Journal of Anesthesia最新文献

{"title":"Study on EEG neural oscillation characteristics during ciprofol general anesthesia.","authors":"Jiaxi Zhu, Quanxin Zhang, Xingan Zhang, Ying Cao, Shuteng Zhan, Zhenhu Liang, Bo Xu","doi":"10.1007/s00540-026-03666-3","DOIUrl":"10.1007/s00540-026-03666-3","url":null,"abstract":"<p><strong>Purpose: </strong>Ciprofol, a novel intravenous anesthetic with GABAA affinity akin to propofol, lacks characterized electroencephalogram (EEG) oscillation profiles during anesthesia.</p><p><strong>Methods: </strong>This prospective observational study included 54 patients undergoing surgery, divided into two groups: 30 adults (18-64 years) and 24 elderly (≥ 65 years). The EEG monitor recorded frontal region EEG, and we analyzed spectral power, wavelet coherence, and phase-amplitude coupling (PAC) across various states.</p><p><strong>Results: </strong> In the awake state, the spectral analysis power, wavelet coherence, and PAC were similar between the patient groups. Under anesthesia, both groups exhibited dominant slow oscillation (SO) and alpha oscillations, but the elderly group showed significantly lower alpha power (adult 4.367 [1.492-6.059] vs. elderly 1.729 [- 2.340-4.096], P < 0.001) and wavelet coherence (adult 0.0375 [0.0092-0.0935] vs. elderly 0.0073 [0.0030-0.0235], P = 0.041) compared to the adult group. During the recovery period, the restoration of beta/gamma activity and the increase in the intensity of the SO-alpha modulation index (MI) indicated a gradual recovery of consciousness. Frontal alpha power showed age dependency under ciprofol-maintained general anesthesia. Alpha-band wavelet coherence and the SO-alpha MI exhibited no significant age dependence, and the PAC pattern weakened with age.</p><p><strong>Conclusion: </strong>This study characterizes the EEG neural oscillation dynamics during ciprofol-induced general anesthesia. Despite the physiological decline in spectral power associated with increasing age, wavelet coherence and PAC demonstrate remarkable stability across different age cohorts. These findings support their potential as reliable, age-independent biomarkers for monitoring the depth of anesthesia.</p>","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":"758-770"},"PeriodicalIF":2.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146149637","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":"Clarifying respiratory safety end points in nonintubated hysteroscopic anesthesia.","authors":"Jiliang He","doi":"10.1007/s00540-026-03668-1","DOIUrl":"10.1007/s00540-026-03668-1","url":null,"abstract":"","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":"859-860"},"PeriodicalIF":2.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146085824","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":"Comments on \"Remimazolam provides better hemodynamic stability than propofol in hypertensive surgical patients: a randomized single-blinded trial\" by Wang et al.","authors":"M Vijayasimha, M Srikanth","doi":"10.1007/s00540-026-03669-0","DOIUrl":"10.1007/s00540-026-03669-0","url":null,"abstract":"","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":"861-862"},"PeriodicalIF":2.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146063539","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":"Health literacy in perioperative care: toward better shared decision-making through navigation and communication design.","authors":"Soichiro Obara, Taiki Kojima, Hirono Ishikawa","doi":"10.1007/s00540-026-03805-w","DOIUrl":"10.1007/s00540-026-03805-w","url":null,"abstract":"<p><p>Perioperative care asks patients and their families or caregivers to make decisions and follow important instructions within a short and stressful period. They may need to understand risks and options, follow fasting and medication instructions, move across multiple appointments and care transitions, and manage recovery after discharge while anxious, tired, or in pain. Shared decision-making is increasingly emphasized in perioperative care, but meaningful participation depends on health literacy. In this setting, health literacy includes personal health literacy, navigational health literacy, and organizational health literacy. Limited personal health literacy has been associated with poorer understanding of perioperative information, lower adherence to instructions, and worse perioperative experiences and outcomes. Navigational challenges arise when patients do not know what happens next, who is responsible for each part of care, or whom to contact at different stages of the pathway. Organizational health literacy refers to how well services make information and care easy to find, understand, and use. Practical approaches include plain language, clear role and contact cues, teach-back, and better communication design across transitions. Anesthesiologists should play a central role in improving organizational health literacy to support clearer communication, safer navigation, and better shared decision-making in perioperative care.</p>","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":"825-837"},"PeriodicalIF":2.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148277465","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":"Association of anesthesia methods for limb and lower abdominal surgeries with postoperative outcomes in patients requiring home oxygen therapy: a nationwide cohort study in Japan.","authors":"Kotaro Sakurai, Chikashi Takeda, Sachiko Tanaka-Mizuno, Toshiyuki Mizota, Moritoki Egi, Koji Kawakami","doi":"10.1007/s00540-026-03664-5","DOIUrl":"10.1007/s00540-026-03664-5","url":null,"abstract":"<p><strong>Purpose: </strong>Home oxygen therapy (HOT) is administered to patients with impaired pulmonary function who cannot adequately oxygenate themselves to meet systemic metabolic demands. Although regional anesthesia (RA) is beneficial for patients requiring HOT, comparative evidence between regional and general anesthesia (GA) is lacking. Thus, this study aimed to compare postoperative outcomes between RA and GA in patients requiring HOT.</p><p><strong>Methods: </strong>We collected data from a nationwide hospital-based database spanning from April 2014 to June 2022. We included patients who received HOT before limb or lower abdominal surgery and divided them into those who received GA and those who received RA. The primary outcome was 30-day hospital-free days. Secondary outcomes included 30-day mortality, postoperative pulmonary complications, and non-pulmonary complications. Additionally, we calculated the propensity scores and applied the overlap weighting method. Unmeasured confounders were addressed using high-dimensional propensity scores.</p><p><strong>Results: </strong>Among 1064 included surgeries, 565 and 499 were assigned to the GA and RA groups, respectively. Post-adjustment, no significant difference in hospital-free days was observed between the GA (10.46 days) and RA (11.29 days) groups (hospital-free day difference: 0.83; 95% confidence interval: - 0.56 to 2.23; p = 0.24). No significant between-group differences were observed in secondary outcomes, including 30-day mortality (odds ratio = 0.97; 95% confidence interval: 0.61-1.56; p = 0.67) and postoperative pulmonary complications (OR = 1.00; 95% CI 0.68-1.48; p = 0.99). Additionally, no difference was noted between the main analysis and the high-dimensional propensity score results for primary and secondary outcomes.</p><p><strong>Conclusions: </strong>Our findings suggest no association between the anesthesia method used and the 30-day hospital-free days among patients requiring HOT.</p>","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":"749-757"},"PeriodicalIF":2.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146029565","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":"Efficacy of BiPAP/CPAP versus COT in patients with obstructive sleep apnea or obesity undergoing sedated gastroenteroscopy: a meta-analysis.","authors":"Weizhong Wang, Pan Zhang, Ting Xu, Zhijuan Wang","doi":"10.1007/s00540-026-03786-w","DOIUrl":"10.1007/s00540-026-03786-w","url":null,"abstract":"<p><p>Patients with obstructive sleep apnea or obesity are at high risk for hypoxemia during sedated gastroenteroscopy. This meta-analysis compares the efficacy of bilevel or continuous positive airway pressure versus conventional oxygen therapy in preventing hypoxemia and reducing airway interventions. We systematically searched PubMed, Embase, Cochrane Library, and Web of Science for RCTs up to September 2025. Eight RCTs (1012 patients) were included; all controls received conventional oxygen therapy. Compared to conventional oxygen therapy, bilevel or continuous positive airway pressure was associated with a significant reduction in hypoxemia (OR 0.26, 95% CI 0.16-0.42), severe hypoxemia (OR 0.15, 95% CI 0.05-0.39), and need for jaw lift (OR 0.21, 95% CI 0.14-0.32), with no significant difference in nausea/vomiting. Subgroup analyses consistently favored bilevel or continuous positive airway pressure. The simplified device SuperNO₂VA also significantly reduced hypoxemia and jaw lift. This meta-analysis suggests that bilevel or continuous positive airway pressure is associated with reduced hypoxemia and airway interventions versus conventional oxygen therapy in high-risk patients undergoing sedated gastroenteroscopy. However, these findings are based on physiological surrogate outcomes, and patient-centered clinical endpoints remain unreported. Limitations include the lack of a blinded design and comparison with high-flow nasal cannula therapy. Future RCTs should compare bilevel or continuous positive airway pressure with high-flow nasal cannula and incorporate patient-centered outcomes to confirm clinical benefit. PROSPERO CRD420251129870.</p>","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":"813-824"},"PeriodicalIF":2.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147972753","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":"Comparison of standardized diaphragm ultrasound measurement and conventional methods for predicting weaning failure: a prospective observational study.","authors":"Yener Aksoy, Asu Ozgultekin, Yelda Balık, Osman Ekinci","doi":"10.1007/s00540-026-03655-6","DOIUrl":"10.1007/s00540-026-03655-6","url":null,"abstract":"<p><strong>Purpose: </strong>Weaning from invasive mechanical ventilation (IMV) is challenging and has multiple causes. The diaphragm is the main respiratory muscle for inspiration. This prospective study aimed to determine the value of standardized diaphragm ultrasound (DUS) measurements [diaphragm excursion (DE), diaphragm thickness fraction (DTF), diaphragmatic rapid shallow breathing index (D-RSBI), rapid shallow diaphragmatic index (RSDI)] in predicting extubation success in intensive care patients, both individually and in combination with conventional indices [rapid shallow breathing index (RSBI), dynamic compliance (Cdyn), airway occlusion pressure, semi-quantitative cough strength score]. To isolate diaphragm contribution, only neurologically intact patients (Glasgow Coma Scale > 14) with adequate airway protection reflexes were included. The second aim was to examine the relationship between IMV and DUS measurements.</p><p><strong>Methods: </strong>151 patients on IMV for > 24 h and eligible for spontaneous breathing trial (SBT) were evaluated. Following exclusion criteria, patients underwent SBT in pressure support ventilation mode (positive end-expiratory pressure 5 cmH₂O, pressure support 8 cmH₂O). During SBT, mechanical ventilation parameters and diaphragm ultrasound measurements were recorded. Extubation failure was defined as need for reintubation or non-invasive ventilation.</p><p><strong>Results: </strong>DE and DTF were significantly higher, D-RSBI was lower in patients with successful extubation. There was no difference in RSDI. Multivariate logistic regression was statistically significant, odds ratios (10.018, 1.109, 1.094) were found for DE, DTF, Cdyn, respectively. The only significant correlation between IMV and DUS was DTF-tidal volume (r = - 0.500).</p><p><strong>Conclusion: </strong>A standardized multiparametric model, combining DUS with conventional indices, provides moderate predictive accuracy for extubation success. Integrating DUS into weaning protocols can improve extubation readiness.</p>","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":"695-707"},"PeriodicalIF":2.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13624037/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146041067","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}

{"title":"Comments on 'Anesthetic induction drugs during tracheal intubation in critically ill patients: a systematic review' by Yatabe et al.","authors":"Cheng-Wei Lu, Ming-Hui Hung","doi":"10.1007/s00540-026-03654-7","DOIUrl":"10.1007/s00540-026-03654-7","url":null,"abstract":"","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":"848-849"},"PeriodicalIF":2.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145951946","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: EEG-guided sevoflurane anesthesia vs. standard care in pediatric emergence delirium: a grade-assessed systematic review and meta-analysis with trial sequential analysis.","authors":"Javeria Javed, Zaryab Bacha, Fareeda Brohi, Munazza Sikandar, Asim Shah, Suleman Khan, Mian Zahid Jan Kakakhel, Muhammad Shahzad, Sajjad Ghanim Al-Badri, Syed Haibat Ullah, Arooba Khitab, Asad Jamal, Kamil Ahmad Kamil, Raheel Ahmed","doi":"10.1007/s00540-026-03828-3","DOIUrl":"10.1007/s00540-026-03828-3","url":null,"abstract":"","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":"869"},"PeriodicalIF":2.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148912094","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":"Reply to the letter by Eylem Yaşar et al.","authors":"Kurumi Saito, Hirotaka Kinoshita, Junichi Saito","doi":"10.1007/s00540-026-03705-z","DOIUrl":"10.1007/s00540-026-03705-z","url":null,"abstract":"","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":"855-856"},"PeriodicalIF":2.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147390113","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}