Anesthesia and pain medicine最新文献_第9页

Sugammadex and emergence-related respiratory adverse events in pediatric tonsillectomy: a randomized controlled trial. 儿童扁桃体切除术中Sugammadex和急诊相关呼吸不良事件：一项随机对照试验。

IF 3.2

Anesthesia and pain medicine Pub Date : 2025-10-01 Epub Date: 2025-10-31 DOI: 10.17085/apm.25315

Sang-Hwan Ji, Pyoyoon Kang, Jung-Bin Park, Young-Eun Jang, Ji-Hyun Lee, Jin-Tae Kim, Hee-Soo Kim, Eun-Hee Kim

{"title":"Sugammadex and emergence-related respiratory adverse events in pediatric tonsillectomy: a randomized controlled trial.","authors":"Sang-Hwan Ji, Pyoyoon Kang, Jung-Bin Park, Young-Eun Jang, Ji-Hyun Lee, Jin-Tae Kim, Hee-Soo Kim, Eun-Hee Kim","doi":"10.17085/apm.25315","DOIUrl":"10.17085/apm.25315","url":null,"abstract":"Background: The effects of sugammadex, which reverses neuromuscular blockade, on emergence-related respiratory events in children remain unclear. This study compared the respiratory outcomes of sugammadex and neostigmine in pediatric tonsillectomy.Methods: Children aged 2 to 6 years undergoing tonsillectomy were randomly assigned to either the sugammadex or neostigmine group. The primary outcome was the occurrence of respiratory adverse events, including oxygen desaturation < 95%, airway obstruction, laryngospasm, bronchospasm, severe coughing, or postoperative stridor. Secondary outcomes included bradycardia, allergic reactions, and emergence delirium.Results: The study included 172 pediatric patients (n = 86 per group). Neuromuscular blockade reversal was faster in the sugammadex group than in the neostigmine group, achieving a train-of-four ratio of 90% in a median of 1 min vs. 4 min in the neostigmine group (P < 0.001). The time to extubation was comparable between the two groups (median, 8 min; P = 0.679), as was the overall incidence of respiratory adverse events (29.0% vs. 30.2%; relative risk, 0.962; 95% confidence interval [CI], 0.607-1.524; P = 0.858). Emergence delirium occurred in 27.9% of patients overall, but the incidence was higher in the sugammadex group than in the neostigmine group (34.9% vs. 20.9%; relative risk, 1.214; 95% CI, 1.005-1.467; P = 0.044).Conclusions: Sugammadex provides significantly faster neuromuscular blockade reversal compared to neostigmine but does not shorten the time to extubation or reduce the incidence of emergence-related respiratory adverse events in children undergoing tonsillectomy. Moreover, its use may be associated with an increased risk of emergence delirium.","PeriodicalId":101360,"journal":{"name":"Anesthesia and pain medicine","volume":"20 4","pages":"406-414"},"PeriodicalIF":3.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12611508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145508538","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

Cervical facet joint interventions for neck pain: an anatomically and clinically focused review. 颈椎小关节介入治疗颈部疼痛：解剖学和临床重点回顾。

IF 3.2

Anesthesia and pain medicine Pub Date : 2025-10-01 Epub Date: 2025-10-31 DOI: 10.17085/apm.25378

Hyung-Sun Won, Yeon-Dong Kim

{"title":"Cervical facet joint interventions for neck pain: an anatomically and clinically focused review.","authors":"Hyung-Sun Won, Yeon-Dong Kim","doi":"10.17085/apm.25378","DOIUrl":"10.17085/apm.25378","url":null,"abstract":"Cervical facet joints (CFJs) are a frequent source of neck pain, contributing to both localized and referred pain patterns. However, diagnosis remains difficult owing to the nonspecific nature of the clinical findings and limited accuracy of current diagnostic methods. Among available approaches, diagnostic blocks with local anesthetics are considered the most reliable technique for identifying CFJ-mediated pain. Although various treatment strategies are available for managing pain, including pharmacologic, rehabilitative, and surgical approaches, this review focuses on interventional treatment modalities. While these techniques are widely used in clinical settings, they show variable outcomes across studies. The anatomical complexity of the cervical spine and its proximity to critical neurovascular structures demand a high level of anatomical understanding and procedural expertise. This review outlines the key anatomical, technical, and clinical considerations for CFJ interventions. It also summarizes current evidence regarding their diagnostic and therapeutic utility within the context of pain management. Given the limitations in diagnostic certainty and variability in treatment response, interventional procedures should be applied using an anatomically guided and evidence-based approach to optimize patient care.","PeriodicalId":101360,"journal":{"name":"Anesthesia and pain medicine","volume":"20 4","pages":"329-340"},"PeriodicalIF":3.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12611518/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145508604","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

Opiranserin injection (Unafra®) as a first-in-class, non-opioid analgesic for the treatment of acute postoperative pain. Opiranserin注射液（Unafra®）作为一流的非阿片类镇痛药用于治疗急性术后疼痛。

IF 3.2

Anesthesia and pain medicine Pub Date : 2025-10-01 Epub Date: 2025-10-31 DOI: 10.17085/apm.25369

Sang-Wook Lee, Inkyung Song, Jina Kim, Ji-Yeon Sim

{"title":"Opiranserin injection (Unafra®) as a first-in-class, non-opioid analgesic for the treatment of acute postoperative pain.","authors":"Sang-Wook Lee, Inkyung Song, Jina Kim, Ji-Yeon Sim","doi":"10.17085/apm.25369","DOIUrl":"10.17085/apm.25369","url":null,"abstract":"Opiranserin injection (Unafra®, Vivozon Inc.) is a first-in-class, non-opioid analgesic for the management of moderate-to-severe postoperative pain. The active ingredient, opiranserin (code name: VVZ-149), is a synthetic molecule that simultaneously antagonizes glycine transporter 2 (GlyT2) and serotonin 2A receptors (5-HT2A), both of which play key roles in pain processing. Opiranserin exemplifies the application of ex vivo phenotypic screening combined with a bait-target approach to identify effective multi-target agents that overcome the limitations of conventional single-target analgesics. In this review, we aim to describe the discovery and optimization of opiranserin through efficacy-based screening using a bait-target approach, outline its pharmacological mechanisms of action as a drug with both central and peripheral activity, and summarize published clinical studies demonstrating its successful translation from preclinical efficacy to reductions in postoperative pain and opioid consumption. We also discuss the clinical implications and future research directions to enhance the therapeutic utility of opiranserin injection and maximize patient benefit within the framework of precision analgesia.","PeriodicalId":101360,"journal":{"name":"Anesthesia and pain medicine","volume":"20 4","pages":"309-317"},"PeriodicalIF":3.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12611517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145508335","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

Age-specific electroencephalography dynamics during anesthesia: monitoring and neurocognitive implications. 麻醉期间年龄特异性脑电图动态：监测和神经认知意义。

IF 3.2

Anesthesia and pain medicine Pub Date : 2025-10-01 Epub Date: 2025-10-31 DOI: 10.17085/apm.25375

Young Song

{"title":"Age-specific electroencephalography dynamics during anesthesia: monitoring and neurocognitive implications.","authors":"Young Song","doi":"10.17085/apm.25375","DOIUrl":"10.17085/apm.25375","url":null,"abstract":"Electroencephalography (EEG) reflects thalamocortical activity during anesthesia, but its signatures vary markedly with age. Alpha oscillations emerge in late infancy, peak in childhood, and decline with aging, producing substantial bias in processed EEG (pEEG) indices derived mainly from adult data. This narrative review summarizes age-specific EEG dynamics under γ-aminobutyric acid (GABA)-ergic anesthesia, highlighting developmental and aging trajectories, age effects on pEEG reliability, and associations with postoperative delirium (POD), emergence agitation (EA), and recovery outcomes. In infants and toddlers, immature alpha activity may lead to less reliable or incompletely suppressed index values even during deep anesthesia, whereas in children up to 6-7 years, indices remain variable and poorly correlated with anesthetic concentration. In older adults, alpha attenuation and spectral flattening elevate pEEG values despite EEG suppression, increasing overdose risk. Age-related EEG differences could influence the interpretation of outcome studies. Although results are mixed, meta-analyses suggest that pEEG-guided or lighter anesthesia may modestly reduce POD incidence but not consistently decrease EA in children. EEG features such as reduced alpha power and increased burst suppression are reliable predictors of POD in adults, while pediatric evidence remains limited. Randomized trials on spectrogram- or raw EEG-guided titration have shown variable neurocognitive outcomes and inconsistent anesthetic-sparing effects. Overall, pEEG reliability declines in both young and older patients. Age-adjusted interpretation-incorporating raw EEG and spectrogram analysis-is essential for accurate anesthetic titration and safer neurocognitive outcomes across the lifespan.","PeriodicalId":101360,"journal":{"name":"Anesthesia and pain medicine","volume":"20 4","pages":"289-300"},"PeriodicalIF":3.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12611512/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145508644","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

Combined thoracic paravertebral block and pectoralis nerve I and II block as a sole technique for awake breast surgery - A case report. 联合胸椎旁阻滞和胸肌神经I、II阻滞作为清醒乳房手术的唯一技术- 1例报告。

IF 3.2

Anesthesia and pain medicine Pub Date : 2025-10-01 Epub Date: 2025-10-31 DOI: 10.17085/apm.25232

Sarah Easby

引用次数: 0

Phonocardiopulmography: the future of perioperative auscultation. 心音心动图：围手术期听诊的未来。

IF 3.2

Anesthesia and pain medicine Pub Date : 2025-10-01 Epub Date: 2025-10-31 DOI: 10.17085/apm.25386

Sung-Hoon Kim

{"title":"Phonocardiopulmography: the future of perioperative auscultation.","authors":"Sung-Hoon Kim","doi":"10.17085/apm.25386","DOIUrl":"10.17085/apm.25386","url":null,"abstract":"Traditionally, anesthesiologists have recommended performing auscultation of breath and heart sounds with a precordial or esophageal stethoscope during anesthesia. The stethoscope is generally considered the most important single device used for monitoring. Unfortunately, many anesthesiologists neglect the perioperative use of a stethoscope, even though it provides a wealth of information about the circulatory system, heart, and lungs. Although point-of-care ultrasound appears to offer greater diagnostic value in some situations, it is premature to dismiss the stethoscope, and its diminished perioperative role should be reconsidered. Recent technological advances have allowed changes in the roles of these modalities to help attending anesthesiologists perform easy assessments using clinically meaningful information from auscultation. The phonocardiopulmogram (PCPG), a real-time visual acoustic monitor, is a rediscovered and renovated technique that allows non-invasive continuous heart-lung function monitoring. However, the novel role of the PCPG as a continuous acoustic monitor, particularly for S1 and S2 heart sounds and their respiratory variations, remains relatively unexplored. This device may convey information about cardiac contractility, cardiac output, and fluid responsiveness. Furthermore, continuous lung sound visualization has potential as a monitoring modality during anesthesia, including during bronchospasm and endobronchial intubation. With its ease of use and intuitive mechanism, the PCPG can be applied during general anesthesia and follow-up in both post-anesthesia and intensive care unit settings, particularly for the detection of acute adverse events during the perioperative period.","PeriodicalId":101360,"journal":{"name":"Anesthesia and pain medicine","volume":"20 4","pages":"301-308"},"PeriodicalIF":3.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12611515/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145508453","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 patients after liver transplantation. 肝移植术后立即拔管的效果。

IF 3.2

Anesthesia and pain medicine Pub Date : 2025-10-01 Epub Date: 2025-10-02 DOI: 10.17085/apm.25278

Jong Ho Kim, So Young Lim, Sung Mi Hwang, Youngsuk Kwon, Jae Jun Lee, Hong Seuk Yang

引用次数: 0

NLRP3 inflammasome: a key driver of neuroinflammation and a novel therapeutic target for neuropathic pain. NLRP3炎性小体：神经炎症的关键驱动因素和神经性疼痛的新治疗靶点。

IF 3.2

Anesthesia and pain medicine Pub Date : 2025-10-01 Epub Date: 2025-08-22 DOI: 10.17085/apm.24132

Zana Montazeri-Khosh, Ahmad Ebrahimpour, Mahyar Hossein-Zargari, Parsa Taghizadeh-Tabrizi, Mohammad Safari-Sahlabadi, Mohammad Hosein Sheybani-Arani, Nahid Davoodian

{"title":"NLRP3 inflammasome: a key driver of neuroinflammation and a novel therapeutic target for neuropathic pain.","authors":"Zana Montazeri-Khosh, Ahmad Ebrahimpour, Mahyar Hossein-Zargari, Parsa Taghizadeh-Tabrizi, Mohammad Safari-Sahlabadi, Mohammad Hosein Sheybani-Arani, Nahid Davoodian","doi":"10.17085/apm.24132","DOIUrl":"10.17085/apm.24132","url":null,"abstract":"Neuropathic pain represents a serious complication arising from a spectrum of disorders that precipitate lesions within the central and peripheral nervous systems. This disabling pain can persist for years, severely diminishing the quality of life of the affected individuals. The treatment options available for neuropathic pain at present have limited efficacy. Moreover, the adverse effects associated with these options restrict their application. The exact etiological mechanisms underlying the pathogenesis of neuropathic pain remain unclear. However, neuroinflammatory processes mediated by the immune system play significant roles in the initiation and progression of neuropathic pain in various models. The nucleotide-binding domain and leucine-rich repeat pyrin-containing protein-3 (NLRP3) inflammasome, a pivotal element of the innate immune system, plays an indispensable role in the pathophysiological mechanisms of central and peripheral neuropathic pain. However, the precise mechanisms facilitating its activation in disparate neuropathic pain conditions remain to be elucidated. Gaining insights into the regulatory mechanisms affecting NLRP3 inflammasome activation in diverse neuropathic pain-associated disorders will aid in developing novel therapeutic avenues. Therefore, this review summarizes the current knowledge on the role of the NLRP3 inflammasome in the pathophysiology of several neuropathic pain-related conditions, such as diabetic neuropathic pain, chemotherapy-induced neuropathic pain, peripheral nerve compression, central nervous system neuropathic pain, radiculopathy, and morphine analgesic tolerance. In addition, this review also discusses the possible use of this inflammasome as a therapeutic target to alleviate the pain-related symptoms of these diseases.","PeriodicalId":101360,"journal":{"name":"Anesthesia and pain medicine","volume":" ","pages":"341-356"},"PeriodicalIF":3.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12611520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208327","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 systematic review of the respiratory effects of ultrasound-guided phrenic nerve block. 超声引导膈神经阻滞对呼吸系统影响的系统综述。

IF 3.2

Anesthesia and pain medicine Pub Date : 2025-10-01 Epub Date: 2025-09-26 DOI: 10.17085/apm.25214

Christian Rafla, Tony Zitek, Michael Shalaby

{"title":"A systematic review of the respiratory effects of ultrasound-guided phrenic nerve block.","authors":"Christian Rafla, Tony Zitek, Michael Shalaby","doi":"10.17085/apm.25214","DOIUrl":"10.17085/apm.25214","url":null,"abstract":"Ultrasound-guided phrenic nerve blocks (UPNBs) have emerged as a promising intervention for clinical conditions involving the diaphragm and adjacent structures. However, UPNB is often understood as an unintended but potentially critical complication of interscalene brachial plexus block (ISB) rather than a planned procedure. Therefore, we review the existing data on the effectiveness of UPNBs in enhancing respiratory functioning. We searched Medline, EMBASE, Web of Science, and Google Scholar for clinical data related to UPNBs up until May 2025. The primary outcome of this review was to determine the impact of UPNB in minimizing dyspnea or desaturation among patients. Secondary outcomes included UPNB's effectiveness in reducing the intensity and frequency of hiccups and enhancing pulmonary function testing (PFT) and arterial blood gas (ABG) values. Twenty-six studies met the inclusion criteria. The findings show that UPNB does not induce or worsen dyspnea among patients. The injection produced better saturation, with some studies reporting 99% and 96% - 100% oxygen saturation. Besides, phrenic nerve block injection is vital in reducing diaphragmatic pain. Patients who exhibited intractable or persistent hiccups had their frequency and severity reduced or vanished after the nerve block injection. Our findings show that UPNB positively affected ABG samples (fair PaO2, PaCO2, and arterial pH) and spirometry/PFT values (fair FEV1, FVC, and PEF). UPNB enhanced oxygen saturation, reduced intractable hiccups, and preserved PFT and ABG values. Additionally, UPNB did not induce or worsen dyspnea and desaturation. Nevertheless, more clinical trials are needed to confirm these findings.","PeriodicalId":101360,"journal":{"name":"Anesthesia and pain medicine","volume":" ","pages":"371-383"},"PeriodicalIF":3.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12611511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208953","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

Clinical roles of point-of-care ultrasonography in airway management. 即时超声检查在气道管理中的临床作用。

IF 3.2

Anesthesia and pain medicine Pub Date : 2025-10-01 Epub Date: 2025-10-31 DOI: 10.17085/apm.25346

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

{"title":"Clinical roles of point-of-care ultrasonography in airway management.","authors":"Hyungseok Seo, Chung-Sik Oh, Geun Joo Choi, Jung-Bin Park","doi":"10.17085/apm.25346","DOIUrl":"10.17085/apm.25346","url":null,"abstract":"Point-of-care ultrasonography (POCUS) has emerged as a valuable tool in airway management, providing real-time visualization of airway anatomy with significant advantages in both routine and emergency settings. This review highlights key ultrasonographic techniques, anatomical landmarks, and clinical evidence supporting the growing role of POCUS in modern airway management. It also outlines the clinical applications of POCUS, including prediction of difficult airways and real-time guidance during emergency procedures such as cricothyrotomy and tracheostomy. In non-operating room anesthesia and emergency settings, POCUS enables rapid, portable assessment and facilitates aspiration risk evaluation through gastric ultrasonography, particularly in patients with delayed gastric emptying or unknown fasting status. Pediatric-specific applications-such as selection of the appropriate endotracheal tube size, confirmation of tube depth, and detection of supraglottic airway malposition-are also discussed. As airway challenges persist despite technological progress, integrating POCUS into airway management protocols enhances patient safety, reduces complications, and supports individualized approaches to airway management.","PeriodicalId":101360,"journal":{"name":"Anesthesia and pain medicine","volume":"20 4","pages":"318-328"},"PeriodicalIF":3.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12611519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145508572","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