European Journal of Anaesthesiology最新文献

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Comparison between ultrasound-guided intertransverse process and erector spinae plane blocks for breast cancer surgery: A randomised controlled trial. 乳腺癌手术中超声引导下横突间和竖脊平面阻滞的比较:随机对照试验
IF 4.2 2区 医学
European Journal of Anaesthesiology Pub Date : 2025-03-01 Epub Date: 2024-10-29 DOI: 10.1097/EJA.0000000000002091
Lulu Qian, Hongye Zhang, Yongsheng Miao, Zongyang Qu, Yuelun Zhang, Bin Hua, Zhen Hua
{"title":"Comparison between ultrasound-guided intertransverse process and erector spinae plane blocks for breast cancer surgery: A randomised controlled trial.","authors":"Lulu Qian, Hongye Zhang, Yongsheng Miao, Zongyang Qu, Yuelun Zhang, Bin Hua, Zhen Hua","doi":"10.1097/EJA.0000000000002091","DOIUrl":"10.1097/EJA.0000000000002091","url":null,"abstract":"<p><strong>Background: </strong>Clinical comparisons between intertransverse process block (ITPB) and erector spinae plane block (ESPB) are lacking.</p><p><strong>Objective: </strong>This study aimed to compare their blocking profile and clinical efficacy in breast cancer surgery.</p><p><strong>Design: </strong>Randomised, blinded, active-controlled superiority trial.</p><p><strong>Setting: </strong>A tertiary hospital in China from 20 February to 31 July 2023.</p><p><strong>Patients: </strong>Sixty-eight females undergoing unilateral breast cancer surgery.</p><p><strong>Intervention: </strong>Patients were randomised to receive either ITPB performed at T2-6 (5 ml of 0.5% ropivacaine per level) or ESPB at T4 (25 ml of 0.5% ropivacaine). General anaesthesia and postoperative analgesia were standardised.</p><p><strong>Main outcome measures: </strong>The primary outcome was the number of blocked dermatomes at anterior T2-7, assessed 45 min after block completion, with a predefined superiority margin of 1.5 dermatomes. The important secondary outcome was the worst resting pain scores (11-point numerical rating scale) within 30 min in the recovery room, which was tested following a gatekeeping procedure. Other secondary outcomes included resting pain scores at various time points, use of rescue analgesics, opioid consumption, patient satisfaction, recovery quality score, and adverse effects within 24 h postoperatively.</p><p><strong>Results: </strong>The ITPB group showed a median [q1, q3] of 5 [4, 6] blocked dermatomes at anterior T2-7, whereas the ESPB group had 1 [0, 4], with a median difference of 4 (95% confidence interval (CI), 3 to 4); the lower 95% CI limit exceeded the predefined superiority margin of 1.5 (superiority P  < 0.001). Worst resting pain scores within 30 min in the recovery room in the ITPB group were 1 [0, 2] vs. 3 [1, 4] in the ESPB group, with a median difference of -1 (95% CI, -2 to 0; P  = 0.004). Patients in the ITPB group required fewer rescue analgesics within 30 min in the recovery room than did those in the ESPB group. No other clinically relevant results were observed in the secondary outcomes.</p><p><strong>Conclusions: </strong>Although ITPB demonstrated more consistent anterior dermatomal spread and improved immediate postoperative analgesia compared to ESPB, no additional benefits were identified for breast cancer surgery. Future studies may investigate the potential of ITPB for surgical anaesthesia.</p><p><strong>Trial registration: </strong>www.chictr.org.cn (ChiCTR2300068454).</p>","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":"224-232"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544489","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
Prevention of viral transmission must be assured before re-use of infusion sets. 在重新使用输液器之前,必须确保预防病毒传播。
IF 4.2 2区 医学
European Journal of Anaesthesiology Pub Date : 2025-03-01 Epub Date: 2025-01-09 DOI: 10.1097/EJA.0000000000002114
Rune Andersson, Egil Lingaas, Ingemar Qvarfordt, Ann Tammelin
{"title":"Prevention of viral transmission must be assured before re-use of infusion sets.","authors":"Rune Andersson, Egil Lingaas, Ingemar Qvarfordt, Ann Tammelin","doi":"10.1097/EJA.0000000000002114","DOIUrl":"10.1097/EJA.0000000000002114","url":null,"abstract":"","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":"278-279"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142947000","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
Reply to: prevention of viral transmission must be assured before re-use of infusion sets. 回复“在重新使用输液器之前必须确保预防病毒传播”。
IF 4.2 2区 医学
European Journal of Anaesthesiology Pub Date : 2025-03-01 Epub Date: 2025-01-09 DOI: 10.1097/EJA.0000000000002115
Snorri Laxdal Karlsson, Jon Edman-Wallér, Magni Vidar Gudmundsson, Peter Bentzer, Per Werner Möller
{"title":"Reply to: prevention of viral transmission must be assured before re-use of infusion sets.","authors":"Snorri Laxdal Karlsson, Jon Edman-Wallér, Magni Vidar Gudmundsson, Peter Bentzer, Per Werner Möller","doi":"10.1097/EJA.0000000000002115","DOIUrl":"10.1097/EJA.0000000000002115","url":null,"abstract":"","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":"279-281"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142947001","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
Hypotension after unilateral versus bilateral spinal anaesthesia: A Systematic review with meta-analysis. 单侧与双侧脊髓麻醉后的低血压:系统回顾与荟萃分析。
IF 4.2 2区 医学
European Journal of Anaesthesiology Pub Date : 2025-03-01 Epub Date: 2024-11-21 DOI: 10.1097/EJA.0000000000002098
Cansheng Gong, Xiuming Ye, Yanling Liao, Peng Ye, Ting Zheng, Xiaochun Zheng
{"title":"Hypotension after unilateral versus bilateral spinal anaesthesia: A Systematic review with meta-analysis.","authors":"Cansheng Gong, Xiuming Ye, Yanling Liao, Peng Ye, Ting Zheng, Xiaochun Zheng","doi":"10.1097/EJA.0000000000002098","DOIUrl":"10.1097/EJA.0000000000002098","url":null,"abstract":"<p><strong>Background: </strong>Spinal anaesthesia is frequently used in surgical procedures involving the lower abdomen and extremities, however, the occurrence of hypotension remains a common and clinically important adverse effect. Unilateral spinal anaesthesia seems to be a promising approach to minimise this complication but the effectiveness of this remains controversial.</p><p><strong>Objective: </strong>A meta-analysis was undertaken to evaluate the superiority of unilateral spinal anaesthesia over bilateral spinal anaesthesia with regard to the incidence of hypotension and other complications.</p><p><strong>Design: </strong>Systematic reviews and meta-analysis of randomised controlled trials (RCTs).</p><p><strong>Date sources: </strong>PUBMED, Embase, Web of Science and Cochrane Central Register of Controlled Trials databases were searched from their inception to 5 March 2024.</p><p><strong>Eligibility criteria: </strong>Randomised controlled trials (RCTs) comparing unilateral spinal anaesthesia with bilateral spinal anaesthesia were eligible for inclusion. Observational studies, case reports, case series, and studies not conducted in humans were excluded. The incidence of hypotension, vasopressor requirement, and other complications were compared. Heterogeneity was assessed by subgroup analyses and sensitivity analysis.</p><p><strong>Results: </strong>Twenty-one trials involving 1358 patients undergoing unilateral lower extremity surgery or lower abdominal surgery were included in the meta-analysis. Hyperbaric solutions were used in most trials. The Mantel-Haenszel random-effect model was used for the analysis of binary endpoints, reported as relative risk (RR) with a 95% confidence interval (CI). The incidence of hypotension was significantly lower in the unilateral spinal anaesthesia group compared with the bilateral spinal anaesthesia (RR 0.38, 95% CI 0.27 to 0.55; P  < 0.001; I2  = 38%). Subgroup analysis shows that the occurrence of hypotension was significantly lower in the unilateral subgroup, regardless of dosage, surgical site, adjuvants to the local anaesthetics, and different definitions of hypotension.</p><p><strong>Conclusions: </strong>Unilateral spinal anaesthesia is associated with a significant reduction in the occurrence of hypotension, despite variations in the definition of hypotension, adjuvants, and site of surgery. These results favour the use of lateral spinal anaesthesia in patients undergoing unilateral lower abdominal or lower limb surgery. However, the GRADE assessment of the quality of evidence was 'low' due to the high risk of bias and heterogeneity. All the results should be treated with caution.</p>","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":"203-223"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11784910/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142686468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Potential influence of different peri-operative analgesic regimens on tumour biology and outcome after oncologic surgery: A narrative review. 不同围手术期镇痛方案对肿瘤生物学和肿瘤手术后预后的潜在影响:一篇叙述性综述。
IF 4.2 2区 医学
European Journal of Anaesthesiology Pub Date : 2025-03-01 Epub Date: 2024-12-26 DOI: 10.1097/EJA.0000000000002118
Lucillia Bezu, Patrice Forget, Markus W Hollmann, Marie-Odile Parat, Tobias Piegeler
{"title":"Potential influence of different peri-operative analgesic regimens on tumour biology and outcome after oncologic surgery: A narrative review.","authors":"Lucillia Bezu, Patrice Forget, Markus W Hollmann, Marie-Odile Parat, Tobias Piegeler","doi":"10.1097/EJA.0000000000002118","DOIUrl":"10.1097/EJA.0000000000002118","url":null,"abstract":"<p><p>The management of peri-operative pain is one of the pillars of anaesthesia and is of particular importance in patients undergoing surgery for solid malignant tumours. Amongst several options, the most commonly employed analgesic regimens involve opioids, NSAIDs and regional anaesthesia techniques with different local anaesthetics. In recent years, several research reports have tried to establish a connection between peri-operative anaesthesia care and outcome after cancer surgery. Experimental studies have indicated that certain pain management substances may influence cancer progression, mainly by modifying the tumour's response to surgical stress and peri-operative inflammation. However, these promising in-vitro and in-vivo data have yet to be confirmed by randomised clinical trials. The reason for this might lie with the nature of tumour biology itself, and in the diversity of patient and tumour phenotypes. In a translational approach, future research should therefore concentrate on patient and tumour-related factors or biomarkers, which might either influence the tumour and its microenvironment or predict potential responses to interventions, including the choice of the analgesic. This might not only be relevant for the daily practice of clinical anaesthesia, but would also be of great importance for patients undergoing cancer surgery, who might be able to receive an individualised anaesthetic regimen based on their phenotypic profile.</p>","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":"233-243"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142913990","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
Postoperative lymphopaenia as a risk factor for postoperative infections in cancer surgery: A prospective multicentre cohort study (the EVALYMPH study). 术后淋巴细胞减少症是癌症手术术后感染的风险因素:前瞻性多中心队列研究(EVALYMPH 研究)。
IF 4.2 2区 医学
European Journal of Anaesthesiology Pub Date : 2025-03-01 Epub Date: 2024-10-29 DOI: 10.1097/EJA.0000000000002089
Ludivine Petit, Bruno Pastene, Guillaume Dupont, Bruno Baffeleuf, Pierre-Alain Goulevant, Jean-Luc Fellahi, Yann Gricourt, Gilles Lebuffe, Alexandre Ouattara, Marc-Olivier Fischer, Paul-Michel Mertes, Daniel Eyraud, Belaid Bouhemad, Alexandra Gomola, Philippe Montravers, Julie Alingrin, Laura Flory, Pascal Incagnoli, Matthieu Boisson, Marc Leone, Guillaume Monneret, Anne Claire Lukaszewicz, Bruno Pereira, Serge Molliex
{"title":"Postoperative lymphopaenia as a risk factor for postoperative infections in cancer surgery: A prospective multicentre cohort study (the EVALYMPH study).","authors":"Ludivine Petit, Bruno Pastene, Guillaume Dupont, Bruno Baffeleuf, Pierre-Alain Goulevant, Jean-Luc Fellahi, Yann Gricourt, Gilles Lebuffe, Alexandre Ouattara, Marc-Olivier Fischer, Paul-Michel Mertes, Daniel Eyraud, Belaid Bouhemad, Alexandra Gomola, Philippe Montravers, Julie Alingrin, Laura Flory, Pascal Incagnoli, Matthieu Boisson, Marc Leone, Guillaume Monneret, Anne Claire Lukaszewicz, Bruno Pereira, Serge Molliex","doi":"10.1097/EJA.0000000000002089","DOIUrl":"10.1097/EJA.0000000000002089","url":null,"abstract":"<p><strong>Background: </strong>Stress due to surgical trauma decreases postoperative lymphocyte counts (LCs), potentially favouring the occurrence of postoperative infections (PIs).</p><p><strong>Objectives: </strong>We aimed to determine whether postoperative lymphopaenia following thoracic or gastrointestinal cancer surgery is an independent risk factor for PIs and to identify modifiable factors related to anaesthesia and surgical procedures that might affect its occurrence.</p><p><strong>Study design: </strong>The EVALYMPH study was a prospective, multicentre cohort study with a 30-day patient follow-up. Multivariate analyses were performed to determine the risk factors for PIs and for postoperative lymphopaenia.</p><p><strong>Setting: </strong>Patients were included from January 2016 to September 2017 in 25 French centres.</p><p><strong>Patients: </strong>Adult patients admitted for thoracic or gastrointestinal cancer surgery were eligible for inclusion.</p><p><strong>Main outcome measure: </strong>PIs within 30 days after surgery were defined as urinary tract infections, pneumonia, surgical site infections and other infections (bloodstream infections or pleurisy).</p><p><strong>Results: </strong>Of 1207 patients included, 273 (22.6%) developed at least one infection within 30 days after surgery, with a median [IQR] time to onset of 8 [5 to 11] days. An increased risk of PI was significantly associated with an ASA score of IV: hazard ratio (HR) 4.27 (95% confidence interval (CI), 1.87 to 9.72), surgery > 200 min (HR 1.58 (1.15 to 2.17) and lymphopaenia on postoperative day 1 (POD1) (HR 1.56 (1.08 to 2.25). This risk was associated with changes in postoperative LC over time ( P  = 0.001) but not with preoperative LC ( P  = 0.536).POD1 lymphopenia was related to patient characteristics and duration of surgery but not to potentially modifiable other surgical or anaesthetics factors.</p><p><strong>Conclusions: </strong>POD1 lymphopaenia was associated with PIs in patients undergoing thoracic or gastrointestinal cancer surgery. To individualise care, patient characteristics and surgery duration should be taken into account.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT02799251.</p>","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":"244-254"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544490","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
Co-administration of dexmedetomidine with total intravenous anaesthesia in carotid endarterectomy reduces requirements for propofol and improves haemodynamic stability: A single-centre, prospective, randomised controlled trial. 在颈动脉内膜剥脱术的全静脉麻醉中同时使用右美托咪定可减少对丙泊酚的需求并改善血流动力学的稳定性:单中心、前瞻性、随机对照试验。
IF 4.2 2区 医学
European Journal of Anaesthesiology Pub Date : 2025-03-01 Epub Date: 2024-11-11 DOI: 10.1097/EJA.0000000000002099
Christian Vetter, Eva R Meyer, Kathleen Seidel, David Bervini, Markus Huber, Vladimir Krejci
{"title":"Co-administration of dexmedetomidine with total intravenous anaesthesia in carotid endarterectomy reduces requirements for propofol and improves haemodynamic stability: A single-centre, prospective, randomised controlled trial.","authors":"Christian Vetter, Eva R Meyer, Kathleen Seidel, David Bervini, Markus Huber, Vladimir Krejci","doi":"10.1097/EJA.0000000000002099","DOIUrl":"10.1097/EJA.0000000000002099","url":null,"abstract":"<p><strong>Background: </strong>Total intravenous anaesthesia guided by electroencephalography and neurophysiological monitoring may be used for carotid endarterectomy. Reduction of brain metabolic demand during cross-clamping of the internal carotid artery with propofol titrated to burst suppression requires effect-site concentrations that may delay emergence and interfere with intraoperative neurophysiological monitoring.</p><p><strong>Objective: </strong>To test the hypothesis that dexmedetomidine decreases the effect-site concentration of propofol required for burst-suppression in patients undergoing carotid endarterectomy.</p><p><strong>Design: </strong>Randomised controlled trial.</p><p><strong>Participants: </strong>Patients undergoing carotid endarterectomy.</p><p><strong>Setting: </strong>University Hospital of Berne, Switzerland, from October 2018 to September 2024.</p><p><strong>Interventions: </strong>Patients were randomised into a control ( n  = 23) and a dexmedetomidine groups ( n  = 22). Total intravenous anaesthesia was administered to both groups. Patients in the dexmedetomidine group received an intravenous bolus of dexmedetomidine (0.4 μg kg -1 over 10 min) before induction, followed by a continuous intravenous infusion (0.4 μg kg -1  h -1 ). The effect-site concentrations of propofol were titrated against frontal electroencephalography parameters. Burst suppression was induced with propofol during cross-clamping of the internal carotid artery.</p><p><strong>Outcome measures: </strong>The primary outcome was the effect-site concentration of propofol required for burst-suppression. The secondary outcomes were the requirement for vasoactive substances, neurophysiological monitoring parameters, and postoperative delirium.</p><p><strong>Results: </strong>The effect-site concentration of propofol required for burst suppression was 4.0 μg ml -1 [3.50 to 4.90] (median [interquartile range]) in the dexmedetomidine group compared with 6.0 μg ml -1 [5.5 to 7.3] in the control group ( P  < 0.001). Less norepinephrine was required in the dexmedetomidine group (total 454 μg [246 to 818] compared with 1000 μg [444 to 1326] ( P  = 0.015) in the control group). Dexmedetomidine did not affect intraoperative neurophysiological monitoring.</p><p><strong>Conclusion: </strong>Co-administration of dexmedetomidine to total intravenous anaesthesia for carotid endarterectomy decreased the effect-site concentrations of propofol required for burst suppression by 33%. The propofol-sparing effect and peripheral alpha-agonism of dexmedetomidine may explain the reduced requirement for vasopressors.</p><p><strong>Trial registration: </strong>Clinicaltrials.gov identifier: NCT04662177.</p>","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":"255-264"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11784905/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","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 novel cricoid pressure sensor device enhances the efficacy of oesophageal occlusion during Sellick's manoeuvre: A randomised controlled trial. 新型环甲膜压力传感器装置可提高塞利克氏操作中食道闭塞的效果:随机对照试验。
IF 4.2 2区 医学
European Journal of Anaesthesiology Pub Date : 2025-03-01 Epub Date: 2024-11-07 DOI: 10.1097/EJA.0000000000002097
Abhilasha Mishra, Vighnesh Ashok, Goverdhan D Puri, Neelesh Kumar, Preethy J Mathew
{"title":"A novel cricoid pressure sensor device enhances the efficacy of oesophageal occlusion during Sellick's manoeuvre: A randomised controlled trial.","authors":"Abhilasha Mishra, Vighnesh Ashok, Goverdhan D Puri, Neelesh Kumar, Preethy J Mathew","doi":"10.1097/EJA.0000000000002097","DOIUrl":"10.1097/EJA.0000000000002097","url":null,"abstract":"<p><strong>Background: </strong>The inability to measure the force applied during cricoid pressure is an important limitation in clinical practice. We developed a novel device to measure this force and provide real-time feedback to the operator.</p><p><strong>Objectives: </strong>To test the hypothesis of superior oesophageal occlusion during cricoid pressure when guided by the novel device as compared with conventional practice.</p><p><strong>Design: </strong>A prospective randomised controlled trial.</p><p><strong>Setting: </strong>Tertiary University Hospital, May to December 2021.</p><p><strong>Patients: </strong>Sixty-five ASA I/II adult patients of either sex scheduled for elective surgery under general anaesthesia requiring tracheal intubation. Patients with comorbidities involving the neck, those at risk of pulmonary aspiration, anticipated difficult airway and BMI at least 35 kg  m -2 were excluded.</p><p><strong>Intervention: </strong>Operators applied cricoid pressure with their fingers in both groups. Participants were randomised into 'feedback group' where the operator adjusted this force based on the force measured by the novel device, and 'control group' where the force measured by the device was shielded from the operator.</p><p><strong>Main outcome measures: </strong>The primary outcome was the rate of occlusion of oesophageal opening assessed by whether a 12 CH orogastric tube could be inserted into the oesophageal entrance during videolaryngoscopy. Secondary outcomes included the magnitudes of force measured during cricoid pressure, oesophageal diameter measured ultrasonographically during cricoid pressure and intubation parameters.</p><p><strong>Results: </strong>Sixty-four patients completed the study. The oesophageal opening was occluded in significantly more patients in the feedback group compared with the control group (94 vs. 6%; P  = 0.001). The mean ± SD force (N) applied was significantly better and consistent at all time points in the feedback group compared to the control group (22.65 ± 7.81 vs. 14.57 ± 11.13, P  < 0.001). The median [IQR] anteroposterior diameter of the oesophagus during cricoid pressure was less in the feedback group compared to the control group (0.49 [0.36 to 0.56] vs. 0.57 [0.48 to 0.65], P  = 0.006).</p><p><strong>Conclusions: </strong>The use of the novel sensor device achieved a significantly high rate of oesophageal occlusion during application of cricoid pressure.</p><p><strong>Trial registration: </strong>Clinical Trial Registry of India (CTRI/2021/05/033484).</p>","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":"265-274"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142602301","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
Anaesthesia practice in Europe: A survey of the National Anaesthesiologists Societies Committee of the European Society of Anaesthesiology and Intensive Care. 欧洲麻醉实践:欧洲麻醉和重症监护学会国家麻醉医师协会委员会的一项调查。
IF 4.2 2区 医学
European Journal of Anaesthesiology Pub Date : 2025-03-01 Epub Date: 2024-12-16 DOI: 10.1097/EJA.0000000000002110
Fulvio Pinelli, Stefano Romagnoli, Sweta Singh, Pierre Albaladejo, Carla Nau, Federico Bilotta
{"title":"Anaesthesia practice in Europe: A survey of the National Anaesthesiologists Societies Committee of the European Society of Anaesthesiology and Intensive Care.","authors":"Fulvio Pinelli, Stefano Romagnoli, Sweta Singh, Pierre Albaladejo, Carla Nau, Federico Bilotta","doi":"10.1097/EJA.0000000000002110","DOIUrl":"10.1097/EJA.0000000000002110","url":null,"abstract":"<p><strong>Background: </strong>Similar to other continents, Europe is experiencing a shortage of anaesthesia workforce, which profoundly impacts the national healthcare systems of affected countries.</p><p><strong>Objective: </strong>To assess the current landscape of the anaesthesia workforce, organisational practices, rules and responsibilities of anaesthesiologists and other anaesthesia providers in operating rooms.</p><p><strong>Design: </strong>Survey.</p><p><strong>Setting: </strong>Thirty-nine out of 41 European countries were surveyed between April 2022 and April 2023.</p><p><strong>Participants: </strong>Delegates of the National Anaesthesiologists Societies Committee (NASC) of the European Society of Anaesthesiology and Intensive Care (ESAIC).</p><p><strong>Intervention: </strong>A faculty of experts from France, Germany and Italy, selected by the Chair of NASC, developed a survey consisting of 16 questions, which was sent to the NASC delegates of all European countries.</p><p><strong>Main outcome measures: </strong>Responses from the NASC delegates.</p><p><strong>Results: </strong>The anaesthesia workforce, composition, roles and duties of anaesthesia teams vary significantly among European countries. The majority of respondents reported a workforce shortage, with variable trends, exacerbated in some cases by an increased loss of anaesthesiologists following the COVID-19 pandemic. Significant differences in anaesthesiologists' salaries exist across countries. A one-to-one anaesthesiologist-to-patient ratio during general anaesthesia maintenance, neuraxial and peripheral blocks is the most common; however, in a notable number of cases, this ratio decreases to one-to-two or even less. In such instances, residents or nonphysician anaesthesia personnel (NPAs) play a crucial role, enabling anaesthesiologists to supervise more than one patient simultaneously. Differences in the training of anaesthesia team members, as well as rules regulating anaesthesia team composition and the autonomy of its members, were also evident.</p><p><strong>Conclusion: </strong>The survey provides data on the current anaesthesia practice in Europe. The availability, composition and organisation of anaesthesia team members differ among European countries. The study highlights areas for further focus in operating room organisation and anaesthesia team composition, particularly regarding safety, efficacy and cost-effectiveness.</p>","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":"189-202"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142834824","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
Gastric ultrasound for the monitoring of enteral nutrition in ventilated intensive care unit patients: A prospective cohort. 胃超声监测通气重症监护病房患者肠内营养:一个前瞻性队列。
IF 4.2 2区 医学
European Journal of Anaesthesiology Pub Date : 2025-03-01 Epub Date: 2024-10-14 DOI: 10.1097/EJA.0000000000002086
Maxime Nguyen, Ayoub Ouharani, Pierre-Grégoire Guinot, Bélaid Bouhemad
{"title":"Gastric ultrasound for the monitoring of enteral nutrition in ventilated intensive care unit patients: A prospective cohort.","authors":"Maxime Nguyen, Ayoub Ouharani, Pierre-Grégoire Guinot, Bélaid Bouhemad","doi":"10.1097/EJA.0000000000002086","DOIUrl":"10.1097/EJA.0000000000002086","url":null,"abstract":"","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":"282-283"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142893174","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
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