European Journal of Anaesthesiology最新文献

{"title":"ESAIC focused guidelines for the management of the failing epidural during labour epidural analgesia.","authors":"Nicolas Brogly, Isabel Valbuena Gómez, Arash Afshari, Kim Ekelund, Peter Kranke, Carolyn F Weiniger, Nuala Lucas, Pierre-Yves Dewandre, Emilia Guasch Arevalo, Alexander Ioscovich, Andrea Kollmann, Kim Lindelof, Sharon Orbach-Zinger, Stephanie Reis, Oscar van den Bosch, Marc Van de Velde, Carolina S Romero","doi":"10.1097/EJA.0000000000002108","DOIUrl":"https://doi.org/10.1097/EJA.0000000000002108","url":null,"abstract":"<p><strong>Background: </strong>Labour epidural analgesia reportedly fails in up to 10 to 25% of cases. A joint taskforce of European Society of Anaesthesiology and Intensive Care (ESAIC) experts was created to develop this focused guideline on the management of failing epidural analgesia in a previously well functioning epidural catheter.</p><p><strong>Design: </strong>Six clinical questions were defined using a PICO (Population/Intervention/Comparison/Outcome) strategy to conduct a systematic literature search. The questions pertained to clinical management of failing epidural (PICOs 1, 2 and 3), human resource and team training (PICOs 4 and 5) and clinical management of a failing epidural for intrapartum caesarean delivery (PICO 6). The taskforce produced recommendations and clinical practice statements (CPS) and validated them through a Delphi process. The final version of the guideline was submitted to all ESAIC members for critical review and approved by the Guidelines Committee and the ESAIC Board of Directors.</p><p><strong>Results: </strong>In the initial search, 3737 titles were identified, 93 were retained for complete article analysis and 56 were finally allocated to the PICOs. The full-text analysis of the selected articles precluded extraction of significant data for all PICOs except for PICO 6, for which six articles were identified. Based on the experience, knowledge and opinion of the experts, the task force proposed and validated two recommendations and 11 CPSs.</p><p><strong>Conclusion: </strong>This guideline complemented other recently published expert opinion papers. We hope that this new guidance will serve clinicians to increase parturient safety and quality of care during labour and delivery, while at the same time provide inspiration for further research to fill the current knowledge gaps.</p>","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":"42 2","pages":"96-112"},"PeriodicalIF":4.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142914054","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}

{"title":"Chronic postsurgical pain ICD11 definition is important but not always usable.","authors":"Valeria Martinez, Thomas Lehman, Esther M Pogatzki Zahn, Marcus Komann, Winfried Meissner, Dominique Fletcher","doi":"10.1097/EJA.0000000000002104","DOIUrl":"https://doi.org/10.1097/EJA.0000000000002104","url":null,"abstract":"","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":"42 2","pages":"181"},"PeriodicalIF":4.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142914033","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}

{"title":"Goal-direct analgesia: can analgesia nociception index effectively reduce intra-operative opioids?","authors":"Alireza Danesh, Hamid R Vahabzadeh-Monshie, Alberto J de Armendi, Amir L Butt","doi":"10.1097/EJA.0000000000002096","DOIUrl":"https://doi.org/10.1097/EJA.0000000000002096","url":null,"abstract":"","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":"42 2","pages":"182-183"},"PeriodicalIF":4.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142914055","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}

{"title":"A comparison between invasive and noninvasive measurement of the Hypotension Prediction Index: A post hoc analysis of a prospective cohort study.","authors":"Santino R Rellum, Eline Kho, Jimmy Schenk, Björn J P van der Ster, Alexander P J Vlaar, Denise P Veelo","doi":"10.1097/EJA.0000000000002082","DOIUrl":"10.1097/EJA.0000000000002082","url":null,"abstract":"<p><strong>Background: </strong>Clinical trials and validation studies demonstrate promising hypotension prediction capability by the Hypotension Prediction Index (HPI). Most studies that evaluate HPI derive it from invasive blood pressure readings, but a direct comparison with the noninvasive alternative remains undetermined. Such a comparison could provide valuable insights for clinicians in deciding between invasive and noninvasive monitoring strategies.</p><p><strong>Objectives: </strong>Evaluating predictive differences between HPI when obtained through noninvasive versus invasive blood pressure monitoring.</p><p><strong>Design: </strong>Post hoc analysis of a prospective observational study conducted between 2018 and 2020.</p><p><strong>Setting: </strong>Single-centre study conducted in an academic hospital in the Netherlands.</p><p><strong>Patients: </strong>Adult noncardiac surgery patients scheduled for over 2 h long elective procedures. After obtaining informed consent, 91 out of the 105 patients had sufficient data for analysis.</p><p><strong>Main outcome measures: </strong>The primary outcome was the difference in area under the receiver-operating characteristics (ROC) curve (AUC) obtained for HPI predictions between the two datasets. Additionally, difference in time-to-event estimations were calculated.</p><p><strong>Results: </strong>AUC (95% confidence interval (CI)) results revealed a nonsignificant difference between invasive and noninvasive HPI, with areas of 94.2% (90.5 to 96.8) and 95.3% (90.4 to 98.2), respectively with an estimated difference of 1.1 (-3.9 to 6.1)%; P  = 0.673. However, noninvasive HPI demonstrated significantly longer time-to-event estimations for higher HPI values.</p><p><strong>Conclusion: </strong>Noninvasive HPI is reliably accessible to clinicians during noncardiac surgery, showing comparable accuracy in HPI probabilities and the potential for additional response time.</p><p><strong>Trial registration: </strong>Clinicaltrials.gov (NCT03795831) https://clinicaltrials.gov/study/NCT03795831.</p>","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":"131-139"},"PeriodicalIF":4.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11676597/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142460959","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}

{"title":"Intra-operative norepinephrine via peripheral venous catheter is safe: A short scientific report.","authors":"Renate Schmucki, Christoph A Rüst, Miodrag Filipovic","doi":"10.1097/EJA.0000000000002080","DOIUrl":"https://doi.org/10.1097/EJA.0000000000002080","url":null,"abstract":"","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":"42 2","pages":"172-173"},"PeriodicalIF":4.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142914056","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}

{"title":"Glucagon-like peptide-1 receptor agonists in peri-operative care: Dispelling myths and unveiling insights with essential considerations for anaesthesiologists.","authors":"Larissa Paggers, Dieter Mesotten, Hendrik Stragier","doi":"10.1097/EJA.0000000000002103","DOIUrl":"10.1097/EJA.0000000000002103","url":null,"abstract":"<p><p>With the growing use of glucagon-like-peptide-1 (GLP-1) receptor (GLP-1R) agonists as anti-obesity medication it is becoming increasingly important to examine its consequences in the peri-operative period. GLP-1R agonists are known for their effects of glucose-lowering and gastroparesis the latter causing some safety concerns regarding induction of anaesthesia, more specifically the risk of pulmonary aspiration. This article gathers the available evidence on this subject in addition to the already established guidelines. Current evidence makes us assume there is indeed an increased level of gastroparesis, but there are no studies to date with evidential confirmation of a presumed elevated risk of pulmonary aspiration. Future perspectives should focus on the actual risk of pulmonary aspiration and the possible implementation of ultrasound in the preoperative assessment.</p>","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":"140-151"},"PeriodicalIF":4.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142767195","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}

{"title":"Continuous peri-operative glucose monitoring in noncardiac surgery: A systematic review.","authors":"Alessandro Putzu, Elliot Grange, Raoul Schorer, Eduardo Schiffer, Karim Gariani","doi":"10.1097/EJA.0000000000002095","DOIUrl":"10.1097/EJA.0000000000002095","url":null,"abstract":"<p><strong>Background: </strong>Glucose management is an important component of peri-operative care. The usefulness of continuous glucose monitoring (CGM) in noncardiac surgery is uncertain.</p><p><strong>Objective: </strong>To systematically assess the glycaemic profile and clinical outcome of patients equipped with a CGM device during the peri-operative period in noncardiac surgery.</p><p><strong>Design: </strong>Systematic review.</p><p><strong>Data sources: </strong>Electronic databases were systematically searched up to July 2024.</p><p><strong>Eligibility criteria: </strong>Any studies performed in the peri-operative setting using a CGM device were included. Closed-loop systems also administering insulin were excluded. Analyses were stratified according to diabetes mellitus status and covered intra-operative and postoperative data. Outcomes included glycaemic profile (normal range 3.9 to 10.0 mmol l -1 ), complications, adverse events, and device dysfunction.</p><p><strong>Results: </strong>Twenty-six studies (1016 patients) were included. Twenty-four studies were not randomised, and six used a control arm for comparison. In bariatric surgery, diabetes mellitus patients had a mean ± SD glucose of 5.6 ± 0.5 mmol l -1 , with 15.4 ± 8.6% time below range, 75.3 ± 5.5% in range and 9.6 ± 6.7% above range. During major surgery, diabetes mellitus patients showed a mean glucose of 9.6 ± 1.1 mmol l -1 , with 9.5 ± 9.1% of time below range, 56.3 ± 13.5% in range and 30.6 ± 13.9% above range. In comparison, nondiabetes mellitus patients had a mean glucose of 6.4 ± 0.6 mmol l -1 , with 6.7 ± 8.4% time below range, 84.6 ± 15.5% in range and 11.2 ± 4.9% above range. Peri-operative complications were reported in only one comparative study and were similar in CGM and control groups. Device-related adverse events were rare and underreported. In 9.21% of cases, the devices experienced dysfunctions such as accidental removal and issues with sensors or readers.</p><p><strong>Conclusion: </strong>Due to the limited number of controlled studies, the impact of CGM on postoperative glycaemic control and complications compared with point-of-care testing remains unknown. Variability in postoperative glycaemic profiles and a device dysfunction rate of 1 in 10 suggest CGM should be investigated in a targeted surgical group.</p>","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":"162-171"},"PeriodicalIF":4.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11676603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142602317","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}

{"title":"Metabolic acidosis in patients with diabetes 2 undergoing cardiac surgery: The impact of SGLT2 inhibitor use: a retrospective cohort study.","authors":"Hege K Brekke, Gunhild Holmaas, Marianne C Astor, Egil Steien, Rune Haaverstad, Fatemeh Z Ghavidel, Marit Farstad","doi":"10.1097/EJA.0000000000002090","DOIUrl":"10.1097/EJA.0000000000002090","url":null,"abstract":"<p><strong>Background: </strong>Sodium-glucose cotransporter 2 inhibitors (SGLT2-i) lower blood sugar and reduce cardiovascular events and kidney failure. However, there have been increasing reports of euglycaemic diabetic ketoacidosis (eDKA) linked to SGLT2-i medicines.</p><p><strong>Objective: </strong>Investigating the association between SGLT2-i use and the incidence of metabolic acidosis in patients with type 2 diabetes undergoing cardiac surgery.</p><p><strong>Design: </strong>A retrospective observational cohort study comprising 121 patients, with 38 in the SGLT2-i group and 83 in the control group.</p><p><strong>Setting: </strong>A 2-year period at Haukeland University Hospital, a tertiary regional hospital in Western Norway.</p><p><strong>Patients: </strong>Patients with type 2 diabetes undergoing cardiac surgery.</p><p><strong>Interventions: </strong>Collection of clinical and laboratory data, including acid/base balance parameters, surgery details and SGLT2-i use.</p><p><strong>Main outcome measures: </strong>Base excess and anion gap measurements as indicators of ketosis development. A subgroup analysis in patients without renal failure (glomerular filtration rate > 60 ml min -1  m -2 ) .</p><p><strong>Results: </strong>Lower base excess levels and increased anion gaps were observed in the SGLT2-i group compared with controls at various time points postoperatively, with no significant differences in serum lactate levels.Twelve hours postoperatively, 41% of SGLT2-i patients without renal failure had a base excess -3 mmol l -1 or less after correction for serum lactate (indicating ketosis) compared with only 8% in the control group ( P  < 0.001). The anion gap was elevated in the SGLT2-i group compared to the control group at 12 h postoperatively ( P  = 0.018).Multivariable regression analysis identified SGLT2-i use as an independent factor associated with a lower base excess after correction for lactate levels ( P  < 0.001). Cessation of SGLT2-i medication did not correlate with the degree of acidosis.</p><p><strong>Conclusion: </strong>While taking SGLT2 inhibitors, diabetic patients undergoing heart surgery are at an increased risk of ketosis and possibly metabolic acidosis. This emphasises the importance of careful observation and effective treatment strategies within this group.</p>","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":"152-161"},"PeriodicalIF":4.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142497443","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}

{"title":"Advancing the utility of bedside airway assessment: Awake-check videolaryngoscopy.","authors":"Jane L Orrock, Patrick A Ward, Alistair F McNarry","doi":"10.1097/EJA.0000000000002084","DOIUrl":"https://doi.org/10.1097/EJA.0000000000002084","url":null,"abstract":"","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":"42 2","pages":"186-187"},"PeriodicalIF":4.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142913993","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}

{"title":"Emergency anesthesia procedures.","authors":"","doi":"10.1097/EJA.0000000000002093","DOIUrl":"https://doi.org/10.1097/EJA.0000000000002093","url":null,"abstract":"","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":"42 2","pages":"188"},"PeriodicalIF":4.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142914053","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}