Anesthesia and pain medicine最新文献_第6页

Revolutionizing trauma care: advancing coagulation management and damage control anesthesia. 革新创伤护理：推进凝血管理和损伤控制麻醉。

Anesthesia and pain medicine Pub Date : 2024-04-01 Epub Date: 2024-04-30 DOI: 10.17085/apm.24038

Min A Kwon, Sung Mi Ji

{"title":"Revolutionizing trauma care: advancing coagulation management and damage control anesthesia.","authors":"Min A Kwon, Sung Mi Ji","doi":"10.17085/apm.24038","DOIUrl":"10.17085/apm.24038","url":null,"abstract":"Despite advances in emergency transfer systems and trauma medicine, the incidence of preventable deaths due to massive hemorrhage remains high. Recent immunological research has elucidated key mechanisms underlying trauma-induced coagulopathy in the early stages of trauma, including sympathoadrenal stimulation, shedding of the glycocalyx, and endotheliopathy. Consequently, the condition progresses to fibrinogen depletion, hyperfibrinolysis, and platelet dysfunction. Coexisting factors such as uncorrected acidosis, hypothermia, excessive crystalloid administration, and a history of anticoagulant use exacerbate coagulopathy. This study introduces damage-control anesthetic management based on recent insights into damage-control resuscitation, emphasizing the importance of rapid transport, timely bleeding control, early administration of antifibrinolytics and fibrinogen concentrates, and maintenance of calcium levels and body temperature. Additionally, this study discusses brain-protective strategies for trauma patients with brain injuries and the utilization of cartridge-based viscoelastic assays for goal-directed coagulation management in trauma settings. This comprehensive approach may provide potential insights for anesthetic management in the fast-paced field of trauma medicine.","PeriodicalId":101360,"journal":{"name":"Anesthesia and pain medicine","volume":"19 2","pages":"73-84"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11089294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140900653","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

Use of vasopressors to manage spinal anesthesia-induced hypotension during cesarean delivery. 在剖宫产过程中使用血管加压剂控制脊髓麻醉引起的低血压。

Anesthesia and pain medicine Pub Date : 2024-04-01 Epub Date: 2024-04-30 DOI: 10.17085/apm.24037

Hee-Sun Park, Woo-Jong Choi

{"title":"Use of vasopressors to manage spinal anesthesia-induced hypotension during cesarean delivery.","authors":"Hee-Sun Park, Woo-Jong Choi","doi":"10.17085/apm.24037","DOIUrl":"10.17085/apm.24037","url":null,"abstract":"Cesarean sections are commonly performed under spinal anesthesia, which can lead to hypotension, adversely affecting maternal and fetal outcomes. Hypotension following spinal anesthesia is generally defined as a blood pressure of 80-90% below the baseline value. Various strategies have been implemented to reduce the incidence of spinal anesthesia-induced hypotension. The administration of vasopressors is a crucial method for preventing and treating hypotension. In the past decade, phenylephrine, a primarily alpha-adrenergic agonist, has been the preferred vasopressor for cesarean sections. Recently, norepinephrine, a potent alpha-agonist with modest beta-agonist activity, has gained popularity owing to its advantages over phenylephrine. Vasopressors can be administered via a bolus or continuous infusion. Although administering boluses alone is simpler in a clinical setting, continuous prophylactic infusion initiated immediately after spinal anesthesia is more effective in reducing the incidence of hypotension. Tailoring the infusion dose based on the patient's body weight and adjusting the rate in response to blood pressure changes, in addition to using a prophylactic or rescue bolus, helps reduce blood pressure variability during cesarean sections under spinal anesthesia until neonatal delivery.","PeriodicalId":101360,"journal":{"name":"Anesthesia and pain medicine","volume":"19 2","pages":"85-93"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11089295/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140900661","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

Unintended subdural anesthesia and subdural air bubbles after attempted epidural anesthesia in a patient undergoing cesarean section. 一名接受剖腹产手术的患者在尝试硬膜外麻醉后出现意外硬膜下麻醉和硬膜下气泡。

Anesthesia and pain medicine Pub Date : 2024-04-01 Epub Date: 2024-04-30 DOI: 10.17085/apm.23105

Jung Eun Kim, Jinse Lee, Giyear Lee, Mi Hwa Chung, Young Ryong Choi, Eun Mi Choi

引用次数: 0

Anesthesia and cancer recurrence: a narrative review. 麻醉与癌症复发：叙述性综述。

Anesthesia and pain medicine Pub Date : 2024-04-01 Epub Date: 2024-04-30 DOI: 10.17085/apm.24041

Hyun Joo Ahn

引用次数: 0

Preoperative echocardiography as a predictor of spinal anesthesia-induced hypotension in older patients with mild left ventricular diastolic dysfunction: a retrospective observational study. 术前超声心动图作为轻度左心室舒张功能障碍老年患者脊髓麻醉诱发低血压的预测指标：一项回顾性观察研究。

Anesthesia and pain medicine Pub Date : 2024-04-01 Epub Date: 2024-04-30 DOI: 10.17085/apm.23161

Eun Ji Park, Ah-Reum Cho, Hyae-Jin Kim, Hyeon-Jeong Lee, Soeun Jeon, Jiseok Baik, Wangseok Do, Christine Kang, Yerin Kang

{"title":"Preoperative echocardiography as a predictor of spinal anesthesia-induced hypotension in older patients with mild left ventricular diastolic dysfunction: a retrospective observational study.","authors":"Eun Ji Park, Ah-Reum Cho, Hyae-Jin Kim, Hyeon-Jeong Lee, Soeun Jeon, Jiseok Baik, Wangseok Do, Christine Kang, Yerin Kang","doi":"10.17085/apm.23161","DOIUrl":"10.17085/apm.23161","url":null,"abstract":"Background: Spinal anesthesia-induced hypotension (SAH) frequently occurs in older patients, many of whom have mild left ventricular (LV) diastolic dysfunction, often asymptomatic at rest. This study investigated the association between preoperative echocardiographic measurements and SAH in older patients with mild LV diastolic dysfunction.Methods: We conducted a retrospective observational study using data from electronic medical records. The patients ≥ 65 years old who underwent spinal anesthesia for urologic surgery between January 2016 and December 2017 and whose preoperative echocardiography within 6 months before surgery revealed grade I LV diastolic dysfunction were recruited. SAH was investigated using the anesthesia records. Logistic regression and receiver operating characteristic (ROC) curve analyses were performed.Results: A total of 163 patients were analyzed. SAH and significant SAH developed in 55 (33.7%) patients. The mitral inflow E velocity was an independent risk factor for SAH (odds ratio [OR], 0.886; 95% confidence interval [CI], 0.845-0.929; P < 0.001). The area under the ROC curve for mitral inflow E velocity to predict SAH was 0.819 (95% CI, 0.752-0.875; P < 0.001). If mitral inflow E velocity was ≤ 60 cm/s, SAH was predicted with a sensitivity of 83.6% and specificity of 70.4%.Conclusions: The preoperative mitral inflow E velocity demonstrated the greatest predictability of SAH in older patients with mild LV diastolic dysfunction. This may assist in identifying patients at high risk of SAH and guiding preventive strategies in the future.","PeriodicalId":101360,"journal":{"name":"Anesthesia and pain medicine","volume":"19 2","pages":"134-143"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11089297/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140900640","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 remimazolam combined with remifentanil on quality of recovery after ambulatory hysteroscopic surgery: a prospective, observational study. 瑞马唑仑联合瑞芬太尼对门诊宫腔镜手术后恢复质量的影响：一项前瞻性观察研究。

Anesthesia and pain medicine Pub Date : 2024-01-01 Epub Date: 2024-01-30 DOI: 10.17085/apm.23102

Insun Park, Junkyu Kim, Seung Hyun Chung, Hyo-Seok Na, Sang-Hwan Do

{"title":"Effects of remimazolam combined with remifentanil on quality of recovery after ambulatory hysteroscopic surgery: a prospective, observational study.","authors":"Insun Park, Junkyu Kim, Seung Hyun Chung, Hyo-Seok Na, Sang-Hwan Do","doi":"10.17085/apm.23102","DOIUrl":"10.17085/apm.23102","url":null,"abstract":"Background: Remimazolam, a new benzodiazepine, is known for its quick onset of effects and recovery time. Recently, it has been licensed for general anesthesia and sedation in Korea and its use is increasing in other countries. However, less is known about its effect on postoperative recovery. We used a patient-reported outcome questionnaire to examine the effect of remimazolam on postoperative recovery.Methods: Patients who underwent hysteroscopy on day surgery basis were administered an induction dose of remimazolam 6 mg/kg/h followed by a maintenance dose of 1-2 mg/kg/h. After surgery, the translated Korean version of 15-item Quality of Recovery scale (QoR-15K) including post-discharge nausea and vomiting (PDNV) and/or pain, was surveyed 24 h after surgery to evaluate patient recovery.Results: Total of 38 patients were enrolled in this prospective, observational study. All patients successfully completed QoR-15K. Only one patient scored low for moderate pain and PDNV. On average, patients scored 9 and above for all QoR-15K items except for moderate pain (8.66 ± 1.68). When QoR-15K items were grouped into dimensions, all dimensions scored an average of 9 or higher on a 10-point scale. In addition, 19 out of 38 patients gave score range of 148 to 150 out of possible 150.Conclusions: Psychometric evaluation based on postoperative QoR-15K among patients receiving remimazolam shows satisfactory patient recovery profiles without significant pain or PDNV. Considering its effectiveness and safety, remimazolam could be one of useful agents for general anesthesia of day surgery in terms of postoperative recovery.","PeriodicalId":101360,"journal":{"name":"Anesthesia and pain medicine","volume":"19 1","pages":"44-53"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10846998/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139699232","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, 2023: journal metrics and statistics, and appreciation to reviewers. 主编和编辑委员会的致辞，2023：期刊指标和统计数据，以及对审稿人的感谢。

Anesthesia and pain medicine Pub Date : 2024-01-01 Epub Date: 2024-01-30 DOI: 10.17085/apm.24008

Jun Hyun Kim, Hyun Kang

引用次数: 0

Preoperative evaluation of systolic murmur with point-of-care echocardiography before an elective thoracic surgery - A case report. 在择期胸外科手术前使用护理点超声心动图对收缩期杂音进行术前评估 - 病例报告。

Anesthesia and pain medicine Pub Date : 2024-01-01 Epub Date: 2024-01-30 DOI: 10.17085/apm.23124

Jaemoon Lee, Minki Lee, Sookyung Lee, Chung-Sik Oh, Tae-Yop Kim

{"title":"Preoperative evaluation of systolic murmur with point-of-care echocardiography before an elective thoracic surgery - A case report.","authors":"Jaemoon Lee, Minki Lee, Sookyung Lee, Chung-Sik Oh, Tae-Yop Kim","doi":"10.17085/apm.23124","DOIUrl":"10.17085/apm.23124","url":null,"abstract":"Background: Systolic murmur suggesting the association of aortic valve (AV) stenosis or obstructive pathology in the left ventricular outflow tract (LVOT) usually requires preoperative echocardiographic evaluation for elective surgery.Case: In a 63-year-old female patient undergoing elective thoracic surgery, the systolic murmur was auscultated on the right sternal border of the second intercostal space in the preoperative patient holding area. Point-of-care (POC) transthoracic echocardiography (TTE) demonstrated a systolic jet flow in the LVOT area. The peak systolic velocity of the continuous wave Doppler tracing, aligned to the LVOT and the AV, was approximately 1.5 m/s. The peak/mean pressure gradient was 11/6 mmHg for the AV and 9/5 mmHg for the LVOT. Anesthesia was induced under continuous TTE imaging. Intraoperative transesophageal echocardiography also confirmed the absence of any cardiac pathology.Conclusions: POC echocardiography offered a thorough preoperative evaluation of an unexpectedly identified systolic murmur, avoiding a potential delay in the operation schedule for conventional preoperative echocardiographic evaluation.","PeriodicalId":101360,"journal":{"name":"Anesthesia and pain medicine","volume":"19 1","pages":"62-67"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10847002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139699235","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

Soiling of non operative lung during one lung ventilation using EZ blocker in a tracheostomised patient. 气管插管患者在使用 EZ 阻断器进行单肺通气时，非手术肺脏被弄脏。

Anesthesia and pain medicine Pub Date : 2024-01-01 Epub Date: 2024-01-30 DOI: 10.17085/apm.23141

Karthik Lakshmikantha, Tanvi M Meshram, Kamlesh Kumari, Darshana Rathod, Ankur Sharma

引用次数: 0

Neuromuscular monitoring of a patient with Charcot-Marie-Tooth disease; which monitoring technique is adequate? - A case report and literature review. 对 Charcot-Marie-Tooth 病患者进行神经肌肉监测；哪种监测技术合适？- 病例报告和文献综述。

Anesthesia and pain medicine Pub Date : 2024-01-01 Epub Date: 2024-01-30 DOI: 10.17085/apm.23111

Seung Un Kim, Seora Kim, Ki Tae Jung

{"title":"Neuromuscular monitoring of a patient with Charcot-Marie-Tooth disease; which monitoring technique is adequate? - A case report and literature review.","authors":"Seung Un Kim, Seora Kim, Ki Tae Jung","doi":"10.17085/apm.23111","DOIUrl":"10.17085/apm.23111","url":null,"abstract":"Background: Charcot-Marie-Tooth disease (CMTD) is a hereditary polyneuropathy associated with a life-threatening risk of pulmonary complications.Case: A 61-year-old male with CMTD for 40 years was admitted for the drainage of an abscess in his left ankle. Total intravenous anesthesia was administered, and an electromyography device was attached to the hand for neuromuscular monitoring; however, the response was not measured. Kinemyography and acceleromyography devices were attached to both hands, and responses were obtained. After neuromuscular blockade (NMB) with rocuronium 0.6 mg/kg, the train-of-four (TOF) response on kinemyography was normally measured, but the post-tetanic count on acceleromyography consistently showed 0 during anesthesia. Sugammadex 200 mg was injected to reverse the NMB. After 5 min, the TOF ratios for kinemyography and acceleromyography exceeded 90%. The patient recovered without any complications.Conclusions: For CMTD patients, acceleromyography or kinemyography is superior to electromyography, and sugammadex can be used to reverse NMB successfully.","PeriodicalId":101360,"journal":{"name":"Anesthesia and pain medicine","volume":"19 1","pages":"54-61"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10846999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139699234","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