Journal of Anesthesia最新文献

Rhomboid intercostal and PECS blocks for breast surgery. 用于乳房手术的斜方肌肋间阻滞和 PECS 阻滞。

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2024-11-19 DOI: 10.1007/s00540-024-03433-2

Gokcen Kulturoglu, Savas Altinsoy, Julide Ergil, Derya Ozkan, Yusuf Ozguner

引用次数: 0

Acknowledgment to reviewers. 感谢审稿人。

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2024-11-19 DOI: 10.1007/s00540-024-03429-y

引用次数: 0

Airway management in pediatrics: improving safety. 儿科气道管理：提高安全性。

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2024-11-18 DOI: 10.1007/s00540-024-03428-z

Lea Zimmermann, Federica Maiellare, Francis Veyckemans, Alexander Fuchs, Tommaso Scquizzato, Thomas Riva, Nicola Disma

{"title":"Airway management in pediatrics: improving safety.","authors":"Lea Zimmermann, Federica Maiellare, Francis Veyckemans, Alexander Fuchs, Tommaso Scquizzato, Thomas Riva, Nicola Disma","doi":"10.1007/s00540-024-03428-z","DOIUrl":"https://doi.org/10.1007/s00540-024-03428-z","url":null,"abstract":"Airway management in children poses unique challenges due to the different anatomy, physiology, and pathophysiology across the pediatric age span. The recently published joint European Society of Anaesthesiology and Intensive Care-British Journal of Anaesthesia (ESAIC-BJA) neonatal and infant airway management guidelines provide recommendations and suggestions to support clinicians in deciding the best strategy. These guidelines represent a framework with the most recent and up-to-date evidence, from the initial assessment to the management of normal and difficult airways up to the extubation phase. However, such guidelines have intrinsic limitations due to the lack of supporting evidence in various fields of airway management. Pediatric institutions should adopt guidelines after careful internal review according to the local circumstances, including caseload, equipment and expertise. The current narrative review focused on providing references and practical tips on pediatric airway management, which is still not completely elucidated. Moreover, the authors put particular emphasis on the influence of human factors on the overall success of tracheal intubation, the incidence of complications, and the outcomes for patients.","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647776","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

Post-esophagectomy patients presenting for general anesthesia induction: a survey of practice among US anesthesiologists (PESO-GAIN-S). 接受全身麻醉诱导的食管切除术后患者：美国麻醉医师实践调查（PESO-GAIN-S）。

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2024-11-18 DOI: 10.1007/s00540-024-03432-3

Nika Samadzadeh Tabrizi, Alexander D Shapeton, Jamel Ortoleva, Sridhar R Musuku, Roman Schumann

{"title":"Post-esophagectomy patients presenting for general anesthesia induction: a survey of practice among US anesthesiologists (PESO-GAIN-S).","authors":"Nika Samadzadeh Tabrizi, Alexander D Shapeton, Jamel Ortoleva, Sridhar R Musuku, Roman Schumann","doi":"10.1007/s00540-024-03432-3","DOIUrl":"10.1007/s00540-024-03432-3","url":null,"abstract":"Purpose: Following esophagectomy, annually several thousand patients in the United States (US) reach a stable post-esophagectomy status. Such patients may require general anesthesia (GA) for elective procedures, but no generally accepted guidelines exist for the induction of GA in post-esophagectomy patients.Methods: A national survey describing a post-esophagectomy patient was emailed to 23,524 attending anesthesiologists who were members of the American Society of Anesthesiologists. The survey included 3 demographic and 12 anesthetic management questions. Responses were further stratified by gender, years in practice and frequency of exposure to the patient population of interest.Results: A total of 744 (3.2%) respondents completed the survey. The respondent demographic characteristics closely reflected recent US anesthesiology workforce analyses. Endotracheal tube was the preferred method of airway management for 648 (87.1%), 419 (64.7%) used a rapid sequence induction, and 504 (67.7%) elected a reverse Trendelenburg position, with the latter two choices being favored among anesthesiologists with routine (vs. rarely/never) exposure to post-esophagectomy patients (76.6% vs. 58.4%; p < 0.001; and 73.6% vs. 63.9%; p = 0.021, respectively). Across survey participants, induction of GA was highly variable with differential effects of gender, years in practice and exposure frequency to post-esophagectomy patients.Conclusions: US attending anesthesiologists' approach to induction of GA in a patient with a history of successful esophagectomy was not uniform. The majority of responses reflected a concern for aspiration in such a patient. Considering surgical and non-surgical upper gastrointestinal changes, establishment of practice guidance to optimize perioperative care is an unmet need.","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667932","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

Involvement of anesthesiologists in pediatric sedation and analgesia outside the operating room in Japan: is it too late, or is there still time? 在日本，麻醉医师参与手术室外的小儿镇静和镇痛：是为时已晚，还是仍有时间？

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2024-11-13 DOI: 10.1007/s00540-024-03431-4

Soichiro Obara

{"title":"Involvement of anesthesiologists in pediatric sedation and analgesia outside the operating room in Japan: is it too late, or is there still time?","authors":"Soichiro Obara","doi":"10.1007/s00540-024-03431-4","DOIUrl":"https://doi.org/10.1007/s00540-024-03431-4","url":null,"abstract":"The global COVID-19 pandemic highlighted significant existing supply-demand imbalances in anesthesia workforce, particularly impacting non-operating room anesthesia. Despite documented risks and mortality rates associated with pediatric procedural sedation and analgesia (PPSA) outside the operating room (OR), there is a pressing need for improvements in safety infrastructure. Comparative analysis with international practices reveals that anesthesiologists' involvement is associated with fewer adverse events and improved outcomes. However, lower reimbursement rate for sedation and anesthesia workforce shortage, and decentralized health resources are contributing factors to limit their participation in PPSA outside the OR in Japan. Enhancing the involvement of anesthesiologists through the public health frameworks such as \"high-risk approach\" and \"population approach\" can contribute to improvement of the safety and quality of PPSA. By tackling these challenges and implementing effective solutions, anesthesiologists can play a key role in ensuring safer and more effective PPSA outside the OR. Future challenges include enhancing training, addressing reduced clinical exposure due to work style reform, and developing effective educational systems. Research on improved educational approaches and fundamental outcome indices is crucial for improving PPSA practices outside the OR.","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142620939","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

The effect of intravenous lidocaine infusion on subarachnoid anesthesia in patients undergoing total knee replacement: a randomised controlled trial. 静脉注射利多卡因对接受全膝关节置换术患者蛛网膜下腔麻醉的影响：随机对照试验。

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2024-11-13 DOI: 10.1007/s00540-024-03430-5

Amulya Kodkani, Anju R Bhalotra, Rahil Singh, Mona Arya

{"title":"The effect of intravenous lidocaine infusion on subarachnoid anesthesia in patients undergoing total knee replacement: a randomised controlled trial.","authors":"Amulya Kodkani, Anju R Bhalotra, Rahil Singh, Mona Arya","doi":"10.1007/s00540-024-03430-5","DOIUrl":"https://doi.org/10.1007/s00540-024-03430-5","url":null,"abstract":"Purpose: Intravenous lidocaine is a non-opioid analgesic adjunct for perioperative pain relief. The aim of our study was to explore whether concurrent administration of intravenous lidocaine prolongs the duration of sensory block during total knee replacement (TKR) under spinal anaesthesia.Methods: This prospective randomized double blind controlled trial was conducted on 28 patients (14 in lidocaine group and 14 in the control group) undergoing unilateral TKR under spinal anesthesia. In the lidocaine group, intravenous lidocaine 1.5 mg·kg-1 followed by an infusion of 1.5 mg·kg-1·h-1 was administered intraoperatively after spinal anesthesia. The primary outcome was the duration of sensory block of spinal anesthesia. Secondary outcomes included onset time of sensory and motor block, duration of motor block, time to first postoperative analgesic, postoperative visual analog scale (VAS) scores and postoperative analgesia requirement in 24 h after surgery.Results: The duration of sensory and motor block was longer in the lidocaine group (Mean ± SD; 112.50 ± 5.80 min versus 78.21 ± 9.12 min; p < 0.001 and 237.14 ± 9.14 min versus 215.00 ± 10.12 min; p < 0.001, respectively). Time to requirement of first rescue analgesia was 184.29 ± 9.38 min in the lidocaine group and 127.14 ± 23.35 min in the control group (p < 0.001). VAS scores were lower in the lidocaine group at 4, 8, 12 and 24 h after surgery (p < 0.00001, p < 0.00001, p < 0.00006, p = 0.032, respectively). Requirement of additional analgesia in the first 24 h was higher in the control group. There were no clinical signs to suggest lidocaine toxicity in any patient.Conclusion: During unilateral TKR under spinal anaesthesia, concurrent use of intravenous lidocaine prolonged sensory block and reduced postoperative analgesic requirements.","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142620848","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

Study of penehyclidine for the prevention of postoperative nausea and vomiting following laparoscopic sleeve gastrectomy under general anesthesia: a randomized, prospective, double-blind trial. 预防全身麻醉下腹腔镜袖带胃切除术后恶心和呕吐的派尼希林研究：一项随机、前瞻性、双盲试验。

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2024-11-11 DOI: 10.1007/s00540-024-03424-3

Min Wang, Ting-Ting Wang, Chen Liu, Zhou-Quan Wu

{"title":"Study of penehyclidine for the prevention of postoperative nausea and vomiting following laparoscopic sleeve gastrectomy under general anesthesia: a randomized, prospective, double-blind trial.","authors":"Min Wang, Ting-Ting Wang, Chen Liu, Zhou-Quan Wu","doi":"10.1007/s00540-024-03424-3","DOIUrl":"https://doi.org/10.1007/s00540-024-03424-3","url":null,"abstract":"Purpose: To investigate the efficacy of penehyclidine (PHC) for preventing postoperative nausea and vomiting (PONV) after laparoscopic sleeve gastrectomy (LSG) under general anesthesia.Materials and methods: In this prospective study, 219 patients who were scheduled to undergo LSG were randomly assigned to three cohorts: the control cohort (received normal saline), the infusion cohort (administered 0.25 mg of PHC intravenously followed by an additional 0.25 mg through an intravenous analgesia pump for 48 h after LSG), and the bolus cohort (received a single intravenous dose of 0.5 mg of PHC). The study outcomes included the incidence of PONV within the first 48 h postoperatively, the severity and intensity of PONV, side effects and postoperative recovery outcomes. Univariate and multivariate logistic analyses were performed to identify independent risk factors associated with PONV.Results: Compared with the control cohort, both the infusion and bolus cohorts presented considerably lower incidences of PONV (61.64% vs. 12.33% vs. 38.36%, P < 0.05), as well as significantly decreased PONV severities (P < 0.05) and intensities (P < 0.05). There were no significant differences in side effects and postoperative recovery outcomes among the three cohorts, with the exception of dry mouthand the administration of rescue antiemetic therapy (P < 0.05). Additionally, the Apfel risk score and PHC intervention were identified as independent risk factors associated with PONV incidence following LSG (P < 0.05).Results: PHC effectively prevented PONV occurrence and reduced its severity in LSG patients without decreasing postoperative recovery outcomes, particularly in the infusion cohort.","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142620847","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

Margin of safety for needle puncture of a radial artery in children: Recommendation for ultrasound-guided cannulation. 儿童桡动脉针刺的安全系数：关于超声引导下插管的建议。

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2024-11-10 DOI: 10.1007/s00540-024-03419-0

Kazuyoshi Furuta, Takashi Asai, Hiroaki Suzuki, Shunsuke Saima, Yasuhisa Okuda

{"title":"Margin of safety for needle puncture of a radial artery in children: Recommendation for ultrasound-guided cannulation.","authors":"Kazuyoshi Furuta, Takashi Asai, Hiroaki Suzuki, Shunsuke Saima, Yasuhisa Okuda","doi":"10.1007/s00540-024-03419-0","DOIUrl":"https://doi.org/10.1007/s00540-024-03419-0","url":null,"abstract":"Background: The radial artery is commonly selected for arterial puncture and cannulation, but radial nerve palsy may occur. To minimize possible damage to the nerve, needle puncture should be made within the margin of safety (between the wrist to the distal end of the radial artery and the radial nerve running in parallel). In adults, the margin of safety for radial artery puncture is approximately 6.8 cm from the wrist in men and approximately 5.4 cm in women, but the margin of safety is not known in children of different age groups.Methods: Using an ultrasound device, we measured the margin of safety in 100 anesthetized patients aged 0 months to 15 yr. Polynomial quadratic regression models were made, and the lower limit of the prediction interval was regarded as the margin of safety. These results were then compared with the results obtained in adults.Results: The margin of safety became wider as a child grows older, and the height, weight, and age were all suitable explanatory variables to predict the margin of safety, providing fairly a constant predicted margin of safety from a few millimeters in neonates to approximately 4 cm in adolescents (much narrower than in adults).Conclusions: In children and adolescents, the margin of safety for radial artery puncture is much narrower than in adults, and these findings support the recommendation to use ultrasound guidance during radial artery puncture in children and adolescents, to minimize the risk of associated complications.Clinical trial registration: jRCT1032230243.","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142620846","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

Ultrasound assessment of the frequency and variation of arteries in the interscalene region. 腋窝间动脉频率和变化的超声评估。

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2024-11-06 DOI: 10.1007/s00540-024-03422-5

Rieko Oishi, Shinju Obara, Keisuke Yoshida, Shin Kurosawa, Hiroyuki Yaginuma, Satoki Inoue

{"title":"Ultrasound assessment of the frequency and variation of arteries in the interscalene region.","authors":"Rieko Oishi, Shinju Obara, Keisuke Yoshida, Shin Kurosawa, Hiroyuki Yaginuma, Satoki Inoue","doi":"10.1007/s00540-024-03422-5","DOIUrl":"https://doi.org/10.1007/s00540-024-03422-5","url":null,"abstract":"Purpose: Given the abundance of arteries in the neck, a significant risk of puncturing arteries exists when performing a brachial plexus block. Therefore, it is important to confirm the presence of arteries when performing a brachial plexus block via the interscalene approach. This study aimed to investigate the frequency and variations of arteries in the interscalene region in healthy Japanese adults using ultrasonography.Methods: This is an observational study at a university hospital. We analyzed videos of the brachial plexus recorded in another study using an ultrasound device and then investigated the frequency of the presence of arteries and the location of arteries in the interscalene region.Results: Among 68 cases, 48 (70.6%) had one or more arteries in the interscalene region (63 arteries in total). The artery frequency on the ventral side of the 5th cervical nerve (C5), between C5 and the 6th cervical nerve (C6), between C6 and the 7th cervical nerve (C7), between C7 and the 8th cervical nerve (C8), and on the dorsal side of C8 was 19.1%, 1.5%, 35.3%, 29.4%, and 7.4%, respectively. The artery frequencies between C6 and C7 and between C7 and C8 were higher than those between C5 and C6 and on the dorsal side of C8.Conclusion: Interscalene observations using ultrasound devices revealed a high artery frequency, with numerous topographic variations.","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142583134","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

Reply to a letter. 回信。

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2024-11-04 DOI: 10.1007/s00540-024-03426-1

Daichi Fujimoto, Norihiko Obata, Satoshi Mizobuchi

引用次数: 0