Journal of Anesthesia最新文献

Comments on: "Dexmedetomidine reduces acute kidney injury in high-risk but not low-risk patients after non-cardiac surgery: secondary analysis of a randomized controlled trial". 评论：“右美托咪定可减少非心脏手术后高危而非低危患者的急性肾损伤：一项随机对照试验的二次分析”。

IF 2.7 3区医学

Journal of Anesthesia Pub Date : 2026-05-09 DOI: 10.1007/s00540-026-03766-0

Jiang-Shen Hu, Xin Lv, Jun Liang, Shun Wan

引用次数: 0

Left ventricular perforation associated with vent catheter insertion without transesophageal echocardiography guidance. 无经食管超声心动图指导的左心室穿孔伴导管插入。

IF 2.7 3区医学

Journal of Anesthesia Pub Date : 2026-05-08 DOI: 10.1007/s00540-026-03772-2

Yumiko Uemura, Taisuke Kumamoto, Yuji Kunitoku, Naoyuki Hirata

引用次数: 0

Author response to: comments on "Postoperative pulmonary complications following major emergency abdominal surgery: incidence, risk factors, and outcomes-an observational study". 作者对“重大急诊腹部手术后肺部并发症：发生率、危险因素和结果——一项观察性研究”的评论作出回应。

IF 2.7 3区医学

Journal of Anesthesia Pub Date : 2026-05-08 DOI: 10.1007/s00540-026-03763-3

Andreas Werner Nærum, Jakob Burcharth, Dunja Kokotovic

引用次数: 0

Objective measurement of uterine tone using a handheld hardness meter during cesarean delivery: comparison with manual palpation. 目的用手持式硬度计测量剖宫产时子宫张力：与手触诊的比较。

IF 2.7 3区医学

Journal of Anesthesia Pub Date : 2026-05-08 DOI: 10.1007/s00540-026-03761-5

Satoshi Naruse, Chieko Akinaga, Yusuke Mazda, Yoshiki Nakajima

{"title":"Objective measurement of uterine tone using a handheld hardness meter during cesarean delivery: comparison with manual palpation.","authors":"Satoshi Naruse, Chieko Akinaga, Yusuke Mazda, Yoshiki Nakajima","doi":"10.1007/s00540-026-03761-5","DOIUrl":"https://doi.org/10.1007/s00540-026-03761-5","url":null,"abstract":"To ensure adequate uterine contractions, oxytocin is routinely administered after fetal delivery during cesarean delivery and additional dosing is typically guided by palpation-based assessment. However, manual palpation is subjective and has limited reproducibility and interobserver consistency. The PEK-MP® is a handheld device that quantifies tissue hardness and may provide an objective intraoperative assessment of uterine contraction. This study aimed to examine the relationship between PEK-MP measurements and palpation-defined uterine tone (sufficient vs. insufficient). In this secondary analysis of a randomized controlled trial, 63 paired data points from 21 patients who underwent elective cesarean delivery were analyzed. Uterine fundal hardness was measured at 3, 5, and 9 min after oxytocin administration by obstetrician-performed palpation. In the primary linear mixed-effects model adjusted for measurement timepoint, the estimated difference in PEK-MP values between the palpation-defined groups (sufficient minus insufficient) was 6.3 (95% CI - 1.0 to 13.6; p = 0.094). The measurement timepoint was significantly associated with PEK-MP values, with lower values observed at later assessments. These findings suggest that quantitative hardness measurements may be subject to temporal variation and that the timing of assessment should, therefore, be taken into account when interpreting these values.","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838262","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}

引用次数: 0

Simulation of suprazygomatic and infrazygomatic approaches for maxillary nerve block in children. 儿童上颌神经阻滞的颧上、颧下入路模拟。

IF 2.7 3区医学

Journal of Anesthesia Pub Date : 2026-05-07 DOI: 10.1007/s00540-026-03764-2

Luka Pušnik, Maks Matej Cuzak, Nejc Umek, Anže Jerman

{"title":"Simulation of suprazygomatic and infrazygomatic approaches for maxillary nerve block in children.","authors":"Luka Pušnik, Maks Matej Cuzak, Nejc Umek, Anže Jerman","doi":"10.1007/s00540-026-03764-2","DOIUrl":"https://doi.org/10.1007/s00540-026-03764-2","url":null,"abstract":"Purpose: To compare the feasibility and risk of arterial injury associated with suprazygomatic and infrazygomatic maxillary nerve block approaches in children using 3D virtual reality.Methods: Suprazygomatic, anterior and posterior infrazygomatic approaches were simulated bilaterally using computed-tomography angiography datasets of 89 children (0-18 years). Feasibility and vascular safety were assessed by positioning trajectories from the simulated needle end-point to the skin in respect to bones and maxillary artery, respectively. Solid angles and skin entry areas were quantified, correlated with age, and complemented by quadrant analysis of maxillary artery.Results: The suprazygomatic approach was feasible in all 178 attempts and safe in 99.4%. It had the smallest skin entry area with a median of 1.48 [0.98-2.20] cm2 and shortest skin-to-pterygomaxillary fissure distance of 45 [43-47] mm (both p < 0.0001). The anterior infrazygomatic approach was feasible in 98.9%, safe in only 42.6%; despite maximal solid angle reduction, 12/101 (11.9%) attempts remained unsafe. The posterior infrazygomatic approach was feasible in all 178 attempts and safe in 65.2%. In unsafe infrazygomatic approaches, the maxillary artery most commonly occupied inferior quadrants (56.4-98.4%). Age correlated with estimated skin area in all approaches (ρ = 0.18-0.29; p ≤ 0.016).Conclusion: The suprazygomatic approach showed the most favorable feasibility and vascular safety profile, supporting its preferential use for maxillary nerve block in children. In infrazygomatic approaches, the maxillary artery frequently lay along potential needle trajectories and may represent a safety concern. For anterior infrazygomatic approach, the safest placement was just anterior to mandibular coronoid process, and for posterior just below zygomatic arch.","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838276","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}

引用次数: 0

Dynamic digital radiography for evaluating diaphragmatic dysfunction after lung transplantation. 动态数字x线摄影评价肺移植术后膈功能障碍。

IF 2.7 3区医学

Journal of Anesthesia Pub Date : 2026-05-06 DOI: 10.1007/s00540-026-03762-4

Chihiro Mamada, Akihiro Kanaya, Shoma Tanaka, Hidenobu Takagi, Masanori Yamauchi

引用次数: 0

Prevalence of disability-free survival at 5 years after surgery: a prospective observational study. 术后5年无残疾生存率的患病率：一项前瞻性观察研究。

IF 2.7 3区医学

Journal of Anesthesia Pub Date : 2026-05-06 DOI: 10.1007/s00540-026-03758-0

Yusuke Naito, Mitsuru Ida, Soshiro Ogata, Yoko Yabuno, Satoki Inoue, Masahiko Kawaguchi

{"title":"Prevalence of disability-free survival at 5 years after surgery: a prospective observational study.","authors":"Yusuke Naito, Mitsuru Ida, Soshiro Ogata, Yoko Yabuno, Satoki Inoue, Masahiko Kawaguchi","doi":"10.1007/s00540-026-03758-0","DOIUrl":"https://doi.org/10.1007/s00540-026-03758-0","url":null,"abstract":"Purpose: To determine the prevalence of disability-free survival (DFS) five years after elective non-cardiac surgery in older adults, and to identify preoperative factors associated with DFS using conventional statistical analyses and machine learning methods.Methods: In this prospective cohort study conducted at a single tertiary hospital in Japan, 2878 patients aged ≥55 years who underwent elective non-cardiac surgery under general anesthesia between 2016 and 2018 were enrolled and followed for 5 years. DFS was defined as survival without significant functional disability, assessed using the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0). Multivariable logistic regression and machine learning models were used to identify preoperative predictive factors.Results: At 5 years after surgery, 80.6% (n = 2321) of the patients achieved DFS. Factors significantly associated with non-DFS included older age (odds ratio [OR]: 1.76), symptomatic cerebrovascular disease (OR: 1.94), low serum albumin (OR: 0.70), poor nutritional status (OR: 0.80), and malignancy (OR: 1.53). The machine learning ensemble model, incorporating support vector machine, neural network, and XGBoost algorithms, achieved a balanced accuracy of 0.69 and an area under the receiver operating characteristic curve (AUC) of 0.76.Conclusion: Multiple preoperative factors were independently associated with long-term DFS after surgery. Machine learning methods demonstrated moderate predictive accuracy, indicating potential clinical utility pending further model refinement.","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838279","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}

引用次数: 0

Intraoperative lactate as an early risk marker in laparoscopic liver resection and its association with modifiable hemodynamic parameters: a retrospective cohort study. 术中乳酸作为腹腔镜肝切除术的早期危险标志物及其与可改变的血流动力学参数的关系：一项回顾性队列研究。

IF 2.7 3区医学

Journal of Anesthesia Pub Date : 2026-05-06 DOI: 10.1007/s00540-026-03757-1

Toshiyuki Nakanishi, Misato Furuta, Daiki Yamazoe, Masashi Shibano, Yuto Makino, Tatsuya Tsuji, Koichi Fujiwara, Kazuya Sobue

{"title":"Intraoperative lactate as an early risk marker in laparoscopic liver resection and its association with modifiable hemodynamic parameters: a retrospective cohort study.","authors":"Toshiyuki Nakanishi, Misato Furuta, Daiki Yamazoe, Masashi Shibano, Yuto Makino, Tatsuya Tsuji, Koichi Fujiwara, Kazuya Sobue","doi":"10.1007/s00540-026-03757-1","DOIUrl":"https://doi.org/10.1007/s00540-026-03757-1","url":null,"abstract":"Purpose: Early postoperative lactate ≥ 3 mmol/L is associated with adverse outcomes following open hepatectomy; however, the prognostic utility of intraoperative lactate in laparoscopic liver resection (LLR) and its associations with hemodynamic parameters remain unclear.Methods: This retrospective cohort study included adults undergoing LLR at a university hospital between January 2017 and August 2024. The predictor was peak arterial lactate from skin incision to PACU discharge, dichotomized at 3 mmol/L. The primary outcome was a 30-day composite of all-cause mortality, post-hepatectomy liver failure (PHLF), or acute kidney injury (AKI). As a secondary objective, associations between intraoperative lactate ≥ 3 mmol/L and prespecified hemodynamic exposures (net fluid balance, vasopressor dose, and indices of low mean arterial pressure (MAP), low or high stroke volume variation (SVV), and low cardiac index) were explored using multivariable logistic regression models.Results: Among 257 patients, 143 (55.6%) had lactate ≥ 3 mmol/L. The composite outcome was more frequent in patients with lactate ≥ 3 mmol/L than in those with lactate < 3 mmol/L (15.4% vs. 4.4%; risk difference, 11.0%; 95% confidence interval, 3.6-18.3%), and discrimination was modest (AUC 0.695). AKI accounted for most events (12.6% vs. 0.9%; risk difference, 11.7%; 95% confidence interval, 5.8-18.2%); mortality and PHLF were similar. Lower net fluid balance and greater exposure to low MAP and low SVV were associated with lactate elevation, whereas vasopressor dose, high SVV, and low cardiac index were not.Conclusion: In LLR, intraoperative lactate ≥ 3 mmol/L showed modest discrimination for the 30-day composite outcome, driven primarily by AKI.","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838313","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}

引用次数: 0

One-lung ventilation in a small infant at a low-volume center: the role of structured decision-making and team preparation. 小容量中心小婴儿单肺通气：结构化决策和团队准备的作用。

IF 2.7 3区医学

Journal of Anesthesia Pub Date : 2026-05-05 DOI: 10.1007/s00540-026-03765-1

Ryohei Fukasawa, Takayuki Hasegawa, Satoki Inoue

{"title":"One-lung ventilation in a small infant at a low-volume center: the role of structured decision-making and team preparation.","authors":"Ryohei Fukasawa, Takayuki Hasegawa, Satoki Inoue","doi":"10.1007/s00540-026-03765-1","DOIUrl":"https://doi.org/10.1007/s00540-026-03765-1","url":null,"abstract":"One-lung ventilation (OLV) in infants is technically demanding and is typically reported from high-volume centers. We describe here perioperative management using OLV in a 6-month-old, 3.5-kg infant undergoing resection of a large emphysematous lung lesion at a low-volume center. Due to limited institutional experiences and anticipated airway challenges, the anesthetic strategy prioritized structured decision-making, predefined withdrawal criteria, and anesthesiologist-led multidisciplinary briefings and simulations. The key elements included planned apneic oxygenation using nasal high-flow oxygen and preparation of alternative confirmation methods. During surgery, bronchial blocker dislodgement required deviation from the initial plan; however, shared situational awareness and open communication enabled flexible adaptation and maintenance of stable ventilation. This case highlights that in rare, high-risk pediatric airway management, non-technical skills-including planning, communication, and team coordination-may play a critical role in ensuring patient safety, particularly in low-volume settings.","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838252","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}

引用次数: 0

Environmental and clinical rationale for the use of desflurane: a review of the literature. 地氟醚使用的环境和临床理由：文献综述。

IF 2.7 3区医学

Journal of Anesthesia Pub Date : 2026-05-04 DOI: 10.1007/s00540-026-03760-6

Takahiro Tamura, Takahiro Ando

{"title":"Environmental and clinical rationale for the use of desflurane: a review of the literature.","authors":"Takahiro Tamura, Takahiro Ando","doi":"10.1007/s00540-026-03760-6","DOIUrl":"https://doi.org/10.1007/s00540-026-03760-6","url":null,"abstract":"Desflurane is a fluorinated ether anesthetic with several clinical benefits, including resistance to defluorination (reducing nephrotoxicity), rapid emergence, cardioprotective properties, and faster recovery of airway reflexes than other volatile agents. However, its use is increasingly restricted because of environmental concerns, and the European Union has finalized regulations to phase out its use from January 2026, citing its global warming potential. Although its 100-year global warming potential exceeds that of comparable agents, the most appropriate emission metric remains debated. Radiative forcing estimates indicate that current atmospheric concentrations of desflurane contribute approximately 0.00014 W/m2, compared with 2.33 W/m2 for CO2, suggesting a minimal overall impact. Since sevoflurane yields lower values for all indicators, it should be prioritized when volatile anesthetics are used, whereas desflurane should be reserved for specific situations. Moreover, alternative anesthetics, including intravenous agents, have their own environmental burdens related to plastic waste, drug disposal, and energy consumption, indicating that restricting desflurane alone will not eliminate anesthetic-related environmental impacts. This review assesses the balance between desflurane's clinical utility and environmental effects, identifies contexts in which it offers clinical advantages, summarizes its greenhouse gas contributions, and discusses mitigation strategies, including low-flow anesthesia, anesthetic gas capture and recycling. Judicious, environmentally conscious use of desflurane may allow it to remain an additional anesthetic option in selected clinical contexts, alongside other inhaled and intravenous anesthetics, while efforts to minimize its environmental footprint continue.","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147815502","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}

引用次数: 0