Journal of Anesthesia最新文献_第10页

Reply to: "Comments on 'The effect of remimazolam versus propofol on respiratory depression for non-intubated general anesthesia: a randomized controlled trial'". 回复：“关于‘雷马唑仑与异丙酚对非插管全身麻醉呼吸抑制的影响：一项随机对照试验’的评论”。

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2026-08-12 DOI: 10.1007/s00540-026-03839-0

Yutao Chen, Congjie Bi

引用次数: 0

Correction: Two-stage diphenhydramine improves early recovery in women after video-assisted thoracoscopic surgery: a randomized controlled trial. 更正：两阶段苯海拉明改善妇女在电视胸腔镜手术后的早期恢复：一项随机对照试验。

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2026-08-10 DOI: 10.1007/s00540-026-03840-7

Jian-Wei Yin, Jie Yin, Si-Si Yang, Xi-Yuan Duan, Chao Zhang, Qing-Ran Wang, Liang He

引用次数: 0

Selection of endotracheal tube size and insertion depth according to pediatric growth charts and physique in Japan. 在日本根据儿童生长图表和体格选择气管插管的尺寸和插入深度。

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2026-08-10 DOI: 10.1007/s00540-026-03865-y

Shinichi Akabane, Masaaki Asamoto, Seiichi Azuma, Mariko Ezaka, Mikiya Otsuji, Kanji Uchida

{"title":"Selection of endotracheal tube size and insertion depth according to pediatric growth charts and physique in Japan.","authors":"Shinichi Akabane, Masaaki Asamoto, Seiichi Azuma, Mariko Ezaka, Mikiya Otsuji, Kanji Uchida","doi":"10.1007/s00540-026-03865-y","DOIUrl":"10.1007/s00540-026-03865-y","url":null,"abstract":"Purpose: This study aimed to describe the distribution of clinically selected endotracheal tube size and insertion depth in relation to pediatric growth charts in Japan.Methods: This single-center retrospective analysis included patients aged 0-15 years who underwent general anesthesia at a university hospital in Japan between December 2006 and July 2023. The correlations between the average endotracheal tube size and depth curves and the growth charts, developed by the Japanese Society for Pediatric Endocrinology and the Japanese Association for Human Auxology, were determined using Pearson's correlation coefficient for the children with heights and weights within ± 2 standard deviations (SD) of the growth chart. For children under 6 years of age in the - 2 to - 3 SD, below - 3 SD, and ± 2 SD groups, a linear mixed model (LMM) was used to model age-related changes in tube size and depth while accounting for clustering by anesthesiologist.Results: A total of 6460 patients were included. In females, uncuffed tube size showed correlations of 0.97 and 0.94 with the height and weight growth charts, respectively; the corresponding correlations for depths were 0.95 and 0.92. In males, the corresponding correlations for size were 0.97 and 0.93, and the corresponding correlations for depth were 0.94 and 0.90. The LMM that accounted for the growth rate of the children showed R-squared values of 0.80 for tube size and 0.76 for insertion depth.Conclusion: The curves for the average endotracheal tube size and depth stratified by age showed concordance with the growth chart.","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148701346","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

Implementing prospective probabilistic scheduling of surgical cases to yield more predictable utilisations. 实施手术病例的前瞻性概率调度，以产生更可预测的利用。

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2026-08-10 DOI: 10.1007/s00540-026-03868-9

Matthew Freer, Camilla Cherrie, Jaideep J Pandit

{"title":"Implementing prospective probabilistic scheduling of surgical cases to yield more predictable utilisations.","authors":"Matthew Freer, Camilla Cherrie, Jaideep J Pandit","doi":"10.1007/s00540-026-03868-9","DOIUrl":"https://doi.org/10.1007/s00540-026-03868-9","url":null,"abstract":"We studied the impact of a prospective, probabilistic scheduling method to replace surgeon-led booking, balancing contradictory goals of maximizing theatre utilised time while minimizing risk of over-utilised time. Implemented in an NHS Scotland hospital, the study analyzed 2420 surgical lists across multiple specialties. The Infix Schedule tool used median and median absolute deviation (MAD) of historical case times to calculate probability of finishing within allocated times, targeting a range 80-90% for utilised time. Data were compared post hoc across three groups: prior surgeon-led scheduling, surgeon over-rides of the tool, and unadjusted Infix-generated schedules. In surgeon-led scheduling, realised utilised time was 78.8%: shadow Infix-generated schedules predicted median utilised time 77.8%, significantly closer to this reality (p = 0.18). Surgeon predictions overestimated utilization (median 87.7%; p < 0.001). Surgeon over-rides were associated with lower utilised time (76.5%) than actual (77.3%) or Infix predicted (78.0%; p < 0.015). Patient cancellation rates were lower for the Infix scheduled cohort (8.51% vs 10.96% for surgeon;(p = 0.0297). However, the tool's performance was dependent on accurate surgical coding. While the \"pessimistic\" mathematical buffer used to ensure reliability was associated with utilization < 80% target, iterative learning and reducing human overrides should refine efficiency and waiting list management.","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148701360","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

Association between lactate-to-albumin ratio and postoperative delirium in elderly patients undergoing cardiac surgery. 老年心脏手术患者乳酸-白蛋白比与术后谵妄的关系。

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2026-08-10 DOI: 10.1007/s00540-026-03859-w

Wenjie Zhu, Yuyan Wang, Rongrong Zhang, Xiaohu Yang

{"title":"Association between lactate-to-albumin ratio and postoperative delirium in elderly patients undergoing cardiac surgery.","authors":"Wenjie Zhu, Yuyan Wang, Rongrong Zhang, Xiaohu Yang","doi":"10.1007/s00540-026-03859-w","DOIUrl":"10.1007/s00540-026-03859-w","url":null,"abstract":"Purpose: Postoperative delirium (POD) is highly prevalent among patients undergoing cardiac surgery, particularly in older adults. The lactate-to-albumin ratio (LAR), a composite biomarker reflecting both hypoxia and inflammatory pathways, could help elucidate the pathophysiological mechanisms underlying POD. This study aimed to determine the relationship between preoperative LAR and POD and to evaluate the potential predictive value of LAR.Methods: This retrospective cohort analysis utilized data extracted from the Medical Information Mart for Intensive Care (MIMIC)-IV database. Patients eligible for inclusion were those ≥65 years of age and having received cardiac surgery. Hierarchical multivariable logistic regression assessed associations, controlling for multicollinearity (VIF) and modeling non-linearity (RCS). Predictive performance was evaluated using Youden index, AUC (DeLong), NRI, IDI, likelihood ratio tests and trend analysis.Results: This retrospective study analyzed data from 1770 elderly patients undergoing cardiac surgery. Of the 1770 patients, 412 (23.28%) developed postoperative delirium, and 131 (7.40%) died during hospitalization. Patients in the high LAR group had a 1.51-fold increased risk of POD compared to the low LAR group (adjusted OR=1.51, 95% CI 1.18-1.95, p < 0.005), and LAR as a continuous variable was independently associated with POD (adjusted OR=1.71 per unit increase, 95% CI 1.20-2.44, p = 0.003). After adjusting for confounding factors, this relationship was attenuated. Nevertheless, higher LAR remained independently associated with a higher risk of POD (all p< 0.05).Conclusion: The results showed that a higher preoperative lactate/albumin ratio (LAR) was independently associated with an increased risk of postoperative delirium (POD) in elderly patients undergoing cardiac surgery, and that there was a non-linear relationship between LAR and the incidence of POD.","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148701350","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

Comment on "Gastric ultrasound assessment of gastric volume and related factors in patients undergoing gastrointestinal endoscopy under sedation". 对“镇静下胃肠内镜患者胃容量及相关因素的胃超声评估”的评论。

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2026-08-10 DOI: 10.1007/s00540-026-03867-w

Rongjiao Shao, Haibei Sun, Yinghua Xu, Xiaoyu Guo, Weidong Gu

引用次数: 0

Effect of granisetron on the spinal anesthesia-induced hemodynamic changes: a meta-analysis of randomized controlled trials. 格拉司琼对脊髓麻醉引起的血流动力学改变的影响：随机对照试验的荟萃分析。

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2026-08-08 DOI: 10.1007/s00540-026-03864-z

Bon-Wook Koo, Hyo-Seok Na, Hyun-Jung Shin

{"title":"Effect of granisetron on the spinal anesthesia-induced hemodynamic changes: a meta-analysis of randomized controlled trials.","authors":"Bon-Wook Koo, Hyo-Seok Na, Hyun-Jung Shin","doi":"10.1007/s00540-026-03864-z","DOIUrl":"https://doi.org/10.1007/s00540-026-03864-z","url":null,"abstract":"Background: Spinal anesthesia induces hemodynamic disturbances such as hypotension and bradycardia. Granisetron, a 5-HT₃ receptor antagonist primarily used for antiemesis, has been proposed to mitigate these effects.Methods: This meta-analysis of randomized controlled trials evaluated intravenous granisetron versus placebo/no treatment in adults undergoing elective surgery under spinal anesthesia, reporting hypotension (primary outcome), bradycardia, shivering, hemodynamic changes, and vasopressor use. A random-effects model was used to calculate relative risks (RR) or mean differences (MD) with 95% confidence intervals (CI), with subgroup analysis by surgical type (cesarean vs. nonobstetric).Results: Fourteen trials (n = 1388) were included. Granisetron significantly reduced overall hypotension (RR = 0.51; p < 0.001), vasopressor use (RR = 0.64; p = 0.008), and shivering (RR = 0.32; p < 0.001). Bradycardia reduction was significant only in nonobstetric participants (RR = 0.48; p = 0.047), not overall (p = 0.118); similarly, mean arterial pressure (MAP) at 5 and 15 min (p = 0.001, p < 0.001) and heart rate at 5 min (p = 0.013) improved only in nonobstetric surgery, with no overall significance. Heterogeneity was substantial for most continuous outcomes (I2 > 85%). Funnel plot asymmetry suggested possible publication bias/small-study effects for hypotension and MAP at 30 min, with no major concern for other outcomes.Conclusions: Granisetron appears effective in reducing hypotension, vasopressor use, and shivering during spinal anesthesia, with early hemodynamic benefits in nonobstetric surgery. Given the heterogeneity and publication bias identified, findings warrant cautious interpretation requiring larger trials.Trial registration: PROSPERO, CRD420251034777. Registered 17 April 2025, https://www.crd.york.ac.uk/prospero/.","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148697606","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

Esketamine versus dexmedetomidine for oxygenation and postoperative quality of recovery in thoracoscopic surgery: a randomized, double-blind, non-inferiority controlled trial. 艾氯胺酮与右美托咪定对胸腔镜手术氧合和术后恢复质量的影响：一项随机、双盲、非效性对照试验。

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2026-08-03 DOI: 10.1007/s00540-026-03853-2

Rui Feng, Zhuoran Wang, Yuqiao Yang, Quan Wang, Yu Zhao, Xi Qian, Jinqiao Qian

{"title":"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/s00540-026-03853-2","DOIUrl":"10.1007/s00540-026-03853-2","url":null,"abstract":"Purpose: One-lung ventilation (OLV) frequently induces hypoxemia. This study investigated whether intraoperative esketamine is non-inferior to dexmedetomidine in maintaining oxygenation during OLV and evaluated its impact on postoperative recovery.Methods: In this prospective, double-blind, non-inferiority trial, 126 adults undergoing thoracoscopic surgery were randomized to saline (Control), dexmedetomidine, or esketamine. The primary outcome was PaO₂/FiO₂ (P/F) ratio at 60 min after OLV initiation. The key secondary outcome was Quality of Recovery-15 (QoR-15) at 24 h. Linear mixed effects models were used.Results: A total of 120 patients were included in the modified intention-to-treat analysis. At T3, esketamine was noninferior to dexmedetomidine for P/F ratio (adjusted mean difference [MD] - 1.92 mmHg; 95% CI: - 41.06 to 37.20). Compared with the control group, esketamine showed more favorable intraoperative respiratory mechanics and lower opioid requirements. Furthermore, esketamine was associated with higher global QoR-15 scores at 24 h postoperatively compared with the Control group (adjusted MD 8.10; 95% CI 2.99 to 13.21) and the Dexmed group (adjusted MD 6.47; 95% CI 1.36 to 11.59). However, the incidence of postoperative pulmonary complications did not differ significantly among the groups (P = 0.86).Conclusion: Intraoperative esketamine is non-inferior to dexmedetomidine for maintaining oxygenation during OLV. Furthermore, it was associated with lower perioperative opioid/anesthetic requirements and higher early postoperative recovery scores, although it did not significantly reduce clinical pulmonary complications.","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148663867","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

Comment on "predictive value of ultrasound-measured tongue base thickness for upper airway obstruction during monitored anesthesia care: a single-center prospective observational study". 点评“超声测量舌底厚度对麻醉监护过程中上呼吸道阻塞的预测价值：一项单中心前瞻性观察研究”。

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2026-08-03 DOI: 10.1007/s00540-026-03857-y

Rongjiao Shao, Haibei Sun, Yinghua Xu, Ting Hong, Weidong Gu

引用次数: 0

Incidence of hyponatremia with different postoperative intravenous maintenance fluids: a single-center, prospective, randomized trial. 不同术后静脉维持液的低钠血症发生率：一项单中心、前瞻性、随机试验

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2026-08-01 Epub Date: 2025-11-18 DOI: 10.1007/s00540-025-03628-1

Naotaka Shirakawa, Masahiro Ushio, Nana Furushima, Daichi Fujimoto, Shohei Makino, Yuki Nomura, Norihiko Obata, Satoshi Mizobuchi

{"title":"Incidence of hyponatremia with different postoperative intravenous maintenance fluids: a single-center, prospective, randomized trial.","authors":"Naotaka Shirakawa, Masahiro Ushio, Nana Furushima, Daichi Fujimoto, Shohei Makino, Yuki Nomura, Norihiko Obata, Satoshi Mizobuchi","doi":"10.1007/s00540-025-03628-1","DOIUrl":"10.1007/s00540-025-03628-1","url":null,"abstract":"Purpose: Patients undergoing surgery are prone to postoperative hyponatremia, which can lead to delirium. However, the optimal sodium concentration for postoperative maintenance fluids in adult patients is still unclear. Therefore, this study examined the incidence of hyponatremia and delirium in postoperative patients.Methods: This was a single-center, non-blinded, randomized trial. The inclusion criteria for this study were age 20 years or older and elective head and neck cancer or esophageal cancer surgery between April 2018 and June 2023. Patients were randomly assigned to one of three groups based on the sodium concentration in the intravenous fluids administered after surgery: the 140 mmol/L sodium (Na140) group, the 77 mmol/L sodium (Na77) group, and the 35 mmol/L sodium (Na35) group.Results: A total of 105 patients had complete data at the end of the study: Na140 group (n = 35), Na77 group (n = 32), and Na35 group (n = 38). The incidence of postoperative hyponatremia was 22.9% (8/35) in the Na140 group, significantly lower than in the Na77 group [56.3% (18/32)] and the Na35 group [60.5% (23/38)] (both p < 0.01). The incidence of postoperative delirium was 20.0% (7/35) in the Na140 group, 31.3% (10/32) in the Na77 group, and 23.7% (9/38) in the Na35 group. No significant difference was observed among the groups (p = 0.56).Conclusion: The use of postoperative fluids with a sodium concentration of 140 mmol/L significantly reduced the incidence of hyponatremia. There was no significant difference in the incidence of postoperative delirium.","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":"519-528"},"PeriodicalIF":2.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145540757","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