European Journal of Anaesthesiology最新文献

{"title":"Chronic pain after surgery = chronic postsurgical pain?","authors":"Ulrike M Stamer","doi":"10.1097/EJA.0000000000002101","DOIUrl":"https://doi.org/10.1097/EJA.0000000000002101","url":null,"abstract":"","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":"42 2","pages":"178-180"},"PeriodicalIF":4.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142913995","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":"Deep anaesthesia may increase postoperative delirium and consequently subsequent mortality: A secondary analysis of data from the Balanced randomised trial.","authors":"Jim Young, Timothy G Short, Luzius A Steiner, Salome Dell-Kuster","doi":"10.1097/EJA.0000000000002100","DOIUrl":"https://doi.org/10.1097/EJA.0000000000002100","url":null,"abstract":"","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":"42 2","pages":"184-186"},"PeriodicalIF":4.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142914041","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":"Mild therapeutic hypothermia after cardiac arrest: effect on survival with good neurological outcome outside of randomised controlled trials: A registry-based analysis.","authors":"Francisco Zarra, Marcos Rolando, Walter Videtta","doi":"10.1097/EJA.0000000000002102","DOIUrl":"https://doi.org/10.1097/EJA.0000000000002102","url":null,"abstract":"","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":"42 2","pages":"181-182"},"PeriodicalIF":4.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142914057","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":"Interrelation between anaesthesiology and intensive care medicine training in Europe: An ESAIC National Anaesthesiologists Societies Committee survey.","authors":"Argyro Zoumprouli, Alessandro Scudellari, Federico Bilotta","doi":"10.1097/EJA.0000000000002094","DOIUrl":"10.1097/EJA.0000000000002094","url":null,"abstract":"","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":"173-176"},"PeriodicalIF":4.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142497441","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":"Tackling the reality gap in clinical research: thinking ahead is half the game.","authors":"Linda Grüßer, Sam Osmani, Rolf Rossaint, Jan Larmann, Nicolaas H Sperna Weiland, Benedikt Schmid, Ana Kowark, Mark Coburn","doi":"10.1097/EJA.0000000000002105","DOIUrl":"https://doi.org/10.1097/EJA.0000000000002105","url":null,"abstract":"","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":"42 2","pages":"93-95"},"PeriodicalIF":4.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142914058","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":"Positive end-expiratory pressure and emergence preoxygenation after bariatric surgery: effect on postoperative oxygenation: A randomised controlled trial.","authors":"Erland Östberg, Alexander Larsson, Philippe Wagner, Staffan Eriksson, Lennart Edmark","doi":"10.1097/EJA.0000000000002071","DOIUrl":"10.1097/EJA.0000000000002071","url":null,"abstract":"<p><strong>Background: </strong>Positive end-expiratory pressure (PEEP) is important to increase lung volume and counteract airway closure during anaesthesia, especially in obese patients. However, maintaining PEEP during emergence preoxygenation might increase postoperative atelectasis by allowing susceptible lung areas to be filled with highly absorbable oxygen that gets entrapped when small airways collapse due to the sudden loss of PEEP at extubation.</p><p><strong>Objective: </strong>This study aimed to test the hypothesis that withdrawing PEEP just before emergence preoxygenation would better maintain postoperative oxygenation.</p><p><strong>Design: </strong>Prospective, randomised controlled trial.</p><p><strong>Setting: </strong>Single centre secondary hospital in Sweden between December 2019 and January 2023.</p><p><strong>Patients: </strong>A total of 60 patients, with body mass index between 35 and 50 kg m -2 , undergoing laparoscopic bariatric surgery.</p><p><strong>Intervention: </strong>Intraoperative ventilation was the same for all patients with a fixed PEEP of 12 or 14 cmH 2 O depending on body mass index. No recruitment manoeuvres were used. After surgery, patients were allocated to maintained PEEP or zero PEEP during emergence preoxygenation.</p><p><strong>Main outcome measures: </strong>The primary outcome was change in oxygenation from before awakening to 45 min postoperatively as measured by estimated venous admixture calculated from arterial blood gases.</p><p><strong>Results: </strong>Both groups had impaired oxygenation postoperatively; in the group with PEEP maintained during awakening, estimated venous admixture increased by mean 9.1%, and for the group with zero PEEP during awakening, estimated venous admixture increased by mean 10.6%, difference -1.5% (95% confidence interval -4.6 to 1.7%), P  = 0.354. Throughout anaesthesia, both groups exhibited low driving pressures and superior oxygenation compared with the awake state.</p><p><strong>Conclusions: </strong>Withdrawing PEEP before emergence preoxygenation, did not alter early postoperative oxygenation in obese patients undergoing laparoscopic bariatric surgery. Intraoperative oxygenation was excellent despite using fixed PEEP and no recruitment manoeuvres, but deteriorated after extubation, indicating a need for future studies aimed at improving the emergence procedure.</p><p><strong>Clinical trial number and registry: </strong>www.clinicaltrials.gov , NCT04150276.</p>","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":"54-63"},"PeriodicalIF":4.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11620321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142344069","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":"Association of mechanical power and postoperative pulmonary complications among young children undergoing video-assisted thoracic surgery: A retrospective study.","authors":"Change Zhu, Rufang Zhang, Jia Li, Lulu Ren, Zhiqing Gu, Rong Wei, Mazhong Zhang","doi":"10.1097/EJA.0000000000002075","DOIUrl":"10.1097/EJA.0000000000002075","url":null,"abstract":"<p><strong>Background: </strong>Previous studies have discussed the correlation between mechanical power (MP) and lung injury. However, evidence regarding the relationship between MP and postoperative pulmonary complications (PPCs) in children remains limited, specifically during one-lung ventilation (OLV).</p><p><strong>Objectives: </strong>Propensity score matching was employed to generate low MP and high MP groups to verify the relationship between MP and PPCs. Multivariable logistic regression was performed to identify risk factors of PPCs in young children undergoing video-assisted thoracic surgery (VATS).</p><p><strong>Design: </strong>A retrospective study.</p><p><strong>Setting: </strong>Single-site tertiary children's hospital.</p><p><strong>Patients: </strong>Children aged ≤2 years who underwent VATS between January 2018 and February 2023.</p><p><strong>Interventions: </strong>None.</p><p><strong>Main outcome measures: </strong>The incidence of PPCs.</p><p><strong>Results: </strong>Overall, 581 (median age, 6 months [interquartile range: 5-9.24 months]) children were enrolled. The median [interquartile range] MP during OLV were 2.17 [1.84 to 2.64) J min-1. One hundred and nine (18.76%) children developed PPCs. MP decreased modestly during the study period (2.63 to 1.99 J min-1; P < 0.0001). In the propensity score matched cohort for MP (221 matched pairs), MP (median MP 2.63 vs. 1.84 J min-1) was not associated with a reduction in PPCs (adjusted odds ratio, 1.43; 95% CI, 0.87 to 2.37; P = 0.16). In the propensity score matched cohort for dynamic components of MP (139 matched pairs), dynamic components (mean 2.848 vs. 4.162 J min-1) was not associated with a reduction in PPCs (adjusted odds ratio, 1.62; 95% CI, 0.85 to 3.10; P  = 0.15).The multiple logistic analysis revealed PPCs within 7 days of surgery were associated with male gender, OLV duration >90 min, less surgeon's experience and lower positive end-expiratory pressure (PEEP) value.</p><p><strong>Conclusions: </strong>MP and dynamic components were not associated with PPCs in young children undergoing VATS, whereas PPCs were associated with male gender, OLV duration >90 min, less surgeon's experience and lower PEEP value.</p><p><strong>Trial registration: </strong>ChiCTR2300074649.</p>","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":"42 1","pages":"64-72"},"PeriodicalIF":4.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11620292/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142767368","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":"Platelet-sparing properties of aprotinin: A scoping review on mechanisms and clinical effects.","authors":"Lennart L W Vanglabeke, Steffen Rex, Raf Van den Eynde","doi":"10.1097/EJA.0000000000002081","DOIUrl":"10.1097/EJA.0000000000002081","url":null,"abstract":"<p><strong>Background: </strong>Cardiac surgery involving cardiopulmonary bypass (CPB) is associated with the risk of acquired coagulopathy, including dysregulated fibrinolysis, which can result in life-threatening bleeding complications. Aprotinin, an antifibrinolytic agent, has been recommended for the prevention of these complications. Its effectiveness has been attributed to its ability to nonspecifically inhibit various serine proteases involved in the coagulation and fibrinolysis cascade. Additionally, aprotinin may protect platelets from CPB-induced dysfunction through a platelet-sparing effect, further enhancing its efficacy.</p><p><strong>Objectives: </strong>The biochemical pathways underlying aprotinin's platelet-sparing effect remain unclear. Furthermore, it is uncertain to what extent this effect contributes to reducing blood loss and need for transfusion.</p><p><strong>Design: </strong>A scoping review.</p><p><strong>Data sources: </strong>MEDLINE, Embase and Cochrane were searched from inception until 21 December 2023.</p><p><strong>Eligibility criteria: </strong>Studies in which a platelet-sparing effect of aprotinin was investigated. These included systematic reviews; experimental, and observational studies describing healthy humans, patients, or animals undergoing any type of surgery; studies in which donated blood was used for in-vitro studies.</p><p><strong>Results: </strong>Sixty-four studies were deemed eligible, the majority of which observed a platelet-sparing effect, attributing it to the inhibition of platelet aggregation (via protection of glycoprotein (GP) IIb/IIIa receptors), platelet adhesion (by protection of GP Ib receptors), both aggregation and adhesion receptors, proteolysis of protease-activated receptor 1 receptors, platelet activation (by inhibition of plasmin) and platelet activation (by inhibition of thrombin). A dose-dependency of the platelet-sparing effect was investigated in both in-vitro studies and randomised controlled trials, yielding mixed results. No studies have explored the relative contribution of aprotinin's platelet-sparing effect and its antifibrinolytic effect in reducing blood loss and need for transfusion.</p><p><strong>Conclusions: </strong>This review elucidated current knowledge on how aprotinin influences platelets and exerts its platelet-sparing effect, while highlighting gaps in the existing literature.</p>","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":"42 1","pages":"36-43"},"PeriodicalIF":4.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142767339","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":"Failure of neuromuscular blockade despite high doses of rocuronium and atracurium in a patient with colorectal carcinoma: A case report.","authors":"Andre Dos Santos Rocha, Marco Betello, Argyro Nikolaou, Roberta Südy, Gergely Albu, Eduardo Schiffer","doi":"10.1097/EJA.0000000000002076","DOIUrl":"10.1097/EJA.0000000000002076","url":null,"abstract":"<p><p>Resistance to the effects of rocuronium and other neuromuscular blocking agents (NMBA) has been previously reported, including delayed onset of relaxation, rapid recovery and incomplete paralysis under recommended doses. These conditions have been associated with denervation injury, burns, immobilisation, infections, metabolic disorders, and drug interactions. In this report, we describe the case of a young male without any known pre-disposing factor for NMBA resistance, who failed to attain muscle relaxation with non-depolarising NMBA despite high doses of rocuronium and atracurium during two surgeries for colorectal cancer, several months apart. Investigations for drug failure and genetic testing did not indicate a plausible cause. After chemotherapy and tumour resection, the patient underwent a third surgical procedure under general anaesthesia with normalised NMBA response. Patient's written consent was obtained for publication.</p>","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":"42 1","pages":"73-76"},"PeriodicalIF":4.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11620290/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142767379","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":"Pre-operative anaemia in nonagenarians and centenarians undergoing hip fracture surgery: A retrospective cohort study.","authors":"Jake V Hinton, Luke Fletcher, Cilla J Haywood, Laurence Weinberg","doi":"10.1097/EJA.0000000000002074","DOIUrl":"10.1097/EJA.0000000000002074","url":null,"abstract":"","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":"77-80"},"PeriodicalIF":4.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142344070","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}