Journal of Anesthesia最新文献_第2页

Comment on "Association between lactate‑to‑albumin ratio and postoperative delirium in elderly patients undergoing cardiac surgery" by Zhu et al. 对Zhu等人“老年心脏手术患者乳酸白蛋白比与术后谵妄的关系”的评论。

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2026-10-09 DOI: 10.1007/s00540-026-03919-1

Ajay Guru

引用次数: 0

Effects of a low-level superoxide-containing environment on SOD activity and cerebral ischemia-reperfusion injury. 低水平超氧环境对SOD活性和脑缺血再灌注损伤的影响。

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2026-10-06 DOI: 10.1007/s00540-026-03917-3

Keiko Uemura, Satoki Inoue, Kotaro Yamanaka, Masahiko Kawaguchi

{"title":"Effects of a low-level superoxide-containing environment on SOD activity and cerebral ischemia-reperfusion injury.","authors":"Keiko Uemura, Satoki Inoue, Kotaro Yamanaka, Masahiko Kawaguchi","doi":"10.1007/s00540-026-03917-3","DOIUrl":"https://doi.org/10.1007/s00540-026-03917-3","url":null,"abstract":"Purpose: Superoxide (SO), a cause of ischemia-reperfusion injury, damages tissues. Superoxide dismutase (SOD) acts as a defense mechanism against SO but is also affected by SO itself. We hypothesized that exposure to a low-level superoxide-containing environment (hereafter referred to as \"low-level SO exposure\") activates SOD and may influence the response to transient forebrain ischemia. This study investigated changes in hippocampal SOD activity with low-level SO exposure and in relation to transient forebrain ischemia.Methods: Male Sprague-Dawley rats were used. SOD activity was measured in rats with low-level SO exposure. Transient forebrain ischemia was induced, and SOD activity was measured before and after ischemia. Neurological and histological evaluations were performed.Results: During low-level SO exposure, SOD activity did not change significantly, but increased significantly at 3 days after cessation of exposure and was significantly suppressed at 7 days. Post-ischemic SOD activity in rats without low-level SO exposure was significantly higher than in normal rats. Rats with low-level SO exposure before ischemia showed significantly lower SOD activities than rats without low-level SO exposure. No significant differences were observed in neurological or histological outcomes. Post-ischemia low-level SO exposure did not affect SOD activity or outcomes.Conclusion: Low-level SO exposure temporarily increased SOD activity after cessation of exposure but suppressed it 7 days later. Pre-ischemia low-level SO exposure reduced post-ischemic SOD activity, but did not affect neurological or histological outcomes. These findings suggest that changes in SOD activity induced by low-level SO exposure may not be sufficient to influence ischemia-reperfusion injury.","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109831","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

Sugammadex versus no pharmacological reversal under quantitative neuromuscular monitoring: a propensity score-matched analysis of postoperative pulmonary complications. 定量神经肌肉监测下，Sugammadex与无药物逆转：术后肺部并发症的倾向评分匹配分析。

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2026-10-02 DOI: 10.1007/s00540-026-03907-5

Soshi Narasaki, Yuki Ota, Hirotsugu Miyoshi, Satoshi Kamiya, Kei Taguchi, Tomomi Ishii, Hiroyuki Kido, Yasuo M Tsutsumi

{"title":"Sugammadex versus no pharmacological reversal under quantitative neuromuscular monitoring: a propensity score-matched analysis of postoperative pulmonary complications.","authors":"Soshi Narasaki, Yuki Ota, Hirotsugu Miyoshi, Satoshi Kamiya, Kei Taguchi, Tomomi Ishii, Hiroyuki Kido, Yasuo M Tsutsumi","doi":"10.1007/s00540-026-03907-5","DOIUrl":"https://doi.org/10.1007/s00540-026-03907-5","url":null,"abstract":"Purpose: Sugammadex may reduce postoperative pulmonary complications (PPCs). However, its association with PPCs remains unclear when quantitative neuromuscular monitoring (NMT) is routinely used, and comparisons with spontaneous recovery are limited. We compared PPCs between cases receiving sugammadex and those receiving no reversal agent.Methods: We included adult noncardiac surgical cases from 2010 through 2020. Eligible cases involved rocuronium administration and removal of the airway device in the operating room. The primary outcome was postoperative pneumonia within 30 days. Secondary outcomes were respiratory failure, ventilatory support, reintubation, and mortality within 30 days. One-to-one propensity score matching was performed using patient characteristics and intraoperative factors. Outcomes were compared using conditional logistic regression. We also evaluated achievement of a train-of-four (TOF) ratio ≥0.9 at airway-device removal and performed a supplementary propensity score-matched analysis restricted to cases meeting this threshold.Results: After matching, each group included 5677 of the 26,621 eligible cases. Postoperative pneumonia occurred in 72 cases (1.3%) in the no-reversal group and 87 (1.5%) in the sugammadex group, with no significant between-group difference (odds ratio [OR], 1.22; 95% confidence interval [CI], 0.89-1.69; P = 0.22); no secondary outcome differed significantly between groups. Achievement of a TOF ratio ≥0.9 was more frequent in the sugammadex group. The supplementary analysis likewise showed no significant between-group differences.Conclusion: Under routine quantitative NMT, sugammadex administration was associated with more frequent achievement of a TOF ratio ≥0.9 but not with lower incidences of postoperative pneumonia or secondary outcomes.","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109913","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 "Usefulness of the phase angle for inflammation criteria of the Global Leadership Initiative on Malnutrition in critically ill patients". 对“全球领导倡议对危重患者营养不良炎症标准的相位角的有用性”的评论。

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2026-10-02 DOI: 10.1007/s00540-026-03914-6

Limin Lin, Siqin Wang, Jiahai Ma

引用次数: 0

Comment on "A comparison of the effects of oliceridine and sufentanil on the quality of recovery after hysteroscopic surgery: a prospective double-blind randomized controlled trial" by Ke et al. 对Ke等人“奥立啶与舒芬太尼对宫腔镜术后恢复质量影响的比较：一项前瞻性双盲随机对照试验”的评论。

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2026-10-01 Epub Date: 2026-01-29 DOI: 10.1007/s00540-026-03667-2

Yu-Fu Guan, Dan-Feng Wang, Fu-Shan Xue

引用次数: 0

Effect of parental presence on intravenous sedation in children with cyanotic heart disease undergoing CT angiography: a prospective randomized trial. 父母在场对接受CT血管造影的紫绀型心脏病患儿静脉镇静的影响：一项前瞻性随机试验

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2026-10-01 Epub Date: 2026-01-21 DOI: 10.1007/s00540-026-03660-9

Ajay Singh, B Naveen Naik, Shweta Aghi, Sachin Kumar, Venkata Ganesh, Nivedita, Preethy J Mathew

{"title":"Effect of parental presence on intravenous sedation in children with cyanotic heart disease undergoing CT angiography: a prospective randomized trial.","authors":"Ajay Singh, B Naveen Naik, Shweta Aghi, Sachin Kumar, Venkata Ganesh, Nivedita, Preethy J Mathew","doi":"10.1007/s00540-026-03660-9","DOIUrl":"10.1007/s00540-026-03660-9","url":null,"abstract":"Purpose: Congenital heart disease (CHD) affects 9.3 per 1000 live births in Asia, with 25% being cyanotic. Advanced imaging such as CT angiography is essential, but requires effective sedation in this high-risk group. While parental presence is known to reduce anxiety during mask induction in operating rooms, its effect on intravenous sedation in non-operating room anesthesia (NORA) settings, particularly for diagnostic imaging, has not been studied. This trial evaluates the effect of parental presence during intravenous procedural sedation on ketamine requirements for children with cyanotic CHD undergoing CT angiography in a NORA environment.Methods: This prospective, randomized trial included 60 children aged 6 months to 3 years with cyanotic CHD. Participants were randomized to receive sedation either on their mother's lap (n = 30) or on the CT table (n = 30). The primary outcome was ketamine dose required for a pediatric sedation state scale of 2. Secondary outcomes included preoperative anxiety scores, episodes of oxygen desaturation, time to achieve sedation, and recovery time.Results: Children sedated on their mother's lap required significantly lower ketamine doses compared to those on the CT table (- 0.15 mg/kg, 95% CI - 0.29 to - 0.01; p = 0.03). The mother's lap group also had lower preoperative anxiety scores and shorter recovery times (- 3 min, 95% CI - 4.08 to - 1.92), with no increase in adverse events.Conclusion: This is the first randomized trial to demonstrate that parental presence during intravenous procedural sedation in a NORA setting reduces sedative requirements, anxiety, and recovery times in high-risk children undergoing CT angiography.Clinical trial registration: Clinical trial registration: CTRI/2023/11/059539, https://www.ctri.nic.in/.","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":"718-725"},"PeriodicalIF":2.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146010320","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

Postoperative reduction in thrombin generation induced by elevated levels of tissue factor pathway inhibitor in cardiac surgery: a prospective observational study. 心脏手术中组织因子通路抑制剂水平升高引起的术后凝血酶生成减少：一项前瞻性观察研究。

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2026-10-01 Epub Date: 2026-01-13 DOI: 10.1007/s00540-026-03657-4

Akiko Kitajo, Nobuyo Umehara, Aya Takemoto, Yudai Yamamoto, Yoshiki Sento, Tomoyuki Fujita, Tokujiro Uchida

{"title":"Postoperative reduction in thrombin generation induced by elevated levels of tissue factor pathway inhibitor in cardiac surgery: a prospective observational study.","authors":"Akiko Kitajo, Nobuyo Umehara, Aya Takemoto, Yudai Yamamoto, Yoshiki Sento, Tomoyuki Fujita, Tokujiro Uchida","doi":"10.1007/s00540-026-03657-4","DOIUrl":"10.1007/s00540-026-03657-4","url":null,"abstract":"Purpose: Tissue factor pathway inhibitor (TFPI) is an intrinsic anticoagulant factor, and its plasma concentration is elevated by heparin administration. Because several hours are required to return to normal range after heparin reversal, we investigated the role of TFPI in the inhibition of thrombin generation (TG) in patients undergoing cardiac surgery.Methods: Blood samples were collected from adult patients undergoing cardiac surgery with cardiopulmonary bypass (CPB) before, at the end of, and 1 day after surgery. Plasma concentration of TFPI, peak height of the TG assay (peak TG), and whole blood coagulation time by dielectric blood coagulometry using a Russell's viper venom cartridge system were evaluated. Nonparametric correlation was evaluated using Spearman's method, and time-dependent change was analyzed using repeated measures analysis of variance.Results: The plasma concentration of TFPI was higher (54 [47-60] ng/mL vs. 18 [13-27] ng/mL; P < 0.001) and the peak TG value was lower (98.1 [48.9-148] nM vs. 268 [244-309]; P < 0.001) at the end of surgery than before surgery. Plasma TFPI concentration showed a positive correlation with whole blood coagulation time as measured by dielectric blood coagulometry (Rs = 0.643) and a negative correlation with peak TG (Rs = - 0.624). Anti-TFPI antibody neutralized reduction in peak TG.Conclusions: In patients undergoing cardiac surgery using CPB, the increase in plasma TFPI concentration at the end of surgery causes a reduction in TG and impairment of whole blood coagulation via a mechanism that includes inhibition of factor Xa activity.","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":"708-717"},"PeriodicalIF":2.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13623792/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145959480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

AMPA receptor, neuroimaging, and chronic pain. AMPA受体，神经成像和慢性疼痛。

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2026-10-01 Epub Date: 2026-05-11 DOI: 10.1007/s00540-026-03729-5

Yu Sakai, Morihiko Kawate, Kenta Wakaizumi, Tomoyuki Miyazaki

{"title":"AMPA receptor, neuroimaging, and chronic pain.","authors":"Yu Sakai, Morihiko Kawate, Kenta Wakaizumi, Tomoyuki Miyazaki","doi":"10.1007/s00540-026-03729-5","DOIUrl":"10.1007/s00540-026-03729-5","url":null,"abstract":"AMPA receptors (AMPARs) are key molecular mediators of fast excitatory neurotransmission and synaptic plasticity in the central nervous system. Increasing evidence indicates that maladaptive regulation of AMPAR trafficking, subunit composition, and phosphorylation contributes to central sensitization underlying chronic pain. Experimental models demonstrate that inflammation or nerve injury induces GluA2 internalization and insertion of calcium-permeable AMPARs in the spinal dorsal horn and supraspinal regions, such as the anterior cingulate cortex, insula, amygdala, and nucleus accumbens. These alterations enhance excitatory transmission and sustain pain perception. Translational advances in molecular neuroimaging have enabled visualization of such mechanisms in vivo. The positron emission tomography (PET) radioligand [11C]K-2 allows quantitative mapping of AMPAR density in the human brain, while FDG-PET captures pain-related metabolic abnormalities within the pain matrix, including the anterior cingulate, insula, and thalamus. Integrating AMPAR-PET with MRI provides a multiscale framework linking molecular receptor dynamics with network-level reorganization. Furthermore, longitudinal PET and MRI studies demonstrate partial reversibility of structural and functional brain alterations following effective treatments, suggesting that pain-related neuroplasticity is modifiable. These insights highlight the potential of AMPAR-targeted imaging biomarkers to objectively characterize chronic pain mechanisms, guide therapeutic stratification, and evaluate treatment response. Establishing standardized multimodal imaging protocols and large collaborative databases will be essential to translate these discoveries into mechanism-based diagnostics and interventions for chronic pain .","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":"800-812"},"PeriodicalIF":2.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13624008/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147868302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Intraoperative oliguria modifies the association between cardiac power index and postoperative acute kidney injury: a retrospective cohort study. 术中少尿改变心功指数与术后急性肾损伤之间的关系：一项回顾性队列研究。

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2026-10-01 Epub Date: 2026-02-12 DOI: 10.1007/s00540-026-03677-0

Terumasa Matsuo, Hideaki Mori, Tetsuro Nikai

{"title":"Intraoperative oliguria modifies the association between cardiac power index and postoperative acute kidney injury: a retrospective cohort study.","authors":"Terumasa Matsuo, Hideaki Mori, Tetsuro Nikai","doi":"10.1007/s00540-026-03677-0","DOIUrl":"10.1007/s00540-026-03677-0","url":null,"abstract":"Purpose: Postoperative acute kidney injury (AKI) is common and associated with adverse outcomes. Intraoperative hypotension and oliguria are risk factors, yet management remains mean arterial pressure (MAP)‑centric. Cardiac power index (CPI) may capture pressure-flow conditions, and its association with AKI may depend on intraoperative urine output.Methods: We analyzed 814 adults undergoing non‑cardiac surgery with FloTrac™ monitoring. AKI was defined by the KDIGO creatinine criteria. The main predictors were CPI0.4_AUT, the time-integrated deficit of CPI below 0.40 W/m2, and intraoperative urine output (mL/kg/h). Multivariable logistic regression models, adjusted for the AKI risk index and other covariates, were fitted with and without a CPI0.4_AUT × urine‑output interaction, and average marginal effects were calculated.Results: AKI occurred in 59 patients (7.2%). Without the interaction term, CPI0.4_AUT was not statistically significant at the 0.05 level (adjusted odds ratio [aOR] 1.02, 95% confidence interval [CI] 1.00-1.04, P = 0.10). With the interaction, CPI0.4_AUT was significantly associated with AKI (aOR 1.05, 95% CI 1.02-1.08, P = 0.004), and the CPI0.4_AUT × urine‑output term also reached significance (aOR 0.97, 95% CI 0.93-0.99, P = 0.03). Average marginal effects showed that higher CPI0.4_AUT was associated with a higher predicted AKI probability at low urine output (< 0.8 mL/kg/h), but this association was minimal when urine output was ≥ 0.9 mL/kg/h.Conclusions: Low intraoperative CPI with oliguria was associated with a higher predicted probability of AKI, whereas the CPI‑AKI association weakened with increased urine output. Integrating CPI and urine output may help characterize hemodynamic management beyond MAP‑centric management.","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":"790-799"},"PeriodicalIF":2.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13624025/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146165510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Comparison of paravertebral block techniques for postoperative analgesia after video-assisted thoracoscopic surgery for lung cancer: a retrospective cohort study. 肺癌电视胸腔镜术后椎旁阻滞镇痛的比较：一项回顾性队列研究。

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2026-10-01 Epub Date: 2026-01-06 DOI: 10.1007/s00540-025-03651-2

Hazuki Nakamura, Shinya Suzuki, Kanae Karita, Akira Motoyasu, Kiyoshi Moriyama, Hiroyuki Seki

{"title":"Comparison of paravertebral block techniques for postoperative analgesia after video-assisted thoracoscopic surgery for lung cancer: a retrospective cohort study.","authors":"Hazuki Nakamura, Shinya Suzuki, Kanae Karita, Akira Motoyasu, Kiyoshi Moriyama, Hiroyuki Seki","doi":"10.1007/s00540-025-03651-2","DOIUrl":"10.1007/s00540-025-03651-2","url":null,"abstract":"Purpose: The purpose of this study was to compare the postoperative analgesic outcomes of ultrasound-guided single-shot, ultrasound-guided continuous, or surgeon-performed direct-vision single-shot approaches to paravertebral block (PVB).Methods: We retrospectively analyzed the data of the adults who underwent video-assisted thoracoscopic surgery (VATS) for lung resection at a university hospital. They were categorized into those who underwent ultrasound-guided single-shot PVB (PVB-US), ultrasound-guided continuous PVB with catheter infusion (PVB-US-Cath), and surgeon-performed intraoperative single-shot PVB under thoracoscopic visualization (PVB-VATS). The primary outcome was the number of rescue analgesic administrations within 24 h of admission to the post-anesthesia care unit (PACU). The secondary outcomes were rescue analgesic use within 24-48 h and pain scores at PACU admission and on the mornings of postoperative days (PODs) 1 and 2.Results: Of the 489 eligible patients, the data of 385 were included in the final analysis (PVB-US, n = 53; PVB-US-Cath, n = 249; PVB-VATS, n = 83). The median (IQR) numbers of rescue analgesic doses within 24 h for the PVB-US, PVB-US-Cath, and PVB-VATS groups were 1 (1-3), 2 (1-3), and 2 (0-3), respectively (p = 0.6880). Rescue analgesic use during 24-48 h and NRS pain scores at the PACU and on PODs 1 and 2 did not significantly differ between the groups.Conclusion: This study found no statistically significant differences in the postoperative analgesic outcomes of the ultrasound-guided single-shot, ultrasound-guided continuous, and surgeon-performed direct-vision single-shot PVB techniques for VATS. Given the predominantly mild and short-lived nature of pain after VATS, a technically simple single-shot strategy may offer an optimal balance between efficacy, feasibility, and procedural efficiency.","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":"688-694"},"PeriodicalIF":2.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145906005","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