Journal of Anesthesia最新文献

{"title":"Effect of intraoperative position on the zero flow pressure of the cerebral circulation under propofol anesthesia: a prospective observational study.","authors":"Shunichi Murakami, Atsuo Yamashita, Seishi Sakamoto, Satoshi Matsumoto, Satoshi Yamashita, Mishiya Matsumoto","doi":"10.1007/s00540-025-03597-5","DOIUrl":"https://doi.org/10.1007/s00540-025-03597-5","url":null,"abstract":"<p><strong>Purpose: </strong>The effect of intraoperative position on cerebral perfusion remains unclear. We examined changes in zero flow pressure (ZFP) relative to the supine position in the beach-chair, Trendelenburg, and prone positions under propofol anesthesia. ZFP is defined as the arterial pressure at which cerebral blood flow theoretically ceases, and it can represent effective downstream pressure, including cerebrovascular tone and intracranial pressure.</p><p><strong>Methods: </strong>This prospective, observational study conducted at two institutions included patients undergoing shoulder surgery, robotic-assisted laparoscopic prostatectomy, or lumbar spine surgery (n = 15 for each position) under propofol anesthesia. The flow velocity of the middle cerebral artery was recorded using transcranial Doppler. ZFP was determined by linear regression analysis of the pressure-flow velocity plot, with a pressure transducer calibrated at the heart level regardless of patient posture.</p><p><strong>Results: </strong>Head height relative to the heart increased by 25 cm in the beach-chair position, decreased by 13 cm in the Trendelenburg position, and was unchanged in the prone position. ZFP significantly increased by 12 and 5 mmHg in the beach-chair and Trendelenburg positions, respectively, whereas no significant change was observed in the prone position.</p><p><strong>Conclusions: </strong>The beach-chair and Trendelenburg positions increased ZFP. In both positions, it might be preferable to maintain mean arterial pressure higher than in the supine position to preserve cerebral perfusion.</p>","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145286121","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":"Beyond labor epidural analgesia: a multidisciplinary approach for postpartum depression.","authors":"Rachel Hogue, Hisako Okada, Amir L Butt","doi":"10.1007/s00540-025-03600-z","DOIUrl":"https://doi.org/10.1007/s00540-025-03600-z","url":null,"abstract":"","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145274761","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":"A three-way stopcock for one-lung ventilation using a 3D printer.","authors":"Katsuhide Masui, Hayato Arime, Kei Takahashi, Takashi Asai","doi":"10.1007/s00540-025-03599-3","DOIUrl":"https://doi.org/10.1007/s00540-025-03599-3","url":null,"abstract":"","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145274717","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":"Opioid ceiling in non-cancer pain: a 90-MME hard stop may overlook sex-specific pharmacokinetics.","authors":"Xi Ouyang, Meiyue Liu, Qing Zhang","doi":"10.1007/s00540-025-03581-z","DOIUrl":"https://doi.org/10.1007/s00540-025-03581-z","url":null,"abstract":"","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238774","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":"Correction: Current practice and awareness of perioperative do-not-attempt-resuscitation orders: a single-center retrospective survey and complete questionnaire survey.","authors":"Keisuke Shimizu, Kyoko Komatsu, Hiroshi Uchida, Mizuki Nawata, Ryo Kubota","doi":"10.1007/s00540-025-03589-5","DOIUrl":"https://doi.org/10.1007/s00540-025-03589-5","url":null,"abstract":"","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238723","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":"Improved oxygenation during one-lung ventilation: a question of statistical versus clinical significance.","authors":"Shu-Yueh Cheng, Ming-Hui Hung","doi":"10.1007/s00540-025-03594-8","DOIUrl":"https://doi.org/10.1007/s00540-025-03594-8","url":null,"abstract":"","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145232563","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":"Anesthesia and mitochondria: balancing toxicity and protection through emerging therapeutic strategies.","authors":"Kevin Zambrano, Karina Castillo, Giselle Maldonado, Kevin Fritzhand, Leonidas S Miranda, Luis Mujica, Cynthia Viera-Catota, Verónica Castañeda, Henry C Vasconez, Andrés Caicedo, Antonio W D Gavilanes","doi":"10.1007/s00540-025-03593-9","DOIUrl":"https://doi.org/10.1007/s00540-025-03593-9","url":null,"abstract":"<p><p>Anesthesia is a cornerstone of modern surgical practice, enabling interventions by deliberately modulating nociception and consciousness-from localized analgesia and mild sedation to deep unconsciousness. Yet the molecular and cellular mechanisms that produce these reversible states remain only partly defined, constraining our ability to predict interpatient variability, prevent mitochondrial- and neurotoxicity-related adverse effects, and optimize agent selection, dosing, and timing across perioperative care. Beyond their intended effects, anesthetics and their adjuvants impose substantial physiological stress on the brain, metabolism, and immune system, with particularly pronounced risks in vulnerable populations such as pediatric and elderly patients with developing and otherwise fragile neural networks. Recent studies have highlighted mitochondria, the cell's energy processing unit and key regulator of homeostasis, as especially susceptible to anesthetic exposure. Evidence indicates that agents used in the perioperative period may disrupt mitochondrial function by altering oxidative phosphorylation, increasing reactive oxygen species (ROS) production, and impairing mitochondrial dynamics. Such disruptions can contribute to neurotoxicity, metabolic dysregulation, and immune suppression, potentially affecting postoperative recovery and long-term cognitive outcomes. This review critically examines emerging data on the interplay between anesthesia agents and mitochondrial function. We discuss the implications of mitochondrial dysfunction for neural health and postoperative recovery, and we highlight current and prospective strategies to possibly refine anesthesia drug protocols through targeted mitochondrial therapeutics. Ultimately, a deeper understanding of these mitochondrial interactions is imperative for developing safer, more effective anesthesia practices, especially for pediatric and other high-risk patient populations.</p>","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225377","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":"Clinical and demographic characteristics of patients with autism spectrum disorder receiving general anesthesia with or without physical restraint: a single-center retrospective study.","authors":"Hidekazu Ito, Tatsuya Tsuji, Kazuya Sobue","doi":"10.1007/s00540-025-03592-w","DOIUrl":"https://doi.org/10.1007/s00540-025-03592-w","url":null,"abstract":"<p><strong>Purpose: </strong>Perioperative management of patients with autism spectrum disorder (ASD) often requires premedication and physical restraint. This study examined the characteristics of patients with ASD who required special interventions for general anesthesia, particularly physical restraint during induction.</p><p><strong>Method: </strong>This retrospective study included patients diagnosed with ASD (autism, pervasive developmental disorder, Rett syndrome, Asperger's syndrome, or childhood disintegrative disorder) based on established criteria. All patients underwent general anesthesia at a hospital for patients with disabilities between April 2019 and March 2022. Data collected included clinical and demographic characteristics, perioperative management (premedication and anesthetic methods), surgical indications, physical restraint use, and induction time. A comparative analysis was conducted to identify differences in patient characteristics and induction times between physical restraint and no-restraint groups. Induction times were compared using Kaplan-Meier survival curves and log-rank tests.</p><p><strong>Results: </strong>A total of 136 procedures were performed on 102 patients. Median age was 23.3 years (interquartile range: 12.8-35.2), 79% of participants were male, and approximately 40% exhibited self-injurious or aggressive behaviors. Dental procedures were the most common indication for anesthesia. Midazolam and pentobarbital were the most frequently administered premedications. Patients requiring physical restraint were generally larger and more likely to exhibit self-injurious or aggressive behaviors than those who did not. However, induction times were not prolonged in the physical restraint group compared with the no-restraint group.</p><p><strong>Conclusion: </strong>The characteristics identified in this study, such as large body size, self-injurious behavior, and aggressive behavior, may inform future research aimed at refining physical restraint use for patients with ASD.</p>","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225410","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.","authors":"Eriya Imai, Yuki Kataoka, Tsutomu Yamazaki","doi":"10.1007/s00540-025-03587-7","DOIUrl":"https://doi.org/10.1007/s00540-025-03587-7","url":null,"abstract":"","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225135","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":"QIPB vs. ESPB: pain management in lumbar discectomy.","authors":"Kristen Duong, Rachel Hogue, Aimee Pak, Amir L Butt","doi":"10.1007/s00540-025-03595-7","DOIUrl":"https://doi.org/10.1007/s00540-025-03595-7","url":null,"abstract":"","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212656","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}