Journal of Anesthesia最新文献

{"title":"Development and external validation of a LASSO-based nomogram to predict epidural-associated postpartum urinary retention.","authors":"Rong Chen, Ying Shao, Junming Huang, Laifeng Luo, Jincai Zhong, Jianqing Lin, Baohui Hong","doi":"10.1007/s00540-026-03916-4","DOIUrl":"https://doi.org/10.1007/s00540-026-03916-4","url":null,"abstract":"<p><strong>Purpose: </strong>To develop and validate a risk prediction model for postpartum urinary retention (PUR) among parturients receiving epidural analgesia (EA) during vaginal delivery, to support individualized bladder management.</p><p><strong>Methods: </strong>This dual-center retrospective cohort study analyzed electronic medical records from two hospitals (2022-2024). Least absolute shrinkage and selection operator (LASSO) regression was used to select independent predictors from demographic, labor, and analgesia-related variables. A clinical nomogram was developed. The model underwent internal and external validation; performance was assessed using calibration, discrimination (area under the receiver operating characteristic curve [AUC]), and decision curve analysis (DCA).</p><p><strong>Results: </strong>Among 1019 parturients receiving EA (PUR incidence 16.09%), prolonged analgesia duration and prolonged second-stage labor were independently associated with PUR, whereas higher intermittent catheterization frequency (ICF) was associated with a lower rate of recorded PUR. The model demonstrated excellent discrimination, satisfactory calibration, and clinical net benefit across validation cohorts.</p><p><strong>Conclusion: </strong>The validated nomogram provides real-time, individualized estimates of PUR risk during late labor. By identifying parturients at elevated risk, it offers an evidence-based basis for risk-adaptive bladder monitoring and individualized care; however, whether such model-guided management ultimately reduces PUR incidence remains to be established in prospective interventional studies.</p>","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stress hyperglycemia ratio as a marker of major postoperative complications after cardiac surgery with cardiopulmonary bypass.","authors":"Hiroki Anezaki, Soichiro Mimuro, Naoki Washiyama, Yuki Takeuchi, Kazuma Okamoto, Yoshiki Nakajima","doi":"10.1007/s00540-026-03921-7","DOIUrl":"https://doi.org/10.1007/s00540-026-03921-7","url":null,"abstract":"<p><strong>Purpose: </strong>This study examined whether the stress hyperglycemia ratio (SHR) at intensive care unit (ICU) admission is associated with major postoperative complications after cardiac surgery with cardiopulmonary bypass and whether this association differs from that of absolute ICU admission glucose.</p><p><strong>Methods: </strong>This single-center retrospective study included 731 surgical episodes from 709 adults who underwent cardiac surgery with cardiopulmonary bypass. SHR was calculated as the first ICU glucose divided by HbA1c-derived estimated average glucose. The primary outcome was an unweighted composite of 30-day mortality, stroke, Kidney Disease: Improving Global Outcomes stage 3 acute kidney injury, reoperation for bleeding, prolonged mechanical ventilation, and deep sternal wound infection. Multivariable logistic regression adjusted for clinically relevant covariates.</p><p><strong>Results: </strong>The composite outcome occurred in 90 surgical episodes (12.3%). SHR was associated with the composite outcome after adjustment (odds ratio [OR], 1.103 per 0.1 increase; 95% confidence interval [CI] 1.008-1.208; P = 0.033), whereas ICU admission glucose was not significantly associated (OR, 1.019 per 10 mg/dL increase; 95% CI 0.946-1.096; P = 0.626).</p><p><strong>Conclusion: </strong>SHR at ICU admission was associated with major postoperative complications in the primary analysis, whereas absolute ICU admission glucose was not significantly associated after multivariable adjustment. Confidence intervals for SHR included 1.0 in several sensitivity analyses. SHR warrants prospective evaluation as an early postoperative risk marker after cardiac surgery with cardiopulmonary bypass.</p>","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In reply to: Comment on \"Esketamine versus dexmedetomidine for oxygenation and postoperative quality of recovery in thoracoscopic surgery: a randomized, double-blind, non-inferiority controlled trial\".","authors":"Rui Feng, Zhuoran Wang, Yuqiao Yang, Quan Wang, Yu Zhao, Xi Qian, Jinqiao Qian","doi":"10.1007/s00540-026-03922-6","DOIUrl":"https://doi.org/10.1007/s00540-026-03922-6","url":null,"abstract":"","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149206871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on \"Efficacy of inserting a flexible bronchoscope to a predetermined depth for orotracheal intubation by inexperienced personnel: a randomized-controlled study\".","authors":"Shutong Xu","doi":"10.1007/s00540-026-03925-3","DOIUrl":"https://doi.org/10.1007/s00540-026-03925-3","url":null,"abstract":"","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149206915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Needle tip position influences bupivacaine concentration within the pterygopalatine fossa during suprazygomatic maxillary nerve block: a cadaveric study.","authors":"Anže Jerman, Nejc Umek, Maks Matej Cuzak, Simon Istenič, Luka Pušnik","doi":"10.1007/s00540-026-03923-5","DOIUrl":"https://doi.org/10.1007/s00540-026-03923-5","url":null,"abstract":"<p><strong>Purpose: </strong>The primary objective was to evaluate the influence of needle tip positioning during suprazygomatic maxillary nerve block on bupivacaine concentration within the pterygopalatine fossa (PPF). The secondary objective was to correlate early injectate spread on computed tomography (CT) with PPF bupivacaine concentrations.</p><p><strong>Methods: </strong>Suprazygomatic maxillary nerve block attempts (n=34) were performed on 17 human cadaveric heads with different needle tip positions. Each attempt involved injection of 5 mL containing 0.4% bupivacaine, iohexol, and methylene blue. Computed tomography was used to determine needle tip location and early injectate spread. PPF samples were harvested via a transmaxillary approach for bupivacaine quantification by liquid chromatography-tandem mass spectrometry.</p><p><strong>Results: </strong>The highest median [Q1-Q3] bupivacaine concentrations were observed when needle tip was positioned within pterygomaxillary fissure or PPF, with 829.3 [728.1-1015.7] µg/g, and when positioned directly against maxillary tuberosity, with 535.3 [355.7-820.7] µg/g. Concentrations were highly variable with off-bone infratemporal placements (range, 0.1-335.8 µg/g). Lateral needle displacement was associated with lower bupivacaine concentrations (β=-0.193, 95% CI -0.301 to -0.086; P<0.001), whereas anterior (β=0.107, 95% CI 0.018-0.196; P=0.020) and cranial displacement (β=0.079, 95% CI 0.017-0.141; P=0.014) were associated with higher concentrations. CT contrast spread between temporalis and lateral pterygoid muscles was not associated with higher PPF bupivacaine concentrations (P=0.117).</p><p><strong>Conclusion: </strong>Needle tip position influenced bupivacaine concentration within PPF, with concentrations generally increasing as the needle approached PPF and with more anterior positioning, including placement at the maxillary tuberosity. More superficial or posterior infratemporal placements yielded lower and more variable concentrations. Moreover, infratemporal contrast spread on early CT imaging was not associated with higher PPF bupivacaine concentrations.</p>","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149194052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to the letter to the editor: comment on \"Usefulness of the phase angle for inflammation criteria of the global leadership initiative on malnutrition in critically ill patients\".","authors":"Shinya Suganuma, Akane Kariya, Naoki Kanda, Minoru Yoshida, Tomoka Miyagi, Shunsuke Takaki, Kensuke Nakamura","doi":"10.1007/s00540-026-03924-4","DOIUrl":"https://doi.org/10.1007/s00540-026-03924-4","url":null,"abstract":"","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149194057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reappearance of a SatShare-derived SpO₂-channel waveform during asystolic cardiac arrest under spinal anesthesia.","authors":"Yuji Suzuki, Shin Suzuki, Midori Suzuki, Tatsuya Ishino, Rie Kitahara, Yu Ikeda, Tomohiro Uchiyama","doi":"10.1007/s00540-026-03929-z","DOIUrl":"https://doi.org/10.1007/s00540-026-03929-z","url":null,"abstract":"","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149194044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Detection of gas leakage from an anesthesia machine using a halogen detector.","authors":"Katsuhide Masui, Naoyuki Tsunoda, Kei Takahashi, Takashi Asai","doi":"10.1007/s00540-026-03930-6","DOIUrl":"https://doi.org/10.1007/s00540-026-03930-6","url":null,"abstract":"","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Propofol injection discomfort recall after monitored anesthesia care or general anesthesia: a prospective observational cohort study.","authors":"Dylan Mai, Kiana Rowshan, Dolly Modha, Katie Chiou, Andres Duran, Farimah Fanaei, Mariam Mabrouk, Kimberley Gimenez, Balbino Lopez, Yunjae Lee, Joseph Rinehart, Teodora Oltean, Alexandre Joosten, Sean Coeckelenbergh","doi":"10.1007/s00540-026-03926-2","DOIUrl":"https://doi.org/10.1007/s00540-026-03926-2","url":null,"abstract":"<p><strong>Purpose: </strong>Pain during propofol injection is common, yet little is known about how often patients remember this experience after anesthesia or which perioperative factors influence memory formation during induction.</p><p><strong>Methods: </strong>In this prospective single-center observational cohort study, English-speaking adults (≥ 18 years) receiving propofol under general anesthesia (GA) or monitored anesthesia care (MAC) were enrolled. Perioperative characteristics, intravenous access details, anesthetic medications and clinician-observed injection pain were recorded. On postoperative day 1, patients were interviewed using a standardized questionnaire assessing recall of discomfort during induction. Univariate and multivariate logistic regression analyses calculated adjusted odds ratios (aOR) and identified factors associated with recall.</p><p><strong>Results: </strong>Of the 1,699 enrolled patients, 1,319 completed the postoperative day 1 assessment; 8.1% reported recall of injection discomfort. Multivariate analysis indicated that younger age (aOR = 1.03; 95% CI = 1.01-1.04; p < 0.001), female gender (aOR = 1.69; 95% CI = 1.02-2.82; p = 0.044), hand IV placement (aOR = 2.164; CI 95% = 1.287-3.636; p = 0.004), and absence of midazolam premedication (aOR = 2.62; 95% CI = 1.44-4.78; p = 0.002) were associated with increased recall.</p><p><strong>Conclusion: </strong>Approximately one in twelve patients recalled discomfort during propofol injection. Patient characteristics and modifiable anesthetic practices, particularly premedication and intravenous access site, were associated with memory of propofol injection discomfort. These findings highlight that memory formation during induction represents a distinct and clinically relevant patient-centered outcome.</p>","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comments on \"Nationwide trends in cardiac anesthesia requiring cardiopulmonary bypass and intraoperative transesophageal echocardiography use in Japan: a claims-based analysis, 2019-2023\".","authors":"Wania Waseem","doi":"10.1007/s00540-026-03928-0","DOIUrl":"https://doi.org/10.1007/s00540-026-03928-0","url":null,"abstract":"","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}