European Journal of Anaesthesiology最新文献

{"title":"Eighteen-year analysis of anaesthetic management in Brugada syndrome: The BRUGANAES study.","authors":"Jaume Borrell-Vega, José Daniel Fernández Font, Miguel Linares, Graciela Martínez-Pallí, Alba Isabel-Roquero, Lluis Mont, Josep Brugada, Elena Arbelo, Marc Giménez-Milà","doi":"10.1097/EJA.0000000000002146","DOIUrl":"10.1097/EJA.0000000000002146","url":null,"abstract":"<p><strong>Background: </strong>Brugada syndrome (BrS) is a genetic disorder that increases the risk of ventricular tachyarrhythmias and sudden cardiac death (SCD). Certain drugs (propofol, local anaesthetics), fever, bradycardia, increased vagal tone and electrolyte imbalances can trigger or worsen BrS arrhythmias.</p><p><strong>Objective: </strong>To evaluate the incidence of malignant ventricular arrhythmias during the perioperative period in patients with BrS, hypothesising that common anaesthetic drugs may be safe to use during daily clinical practice.</p><p><strong>Design: </strong>The BRUGANAES study was an observational, retrospective project including BrS patients who underwent various types of anaesthesia.</p><p><strong>Setting: </strong>BrS patients undergoing any type of anaesthesia intervention from 1 January 2006, to 31 December 2023, from a tertiary hospital in Barcelona.</p><p><strong>Main outcome measures: </strong>The primary outcome was the occurrence of malignant ventricular arrhythmias and/or SCD during and up to 30 days postanaesthesia. Secondary outcomes included adverse events during hospitalisation, 30-day readmission rates and 30-day mortality rates.</p><p><strong>Results: </strong>Among 652 BrS patients registered in the hospital, 111 patients and 189 procedures were analysed. General anaesthesia was administered in 51.3% of cases, sedation in 36% and regional/neuraxial anaesthesia exclusively in 12.7%. Overall, nonrecommended drugs (propofol, ketamine and local anaesthetics) were used in 129 (68.3%) procedures, either bolus and/or continuous infusion. Epidural blocks were performed in 34% of regional anaesthesia cases, mostly in obstetrics, and subarachnoid blocks in 31.8%. The primary outcome occurred in two patients intraoperatively (1% of procedures): one with bradycardia-induced ventricular fibrillation after a nonrecommended drug and one with transient ventricular tachycardia after a drug not listed as potentially harmful.</p><p><strong>Conclusion: </strong>To date, this is one of the largest cohorts describing the perioperative approach for BrS patients, including a wide range of anaesthesia procedures and drugs. Most of the patients undergoing anaesthesia for an interventional procedure received an anaesthetic drug classified as not recommended.</p>","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":"458-467"},"PeriodicalIF":4.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406492","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":"Assessment of the paratracheal force required to occlude the oesophagus: is there a sex difference?: A short scientific report.","authors":"Benjamin Javillier, Nicolas Gillain, Vincent Bonhomme, Eric Deflandre","doi":"10.1097/EJA.0000000000002179","DOIUrl":"https://doi.org/10.1097/EJA.0000000000002179","url":null,"abstract":"","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771741","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":"Prehabilitation brings benefits to neurogenesis and peri-operative neurocognitive disorders in amyotrophic rats.","authors":"Akira Nemoto, Toru Goyagi, Satoshi Sunaga, Wataru Nemoto, Yukitoshi Niiyama","doi":"10.1097/EJA.0000000000002140","DOIUrl":"https://doi.org/10.1097/EJA.0000000000002140","url":null,"abstract":"<p><strong>Background: </strong>Peri-operative neurocognitive disorder (PND) is a postoperative complication associated with defects in hippocampal neurogenesis. Pre-operative muscle atrophy is implicated in PND. Although exercise improves cognitive function, its effects on PND remain unclear.</p><p><strong>Objective: </strong>This study investigated the relationship between PND and pre-operative exercise (PEx) in adult rats.</p><p><strong>Design: </strong>Animal study.</p><p><strong>Setting: </strong>Laboratory.</p><p><strong>Animals: </strong>A total of 64 male, 21 weeks old Sprague-Dawley rats were divided into four groups before 2 weeks of tail suspension to induce atopy of the hind legs: nonexercise (NEx) group, NEx with surgery (NEx + S), exercise without surgery (PEx) and pre-operative exercise with surgery (PEx + S).</p><p><strong>Interventions: </strong>PEx and PEx + S rats were subject to treadmill running for a week before surgery. The rats in the surgery groups were anaesthetised with 3% sevoflurane and underwent abdominal surgery.</p><p><strong>Main outcome measures: </strong>After a 1 week recovery period following surgery, cognitive function was assessed by a fear conditioning test, and then the Morris water maze test (finding an underwater hidden platform) was conducted over 5 days. Hippocampal neurogenesis was evaluated by assessing brain-derived neurotrophic factor (BDNF) secretion and immunohistochemical labelling.</p><p><strong>Results: </strong>Compared with the NEx rats, there was a retained contextual fear memory (P = 0.02), and in the Morris water maze test, the PEx and PEx + S groups found the underwater hidden platform faster (P < 0.001) and had a shorter path length (P = 0.03). The levels of hippocampal BDNF in the PEx and PEx + S groups were higher than those in the other groups (P < 0.001). The number of immature cells in the dentate gyrus was significantly higher in the PEx and PEx + S groups (P = 0.004) compared with the NEx and NEx +S groups.</p><p><strong>Conclusion: </strong>In rats, PEx for hind limb muscle atrophy induced by tail suspension reduced PND and increased neurogenesis in the dentate gyrus. We concluded that PEx may reduce PND. Our findings may benefit peri-operative care by improving patient outcomes.</p><p><strong>Trial registration: </strong>Approval number a-1-3012.</p>","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771780","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":"Reply to: videolaryngoscopy in neonates is not a matter of perspective.","authors":"Tom G Hansen, Laszlo Vutskits","doi":"10.1097/EJA.0000000000002147","DOIUrl":"10.1097/EJA.0000000000002147","url":null,"abstract":"","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":"42 4","pages":"372-373"},"PeriodicalIF":4.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536802","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":"Association of remimazolam with delirium and cognitive function: A systematic review and meta-analysis of randomised controlled trials.","authors":"Jaime Andres Arias, Gustavo Roberto Minetto Wegner, Bruno Francisco Minetto Wegner, Larissa Santos Silva, Francisco José Lucena Bezerra, Rafaela Goes Machado Filardi","doi":"10.1097/EJA.0000000000002107","DOIUrl":"10.1097/EJA.0000000000002107","url":null,"abstract":"<p><strong>Background and study objective: </strong>Delirium is an organic mental syndrome significantly associated with long-term cognitive decline, increased hospital stays and higher mortality. This systematic review of randomised controlled trials (RCTs) with meta-analysis assesses the association of remimazolam with postoperative cognitive function and delirium compared with non-benzodiazepine hypnotics.</p><p><strong>Design: </strong>Systematic review of RCTs with meta-analysis.</p><p><strong>Data sources: </strong>PubMed, Embase, Cochrane Library and Web of Science databases up to 27 April 2024.</p><p><strong>Eligibility criteria: </strong>Adult patients undergoing general anaesthesia or sedation procedures; use of remimazolam as the primary hypnotic or as an adjunct, administered via intermittent bolus or continuous infusion; comparison with other hypnotics or sedatives; evaluation of cognitive function or delirium.</p><p><strong>Main results: </strong>Twenty-three RCTs with 3598 patients were included. The incidence of delirium was not significantly different between remimazolam and other sedatives in general anaesthesia and sedation procedures [ n  = 3261; odds ratio (OR) = 1.2, 95% confidence interval (CI), 0.76 to 1.91; P  = 0.378843; I2  = 17%]. Regarding cognitive function evaluation, remimazolam showed no difference compared with the control group in Mini-Mental State Examination (MMSE) scores on the first postoperative day ( n  = 263; mean difference = 0.60, 95% CI, -1.46 to 2.66; P  = 0.5684; I2  = 90%) or on the third postoperative day ( n  = 163; mean difference  = 1.33, 95% CI, -0.72 to 3.38; P  = 0.2028; I2  = 93%). Remimazolam exhibited superiority over the control group in MMSE scores on the seventh postoperative day ( n  = 247; mean difference = 0.53, 95% CI, 0.30 to 0.75; P  < 0.0001; I2  = 28%).</p><p><strong>Conclusion: </strong>Remimazolam does not increase the incidence of delirium or cognitive impairments compared with non-benzodiazepine hypnotics. However, the analysis showed that the type of surgery significantly influenced the incidence of delirium. Additionally, remimazolam was associated with better short-term postoperative cognitive function.</p><p><strong>Systematic review registration: </strong>PROSPERO CRD42024532751.</p>","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":"285-297"},"PeriodicalIF":4.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142853454","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":"The risks we miss: Accounting for demographic and surgical variability in anaemia studies.","authors":"Emma G Sampson, Sathish Ramanathan, Kenichi A Tanaka, Amir L Butt","doi":"10.1097/EJA.0000000000002139","DOIUrl":"10.1097/EJA.0000000000002139","url":null,"abstract":"","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":"42 4","pages":"378-379"},"PeriodicalIF":4.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536901","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 call for standardised videolaryngoscopy evaluation.","authors":"Manuel Á Gómez-Ríos, Miguel Á Fernández-Vaquero, André A J Van Zundert","doi":"10.1097/EJA.0000000000002129","DOIUrl":"10.1097/EJA.0000000000002129","url":null,"abstract":"","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":"42 4","pages":"380-381"},"PeriodicalIF":4.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536692","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":"Cardiac index-guided haemodynamic management and myocardial injury after hepatopancreatic surgery.","authors":"Nancy Boulos, Amelie Delaporte, Matthieu Legrand, Bernd Saugel, Alexandre Joosten","doi":"10.1097/EJA.0000000000002120","DOIUrl":"10.1097/EJA.0000000000002120","url":null,"abstract":"","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":"42 4","pages":"374-375"},"PeriodicalIF":4.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536711","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":"Reply to comments on: mean arterial pressure versus cardiac index for haemodynamic management and myocardial injury after hepatopancreatic surgery.","authors":"Taner Abdullah, Hürü Ceren Gökduman, Achmet Ali, Funda Gümüş Özcan","doi":"10.1097/EJA.0000000000002125","DOIUrl":"10.1097/EJA.0000000000002125","url":null,"abstract":"","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":"42 4","pages":"375-377"},"PeriodicalIF":4.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536774","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 safety checklist for apnoeic oxygenation using high-flow nasal oxygen for laryngotracheal surgery in adults: An international Delphi consensus.","authors":"Parineeta Ghosh, Patrick A Ward, Jane L Orrock, Robert Greif, Alistair F McNarry","doi":"10.1097/EJA.0000000000002128","DOIUrl":"10.1097/EJA.0000000000002128","url":null,"abstract":"<p><strong>Background: </strong>Apnoeic oxygenation using high-flow nasal oxygen is becoming a commonly used technique in adult patients undergoing laryngotracheal surgery. Despite widespread adoption, there are no best practice guidelines governing its safe delivery.</p><p><strong>Objective: </strong>To develop a checklist for use during laryngotracheal surgery to guide the safe delivery of apnoeic oxygenation using high-flow nasal oxygen.</p><p><strong>Design: </strong>Recognised experts in the field of apnoeic oxygenation were invited to participate in a Delphi process to establish essential items for inclusion in the safety checklist. An online Delphi survey platform was used to facilitate this process.</p><p><strong>Setting: </strong>A panel of 36 experts was assembled from 11 countries. They participated voluntarily in an 8-week Delphi process that included one preliminary round, two electronic voting rounds and a final virtual roundtable discussion. A small steering group was responsible for leading the Delphi process, collating the electronic voting responses, analysing the results and compiling the final checklist.</p><p><strong>Main outcome measures: </strong>The consensus threshold for inclusion/exclusion of items in the safety checklist was set at at least 80% for the first and second electronic voting rounds. The consensus threshold was set at 70% for the final roundtable discussion.</p><p><strong>Results: </strong>The final checklist comprises 19 items, sub-divided into pre-procedure, peri-procedure and post-procedure aspects of patient care. The Delphi process was well attended, with an expert attrition rate of only 6%. A number of items reached more than 90% consensus, including the requirement to establish patients' suitability for the technique in advance of surgery and preparedness for the immediate implementation of an agreed individualised rescue oxygenation strategy.</p><p><strong>Conclusion: </strong>A Delphi process involving international experts has formulated a 19-item checklist for guiding the safe delivery of apnoeic oxygenation using high-flow nasal oxygen in adult patients undergoing laryngotracheal surgery. Further studies are required to assess the effects of this checklist on patient safety and outcomes.</p>","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":"357-365"},"PeriodicalIF":4.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064700","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}