European Journal of Anaesthesiology最新文献

{"title":"Application of lung protective ventilation strategies in paediatric pulmonary resection surgery.","authors":"Guan-Yu Yang","doi":"10.1097/EJA.0000000000002121","DOIUrl":"10.1097/EJA.0000000000002121","url":null,"abstract":"","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":"42 4","pages":"377"},"PeriodicalIF":4.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536700","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":"Videolaryngoscopy in neonates is not a matter of perspective.","authors":"Britta S von Ungern-Sternberg, James Peyton, Clyde Matava","doi":"10.1097/EJA.0000000000002117","DOIUrl":"10.1097/EJA.0000000000002117","url":null,"abstract":"","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":"42 4","pages":"371-372"},"PeriodicalIF":4.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536903","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 effect of stand-alone and additional preoperative video education on patients' knowledge of anaesthesia: A randomised controlled trial.","authors":"Sander F van den Heuvel, Philip Jonker, Sanne E Hoeks, Sohal Y Ismail, Robert Jan Stolker, Jan-Wiebe H Korstanje","doi":"10.1097/EJA.0000000000002109","DOIUrl":"10.1097/EJA.0000000000002109","url":null,"abstract":"<p><strong>Background: </strong>Fully digital preoperative information could save valuable time and resources. However, compared with face to face consultations, equivalent levels of safety, patient satisfaction and participation need to be maintained when using other methods to inform patients. This trial compared knowledge retention between preoperative stand-alone video education and face-to-face education by an anaesthesiologist.</p><p><strong>Objectives: </strong>To assess if video education, alone or combined with face-to-face education, leads to better knowledge retention more than conventional face-to-face education.</p><p><strong>Design: </strong>A randomised controlled trial with four arms: Video, Anaesthesiologist, Video & Anaesthesiologist, and Reference for baseline measurements and exploration of a test-enhanced learning effect.</p><p><strong>Setting: </strong>A Dutch tertiary care centre from February 2022 to February 2023.</p><p><strong>Patients: </strong>A total of 767 adult patients undergoing preoperative consultation for elective non-cardiothoracic surgery, with 677 included in the complete case analysis.</p><p><strong>Interventions: </strong>Stand-alone preoperative video education and video education in combination with face-to-face education in the preoperative outpatient clinic.</p><p><strong>Main outcome measures: </strong>Primary outcome, measured by the Rotterdam Anaesthesia Knowledge Questionnaire, was knowledge retention on day 0. Secondary outcomes included knowledge retention at 14 and 42 days, preoperative anxiety, and the need for additional information using the Amsterdam Preoperative Anxiety and Information Scale. Other outcomes were satisfaction, self-assessed knowledge, and test-enhanced learning effect.</p><p><strong>Results: </strong>Stand-alone video education led to higher Rotterdam Anaesthesia Knowledge Questionnaire scores than face-to-face education on day 0: median [IQR], 87.5 [81.3 to 93.8] vs. 81.3 [68.8 to 87.5], P  < 0.001. Combined education in the \"Video & Anaesthesiologist\" group led to better knowledge retention compared with both the \"Anaesthesiologist\" group and the Video group: 93.8 [87.5 to 93.8] vs. 81.3 [68.8 to 87.5], P  < 0.001; 93.8 [87.5 to 93.8] vs. 87.5 [81.3 to 93.8], P  = 0.01, respectively. No differences in the patients' preoperative anxiety and satisfaction levels were found.</p><p><strong>Conclusion: </strong>Compared with face-to-face education by an anaesthesiologist, stand-alone video and combined video education improve short-term knowledge retention, without increasing patient anxiety.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT05188547.</p>","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":"313-323"},"PeriodicalIF":4.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11872255/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142863721","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":"Sphenopalatine ganglion block for postoperative analgesia after transsphenoidal hypophysectomy: A pilot study.","authors":"Brynner Mota Buçard, Alexandra Rezende Assad, Nubia Verçosa, Ismar L Cavalcanti","doi":"10.1097/EJA.0000000000002112","DOIUrl":"10.1097/EJA.0000000000002112","url":null,"abstract":"","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":"368-370"},"PeriodicalIF":4.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142947003","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 implementation of intrathecal morphine for caesarean delivery into clinical practice, and assessment of its impact on patient-reported quality of recovery using the ObsQoR-10-Dutch scale: A single-centre cohort study.","authors":"Oscar F C van den Bosch, Mienke Rijsdijk, Suzanne E Rosier, Lottie van Baal, Timme P Schaap, Pervez Sultan, Wolfgang Bühre","doi":"10.1097/EJA.0000000000002127","DOIUrl":"10.1097/EJA.0000000000002127","url":null,"abstract":"<p><strong>Background: </strong>Optimising a mother's quality of recovery following caesarean delivery is of paramount importance as it facilitates maternal care of the newborn and affects physical, psychological and emotional well being. Intrathecal morphine (ITM) reduces postoperative pain and may improve quality of recovery: however its widespread use is limited.</p><p><strong>Objective: </strong>To assess the effects of implementing ITM for caesarean delivery on postoperative quality of recovery.</p><p><strong>Study design: </strong>Single-centre observational before-after study.</p><p><strong>Setting: </strong>Tertiary university hospital, the Netherlands, January 2023 until April 2024.</p><p><strong>Study population: </strong>Patients who underwent caesarean delivery under spinal anaesthesia.</p><p><strong>Intervention: </strong>Patients recruited before implementation of ITM ( n  = 55) received patient-controlled intravenous analgesia with morphine or continuation of epidural analgesia previously used for labour ('pre-ITM group'). Patients recruited after implementation of ITM ( n  = 47) received ITM 100 μg and oral morphine tablets 10 mg as needed ('ITM group').</p><p><strong>Outcomes: </strong>Primary outcome was the score on the Obstetric Quality of Recovery (ObsQoR-10-Dutch) questionnaire (0 to 100). Secondary outcomes included ObsQoR-10 subscores, length of stay, opioid consumption and self-reported general health score (0 to 100).</p><p><strong>Results: </strong>Protocol adherence for ITM was 98%. Quality of recovery improved significantly [ObsQoR-10 scores pre-ITM 65 ± 16 vs. ITM 74 ± 13 points, mean difference 9.0 (95% CI, 3.1 to 15] points, P  = 0.002], with improvement in pain scores, physical comfort, independence and psychological wellbeing. In multivariate analysis, the improvement was 6.3 (95% CI, 0.37 to 12.2] points, which was statistically significant but did not reach the predefined threshold for clinical relevance. There was, however, an improvement in self-reported general health score (57 ± 18 vs. 68 ± 17, P  = 0.002), median [IQR] length of hospital stay (41 [36 to 51] vs. 37 [32 to 49] h, P  = 0.032) and median [IQR] opioid consumption (52 [35 to 73] vs. 0 [0 to 0] mg, P  < 0.001).</p><p><strong>Conclusions: </strong>Implementing ITM for caesarean delivery resulted in moderate improvements in obstetric recovery and reduced opioid consumption. Cautious interpretation is warranted given the nonrandomised design of this implementation study. Our findings support the use of ITM in a multimodal analgesia strategy for patients undergoing caesarean delivery.</p>","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":"332-339"},"PeriodicalIF":4.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11872268/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064702","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":"Portal vein pulsatility is associated with the cumulative fluid balance: A post hoc longitudinal analysis of a prospective, general intensive care unit cohort.","authors":"Stefan Andrei, Dan Longrois, Maxime Nguyen, Belaid Bouhemad, Pierre-Gregoire Guinot","doi":"10.1097/EJA.0000000000002111","DOIUrl":"10.1097/EJA.0000000000002111","url":null,"abstract":"<p><strong>Background: </strong>Previous studies have explored tools for evaluating the effects of positive fluid balance, with recent emphasis, and controversies, on venous ultrasound parameters and composite scores. The portal vein pulsatility index and the renal venous pattern have emerged as the most promising indicators of volume-induced venous congestion. But in the general intensive care unit (ICU), numerous factors influence cardiovascular homeostasis, affecting venous function.</p><p><strong>Objectives: </strong>This study aimed to evaluate the factors associated with portal vein pulsatility index in general ICU patients. Secondary objectives were to examine the correlations between pulsatility index and additional markers of congestion.</p><p><strong>Design: </strong>This exploratory study was a post hoc analysis of a prospective, multicentric, observational database.</p><p><strong>Setting: </strong>The data collection was performed in four ICUs in university-affiliated or tertiary hospitals.</p><p><strong>Patients: </strong>This study included adult patients within 24 h of general ICU admission with an expected ICU length of stay of more than 2 days.</p><p><strong>Intervention: </strong>Patients underwent clinical, biological, and echocardiographic assessments at several times: ICU admission, day 1, day 2, day 5 and the last day of ICU.</p><p><strong>Main outcome measure: </strong>The study primary endpoint was the portal vein pulsatility index during the course of the patients' stay on the ICU.</p><p><strong>Results: </strong>One hundred forty-five patients and 514 haemodynamic evaluations were analysed. The mean age of the patients was 64 ± 15 years, 41% were women, with a median [IQR] admission simplified acute physiology score II of 46 [37 to 59]. The univariable followed by multivariable mixed-effects linear regression analyses demonstrated an association between portal vein pulsatility index, heart rate [estimate -0.002 (95% CI, -0.003 to -0.001), P  < 0.001] and the cumulative fluid balance [estimate 0.0007 (95% CI, 0.00007 to 0.001), P  = 0.024]. Portal vein pulsatility index showed no agreement with CVP of at least 12 mmHg (kappa correlation -0.008, P  = 0.811), negative passive leg raising (kappa correlation -0.036, P  = 0.430), mean inferior vena caval (IVC) diameter greater than 2 cm (kappa correlation -0.090, P  = 0.025), maximal IVC diameter greater than 2 cm (kappa correlation -0.010, P  = 0.835), hepatic vein systolic/diastolic ratio less than 1 (kappa correlation 0.043, P  = 0.276), or renal vein pulsatile pattern (kappa correlation -0.243, P  < 0.001).</p><p><strong>Conclusion: </strong>The study findings emphasise the unique sensitivity of portal vein pulsatility index in assessing fluid balance in general ICU patients. The lack of correlation between portal vein pulsatility index and other parameters of venous congestion underscores its potential to provide distinctive insights into venous congestion.</p>","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":"324-331"},"PeriodicalIF":4.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142834825","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 for procedural sedation: A systematic review with meta-analyses and trial sequential analyses.","authors":"Lasse Pingel, Mathias Maagaard, Casper D Tvarnø, Sandra Sorenson, Shaheer Bukhari, Lars Peter Kloster Andersen, Jakob Hessel Andersen, Ole Mathiesen","doi":"10.1097/EJA.0000000000002126","DOIUrl":"10.1097/EJA.0000000000002126","url":null,"abstract":"<p><strong>Background: </strong>Midazolam and propofol are frequently used for procedural sedation. Remimazolam may provide a more controllable sedation with fewer adverse effects.</p><p><strong>Objective: </strong>To assess the sedation success rate and respiratory and cardiovascular complications of remimazolam versus placebo and other sedatives in adults undergoing procedural sedation.</p><p><strong>Design: </strong>A systematic review of randomised controlled trials (RCTs) with meta-analyses, trial sequential analyses (TSA), and GRADE evaluations of the certainty of evidence.</p><p><strong>Data sources: </strong>We searched Medline, Embase, CENTRAL, BIOSIS, CINAHL, and Web of Science Core Collection from their inception to 22 June 2024.</p><p><strong>Eligibility criteria: </strong>RCTs allocating participants undergoing procedural sedation to remimazolam versus placebo or any active comparator.</p><p><strong>Results: </strong>We included 63 trials randomising 13 953 participants. All included trial results were judged to be at high risk of bias. The sedation success rate was similar with remimazolam versus active comparators, relative risk (RR) 1.04, [97.5% confidence interval (CI), 0.96 to 1.14; TSA-adjusted CI, 0.95 to 1.18], P   =  0.26, GRADE: very low. Subgroup analyses indicated that remimazolam versus midazolam increased sedation success rate, while the risks were similar with remimazolam versus comparators. Remimazolam versus active comparators decreased the risk of respiratory complications, RR 0.47, (97.5% CI, 0.36 to 0.61; TSA-adjusted CI, 0.35 to 0.61), P  < 0.01; and cardiovascular complications, RR 0.46, (97.5% CI, 0.37 to 0.56; TSA-adjusted CI, 0.38 to 0.57), P  < 0.01. Subgroup analyses indicated that remimazolam versus propofol reduced respiratory and cardiovascular complications, while the risks were similar versus midazolam.</p><p><strong>Conclusion: </strong>Remimazolam seems to provide a similar sedation success rate as other active comparators (propofol, ciprofol, midazolam, dexmedetomidine, etomidate), although subgroup analyses indicated that remimazolam increased sedation success rate compared to midazolam. Remimazolam compared to propofol may decrease the risk of respiratory and cardiovascular complications. The certainty of the evidence was very low to low, and firm conclusions could not be drawn.</p>","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":"298-312"},"PeriodicalIF":4.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188592","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 impact of psychophysiological well being on executive functions among anaesthesia residents.","authors":"Annalisa Boscolo, Luca Queirolo, Paolo Navalesi","doi":"10.1097/EJA.0000000000002106","DOIUrl":"10.1097/EJA.0000000000002106","url":null,"abstract":"","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":"366-368"},"PeriodicalIF":4.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11872262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142738922","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":"Reply to: the risks we miss.","authors":"Luciana Cadore Stefani, Paulo Correa da Silva Neto, Clarissa Mendanha","doi":"10.1097/EJA.0000000000002134","DOIUrl":"10.1097/EJA.0000000000002134","url":null,"abstract":"","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":"42 4","pages":"379-380"},"PeriodicalIF":4.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536798","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":"Risk of myocardial injury in mean arterial pressure or cardiac index guided intra-operative haemodynamic management.","authors":"Ajay Kumar Jha, Nivedita Jha","doi":"10.1097/EJA.0000000000002119","DOIUrl":"10.1097/EJA.0000000000002119","url":null,"abstract":"","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":"42 4","pages":"373-374"},"PeriodicalIF":4.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536828","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}