery: a comparison between carotid Doppler peak systolic velocity and inferior vena cava distensibility index: a prospective observational trial. 即时超声预测非体外循环冠状动脉搭桥手术中液体反应性：颈动脉多普勒峰值收缩速度和下腔静脉扩张指数的比较：一项前瞻性观察性试验。

IF 3.2

Anesthesia and pain medicine Pub Date : 2026-05-13 DOI: 10.17085/apm.25342

Sabah Naguib Barsoom Ayoub, Ramy Mahrose, Abdelkader Abdelrahman Elbakry, Mohammed Sayed Shorbagy

{"title":"Point-of-care ultrasound for the prediction of fluid responsiveness in off-pump coronary artery bypass grafting surgery: a comparison between carotid Doppler peak systolic velocity and inferior vena cava distensibility index: a prospective observational trial.","authors":"Sabah Naguib Barsoom Ayoub, Ramy Mahrose, Abdelkader Abdelrahman Elbakry, Mohammed Sayed Shorbagy","doi":"10.17085/apm.25342","DOIUrl":"https://doi.org/10.17085/apm.25342","url":null,"abstract":"Background: Evidence remains inconclusive regarding the ability of the inferior vena cava (IVC) distensibility index and common carotid Doppler flow velocity parameters to predict fluid responsiveness before off-pump cardiac surgery. Therefore, we sought to evaluate the relationship between the IVC distensibility index, common carotid Doppler flow velocity parameters, and fluid responsiveness during off-pump coronary artery bypass surgery.Methods: In this prospective observational study conducted at Ain Shams University Hospitals (Cardiothoracic Academy), 30 adult patients (ejection fraction > 45%) scheduled for off-pump coronary artery bypass surgery after an 8-h fasting period were enrolled. Following induction of anesthesia, a fluid challenge of 5 ml/kg crystalloid was administered. Hemodynamic variables (mean arterial pressure, heart rate, central venous pressure, IVC distensibility index, common carotid Doppler peak velocity, and transthoracic cardiac output [CO]) were recorded before and after fluid loading. An increase in CO of > 15% after the fluid challenge indicates fluid responsiveness.Results: Sonographic measurements demonstrated statistically significant changes in CO following fluid loading. However, neither the change in the IVC distensibility index (ΔIVC) nor the change in carotid Doppler peak systolic velocity (ΔVpeakCCA) demonstrated adequate discriminatory ability to differentiate fluid responders from non-responders in this cohort.Conclusions: Point-of-care ultrasound parameters, including the IVC distensibility index and carotid Doppler velocity, showed limited value for predicting fluid responsiveness in off-pump cardiac surgery and, therefore, should not be used in isolation to guide perioperative fluid administration.","PeriodicalId":101360,"journal":{"name":"Anesthesia and pain medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147936748","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 3.6

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":"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":3.6,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13444179/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147625106","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