European Journal of Anaesthesiology最新文献

{"title":"Cottrell and Patel's neuroanesthesia.","authors":"","doi":"10.1097/EJA.0000000000002062","DOIUrl":"10.1097/EJA.0000000000002062","url":null,"abstract":"","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":"41 11","pages":"869"},"PeriodicalIF":4.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142602825","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":"Artificial intelligence in obstetric anaesthesia: How the next decade may unfold.","authors":"Cian Hurley, Nuala Lucas, Rosemarie Kearsley","doi":"10.1097/EJA.0000000000002066","DOIUrl":"10.1097/EJA.0000000000002066","url":null,"abstract":"","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":"41 11","pages":"795-799"},"PeriodicalIF":4.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142602673","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":"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":" ","pages":"821-830"},"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}

{"title":"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.","authors":"Pierre-Henri Moury, Quentin Jegousso, Maxime Durost, Jérôme Nicolas, Pierre Albaladejo","doi":"10.1097/EJA.0000000000002056","DOIUrl":"10.1097/EJA.0000000000002056","url":null,"abstract":"","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":"865-867"},"PeriodicalIF":4.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142119309","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":"Commentary on the ANNEXA-I trial from the guideline group of the European Society of Anaesthesiology and Intensive Care (ESAIC) on the reversal of direct oral anticoagulants in patients with life threatening bleeding.","authors":"Christian von Heymann, Arash Afshari, Aamer Ahmed, Eleni Arnaoutoglou, Daniel Bolliger, Christian Fenger-Eriksen, Oliver Grottke","doi":"10.1097/EJA.0000000000002061","DOIUrl":"10.1097/EJA.0000000000002061","url":null,"abstract":"","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":"41 11","pages":"867-868"},"PeriodicalIF":4.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142602700","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":"Intravenous lidocaine for postoperative analgesia management in paediatrics: A systematic review with meta-analysis of published studies.","authors":"Pierre Pardessus, Maud Loiselle, Kelly Brouns, Anne-Laure Horlin, Beatrice Bruneau, Yara Maroun, Martin Lagarde, Maxime Deliere, Florence Julien-Marsollier, Souhayl Dahmani","doi":"10.1097/EJA.0000000000002046","DOIUrl":"10.1097/EJA.0000000000002046","url":null,"abstract":"<p><strong>Background: </strong>The administration of intravenous lidocaine during the peri-operative period may improve pain management after paediatric surgery.</p><p><strong>Objective: </strong>To explore the decrease in postoperative pain intensity and opioid consumption associated with peri-operative lidocaine administration in the paediatric population.</p><p><strong>Design: </strong>A systematic review with meta-analysis of randomised controlled trials and a Grading of Recommendations Assessment, Development and Evaluation (GRADE) analysis.</p><p><strong>Data sources: </strong>Extensive literature review.</p><p><strong>Eligibility criteria: </strong>This study includes clinical trials conducted during surgery that examined the effect of intravenous lidocaine compared with placebo on postoperative pain management.</p><p><strong>Results: </strong>Lidocaine administration decreased pain intensity in PACU (standardised mean difference (SMD) = -1.89 [-3.75, -0.03], I2  = 97%, P of I2  < 0.001) and on postoperative day 1 (SMD = -2.02 [-3.37, -0.66], I2  = 96%, P of I2  < 0.001, number of studies = 5). Lidocaine was associated with a decrease in opioid consumption on postoperative day 1 (SMD = -1.2 [-2.19, -0.2], I2  = 93%, P of I2  < 0.001) but not on postoperative day 2 (SMD = -1.73 [-3.9, 0.44], I2  = 96%, P of I2  < 0.001). GRADE analyses resulted in low-quality results. Subgroup analyses revealed that pain intensity in PACU and opioid consumption on postoperative day 1 decreased when lidocaine was administered during both the intra-operative and postoperative periods.</p><p><strong>Conclusions: </strong>The use of lidocaine is associated with improved pain management. However, further studies are needed to increase the level of evidence and determine the optimal administration regimen for pain management.</p>","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":"856-864"},"PeriodicalIF":4.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141792194","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":"Ultrasound-guided transversalis fascia plane block or transversus abdominis plane block for recovery after caesarean section: A randomised clinical trial.","authors":"Ahmet Pinarbaşi, Başak Altiparmak, Melike Korkmaz Toker, Fatih Pirinççi, Bakiye Uğur","doi":"10.1097/EJA.0000000000002041","DOIUrl":"10.1097/EJA.0000000000002041","url":null,"abstract":"<p><strong>Background: </strong>Caesarean section is a widely performed surgical procedure that often results in moderate-to-severe postoperative pain. If left untreated, this pain can lead to short-term and long-term consequences. Transversalis fascia plane (TFP) block and transversus abdominis plane (TAP) block are among the regional anaesthesia techniques employed for managing pain after a caesarean section.</p><p><strong>Objective: </strong>We aimed to compare the impact of these two blocks on the quality of recovery in patients undergoing elective caesarean section under spinal anaesthesia.</p><p><strong>Design: </strong>A single-centre, double-blind, randomised trial.</p><p><strong>Settings: </strong>Operating room, postanaesthesia recovery unit, and ward in a tertiary hospital.</p><p><strong>Participants: </strong>Ninety-three patients (ASA 2 to 3) were recruited. After exclusion, 79 patients were included in the final analysis: 40 in the TFP block group and 39 in the TAP block group.</p><p><strong>Interventions: </strong>After surgery, participants received either TFP block (20 ml 0.25% bupivacaine for each side) or TAP block (20 ml 0.25% bupivacaine for each side).</p><p><strong>Main outcome measures: </strong>The primary outcome was the difference in obstetric quality of recovery 11-Turkish (ObsQoR-11T) scores between groups. Secondary outcomes included pain scores, opioid consumption and incidence of opioid-related complications.</p><p><strong>Results: </strong>The mean ObsQoR-11T score was higher in the TFP block group compared with the TAP block group (97.13 ± 6.67 points vs. 87.10 ± 9.84 points, respectively; P  < 0.001). The pain scores in the TFP block group were slightly lower between postoperative 4 and 24 h. The mean total morphine consumption was 15.08 ± 2.21 mg in the TFP block group and 22.21 ± 3.04 mg in the TAP block group ( P  < 0.001). More patients required rescue analgesia between 4 and 8 h in the TAP block group [2.00 (5.00%) vs. 9.00 (23.08%), P  = 0.02]. No significant differences were observed between groups in terms of opioid-related side effects.</p><p><strong>Conclusion: </strong>TFP block used for analgesic purposes yielded a better quality recovery period than TAP block and also reduced opioid consumption.</p><p><strong>Trial registration: </strong>Clinicaltrials.gov (NCT05999981).</p><p><strong>Visual abstract: </strong>http://links.lww.com/EJA/B6 .</p>","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":"769-778"},"PeriodicalIF":4.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141747760","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":"Diaphragm-sparing efficacy of subparaneural upper trunk block for arthroscopic shoulder surgery: A randomised controlled trial.","authors":"Yumin Jo, Chahyun Oh, Woo-Yong Lee, Donggeun Lee, Suyeon Shin, Woosuk Chung, Chaeseong Lim, Sun Yeul Lee, Boohwi Hong","doi":"10.1097/EJA.0000000000002034","DOIUrl":"10.1097/EJA.0000000000002034","url":null,"abstract":"<p><strong>Background: </strong>Inter-scalene block (ISB) is associated with an inevitable risk of hemi-diaphragmatic paresis (HDP). To reduce the risk of HDP, an upper trunk block (UTB) has been proposed at the brachial plexus division level.</p><p><strong>Objective: </strong>We hypothesised that UTB would be associated with a lower incidence of HDP than ISB while providing sufficient analgesia following arthroscopic shoulder surgery.</p><p><strong>Design: </strong>Randomised controlled trial.</p><p><strong>Setting: </strong>A tertiary teaching hospital.</p><p><strong>Patients: </strong>Seventy patients aged 20 to 80 years undergoing arthroscopic rotator cuff repair.</p><p><strong>Intervention: </strong>Ultrasound-guided ISB or UTB was performed with 5 ml 0.75% ropivacaine.</p><p><strong>Main outcome measures: </strong>The primary outcome was the incidence of complete HDP, assessed by diaphragm excursion using ultrasound, defined as a decrease to 25% or less of baseline or occurrence of paradoxical movement. Postoperative pulmonary function change, pain scores, opioid consumption and pain-related outcomes were the secondary outcomes.</p><p><strong>Results: </strong>The UTB group had a significantly lower incidence of complete HDP than the ISB group [5.9% (2/34) vs. 41.7% (15/36); absolute difference, 35.8%; 95% confidence interval (CI), 17.8 to 53.7%; P  < 0.001]. The postblockade decline in pulmonary function was more pronounced in the ISB group than that in the UTB group. The pain score at 1 h postoperatively was not significantly different between the groups (ISB vs. UTB group: median 0 vs. 1; median difference, -1; 95% CI, -2 to 0.5). No significant difference was observed in any other secondary outcomes.</p><p><strong>Conclusion: </strong>UTB was associated with a lower incidence of HDP compared with ISB while providing excellent analgesia in arthroscopic shoulder surgery.</p><p><strong>Trial registration: </strong>Clinical Trial Registry of Korea ( https://cris.nih.go.kr ) identifier: KCT0007002.</p><p><strong>Irb number: </strong>Chungnam National University Hospital Institutional Review Board No. 2021-12-069.</p>","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":"760-768"},"PeriodicalIF":4.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141497463","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":"Quality of recovery after major noncardiac surgery in a high-acuity postoperative unit: A prospective validation study to evaluate the QoR-15GE during advanced recovery room care.","authors":"Lili Plümer, Eva Jung, Linda Krause, Marlene Fischer","doi":"10.1097/EJA.0000000000002036","DOIUrl":"10.1097/EJA.0000000000002036","url":null,"abstract":"","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":"787-789"},"PeriodicalIF":4.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141733766","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":"Remimazolam vs. propofol for general anaesthesia in elderly patients: a meta-analysis with trial sequential analysis.","authors":"Eduardo Maia Pereira, Vitor Ryuiti Moraes, Mariana Gaya da Costa, Tatiana Souza do Nascimento, Eric Slawka, Carlos Galhardo Júnior, Michel Mrf Struys","doi":"10.1097/EJA.0000000000002042","DOIUrl":"10.1097/EJA.0000000000002042","url":null,"abstract":"<p><strong>Background: </strong>Elderly patients comprise an increasing proportion of patients undergoing surgery, and they require special attention due to age-related physiological changes. Propofol is the traditional agent for anaesthesia, and recently, remimazolam, a novel ultra-short-acting benzodiazepine, has emerged as an alternative to propofol in general anaesthesia.</p><p><strong>Objectives: </strong>We aim to compare remimazolam vs . propofol for general anaesthesia in elderly patients regarding hypotension, induction characteristics, haemodynamics and recovery outcomes.</p><p><strong>Design: </strong>Meta-analysis with sensitivity and trial sequential analyses (TSA) to assess inconsistencies. Risk ratios and mean differences with 95% confidence intervals (95% CIs) were computed using a random effects model. Subgroups and meta-regression according to anaesthesia methods were also performed.</p><p><strong>Data sources: </strong>We systematically searched MEDLINE, Embase and Cochrane for randomised controlled trials (RCTs) up to January 1, 2024.</p><p><strong>Eligibility criteria: </strong>Patients at least 60 years old, comparing remimazolam vs . propofol for general anaesthesia.</p><p><strong>Results: </strong>Eleven RCTs (947 patients) were included. Compared with propofol, remimazolam was associated with lower postinduction and intra-operative hypotension (RR 0.41, 95% CI 0.27 to 0.62, P  < 0.001) and incidence of bradycardia (risk ratio 0.58, 95% CI 0.34 to 0.98, P  = 0.04), with a higher heart rate ( P  = 0.01). The incidence of injection pain was lower ( P  < 0.001), but remimazolam was associated with a longer time to loss of consciousness ( P  < 0.001) and a higher bispectral index at loss of consciousness ( P  = 0.04). No differences were found for mean arterial pressure, emergence time, extubation time and incidence of emergence agitation. The TSA was consistent and achieved the required information size for hypotension.</p><p><strong>Conclusions: </strong>Remimazolam significantly reduced the risk of hypotension, bradycardia and injection pain, despite an increase in the time to loss of consciousness. Remimazolam appears to be an effective and well tolerated alternative to propofol in elderly patients undergoing general anaesthesia.</p>","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":"738-748"},"PeriodicalIF":4.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11377052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141787619","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}