European Journal of Anaesthesiology最新文献

{"title":"Guidelines on strategies for the universal implementation of videolaryngoscopy.","authors":"Manuel Á Gómez-Ríos, André A J Van Zundert, Alistair F McNarry, J Adam Law, Andy Higgs, Audrey De Jong, Samir Jaber, Kunal Karamchandani, Jan Hansel, Kemal Tolga Saracoglu, Robert Leach, Helio Penna Guimaraes, Alfredo Abad-Gurumeta, David Gómez-Ríos, Pavel Michalek, Lauren C Berkow, Miguel Á Fernández-Vaquero, Alfredo Serrano-Moraza, Luis Gaitini, Sonia Vaida, Mostafa Somri, Tomasz Gaszyński, David Brewster, Neel Desai, Ayten Saracoglu, Samuel Ern Hung Tsan, Vassilis Athanassoglou, Nobuyasu Komasawa, Rakesh Garg, Faisal Shamim, Rajkumar Rajendram, Uxía Gutierrez-Couto, Teresa López, Nekari De Luis-Cabezón, Daniel Tevar Flores, José Carlos Garzón, José A Sastre, Andrés Roca de Togores López, Diego Meléndez-Salinas, José M Fandiño-Orgeira, Rubén Casans-Frances, Marta Casalderrey-Rivas, Eva Romero-García, Clara Marín-Zaldívar, Ana Aroca-Tanarro, Oscar Alonso-Correa, Luis Jesús Rodríguez-Martín, Salvador Espinosa-Ramírez, Carin A Hagberg","doi":"10.1097/EJA.0000000000002210","DOIUrl":"https://doi.org/10.1097/EJA.0000000000002210","url":null,"abstract":"<p><strong>Objective: </strong>The Airway Section of the Spanish Society of Anaesthesiology, Resuscitation, and Pain Therapy (SEDAR), the Spanish Society of Emergency Medicine (SEMES), the Latin American Federation of Emergency Medicine (FLAME) and an international group of airway experts (IAG) aimed to establish multidisciplinary recommendations advocating for the universal use of videolaryngoscopy (VL) in both emergency and planned care settings.</p><p><strong>Design: </strong>A committee of experts from the two national scientific societies and an international group of airway experts was convened. Relevant research questions aligning with the document's objective were identified. A rapid systematic review of the evidence was performed, and the quality of evidence was assessed. Recommendations were formulated using the GRADE methodology (Grading of Recommendations Assessment, Development, and Evaluation) The entire process was conducted independently of industry funding.</p><p><strong>Methods: </strong>Six domains were defined pertaining to VL: Clinical Benefits; Infrastructure and Accessibility; Clinical Guidelines and Protocols; Teaching and Clinical Training; Dissemination and Promotion of Clinical Benefits; Innovation, Sustainability, and Research. For each domain, specific questions were developed using the PICO model (Population, Intervention, Comparison, and Outcomes). A literature search was conducted following PRISMA-R guidelines and analysed using the GRADE methodology.</p><p><strong>Results: </strong>The synthesis process resulted in 12 recommendations. Due to the low quality of available evidence, most recommendations were formulated based on expert opinion.</p><p><strong>Conclusion: </strong>The experts achieved strong consensus, formulating 12 recommendations to support strategies aimed at universalising the use of videolaryngoscopy.</p>","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324853","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 noninvasive blood pressure monitoring with wearable photoplethysmography: A method comparison study in high-risk patients recovering from noncardiac surgery.","authors":"Moritz Flick, Leon Gebhardt, Alina Bergholz, Kristen K Thomsen, Max Bossemeyer, Alexander Hapfelmeier, Julia Auinger, Bernd Saugel","doi":"10.1097/EJA.0000000000002222","DOIUrl":"https://doi.org/10.1097/EJA.0000000000002222","url":null,"abstract":"<p><strong>Background: </strong>The Biobeat wrist monitor (BB-613W; Biobeat Technologies, Petah-Tikva, Israel) and the Biobeat chest monitor (BB-613P; Biobeat Technologies) are wearable solutions for continuous noninvasive blood pressure monitoring.</p><p><strong>Objectives: </strong>We aimed to investigate the blood pressure measurement performance of the Biobeat wrist monitor and chest monitor after external calibration.</p><p><strong>Design: </strong>A prospective method comparison study.</p><p><strong>Setting: </strong>University Medical Center Hamburg-Eppendorf, Hamburg, Germany.</p><p><strong>Patients: </strong>Fifty high-risk patients recovering from noncardiac surgery in an advanced postanaesthesia care unit.</p><p><strong>Main outcome measures: </strong>We compared blood pressure measurements from the Biobeat wrist monitor (BPWRIST-ART) and the Biobeat chest monitor (BPCHEST-ART) with intra-arterial blood pressure measurements (BPART). In addition, we aimed to compare blood pressure measurements from the Biobeat wrist monitor (BPWRIST-OSCI) with those from an oscillometric upper-arm cuff (BPOSCI). We used Bland-Altman analysis, four-quadrant plot and error grid analysis for statistical analysis.</p><p><strong>Results: </strong>The mean of the differences ± standard deviation (95%-limits of agreement) between BPWRIST-ART and BPART was 3 ± 11 mmHg (-19 to 25 mmHg) for mean blood pressure with a concordance rate to track 15-min blood pressure changes of 51%. The mean of the differences between BPCHEST-ART and BPART was 3 ± 11 mmHg (-17 to 24 mmHg) for mean blood pressure with a concordance rate to track 15-min blood pressure changes of 61%. The mean of the differences between BPWRIST-OSCI and BPOSCI was 6 ± 11 mmHg (-16 to 27 mmHg) for mean blood pressure with a concordance rate to track 15-min blood pressure changes of 49%.</p><p><strong>Conclusions: </strong>Blood pressure measurements from the Biobeat wrist monitor and the Biobeat chest monitor did not show clinically acceptable agreement either with intra-arterial blood pressure measurements or with blood pressure measurements from an oscillometric upper-arm cuff in high-risk patients recovering from noncardiac surgery in an advanced postanaesthesia care unit.</p>","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144505232","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":"Intraoperative hypotension during robotic-assisted radical prostatectomy: A randomised controlled trial comparing standard goal-directed fluid therapy with hypotension prediction index-guided goal-directed fluid therapy.","authors":"Cotoia Antonella, Antonello Discenza, Michela Rauseo, Mario Matella, Girolamo Caggianelli, Rossana Ciaramelletti, Lucia Mirabella, Gilda Cinnella","doi":"10.1097/EJA.0000000000002211","DOIUrl":"https://doi.org/10.1097/EJA.0000000000002211","url":null,"abstract":"<p><strong>Background: </strong>Robot-assisted radical prostatectomy (RARP) represents the leading application of robotic surgery in the treatment for prostate cancer with faster recovery and reduced invasiveness. Maintaining stable blood pressure during RARP is crucial to avoid complications. The approach used is goal-directed therapy (GDT); however, the Hypotension Prediction Index (HPI), a machine learning algorithm that analyses arterial waveforms, may provide additional benefits.</p><p><strong>Objective: </strong>To evaluate the cumulative amount, frequency and duration of intraoperative hypotension episodes in patients undergoing RARP, comparing those managed with a GDT protocol guided by the HPI algorithm versus those managed without it.</p><p><strong>Design: </strong>Prospective randomised study.</p><p><strong>Setting: </strong>Single-centre university hospital. Recruitment from January 2022 to April 2023.</p><p><strong>Participants: </strong>Eighty-two patients.</p><p><strong>Interventions: </strong>Patients undergoing RARP were randomly assigned to either a GDT protocol alone (control) or a GDT protocol guided by the HPI (HPI group). All patients received both general anaesthesia and a single-shot spinal technique.</p><p><strong>Mean outcome measures: </strong>Cumulative amount of intraoperative hypotension [measured using the time-weighted average (TWA) of mean arterial pressure (MAP) below 65 mmHg]; frequency of hypotensive events; duration of hypotensive events; postoperative complications; length of stay.</p><p><strong>Results: </strong>No differences were observed in TWA-MAP, or in the frequency and duration of hypotensive events between the groups. Both groups maintained stable haemodynamics with minimal hypotension, and had similar fluid infusion and vasoconstrictor administration. Additionally, there were no differences in postoperative complications or length of stay.</p><p><strong>Conclusions: </strong>In our study, HPI guidance did not reduce intraoperative hypotension during RARP. Interestingly, the control group experienced fewer hypotensive events than typically reported in the literature, likely because of the high standards of haemodynamic and anaesthesiologic management maintained across both groups.</p><p><strong>Trial registration: </strong>Clinicaltrials.gov identifier: NCT06535464.</p>","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144257683","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":"Anaesthetic strategies for managing placenta accreta spectrum with REBOA: Insights from an international multicentre retrospective study.","authors":"Karam Azem, Sharon Orbach-Zinger, Alexander Ioscovich, Nicolas Brogly, Efrat Spiegel, Avivit Shoham, Daniel Shatalin, Isabel Valbuena, Amit Frenkel, Luis Manuel Vegas Isasi, Yuri Matatov, Shai Fein, Dmitry Greenman, Yuval Neeman, Emilia Guasch, Yair Binyamin","doi":"10.1097/EJA.0000000000002218","DOIUrl":"https://doi.org/10.1097/EJA.0000000000002218","url":null,"abstract":"<p><strong>Background: </strong>Placenta accreta spectrum (PAS) with resuscitative endovascular balloon occlusion of the aorta (REBOA) presents unique anaesthetic challenges, yet optimal management strategies remain undefined.</p><p><strong>Objective: </strong>To provide a real-world description of anaesthetic practices, REBOA management, and surgical outcomes in patients undergoing caesarean delivery with REBOA for PAS across four international centres.</p><p><strong>Design: </strong>International multicentre retrospective cohort study.</p><p><strong>Setting: </strong>Four tertiary care centres across Israel and Spain between January 2019 and December 2023.</p><p><strong>Patients: </strong>A total of 47 patients diagnosed with PAS who underwent caesarean delivery with REBOA placement.</p><p><strong>Intervention: </strong>None.</p><p><strong>Main outcome measures: </strong>The primary outcome was to evaluate the anaesthetic management and outcomes of PAS patients undergoing caesarean delivery with REBOA. Secondary outcomes included assessment of REBOA utilisation patterns, blood loss management strategies and maternal and neonatal outcomes.</p><p><strong>Results: </strong>Initial anaesthesia was predominantly neuraxial (85.1%), with combined spinal-epidural being the most common (46.8%). Conversion to general anaesthesia occurred in 52.5% of neuraxial cases, primarily due to pain (52.4%) and surgeon requests (42.9%). REBOA was placed in all cases but inflated in only 76.6%, mainly under ultrasound guidance (57.4%), with significantly shorter anaesthesia-to-delivery intervals than fluoroscopy (60.0 vs. 111.0 min, P = 0.003). Median estimated blood loss was 1.5 l [0.9 to 2.5]. Hysterectomy was performed in 57.4% of cases. REBOA-related complications were minimal (4.3%), and maternal outcomes were generally favourable, with 31.9% requiring intensive care admission. Neonatal outcomes were good, with median Apgar scores of 9.0 at both one and five minutes.</p><p><strong>Conclusions: </strong>Although REBOA shows promise in PAS management, the high neuraxial-to-general anaesthesia conversion rate suggests the need for refined anaesthetic protocols. Combined spinal-epidural with readiness to convert to general anaesthesia may offer the optimal approach. Ultrasound-guided REBOA placement appears to significantly reduce procedural time. Success depends on thorough preparation, clear communication and adaptability to rapidly changing clinical situations.</p><p><strong>Trial registration: </strong>Not applicable.</p>","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144233601","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":"Oxygen reserve index as a peri-operative guide for alveolar recruitment manoeuvre during Whipple's surgical procedure: A randomised controlled trial.","authors":"Yasmin Kamel, Amira Elkholy, Ashraf Eskandr, Ahmed A Metwally, Khaled Ahmed Yassen","doi":"10.1097/EJA.0000000000002207","DOIUrl":"https://doi.org/10.1097/EJA.0000000000002207","url":null,"abstract":"","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144233603","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":"Hypnotic and antinociceptive contribution of magnesium sulphate during balanced total intravenous anaesthesia in total thyroidectomy: A randomised double-blind clinical trial.","authors":"Florian Beck, Vincent L Bonhomme, Pierre-Yves Hardy, Abdourahamane Kaba, Michele Carella","doi":"10.1097/EJA.0000000000002216","DOIUrl":"https://doi.org/10.1097/EJA.0000000000002216","url":null,"abstract":"","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144233602","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":"Regional anaesthesia-related complications in Switzerland: Lessons learned from the national closed claims analysis over the past 30 years.","authors":"Michael Thomas Ganter, Thierry Girard, Vincent A Stadelmann, Benno Rehberg-Klug, Sven Staender, Christoph Karl Hofer","doi":"10.1097/EJA.0000000000002220","DOIUrl":"10.1097/EJA.0000000000002220","url":null,"abstract":"<p><strong>Background: </strong>Regional anaesthesia is widely used in clinical practice, offering significant benefits but carrying risks such as nerve damage and other complications. Understanding medicolegal trends associated with regional anaesthesia is essential for improving patient safety and refining practices.</p><p><strong>Objectives: </strong>To analyse closed claims related to regional anaesthesia in Switzerland over the past 30 years, identify trends in complications and assess their medicolegal implications.</p><p><strong>Design: </strong>Retrospective analysis of the Swiss Anaesthesiology Closed Claims Analysis database, focusing on cases involving regional anaesthesia from 1992 to 2022.</p><p><strong>Setting: </strong>The study was conducted using data from Swiss medical malpractice insurers and the Swiss Society of Anaesthesiology and Perioperative Medicine together with their Foundation for Patient Safety in Anaesthesia.</p><p><strong>Patients: </strong>A total of 244 closed claims of patients were reviewed, of which 140 cases involved regional anaesthesia.</p><p><strong>Interventions: </strong>None.</p><p><strong>Main outcome measures: </strong>Key measures included patient demographics, type of anaesthesia, complications, adherence to best practices and legal outcomes such as liability acceptance and compensation amounts.</p><p><strong>Results: </strong>The number of claims involving regional anaesthesia decreased significantly over three decades, from 69 (49%) in the first decade to 30 (21%) in the last. Nerve damage was the most common complication (76%), with a notable reduction in permanent injuries from 57 to 28%. Advances in ultrasound-guided techniques and improved documentation may have contributed to these trends. Male patients tended to have higher rates of nerve injuries, while female patients reported more nonspecific pain syndromes and posttraumatic stress disorders because of the health impairment associated with the liability case. Liability was accepted in 43% of cases, with compensation often exceeding CHF 100 000. The highest compensations seemed to have been paid to male patients.</p><p><strong>Conclusions: </strong>The decline in claims may reflect advancements in anaesthetic techniques and safety practices. This study underscores the importance of communication and training best practices in regional anaesthesia, including sufficient patient information and documentation to enhance patient safety and reduce medicolegal risks. Pain during performance, multiple attempts and re-injections should be avoided whenever possible.</p><p><strong>Trial registration: </strong>No registration.</p>","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224791","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":"Evaluation of the 'Sip Til Send' regimen before elective caesarean delivery using bedside gastric ultrasound.","authors":"Benjamin Luke Olesnicky","doi":"10.1097/EJA.0000000000002173","DOIUrl":"https://doi.org/10.1097/EJA.0000000000002173","url":null,"abstract":"","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":"42 6","pages":"575"},"PeriodicalIF":4.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976110","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":"Neuroprotection and haemodynamic stability: considerations for tailored anaesthesia in carotid endarterectomy.","authors":"Carlo Chiumiento, Giovanna Nicolella, Giulio Accarino","doi":"10.1097/EJA.0000000000002163","DOIUrl":"https://doi.org/10.1097/EJA.0000000000002163","url":null,"abstract":"","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":"42 6","pages":"569-570"},"PeriodicalIF":4.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143988797","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":"In response to 'A big little problem - postoperative nausea and vomiting incidences are too low!'","authors":"Polyxeni Theodosopoulou, Chryssoula Staikou","doi":"10.1097/EJA.0000000000002168","DOIUrl":"https://doi.org/10.1097/EJA.0000000000002168","url":null,"abstract":"","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":"42 6","pages":"572-573"},"PeriodicalIF":4.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959644","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}