Journal of Anesthesiology and Pain Therapy最新文献

Navigating Challenges During Airway Management and Anesthetic Considerations in a Patient with a Supraglottic Mass: Integrating Anesthesiologists and Otolaryngologist Expertise 应对声门上肿块患者气道管理过程中的挑战和麻醉注意事项：整合麻醉师和耳鼻喉科医师的专业知识

Journal of Anesthesiology and Pain Therapy Pub Date : 2024-01-10 DOI: 10.29245/2768-5365/2023/1.1146

Najah Arafat Albayedh, Muzan Abdelbagi, Yasser Samir Elmehellawy, Ragai Abdelbasset Gemi, Omar Majed Abdul Baki

{"title":"Navigating Challenges During Airway Management and Anesthetic Considerations in a Patient with a Supraglottic Mass: Integrating Anesthesiologists and Otolaryngologist Expertise","authors":"Najah Arafat Albayedh, Muzan Abdelbagi, Yasser Samir Elmehellawy, Ragai Abdelbasset Gemi, Omar Majed Abdul Baki","doi":"10.29245/2768-5365/2023/1.1146","DOIUrl":"https://doi.org/10.29245/2768-5365/2023/1.1146","url":null,"abstract":"Introduction: Managing patients undergoing head and neck surgeries necessitates meticulous evaluation, strategic planning, and collaborative efforts with surgical teams. This approach is crucial to mitigate perioperative complications and optimize patient safety. Rationale: Expert navigation of the challenging airway in these patients, particularly in the perioperative period, is essential to significantly reduce the risks of morbidity and mortality associated with such complex conditions. Patient Concerns and Diagnosis: The patient presented with a supraglottic mass extending into the epiglottis space, posing significant anesthetic challenges to airway management. Outcomes: A surgical airway was established via tracheostomy. Postoperatively, the patient was monitored in the intensive care unit for further management and was subsequently discharged to commence chemoradiotherapy. The tracheostomy tube remained in place at the time of discharge. Lessons: This case underscored our commitment to enhancing expertise in airway management for patients with oral cancer. Our experience contributes valuable insights to the evolving field of airway management in complex head and neck surgeries.","PeriodicalId":111293,"journal":{"name":"Journal of Anesthesiology and Pain Therapy","volume":"93 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140511156","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

Pericapsular Nerve Group Block in Hip Surgery: A Narrative Review 髋关节手术中囊周神经群阻滞:叙述回顾

Journal of Anesthesiology and Pain Therapy Pub Date : 2023-06-14 DOI: 10.29245/2768-5365/2023/2.1141

Daniela Bravo, Rousmery Atton, D. Mora, Julián Aliste

{"title":"Pericapsular Nerve Group Block in Hip Surgery: A Narrative Review","authors":"Daniela Bravo, Rousmery Atton, D. Mora, Julián Aliste","doi":"10.29245/2768-5365/2023/2.1141","DOIUrl":"https://doi.org/10.29245/2768-5365/2023/2.1141","url":null,"abstract":"Study Objective: This narrative review discusses the anatomy, mechanism of action, techniques, indications and complications of the pericapsular nerve group block in a hip surgery setting. Interventions: The MEDLINE, EMBASE and Google Scholar databases (inception to the first week of March 2023) were searched. For anatomy, mechanism of action, techniques, and complications, cadaveric research, randomized trials, retrospective studies and case series were considered. Nonetheless, for surgery indications, to highlight the best evidence available, only randomized trials without major discrepancies with their prospective registration, blinded assessment and sample size justification were retained for analysis. Main Results: The anatomical studies suggest that pericapsular nerve group block may work through a combination of different mechanisms (i.e., blocking lateral capsule nerves, local anesthetic spread to the femoral nerve, spread towards medial capsule nerves). Compared to alternatives, except for the periarticular local anesthetic infiltration, pericapsular nerves group block results in similar or improved postoperative analgesia in total hip arthroplasty. It should be noted that the motor blockade has not been completely circumvented and the scarcity of adequate studies on other surgical procedures prevents from obtaining further conclusions about its indications. Conclusions: The pericapsular nerve group block has become very popular after its first description as an analgesic motor-sparing technique for hip fractures. However, without an absolute motor-sparing effect, its current indication is better supported in postoperative analgesia for total hip arthroplasty. Therefore, further investigation is required to find the optimal motor-sparing analgesic block for hip surgery.","PeriodicalId":111293,"journal":{"name":"Journal of Anesthesiology and Pain Therapy","volume":"120 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114086404","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

Migraine treatment with GON blockade at the level of C2: The tip of the iceberg and the submerged portion 在C2水平上应用神经甾体素阻断治疗偏头痛:冰山一角和淹没部分

Journal of Anesthesiology and Pain Therapy Pub Date : 2023-04-26 DOI: 10.29245/2768-5365/2023/1.1140

M. Karaoğlan

引用次数: 0

A Case Series on the Utility of Dexmedetomidine for the Immediate Treatment of Postoperative Muscle Spasm 右美托咪定即刻治疗术后肌肉痉挛的一系列案例

Journal of Anesthesiology and Pain Therapy Pub Date : 2023-04-11 DOI: 10.29245/2768-5365/2023/1.1139

V. Trinh, J. Villaluz

{"title":"A Case Series on the Utility of Dexmedetomidine for the Immediate Treatment of Postoperative Muscle Spasm","authors":"V. Trinh, J. Villaluz","doi":"10.29245/2768-5365/2023/1.1139","DOIUrl":"https://doi.org/10.29245/2768-5365/2023/1.1139","url":null,"abstract":"Postoperative muscle spasm is a common complaint in the post-anesthesia care unit. Management of postoperative muscle spasm remains a major challenge as first-line anti-spasmodic agents are not without risk. Due to the adverse effects of sedation and risk for respiratory depression and pulmonary aspiration, conventional anti-spasmodic agents may not be an ideal choice for patients who are recovering from anesthesia. In this case series, we present three patients who underwent nonemergent surgeries with subsequent postoperative cervical muscle spasm that went unresolved with conventional PACU pain medications. Below, we demonstrate the potential utility of dexmedetomidine for management of postoperative muscle spasm. This is most notable when oral anti-spasmodic formulations are contraindicated in sedated patients and intravenous skeletal muscle relaxants are inaccessible in the PACU. After receiving incremental boluses of dexmedetomidine, the patients demonstrated immediate improvement in their cervical range of motion and their cervical muscle spasms were markedly reduced. Dexmedetomidine’s unique qualities, such as its quick onset, intravenous route of administration, and minimal effect on respiratory physiology, make it an ideal choice for management of postoperative muscle spasm.","PeriodicalId":111293,"journal":{"name":"Journal of Anesthesiology and Pain Therapy","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130126506","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

Intensive Care Strain Indicators: Recommendations for Critical Care Processes and Research Objectives 重症监护应变指标:重症监护过程和研究目标的建议

Journal of Anesthesiology and Pain Therapy Pub Date : 2023-03-06 DOI: 10.29245/2768-5365/2023/1.1138

{"title":"Intensive Care Strain Indicators: Recommendations for Critical Care Processes and Research Objectives","authors":"","doi":"10.29245/2768-5365/2023/1.1138","DOIUrl":"https://doi.org/10.29245/2768-5365/2023/1.1138","url":null,"abstract":"Intensive care units (ICU’s) are particularly susceptible to resource and personnel strain given the complexity and unpredictability of care. This featured prominently in the early course of the SARS-CoV-2 (COVID-19) pandemic, where poor patient outcomes were clearly linked to the increasing severity of ICU strain associated with decreased ICU capacity. Despite attempts at measuring ICU strain, there exists no operational model that ICU directors can implement to monitor strain or researchers can use to examine its effects. This article reviews ICU strain indicators including census load (census, acuity, and admissions), ICU flow characteristics (admission/discharge criteria, sufficient staffing levels, and ICU performance), and consequence mediators (ICU queuing time and high-risk discharges) with attention to common themes and measures. Census load data suggests mortality risk is greater when ICU census starts higher, has high overall acuity, and with greater numbers of admissions especially when they arrive close together. Optimal ICU flow depends on maintaining a “strain mindset” when prioritizing patients, optimal ICU professional staffing, and maintaining high level ICU performance processes. Finally, delaying ICU admissions beyond six hours, or “after hours” or rushed ICU discharges result in increased mortality risk. Incorporating these ICU strain factors into an outcomes-focused model is proposed based on a conceptual framework with future research objectives recommended.","PeriodicalId":111293,"journal":{"name":"Journal of Anesthesiology and Pain Therapy","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128070815","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

Assessment and Management of Difficult Airway Post Mandibulectomy: A Narrative Review 下颌骨切除术后气道困难的评估与处理:综述

Journal of Anesthesiology and Pain Therapy Pub Date : 2023-02-06 DOI: 10.29245/2768-5365/2023/1.1137

Swati Patel, A. Reddy, Amiya Kumar Barik, Shiv Lal Soni, N. Kaloria

{"title":"Assessment and Management of Difficult Airway Post Mandibulectomy: A Narrative Review","authors":"Swati Patel, A. Reddy, Amiya Kumar Barik, Shiv Lal Soni, N. Kaloria","doi":"10.29245/2768-5365/2023/1.1137","DOIUrl":"https://doi.org/10.29245/2768-5365/2023/1.1137","url":null,"abstract":"Mandibulectomy most commonly performed as surgical management of oropharyngeal carcinoma leads to a wide array of anatomical and physiological changes which result in an anticipated difficult airway. There may be posterosuperior displacement of hyoid bone and tongue leading to reduction of retropalatal space along with loss of structural support to the tongue predisposing it to prolapse and development of obstructive sleep apnoea. Bulky flap reconstruction, limited mouth opening, and radiotherapy limiting neck mobility further compound the difficulty in airway management. This leads to a wide spectrum of issues ranging from difficulty in face mask ventilation to laryngoscopy and intubation. It is essential to individualize each case with a preformulated strategy outlining the primary and alternative approaches. A literature search was carried out using search engines like PubMed, Embase, Medline, and Google scholar using the terms “Difficult airway”, “Post-mandibulectomy”, “Difficult laryngoscopy, and Intubation”. The available literature was thoroughly reviewed by the authors before the final drafting of this article. A multidisciplinary team approach, thorough assessment, meticulous preparation, and critical decision-making are essential for successfully managing a difficult airway post-mandibulectomy.","PeriodicalId":111293,"journal":{"name":"Journal of Anesthesiology and Pain Therapy","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128304628","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

Acute Onset Dysphagia: Using Awake Fiberoptic Techniques to Avoid an Airway Disaster 急性发作的吞咽困难:使用清醒光纤技术避免气道灾难

Journal of Anesthesiology and Pain Therapy Pub Date : 2022-10-19 DOI: 10.29245/2768-5365/2022/3.1134

Adrian G. Yabut, Joseph Evan Villaluz

引用次数: 0

Pain Management during Surgery for Spontaneous Abortion in Early Pregnancy: Paracervical Block 早期妊娠自然流产手术中的疼痛管理:宫颈旁阻滞

Journal of Anesthesiology and Pain Therapy Pub Date : 2022-10-07 DOI: 10.29245/2768-5365/2022/1.1135

Toshiyuki Kakinuma

{"title":"Pain Management during Surgery for Spontaneous Abortion in Early Pregnancy: Paracervical Block","authors":"Toshiyuki Kakinuma","doi":"10.29245/2768-5365/2022/1.1135","DOIUrl":"https://doi.org/10.29245/2768-5365/2022/1.1135","url":null,"abstract":"The World Health Organization (WHO) recommends using vacuum aspiration as a surgical treatment for spontaneous and surgical abortion in early pregnancy. They also state that dilatation and curettage (D & C) should be avoided from the perspective of safety and effectiveness and to prevent the risk of endometrial injury as it can cause thinning of the endometrium and Asherman syndrome. Maintaining a good endometrial environment is important for improving the chance of pregnancy. Manual vacuum aspiration (MVA) was developed in the 1970s. For spontaneous abortion in the first trimester, MVA reduces the risk of endometrial injury, leading to less intra- and postoperative pain and simplification of anesthesia during surgical treatment for spontaneous abortion. The WHO recommends administering standard pain relief during surgical treatment for medication-induced and spontaneous abortion but does not recommend using routine general anesthesia during MVA and D & C procedures. At our hospital, we perform MVA alone under local anesthesia using a paracervical block for the surgical treatment for spontaneous abortion in early pregnancy, and the safety and effectiveness of this has been previously reported. Here, we will describe the pain management strategy used at our hospital for spontaneous abortion in early pregnancy using MVA.","PeriodicalId":111293,"journal":{"name":"Journal of Anesthesiology and Pain Therapy","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124652146","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

Using Electronic Health Record Data to Explore the Challenges of Opioid Prescribing: A Short Communication 使用电子健康记录数据探索阿片类药物处方的挑战:简短的交流

Journal of Anesthesiology and Pain Therapy Pub Date : 2021-07-10 DOI: 10.29245/2768-5365/2021/1.1117

Heather R. Walker, Heather Mueller, Tyson C Christensen, Heidi B. Cozart, Scott R. Junkins

引用次数: 0

A Review of the Effectiveness and Safety of Topical Anesthetics in Corneal Abrasions 表面麻醉剂治疗角膜擦伤的有效性和安全性综述

Journal of Anesthesiology and Pain Therapy Pub Date : 2021-05-26 DOI: 10.29245/2768-5365/2021/1.1116

Stacia B. Shipman, Kelly A. Painter

{"title":"A Review of the Effectiveness and Safety of Topical Anesthetics in Corneal Abrasions","authors":"Stacia B. Shipman, Kelly A. Painter","doi":"10.29245/2768-5365/2021/1.1116","DOIUrl":"https://doi.org/10.29245/2768-5365/2021/1.1116","url":null,"abstract":"Corneal abrasions are known to be extremely painful and are a commonly seen eye condition. Topical anesthetic drops used for diagnosis of corneal abrasions provide immediate pain relief for most patients, but their use for outpatient use has been controversial. There is lack of consensus regarding ideal management of pain associated with corneal abrasions, with some physicians prescribing nonsteroidal anti-inflammatory drugs or opioids which both can have serious side-effects and/or abuse potential. In recent years, several studies have been conducted to assess the efficacy and safety of short term topical anesthetic use for the treatment of acute corneal abrasions. For this review, four published randomized controlled trials were identified that focused on the effectiveness and safety of various topical analgesics used in treating corneal abrasions. These showed varying degrees of efficacy depending on the outcomes measured without any significant difference in complication rates. Additionally, we reviewed an observational study that investigated whether routinely sending corneal abrasion patients home with a 24-hour supply of topical tetracaine is safe. They found no increased risk of ED revisits, fluorescein uptake at follow up, or ophthalmology clinic referrals. Larger prospective studies are still required to establish definitive safety, but the current available evidence suggests use of topical anesthetics for simple corneal abrasions is efficacious and safe.","PeriodicalId":111293,"journal":{"name":"Journal of Anesthesiology and Pain Therapy","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130053337","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: 1