European Journal of Anaesthesiology最新文献

{"title":"Paravertebral block is not superior to the interpectoral and pectoserratus plane block for patients undergoing breast surgery: An updated meta-analysis of randomised controlled trials with meta-regression and trial sequential analysis.","authors":"Burhan Dost, Dario Bugada, Yunus Emre Karapinar, Eleonora Balzani, Muzeyyen Beldagli, Giulia Aviani Fulvio, Mirac Selcen Ozkal Yalin, Esra Turunc, Nicolò Sella, Alessandro De Cassai","doi":"10.1097/EJA.0000000000002148","DOIUrl":"10.1097/EJA.0000000000002148","url":null,"abstract":"<p><strong>Background: </strong>Breast surgery is frequently associated with significant acute postoperative pain, necessitating effective pain management strategies. Both thoracic paravertebral block (PVB) and interpectoral plane and pectoserratus plane (IP+PS) blocks have been used to relieve pain after breast surgery.</p><p><strong>Objective: </strong>In this systematic review and meta-analysis with trial sequential analysis, we aimed to identify the optimal analgesic technique for achieving effective pain relief in breast surgery. The primary outcome of this study was postoperative opioid consumption expressed as morphine milligram equivalent (MME) at 24 h. Secondary outcomes included resting and movement pain scores at 0, 6, 12 and 24 h, postoperative nausea and vomiting (PONV), and rescue analgesic requirements within the first 24 h.</p><p><strong>Design: </strong>A meta-analysis of randomised controlled trials (RCTs) with meta-regression and trial sequential analysis (TSA).</p><p><strong>Data search: </strong>We systematically searched Pubmed, Scopus, the Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, Google Scholar, Medline (from inception to until 1 October 2024).</p><p><strong>Eligibility criteria: </strong>RCTs that include patients undergoing breast surgery with PVB or IP+PS block, with no language restriction.</p><p><strong>Results: </strong>Eighteen RCTs with 924 patients were included. No significant difference in MME consumption at 24 h was observed between the two techniques; mean difference (MD) -1.94 (95% confidence interval (CI) -4.27 to 0.38, P = 0.101). Subgroup analyses revealed a minor advantage for IP+PS in patients without axillary involvement; MD -2.42 (95% CI -3.56 to -1.29, P  < 0.001), though below the threshold of clinical significance. Secondary outcomes, including pain scores, PONV incidence and rescue analgesic requirements were comparable. Trial sequential analysis (TSA) confirmed sufficient sample size, suggesting further studies may not alter conclusions.</p><p><strong>Conclusion: </strong>PVB and IP+PS blocks offer comparable analgesic efficacy and opioid-sparing effects after breast surgery, with no meaningful differences in 24-h MME consumption, pain scores, or PONV incidence.</p>","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":"637-648"},"PeriodicalIF":4.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143398678","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":"Factors influencing the choice of lumbar epidural analgesia and its association with postpartum depression risk.","authors":"Sana Asif, Natasa Kollia, Andrea Kollmann, Birgitta Birgisdottir, Richard Aubrey White, Miklós Lipcsey, Alkistis Skalkidou","doi":"10.1097/EJA.0000000000002180","DOIUrl":"10.1097/EJA.0000000000002180","url":null,"abstract":"<p><strong>Background: </strong>The use of lumbar epidural analgesia (LEA) during childbirth varies significantly among women. Factors influencing a woman's choice of LEA and its possible effects on postpartum depression (PPD) remain underexplored.</p><p><strong>Objectives: </strong>To investigate factors influencing the choice of LEA among women with intended vaginal deliveries. A secondary objective was to explore the association between LEA use and PPD.</p><p><strong>Study design: </strong>A longitudinal cohort study.</p><p><strong>Setting: </strong>Uppsala University Hospital, Sweden, 2010 to 2019.</p><p><strong>Population: </strong>Women with an intended vaginal delivery.</p><p><strong>Exclusions: </strong>Twins, elective caesarean section, induction of labour.</p><p><strong>Methods: </strong>Data were collected by web-based self-completed questionnaires at gestational weeks 17, 32 and at 6 weeks and 6 months postpartum. The exposures were sociodemographic, resilience-related, medical and obstetric characteristics of all participants from the BASIC (Biology, Affect, Stress, Imaging and Cognition) study. Information on the use of LEA was retrieved from medical records. PPD was assessed using either the Edinburgh Postnatal Depression Scale, or the Depression Self-Rating Scale, and/or the Mini-International Neuropsychiatric Interview at 6 to 8 weeks and 6 months postpartum. Bayesian models were applied to investigate the associations of multivariate factors with the choice for LEA, and the association between the use of LEA and PPD.</p><p><strong>Results: </strong>Among 4436 participants, 38% opted for LEA, while 62% did not. LEA users were younger, primiparous, reported higher rates of intimate partner violence (IPV) and had lower resilience. The adjusted model revealed primiparity, previous caesarean section, IPV, pregnancy length at least 280 days and fear of childbirth as independent predictors of LEA use. While LEA use was associated with higher odds of PPD in the crude regression model, it was no longer statistically significant after adjusting for possible confounders and mediators.</p><p><strong>Conclusion: </strong>Social and psychological vulnerabilities influence a woman's decision to opt for LEA during childbirth. LEA was not associated with PPD in adjusted models.</p><p><strong>Trial registration: </strong>This is a longitudinal study which was not registered in 2010.</p>","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":"626-636"},"PeriodicalIF":4.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993056","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":"Impact of recruitment manoeuvres on Nociception Index Level during general anaesthesia: An open monocentric pilot study.","authors":"Charles Hickel, Julien Richard, Morgan Le Guen","doi":"10.1097/EJA.0000000000002151","DOIUrl":"https://doi.org/10.1097/EJA.0000000000002151","url":null,"abstract":"","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":"42 7","pages":"649-651"},"PeriodicalIF":4.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215337","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":"ESAIC Mellin-Olsen declaration on diversity, equity and inclusion.","authors":"Mia Gisselbaek, Sarah Saxena, Joana Berger-Estilita, Bazil Ateleanu, Luca Brazzi, Wolfgang Buhre, Iulia Crisan, Anne-Marie Camilleri-Podesta, Mark Coburn, Vesna Durnev, Daniela Filipescu, David Ghezel-Ahmadi, Iveta Golubovska, Emilia Guasch Arévalo, Cristina Honorato-Cia, Markus Klimek, Basak Ceyda Meco, Sheila N Myatra, Orit Nahtomi-Shick, Vojislava Neskovic, Ellen O'Sullivan, Francesca Rubulotta, Carolina Romero, Olegs Sabelnikovs, Michel Mrf Struys, Roberta Südy, Cathy Weynants, Else-Marie Ringvold, Idit Matot","doi":"10.1097/EJA.0000000000002186","DOIUrl":"10.1097/EJA.0000000000002186","url":null,"abstract":"","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":"579-583"},"PeriodicalIF":4.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959641","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 tosylate or propofol and delirium in frail elderly patients after hip surgery: A randomised controlled clinical trial.","authors":"Wenlan Cai, Fangming Shen, Lanyue Zhu, Yuqing Xue, Menghan Sun, Xiaoxiang Tan, Kaikai Shi, Yuzhou Chen, Jie Sun","doi":"10.1097/EJA.0000000000002226","DOIUrl":"https://doi.org/10.1097/EJA.0000000000002226","url":null,"abstract":"<p><strong>Background: </strong>Remimazolam tosylate, a novel short-acting benzodiazepine, is increasingly being used in general anaesthesia, but its role in the incidence of postoperative delirium is uncertain, particularly in frail elderly patients.</p><p><strong>Objective: </strong>To compare the effects of remimazolam tosylate with propofol on the incidence of postoperative delirium in frail elderly patients undergoing hip surgery.</p><p><strong>Design: </strong>Randomised, single-centre, single-blind controlled trial.</p><p><strong>Setting: </strong>A tertiary teaching hospital in China, conducted from March to December 2023.</p><p><strong>Patients: </strong>Frail elderly patients (Reported Edmonton Frail Scale Score ≥ 6) undergoing hip surgery under general anaesthesia.</p><p><strong>Interventions: </strong>Patients were randomly assigned to either the propofol or remimazolam group. Both groups received total intravenous anaesthesia following a standardised protocol with either propofol or remimazolam tosylate for induction and maintenance.</p><p><strong>Main outcome measures: </strong>The primary outcome was the incidence of postoperative delirium within three postoperative days, assessed twice daily using the 3D Confusion Assessment Method (3D-CAM). The secondary outcomes included the quality of postoperative recovery and adverse events.</p><p><strong>Result: </strong>A total of 136 patients were enrolled. The incidence of postoperative delirium was significantly lower in the remimazolam group than in the propofol group [3 of 68 (4.4%) vs. 12 of 68 (17.6%), risk differece (RD) -13.2%, 95% CI -23.5% to -2.9%, relative risk (RR) 0.25, 95% CI 0.074 to 0.847, NNT 7.6, P = 0.0143]. The incidence of hypotension after induction was also lower in the remimazolam group [16 of 68 (23.5%) vs. 32 of 68 (47.1%), RD -23.5%, 95%CI -39.1% to -8.0%, RR 0.5, 95% CI 0.304 to 0.822, NNT 4.3, P = 0.004], with fewer patients requiring vasopressors [55 of 68 (80.9%) vs. 66 of 68 (97.1%), RD -16.2%, 95% CI -26.3 to -6.0, RR 0.8, 95% CI 0.737 to 0.942, NNT 6.2, P = 0.003]. Notably, the remimazolam group exhibited significantly less burst suppression compared with the propofol group, both in terms of burst suppression time (2.2 s [0 to 17.6] vs. 21.9 s [2.3 to 115.3] median difference = 11.98 s, 95% CI 2.44 to 27.90, P < 0.001) and its proportion relative to the total surgery time (0.3‰ [0 to 2.1] vs. 2.8‰ [0.2 to 14.7], median difference 1.30‰, 95% CI 0.27 to 3.34, P < 0.001).</p><p><strong>Conclusion: </strong>In frail elderly patients, remimazolam tosylate was associated with a lower incidence of postoperative delirium compared with propofol.</p><p><strong>Trial registration: </strong>Chinese Clinical Trial Registry, Chictr.org.cn, identifier: ChiCTR2300068632.</p>","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144505234","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":"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}

{"title":"Challenging cases in palliative care.","authors":"","doi":"10.1097/EJA.0000000000002170","DOIUrl":"https://doi.org/10.1097/EJA.0000000000002170","url":null,"abstract":"","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":"42 6","pages":"577"},"PeriodicalIF":4.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993057","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}