European Journal of Anaesthesiology最新文献

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Plethysmography variability index guided fluid management is superior to conventional approach for elective urological surgery in children - a prospective randomised controlled trial. 前瞻性随机对照试验:在儿童泌尿外科择期手术中,胸廓造影变异指数指导下的液体管理优于传统方法。
IF 4.2 2区 医学
European Journal of Anaesthesiology Pub Date : 2024-12-01 Epub Date: 2024-05-24 DOI: 10.1097/EJA.0000000000002014
Ankita Dhir, Neerja Bhardwaj, Muneer Abas Malik, Preethy J Mathew
{"title":"Plethysmography variability index guided fluid management is superior to conventional approach for elective urological surgery in children - a prospective randomised controlled trial.","authors":"Ankita Dhir, Neerja Bhardwaj, Muneer Abas Malik, Preethy J Mathew","doi":"10.1097/EJA.0000000000002014","DOIUrl":"10.1097/EJA.0000000000002014","url":null,"abstract":"","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141157782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Lung-protective ventilation and postoperative pulmonary complications during pulmonary resection in children: A prospective, single-centre, randomised controlled trial. 儿童肺切除术中的肺保护性通气和术后肺部并发症:前瞻性单中心随机对照试验。
IF 4.2 2区 医学
European Journal of Anaesthesiology Pub Date : 2024-12-01 Epub Date: 2024-09-05 DOI: 10.1097/EJA.0000000000002063
Change Zhu, Mazhong Zhang, Saiji Zhang, Rufang Zhang, Rong Wei
{"title":"Lung-protective ventilation and postoperative pulmonary complications during pulmonary resection in children: A prospective, single-centre, randomised controlled trial.","authors":"Change Zhu, Mazhong Zhang, Saiji Zhang, Rufang Zhang, Rong Wei","doi":"10.1097/EJA.0000000000002063","DOIUrl":"10.1097/EJA.0000000000002063","url":null,"abstract":"<p><strong>Background: </strong>Children are more susceptible to postoperative pulmonary complications (PPCs) due to their smaller functional residual capacity and higher closing volume; however, lung-protective ventilation (LPV) in children requiring one-lung ventilation (OLV) has been relatively underexplored.</p><p><strong>Objectives: </strong>To evaluate the effects of LPV and driving pressure-guided ventilation on PPCs in children with OLV.</p><p><strong>Design: </strong>Randomised, controlled, double-blind study.</p><p><strong>Setting: </strong>Single-site tertiary hospital, 6 May 2022 to 31 August 2023.</p><p><strong>Patients: </strong>213 children aged < 6 years, planned for lung resection secondary to congenital cystic adenomatoid malformation.</p><p><strong>Interventions: </strong>Children were randomly assigned to LPV ( n  = 142) or control ( n  = 71) groups. Children in LPV group were randomly assigned to either driving pressure group ( n  = 70) receiving individualised positive end-expiratory pressure (PEEP) to deliver the lowest driving pressure or to conventional protective ventilation group ( n  = 72) with fixed PEEP of 5 cmH 2 O.</p><p><strong>Main outcome measures: </strong>The primary outcome was the incidence of PPCs within 7 days after surgery. Secondary outcomes were pulmonary mechanics, oxygenation and mechanical power.</p><p><strong>Results: </strong>The incidence of PPCs did not differ between the LPV (24/142, 16.9%) and the control groups (15/71, 21.1%) ( P  = 0.45). The driving pressure was lower in the driving pressure group than in the 5 cmH 2 O PEEP group (15 vs. 17 cmH 2 O; P   =  0.001). Lung compliance and oxygenation were higher while the dynamic component of mechanical power was lower in the driving pressure group than in the 5 cmH 2 O PEEP group. The incidence of PPCs did not differ between the driving pressure (11/70, 15.7%) and the 5 cmH 2 O PEEP groups (13/72, 18.1%) ( P   =  0.71).</p><p><strong>Conclusions: </strong>LPV did not decrease the occurrence of PPCs compared to non-protective ventilation. Although lung compliance and oxygenation were higher in the driving pressure group than in the 5 cmH 2 O PEEP group, these benefits did not translate into significant reductions in PPCs. However, the study is limited by a small sample size, which may affect the interpretation of the results. Future research with larger sample sizes is necessary to confirm these findings.</p><p><strong>Trial registration: </strong>ChiCTR2200059270.</p>","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142139670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Safety and efficacy of high thoracic epidural analgesia for chest wall surgery in young adolescents: A retrospective cohort analysis and a new standardised definition for success rate. 青少年胸壁手术高位胸腔硬膜外镇痛的安全性和有效性:回顾性队列分析和新的成功率标准化定义。
IF 4.2 2区 医学
European Journal of Anaesthesiology Pub Date : 2024-12-01 Epub Date: 2024-10-03 DOI: 10.1097/EJA.0000000000002064
Steve Coppens, Geertrui Dewinter, Danny Feike Hoogma, Marc Raudsepp, Randy Vogelaerts, Liesbeth Brullot, Arne Neyrinck, Hans Van Veer, Rebekka Dreelinck, Steffen Rex
{"title":"Safety and efficacy of high thoracic epidural analgesia for chest wall surgery in young adolescents: A retrospective cohort analysis and a new standardised definition for success rate.","authors":"Steve Coppens, Geertrui Dewinter, Danny Feike Hoogma, Marc Raudsepp, Randy Vogelaerts, Liesbeth Brullot, Arne Neyrinck, Hans Van Veer, Rebekka Dreelinck, Steffen Rex","doi":"10.1097/EJA.0000000000002064","DOIUrl":"10.1097/EJA.0000000000002064","url":null,"abstract":"<p><strong>Background: </strong>Chest wall surgery for the correction of pectus excavatum or pectus carinatum has gained increased interest in recent years. Adequate pain treatment, respiratory physiotherapy and early ambulation are key to improving the outcomes. Although thoracic epidural analgesia is highly effective, its safety is controversial, leading to extensive scrutiny and questioning of its role.</p><p><strong>Objectives: </strong>We hypothesise that thoracic epidural analgesia is effective and well tolerated to use in adolescents, with a high success rate and low pain scores.</p><p><strong>Design: </strong>Observational retrospective cohort study.</p><p><strong>Setting: </strong>All adolescent cases in a high-volume academic tertiary chest wall surgery centre between March 1993 and December 2017 were included.</p><p><strong>Patients: </strong>A total of 1117 patients aged from 12 to 19 years of age and receiving either Ravvitch, Nuss or Abramson chest wall reconstruction for pectus excavatum were identified in our institutional chest wall surgery database. After applying selection and exclusion criteria, 532 patients were included in the current analysis.</p><p><strong>Main outcome measures: </strong>The primary endpoint of this study was the safety of epidural analgesia, assessed by the incidence of acute adverse events. Secondary endpoints were block success rates using a specific novel definition, and analgesic efficacy using recorded postoperative pain scores.</p><p><strong>Results: </strong>More than 60% of patients experienced one or more adverse events. However, all events were minor and without consequences. No serious or long-term adverse events were detected. The success rate of thoracic epidural placement was 81%. Low postoperative pain scores were observed.</p><p><strong>Conclusion: </strong>Thoracic epidural analgesia is an extremely effective pain control technique, with a surprisingly high number of minor adverse events but safe with regard to serious adverse events.</p><p><strong>Trial registration: </strong>The local research ethics committee approved and registered this study on 16 May 2022 (registration number: S66594).</p>","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142371262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Amendment to the Glasgow Declaration. 格拉斯哥宣言修正案。
IF 4.2 2区 医学
European Journal of Anaesthesiology Pub Date : 2024-12-01 Epub Date: 2024-09-25 DOI: 10.1097/EJA.0000000000002068
Patricio Gonzalez-Pizarro, Edoardo De Robertis, Wolfgang Buhre
{"title":"Amendment to the Glasgow Declaration.","authors":"Patricio Gonzalez-Pizarro, Edoardo De Robertis, Wolfgang Buhre","doi":"10.1097/EJA.0000000000002068","DOIUrl":"10.1097/EJA.0000000000002068","url":null,"abstract":"","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142344068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Influence of pairing in examiner leniency and stringency ('hawk-dove effect') in part II of the European Diploma of Anaesthesiology and Intensive Care: A cohort study. 欧洲麻醉学和重症监护文凭第二部分考试中考官宽严搭配("鹰鸽效应")的影响:一项队列研究。
IF 4.2 2区 医学
European Journal of Anaesthesiology Pub Date : 2024-12-01 Epub Date: 2024-08-28 DOI: 10.1097/EJA.0000000000002052
Stephen Sciberras, Markus Klimek, Bazil Ateleanu, Hugues Scipioni, Rodolphe Di Loreto, Joana Berger-Estilita
{"title":"Influence of pairing in examiner leniency and stringency ('hawk-dove effect') in part II of the European Diploma of Anaesthesiology and Intensive Care: A cohort study.","authors":"Stephen Sciberras, Markus Klimek, Bazil Ateleanu, Hugues Scipioni, Rodolphe Di Loreto, Joana Berger-Estilita","doi":"10.1097/EJA.0000000000002052","DOIUrl":"10.1097/EJA.0000000000002052","url":null,"abstract":"<p><strong>Background: </strong>The European Diploma of Anaesthesiology and Intensive Care (EDAIC) Part II examination is a supranational examination for anaesthesiologists.</p><p><strong>Objectives: </strong>We explore the impact of examiner pairing on leniency and stringency, commonly referred to as the 'hawk-dove effect'. We investigate the potential variations in grading approaches, resulting from different examiner pairs and their implications for candidate performance.</p><p><strong>Design: </strong>Retrospective cohort, observational design.</p><p><strong>Setting: </strong>EDAIC Part II examination data from 2021 to 2023.</p><p><strong>Participants: </strong>Three hundred and twenty-five examiners across 122 EDAIC Part II single-day examination sessions.</p><p><strong>Interventions: </strong>We analysed the influence of examiner leniency and examiner pairing on candidate performance in the EDAIC Part II using many-facet Rasch modelling.</p><p><strong>Main outcome measures: </strong>The study's main outcome measure was determining a leniency score among the examiner population. The study also aimed to assess how examiner pairing influenced candidate performance, as measured by their scores in the examination.</p><p><strong>Results: </strong>During the study period, the number of examiners who participated in 2021, 2022 and 2023 were 253, 242 and 247, respectively. The median [IQR] single-day sessions attended were 7.0 [3 to 10]. The examination data revealed a mean leniency score of 0 (95% confidence interval (CI) -0.046 to 0.046), with the standard deviation being one-third that of the candidates' ability scores. There were 1424 different pairs of examiners, with most pairs (97%) having only a one-point difference in marking. The mean leniency score for the pair of examiners was -0.053 (95% CI -0.069 to -0.037).</p><p><strong>Conclusion: </strong>The variations in grading approaches associated with different pairings emphasise the potential for the 'hawk-dove effect' to influence candidate performance and outcomes. Understanding these variations can guide curriculum development, examiner training and coupling, ensuring a balanced and equitable assessment process.</p><p><strong>Trial registration: </strong>None.</p>","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142079773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comparison of a videolaryngoscope with a 3D-printed angled blade and a direct laryngoscope with a Macintosh blade for rapid sequence tracheal intubation: An observational study. 在快速顺序气管插管中,带有 3D 打印倾斜刀片的视频喉镜与带有 Macintosh 刀片的直接喉镜的比较:一项观察性研究。
IF 4.2 2区 医学
European Journal of Anaesthesiology Pub Date : 2024-12-01 Epub Date: 2024-09-05 DOI: 10.1097/EJA.0000000000002058
Andréa Jorge E Silva, Nubia Verçosa, Marco A C de Resende, Ismar L Cavalcanti
{"title":"Comparison of a videolaryngoscope with a 3D-printed angled blade and a direct laryngoscope with a Macintosh blade for rapid sequence tracheal intubation: An observational study.","authors":"Andréa Jorge E Silva, Nubia Verçosa, Marco A C de Resende, Ismar L Cavalcanti","doi":"10.1097/EJA.0000000000002058","DOIUrl":"10.1097/EJA.0000000000002058","url":null,"abstract":"","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142139669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Relationship between intra-operative urine output and postoperative acute kidney injury in paediatric cardiac surgery: A retrospective observational study. 小儿心脏手术术中尿量与术后急性肾损伤之间的关系:一项回顾性队列研究。
IF 4.2 2区 医学
European Journal of Anaesthesiology Pub Date : 2024-12-01 Epub Date: 2024-08-16 DOI: 10.1097/EJA.0000000000002044
Dongyun Bie, Yinan Li, Hongbai Wang, Qiao Liu, Dou Dou, Yuan Jia, Su Yuan, Qi Li, Jianhui Wang, Fuxia Yan
{"title":"Relationship between intra-operative urine output and postoperative acute kidney injury in paediatric cardiac surgery: A retrospective observational study.","authors":"Dongyun Bie, Yinan Li, Hongbai Wang, Qiao Liu, Dou Dou, Yuan Jia, Su Yuan, Qi Li, Jianhui Wang, Fuxia Yan","doi":"10.1097/EJA.0000000000002044","DOIUrl":"10.1097/EJA.0000000000002044","url":null,"abstract":"<p><strong>Background: </strong>Intra-operative urine output (UO) has been shown to predict postoperative acute kidney injury (AKI) in adults; however, its significance in children undergoing cardiac surgery remains unknown.</p><p><strong>Objective: </strong>To explore the association between intra-operative UO and postoperative AKI in children with congenital heart disease.</p><p><strong>Design: </strong>A retrospective observational study.</p><p><strong>Setting: </strong>A tertiary hospital.</p><p><strong>Patients: </strong>Children aged >28 days and <6 years who underwent cardiac surgery at Fuwai Hospital from 1 April 2022 to 30 August 2022.</p><p><strong>Main outcome measures: </strong>AKI was identified by the highest serum creatinine value within postoperative 7 days using Kidney Disease Improving Global Outcomes (KDIGO) criteria.</p><p><strong>Results: </strong>In total, 1184 children were included. The incidence of AKI was 23.1% (273/1184), of which 17.7% (209/1184) were stage 1, 4.2% (50/1184) were stage 2, and others were stage 3 (1.2%, 14/1184). Intra-operative UO was calculated by dividing the total intra-operative urine volume by the duration of surgery and the actual body weight measured before surgery. There was no significant difference in median [IQR] intra-operative UO between the AKI and non-AKI groups (2.6 [1.4 to 5.4] and 2.7 [1.4 to 4.9], respectively, P  = 0.791), and multivariate logistic regression analyses showed that intra-operative UO was not associated with postoperative AKI [adjusted odds ratio (OR) 0.971; 95% confidence interval (CI), 0.930 to 1.014; P  = 0.182]. Regarding the clinical importance of severe forms of AKI, we further explored the association between intra-operative UO and postoperative moderate-to-severe AKI (adjusted OR 0.914; 95% CI, 0.838 to 0.998; P  = 0.046).</p><p><strong>Conclusions: </strong>Intra-operative UO was not associated with postoperative AKI during paediatric cardiac surgery. However, we found a significant association between UO and postoperative moderate-to-severe AKI. This suggests that reductions in intra-operative urine output below a specific threshold may be associated with postoperative renal dysfunction.</p><p><strong>Trial registration: </strong>Clinicaltrials.gov identifier: NCT05489263.</p>","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141633023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Pain management after laparoscopic cholecystectomy: A systematic review and procedure-specific postoperative pain management (PROSPECT) recommendations. 腹腔镜胆囊切除术后疼痛管理:腹腔镜胆囊切除术后疼痛管理:系统回顾和特定手术术后疼痛管理(PROSPECT)建议。
IF 4.2 2区 医学
European Journal of Anaesthesiology Pub Date : 2024-11-01 Epub Date: 2024-09-03 DOI: 10.1097/EJA.0000000000002047
Camille Bourgeois, Lukas Oyaert, Marc Van de Velde, Esther Pogatzki-Zahn, Stephan M Freys, Axel R Sauter, Girish P Joshi, Geertrui Dewinter
{"title":"Pain management after laparoscopic cholecystectomy: A systematic review and procedure-specific postoperative pain management (PROSPECT) recommendations.","authors":"Camille Bourgeois, Lukas Oyaert, Marc Van de Velde, Esther Pogatzki-Zahn, Stephan M Freys, Axel R Sauter, Girish P Joshi, Geertrui Dewinter","doi":"10.1097/EJA.0000000000002047","DOIUrl":"10.1097/EJA.0000000000002047","url":null,"abstract":"<p><p>Laparoscopic cholecystectomy can be associated with significant postoperative pain that is difficult to treat. We aimed to evaluate the available literature and develop updated recommendations for optimal pain management after laparoscopic cholecystectomy. A systematic review was performed using the procedure-specific postoperative pain management (PROSPECT) methodology. Randomised controlled trials and systematic reviews published in the English language from August 2017 to December 2022 assessing postoperative pain after laparoscopic cholecystectomy using analgesic, anaesthetic or surgical interventions were identified from MEDLINE, Embase and Cochrane Databases. From 589 full text articles, 157 randomised controlled trials and 31 systematic reviews met the inclusion criteria. Paracetamol combined with NSAIDs or cyclo-oxygenase-2 inhibitors should be given either pre-operatively or intra-operatively, unless contraindicated. In addition, intra-operative intravenous (i.v.) dexamethasone, port-site wound infiltration or intraperitoneal local anaesthetic instillation are recommended, with opioids used for rescue analgesia. As a second-line regional technique, the erector spinae plane block or transversus abdominis plane block may be reserved for patients with a heightened risk of postoperative pain. Three-port laparoscopy, a low-pressure pneumoperitoneum, umbilical port extraction, active aspiration of the pneumoperitoneum and saline irrigation are recommended technical aspects of the operative procedure. The following interventions are not recommended due to limited or no evidence on improved pain scores: single port or mini-port techniques, routine drainage, low flow insufflation, natural orifice transluminal endoscopic surgery (NOTES), infra-umbilical incision, i.v. clonidine, nefopam and regional techniques such as quadratus lumborum block or rectus sheath block. Several interventions provided better pain scores but are not recommended due to risk of side effects: spinal or epidural anaesthesia, gabapentinoids, i.v. lidocaine, i.v. ketamine and i.v. dexmedetomidine.</p>","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141916412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Transcutaneous electrical nerve stimulation and catheter-related bladder discomfort following transurethral resection of bladder tumour: A randomised controlled trial. 经皮神经电刺激与经尿道膀胱肿瘤切除术后导尿管相关的膀胱不适:随机对照试验。
IF 4.2 2区 医学
European Journal of Anaesthesiology Pub Date : 2024-11-01 Epub Date: 2024-08-13 DOI: 10.1097/EJA.0000000000002050
Jun-Young Park, Jihion Yu, Chan-Sik Kim, Ji-Won Baek, Taeho Mun, Young-Kug Kim
{"title":"Transcutaneous electrical nerve stimulation and catheter-related bladder discomfort following transurethral resection of bladder tumour: A randomised controlled trial.","authors":"Jun-Young Park, Jihion Yu, Chan-Sik Kim, Ji-Won Baek, Taeho Mun, Young-Kug Kim","doi":"10.1097/EJA.0000000000002050","DOIUrl":"10.1097/EJA.0000000000002050","url":null,"abstract":"<p><strong>Background: </strong>Catheter-related bladder discomfort (CRBD) is problematic in patients with a urinary catheter. Transcutaneous electrical nerve stimulation (TENS) is a non-invasive analgesic modality used to relieve various types of pain.</p><p><strong>Objectives: </strong>We evaluated the effect of TENS on CRBD after transurethral resection of bladder tumours (TURBT).</p><p><strong>Design: </strong>A randomised controlled trial.</p><p><strong>Setting: </strong>A large university tertiary hospital, from October 2022 to March 2023.</p><p><strong>Patients: </strong>Patients requiring urinary catheterisation after TURBT.</p><p><strong>Intervention: </strong>In this randomised controlled trial, patients were randomly allocated to the TENS ( n   =  56) or control ( n   =  56) groups. CRBD manifests as a burning sensation with an urge to void or discomfort in the suprapubic area. Moderate to severe CRBD was defined as patients self-reporting CRBD symptoms with or without behavioural response, including attempts to remove the urinary catheter, intense verbal reactions, and flailing limbs. TENS was performed from the end of surgery to 1 h postoperatively.</p><p><strong>Main outcome measure: </strong>The primary endpoint was considered moderate to severe CRBD immediately postoperatively. Secondary endpoints included moderate to severe CRBD at 1, 2 and 6 h postoperatively. Additionally, postoperative pain, patient satisfaction, and TENS-related adverse effects were evaluated.</p><p><strong>Results: </strong>Moderate to severe CRBD immediately postoperatively was significantly less frequent in the TENS group than in the control group: 10 (17.9%) vs. 34 (60.7%); P  < 0.001; relative risk (95% CI) = 0.294 (0.161 to 0.536); absolute risk reduction = 0.43; number needed to treat = 2.3. Moderate to severe CRBD differed between the two groups at 1 h postoperatively: 1 (1.8%) vs. 16 (28.6%); P  < 0.001; relative risk = 0.06 (95% CI 0.01 to 0.46); absolute risk reduction = 0.27; number needed to treat = 3.7. The TENS group exhibited a significantly lower score for postoperative pain at 1 h (1.8 ± 0.6 vs. 2.2 ± 0.4; P  < 0.001, mean difference (95% CI) = 0.4 (0.2 to 0.6) and a higher score for patient satisfaction, 5.0 (4.0 to 6.0) vs. 3.0 (3.0 to 4.0); P  < 0.001; median difference (95% CI) = 2.0 (1.0 to 2.0).</p><p><strong>Conclusions: </strong>TENS reduced moderate to severe CRBD, decreased postoperative pain, and increased patient satisfaction after TURBT.</p><p><strong>Clinical trial registry: </strong>Clinical Research Information Service (KCT0007450).</p>","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141975399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Diagnostic value of lung ultrasound, clinical examination, and colourflow Doppler compared with fiberoptic bronchoscopy to predict appropriate lung exclusion in thoracic surgery: A cohort study. 肺部超声波、临床检查和彩色血流多普勒与纤维支气管镜相比,在预测胸外科手术中适当肺部排异方面的诊断价值:一项队列研究。
IF 4.2 2区 医学
European Journal of Anaesthesiology Pub Date : 2024-11-01 Epub Date: 2024-09-02 DOI: 10.1097/EJA.0000000000002056
Pierre-Henri Moury, Quentin Jegousso, Maxime Durost, Jérôme Nicolas, Pierre Albaladejo
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