Journal of Anesthesia最新文献_第4页

The ability of diaphragmatic excursion after extubation to predict the need for resumption of ventilatory support in critically ill surgical patients. 拔管后膈肌漂移预测危重外科患者是否需要恢复呼吸支持的能力。

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2025-01-05 DOI: 10.1007/s00540-024-03442-1

Ahmed Hasanin, Mina A Helmy, Ayman Aziz, Maha Mostafa, Mostafa Alrahmany, Mamdouh M Elshal, Walid Hamimy, Ahmed Lotfy

{"title":"The ability of diaphragmatic excursion after extubation to predict the need for resumption of ventilatory support in critically ill surgical patients.","authors":"Ahmed Hasanin, Mina A Helmy, Ayman Aziz, Maha Mostafa, Mostafa Alrahmany, Mamdouh M Elshal, Walid Hamimy, Ahmed Lotfy","doi":"10.1007/s00540-024-03442-1","DOIUrl":"https://doi.org/10.1007/s00540-024-03442-1","url":null,"abstract":"Background: This study evaluated the ability of diaphragmatic excursion (DE), measured 2 h after extubation, to predict the need for resumption of ventilatory support within 48 h in surgical critically ill patients.Methods: This prospective observational study included adult surgical critically ill patients intubated for > 24 h and extubated after a successful spontaneous breathing trial. Sonographic measurement of the DE was performed 2 h after extubation. Patients were followed up for 48 h after extubation and were divided into reintubation group and successful weaning group. The primary outcome was DE's ability to predict the need for resumption of ventilatory support using the area under receiver characteristic curve (AUC) analysis.Results: Data from 70 patients were analyzed and 25/70 (36%) patients needed reintubation. DE was lower in the reintubation group than the successful weaning group. The AUC (95% confidence interval) for the ability of DE to predict the need for resumption of ventilatory support was 0.98(0.92-1.00) and 0.97(0.89-1.00) for the right and left side, respectively. At cutoff values of 20.8 and 19.8 mm, the right and left DE had positive predictive values of 92% and 88% and negative predictive values of 96% and 93%, respectively.Conclusion: Among surgical critically ill patients undergoing weaning from invasive mechanical ventilation, DE obtained 2h after extubation is an accurate predictor for the need for resumption of ventilatory support. Diaphragmatic excursion < 20-21 mm could predict the need for resumption of ventilatory support with a positive predictive value of 88-92% and negative predictive value of 93-96%.","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931883","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

Pitfalls in peripheral venous access under ultrasound guidance. 超声引导下外周静脉通路的陷阱。

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2025-01-03 DOI: 10.1007/s00540-024-03452-z

Keisuke Yoshida, Yuki Yamazaki, Ko Kakinouchi, Takayuki Hasegawa, Satoki Inoue

引用次数: 0

Current practice and awareness of perioperative do-not-attempt-resuscitation orders: a single-center retrospective survey and complete questionnaire survey. 围手术期不尝试复苏命令的实践和意识：单中心回顾性调查和完整的问卷调查。

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2024-12-25 DOI: 10.1007/s00540-024-03447-w

Keisuke Shimizu, Kyoko Komatsu, Hiroshi Uchida, Mizuki Nawata, Ryo Kubota

{"title":"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/s00540-024-03447-w","DOIUrl":"https://doi.org/10.1007/s00540-024-03447-w","url":null,"abstract":"Purpose: We investigated whether patients who have been issued a do-not-attempt-resuscitation order (DNAR) preoperatively (hereafter, DNAR patients) are informed of the DNAR code change when they undergo anesthesia. We also conducted a survey of the awareness of medical staff regarding perioperative DNARs, and investigated the current situation at a single-center in Japan.Methods: For DNAR patients managed by anesthesiologists from January 2019 to September 2022, we retrospectively investigated whether the patient was informed of the DNAR code change or the DNAR was automatically suspended without explanation. Next, in July 2023, a questionnaire survey on perioperative DNARs was conducted among all medical staff at our center.Results: Among the 4,164 cases managed by anesthesiologists during the study period, 100 DNAR patients (2.4%) were identified. Of these, 27 patients received an explanation about the DNAR code change before surgery. Multivariate analysis showed that female patients (odds ratio [OR] 5.3, 95% confidence interval [CI] 3.8-6.7; p = 0.023) and patients with low Barthel Index (OR 0.98, 95% CI 0.96-0.99; p = 0.010) tended to receive explanations about DNAR code changes. In the questionnaire survey, 25% of the 1,051 respondents answered that DNAR code changes should be explained to patients before surgery.Conclusion: In clinical practice, 27% of DNAR patients were informed of DNARs code change before surgery. Perioperative advance care planning should be further promoted in clinical practice by creating guidelines and training programs regarding perioperative DNARs.","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894510","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

Bridging old and new: obturator nerve block in the obturator canal to prevent obturator jerk during transurethral resection of bladder tumor. 架起新旧桥梁：经尿道膀胱肿瘤切除术中闭孔神经阻滞防止闭孔痉挛。

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2024-12-22 DOI: 10.1007/s00540-024-03446-x

Hiroaki Murata

引用次数: 0

Day surgery in children: 15-year analysis of unplanned admissions at a Japanese tertiary children's hospital. 儿童日间手术：日本某三级儿童医院15年计划外入院分析

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2024-12-21 DOI: 10.1007/s00540-024-03445-y

Aya Sueda, Tetsuro Kagawa, Taiki Kojima

{"title":"Day surgery in children: 15-year analysis of unplanned admissions at a Japanese tertiary children's hospital.","authors":"Aya Sueda, Tetsuro Kagawa, Taiki Kojima","doi":"10.1007/s00540-024-03445-y","DOIUrl":"https://doi.org/10.1007/s00540-024-03445-y","url":null,"abstract":"Purpose: Unplanned hospital admission following pediatric day surgery is a crucial quality indicator. This study examined the incidence, related risks, interventions, and outcomes of unplanned hospital admission following pediatric day surgery among children in Japan.Methods: This single-center, retrospective study analyzed data of 14,529 pediatric patients under the age of 18 years who underwent day surgery between August 2007 and December 2022. Unplanned hospital admission was defined as an overnight hospital stay that was not planned preoperatively, including patients who returned to the emergency department and required admission within 24 h of discharge. Reasons for unplanned hospital admission and interventions were categorized, and risk factors were identified using logistic regression.Results: The incidence of unplanned hospital admission was 0.19%. The most common reasons for unplanned hospital admission were anesthetic-related, particularly postoperative nausea and vomiting (36%), which was managed primarily with intravenous fluids (36%) and antiemetic medications (21%). Medical and surgical factors were next most common. Logistic regression identified longer operation time (adjusted Odds ratio 1.03; 95% confidence interval [1.01, 1.04]; P < 0.001) and exit from the operating room after 15:00 (adjusted Odds ratio 29.3; 95% confidence interval [7.09, 121]; P < 0.001) as significant risk factors for unplanned hospital admission.Conclusion: Unplanned hospital admission was most commonly anesthetic-related and was managed with intravenous fluids and antiemetic medications. Longer operation time and later exit from the operating room were significant risk factors. These findings can guide targeted strategies to further reduce unplanned hospital admission and improve pediatric day surgery quality.","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872147","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

Errors and omissions in GA predictors for cesarean delivery. 剖宫产GA预测因子的误差和遗漏。

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2024-12-20 DOI: 10.1007/s00540-024-03448-9

Grace Townsend, Lily Robistow, Amir L Butt, Aimee Pak

引用次数: 0

Correction: Consensus statement on chronic pain treatment in cancer survivors. 更正：关于癌症幸存者慢性疼痛治疗的共识声明。

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2024-12-18 DOI: 10.1007/s00540-024-03441-2

Keiko Mamiya, Hiroki Iida, Masako Iseki, Shigeki Yamaguch, Hiroshi Yonekura, Hiroshi Ueno, Toshifumi Kosugi, Takeshi Sasara, Yumiko Takao, Toshifumi Takasusuki, Saori Hashiguchi, Naomi Hirakawa, Yoko Sugiyama, Keiko Yamada, Kenji Yamamoto

引用次数: 0

Correlation of preoperative fibrinogen/albumin ratio with morbidity following advanced-age hip fractures: an observational study. 术前纤维蛋白原/白蛋白比值与高龄髋部骨折后发病率的相关性：一项观察性研究。

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2024-12-15 DOI: 10.1007/s00540-024-03444-z

Emine Dizem Sunal Altın, Nur Canbolat, Mehmet I Buget, Yekta Furkan Altın, Serkan Bayram, Kemalettin Koltka

{"title":"Correlation of preoperative fibrinogen/albumin ratio with morbidity following advanced-age hip fractures: an observational study.","authors":"Emine Dizem Sunal Altın, Nur Canbolat, Mehmet I Buget, Yekta Furkan Altın, Serkan Bayram, Kemalettin Koltka","doi":"10.1007/s00540-024-03444-z","DOIUrl":"https://doi.org/10.1007/s00540-024-03444-z","url":null,"abstract":"Purpose: Given the occurrence of comorbidities in geriatric patients, the postoperative period of hip fractures may progress with high morbidity and mortality. Recently, several inflammatory markers have been used to evaluate the treatment course. Herein, we prospectively followed-up and examined the relationship between preoperative fibrinogen/albumin ratio(FAR) and morbidity/mortality in elderly patients with hip fracture.Methods: Patients aged ≥ 85 years who underwent hip fracture surgery under unilateral spinal anesthesia were included in this prospective observational study. The patients' preoperative FAR, age-adjusted Charlson comorbidity index(AACCI) score, Nottingham Hip Fracture Score, and Clinical Frailty Scale score were calculated. In addition, data on patients' morbidity, 3-month mortality, and lengths of intensive care unit (ICU) and hospital stay were recorded. The patients were categorized into two groups based on the FAR cutoff value of 0.102. A total of 108 patients participated in the study, with 43 assigned to Group 1(FAR < 0.102) and 65 to Group 2(FAR ≥ 0.102).Results: A significant difference was found in the risk of death within 3-months between patients with high and low FAR scores(p = 0.018). Patients with higher FAR scores were more likely to die within 3 months. A significantly positive association was observed between the FAR and AACCI score, with the AACCI score of Group2 being significantly higher than that of Group 1(p = 0.029). The lengths of hospital(p = 0.044) and ICU(p = 0.013) stay were significantly higher in Group2 than in Group1.Conclusion: Preoperative FAR, which is an inexpensive and readily available test, is a promising index for predicting mortality and complications in patients with hip fracture.","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142828610","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

Transesophageal motor-evoked potentials, a novel method induced by transesophageal spinal cord stimulation, are less sensitive to anesthetics than transcranial motor-evoked potentials. 经食管运动诱发电位是一种通过经食管脊髓刺激诱发的新型方法，与经颅运动诱发电位相比，经食管运动诱发电位对麻醉剂的敏感性较低。

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2024-12-15 DOI: 10.1007/s00540-024-03443-0

Tadayoshi Kurita, Shingo Kawashima, Mohamed Mathar Sahib Ibrahim Khaleelullah, Yoshiki Nakajima

{"title":"Transesophageal motor-evoked potentials, a novel method induced by transesophageal spinal cord stimulation, are less sensitive to anesthetics than transcranial motor-evoked potentials.","authors":"Tadayoshi Kurita, Shingo Kawashima, Mohamed Mathar Sahib Ibrahim Khaleelullah, Yoshiki Nakajima","doi":"10.1007/s00540-024-03443-0","DOIUrl":"https://doi.org/10.1007/s00540-024-03443-0","url":null,"abstract":"Purpose: Intraoperative neurologic monitoring can be useful, but transcranial motor evoked potentials (TcMEPs) are sensitive to anesthetic agents. We compared the effects of anesthetics on the newly developed transesophageal motor evoked potentials (TeMEPs) with those on TcMEPs.Methods: Eleven pigs (25.6 ± 0.8 kg) were anesthetized by desflurane inhalation, remifentanil was maintained at 0.5 µg/kg/min until the end of the experiment. End-tidal desflurane concentration was then maintained at 7, 4, 10, and 13%, and TcMEPs and TeMEPs were measured at each concentration. Desflurane was then discontinued and propofol was infused at 10, 20, 40, and 60 mg/kg/h, and TcMEPs and TeMEPs were measured at each infusion dose. An electroencephalogram monitor was used to measure the hypnotic level.Results: Both desflurane and propofol anesthesia decreased bispectral index in a dose-dependent manner (P < 0.0001), replicating shallow (or adequate) to deep hypnotic levels in both anesthetic methods. The amplitude of TeMEPs was clearly larger than that of TcMEPs and was significantly larger at all anesthetic depths and all limb sites (P < 0.0001). Amplitudes of the lower extremities were lower than those of the upper extremities (P < 0.0001) for both TcMEPs and TeMEPs, but the amplitudes of TeMEPs were sufficiently large under desflurane as under propofol. The trend of concentration-dependent decrease in the amplitudes of TeMEPs under both anesthetics was not as apparent as in that of TcMEPs.Conclusions: TeMEPs are more tolerant to anesthesia than TcMEPs and may be a promising MEP monitoring technique for the lower corticospinal tract.","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142828687","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

Enhancing acute normovolemic hemodilution in cardiac surgery: the role of remimazolam and hemodynamic stability. 心脏手术中增强急性等容血稀释：雷马唑仑和血流动力学稳定性的作用。

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2024-12-09 DOI: 10.1007/s00540-024-03438-x

Eriko Kusudo, Shuji Kawamoto, Moritoki Egi

引用次数: 0