Journal of Anesthesia最新文献_第4页

Ultrasound assessment of the frequency and variation of arteries in the interscalene region. 腋窝间动脉频率和变化的超声评估。

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2024-11-06 DOI: 10.1007/s00540-024-03422-5

Rieko Oishi, Shinju Obara, Keisuke Yoshida, Shin Kurosawa, Hiroyuki Yaginuma, Satoki Inoue

{"title":"Ultrasound assessment of the frequency and variation of arteries in the interscalene region.","authors":"Rieko Oishi, Shinju Obara, Keisuke Yoshida, Shin Kurosawa, Hiroyuki Yaginuma, Satoki Inoue","doi":"10.1007/s00540-024-03422-5","DOIUrl":"https://doi.org/10.1007/s00540-024-03422-5","url":null,"abstract":"Purpose: Given the abundance of arteries in the neck, a significant risk of puncturing arteries exists when performing a brachial plexus block. Therefore, it is important to confirm the presence of arteries when performing a brachial plexus block via the interscalene approach. This study aimed to investigate the frequency and variations of arteries in the interscalene region in healthy Japanese adults using ultrasonography.Methods: This is an observational study at a university hospital. We analyzed videos of the brachial plexus recorded in another study using an ultrasound device and then investigated the frequency of the presence of arteries and the location of arteries in the interscalene region.Results: Among 68 cases, 48 (70.6%) had one or more arteries in the interscalene region (63 arteries in total). The artery frequency on the ventral side of the 5th cervical nerve (C5), between C5 and the 6th cervical nerve (C6), between C6 and the 7th cervical nerve (C7), between C7 and the 8th cervical nerve (C8), and on the dorsal side of C8 was 19.1%, 1.5%, 35.3%, 29.4%, and 7.4%, respectively. The artery frequencies between C6 and C7 and between C7 and C8 were higher than those between C5 and C6 and on the dorsal side of C8.Conclusion: Interscalene observations using ultrasound devices revealed a high artery frequency, with numerous topographic variations.","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142583134","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

Reply to a letter. 回信。

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2024-11-04 DOI: 10.1007/s00540-024-03426-1

Daichi Fujimoto, Norihiko Obata, Satoshi Mizobuchi

引用次数: 0

Preoperative hypoxic biomarkers and postoperative delirium in patients with obstructive sleep apnea. 阻塞性睡眠呼吸暂停患者术前缺氧生物标志物和术后谵妄。

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2024-11-04 DOI: 10.1007/s00540-024-03417-2

Martin Breitkopf, Elena Ahrens, Matthias L Herrmann, Stephanie Heinemann, Olivia Kuester, Haobo Ma, Andreas Walther, Christine Thomas, Gerhard W Eschweiler, Christine A F von Arnim, Soeren Wagner

{"title":"Preoperative hypoxic biomarkers and postoperative delirium in patients with obstructive sleep apnea.","authors":"Martin Breitkopf, Elena Ahrens, Matthias L Herrmann, Stephanie Heinemann, Olivia Kuester, Haobo Ma, Andreas Walther, Christine Thomas, Gerhard W Eschweiler, Christine A F von Arnim, Soeren Wagner","doi":"10.1007/s00540-024-03417-2","DOIUrl":"https://doi.org/10.1007/s00540-024-03417-2","url":null,"abstract":"Purpose: Postoperative delirium (POD) in patients with obstructive sleep apnea (OSA) is associated with increased mortality and healthcare costs. In this study, we investigated the association of OSA risk, serum biomarkers for central nervous ischemia (S100B and NSE), and POD.Methods: After research ethics approval, patients completed the STOP BANG assessment before undergoing elective surgery. Blood was drawn for S100B and NSE measurement, and cognitive performance was tested using the Montreal Cognitive Assessment (MoCA) at study admission and postoperatively at discharge. Delirium assessment was performed using the Nursing Delirium Screening Scale (NuDESC) and the Confusion Assessment Method (CAM).Results: One hundred twenty-four enrolled patients were separated into three OSA-risk groups based on STOP BANG score testing (low risk, n = 22; intermediate risk, n = 67; high risk, n = 35). Preoperative NSE values increased with OSA risk (NSE in ng/ml; mean [range]; low risk: 15.6 [9.2-44.3]; intermediate risk: 21.8 [7.6-114.1]; high risk: 29.2 [10.1-151]; p = 0.039). Postoperative MoCA and NuDESC assessments were not different between the OSA-risk groups. We found a decreasing incidence for POD with increasing OSA risk (positive CAM: low risk: 18.1%, intermediate risk: 12.0%; high risk: 11.5%, p = 0.043). However, this was no longer detectable in a complete case analysis. In patients with POD, postoperative ischemic biomarker values were not different between OSA-risk groups.Conclusion: We found a trend of decreasing POD incidence with increasing OSA risk, which was not robust in a complete case analysis. Our results possibly support the phenomenon of hypoxic preconditioning.","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568201","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

Effect of use of cuffed endotracheal tubes on the occurrence of postoperative extubation-related respiratory adverse events in pediatric patients with airway hypersensitivity: a retrospective cohort study. 使用带袖带的气管导管对气道过敏的儿科患者术后拔管相关呼吸系统不良事件发生率的影响：一项回顾性队列研究。

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2024-10-29 DOI: 10.1007/s00540-024-03423-4

Kazuma Sasaki, Jun Takeshita, Sayaka Nakamura, Kazuya Tachibana

{"title":"Effect of use of cuffed endotracheal tubes on the occurrence of postoperative extubation-related respiratory adverse events in pediatric patients with airway hypersensitivity: a retrospective cohort study.","authors":"Kazuma Sasaki, Jun Takeshita, Sayaka Nakamura, Kazuya Tachibana","doi":"10.1007/s00540-024-03423-4","DOIUrl":"https://doi.org/10.1007/s00540-024-03423-4","url":null,"abstract":"Purpose: Whether endotracheal tube (ETT) configuration (cuffed or uncuffed) influences the occurrence of respiratory adverse events (RAEs) in patients at risk remains largely unknown. We investigated the effects of cuffed ETTs on RAE occurrence after extubation in pediatric patients with airway hypersensitivity.Methods: Children aged < 8 years with increased airway hypersensitivity (defined as upper airway symptoms, recent upper respiratory infection within 2 weeks, or a history of asthma) who underwent general endotracheal anesthesia with inhaled agents between January 2021 and December 2022 were included. We retrospectively examined the patients' background and intraoperative anesthesia conditions by comparing the cuffed and uncuffed ETT groups. Multiple logistic regression analysis was performed to estimate the association between ETT configuration (cuffed vs. uncuffed) and the occurrence of RAEs or respiratory interventions (laryngospasm, peripheral capillary oxygen saturation < 92%, oxygen supplementation, epinephrine inhalation, or reintubation) after extubation.Results: Cuffed ETTs were used in 163 patients and uncuffed ETTs in 143 patients. Apart from the frequency of upper airway surgery and intraoperative fluid balance, no significant differences in background characteristics were observed between the groups. RAEs after extubation were observed in 36 (22.1%) and 28 (19.6%) patients in each cuffed and uncuffed ETT groups. After adjusting for known RAE risk factors, no difference was observed in RAEs or respiratory interventions after extubation between both groups (odds ratio, 1.14; 95% confidence interval: 0.64, 2.06).Conclusion: In pediatric patients with airway hypersensitivity, the use of cuffed ETTs did not increase the occurrence of RAEs or respiratory interventions after extubation.","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545599","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

New insights in cardiovascular anesthesia: a dual focus on clinical practice and research. 心血管麻醉的新见解：临床实践与研究的双重重点。

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2024-10-29 DOI: 10.1007/s00540-024-03421-6

Takahiro Tamura, Yusuke Yoshikawa, Satoru Ogawa, Mitsuru Ida, Naoyuki Hirata

{"title":"New insights in cardiovascular anesthesia: a dual focus on clinical practice and research.","authors":"Takahiro Tamura, Yusuke Yoshikawa, Satoru Ogawa, Mitsuru Ida, Naoyuki Hirata","doi":"10.1007/s00540-024-03421-6","DOIUrl":"https://doi.org/10.1007/s00540-024-03421-6","url":null,"abstract":"Accumulation of the results of basic and clinical research has advanced the safety and quality of management in cardiovascular anesthesia. To address recent developments in this field, a symposium was held during the 71th Japanese Society of Anesthesiologists annual meetings in 2024, focusing on new advancements in both clinical and basic research in cardiovascular anesthesia. During this symposium, four experts reviewed recent findings in their respective areas of study, covering the following topics: clinical reliability and concerns regarding volatile anesthetics during cardiopulmonary bypass; novel basic and clinical findings regarding the cardioprotective effects of dexmedetomidine; advancements in optimizing blood and hemostasis management during cardiovascular surgery; and innovative strategies for managing postoperative cognitive disorders following cardiovascular and thoracic surgery. Each expert summarized recent novel findings, clinical reliability and concerns, as well as future directions in their respective topics. We believe that this special article provides valuable insights into both clinical practice and basic research in cardiovascular anesthesia while also inspiring anesthesiologists to pursue further research in this field.","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545600","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

pBIC in analgesia management: sensitivity vs. specificity. 镇痛管理中的 pBIC：敏感性与特异性。

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2024-10-29 DOI: 10.1007/s00540-024-03425-2

Parker G Allan, Alireza Danesh, Kenichi A Tanaka, Amir L Butt

引用次数: 0

Rhomboid intercostal vs PECS blocks in radical mastectomies. 根治性乳房切除术中的横纹肌肋间阻滞与 PECS 阻滞。

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2024-10-19 DOI: 10.1007/s00540-024-03418-1

Raghuraman M Sethuraman, Srinidhi Narayanan, Sathyasuba Meenakshisundaram

引用次数: 0

Reply to the letter by Obara S. 对 Obara S. 来信的答复

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2024-10-13 DOI: 10.1007/s00540-024-03415-4

Masayuki Shima, Yasuhiro Takeshima, Munetaka Hirose

引用次数: 0

Anesthetic and obstetric predictors of general anesthesia in urgent or emergent Cesarean delivery: a retrospective case-control study. 紧急或急诊剖宫产全身麻醉的麻醉和产科预测因素：一项回顾性病例对照研究。

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2024-10-09 DOI: 10.1007/s00540-024-03411-8

G Raghavan, N Siddiqui, W Whittle, K Downey, X Y Ye, J C A Carvalho

{"title":"Anesthetic and obstetric predictors of general anesthesia in urgent or emergent Cesarean delivery: a retrospective case-control study.","authors":"G Raghavan, N Siddiqui, W Whittle, K Downey, X Y Ye, J C A Carvalho","doi":"10.1007/s00540-024-03411-8","DOIUrl":"https://doi.org/10.1007/s00540-024-03411-8","url":null,"abstract":"Purpose: While regional anesthesia (RA) is considered preferable to general anesthesia (GA) for Cesarean delivery (CD), certain situations necessitate GA. This study reviewed the practice patterns around the use of GA for CD to identify modifiable predictors of GA with the goal of reducing GA rates.Methods: This was a retrospective, case-control study. Patients undergoing urgent/emergent CD over a 3-year period were identified, from which 102 patients undergoing GA and 102 patients undergoing RA were randomly selected. The data included patient characteristics, obstetrical indications for CD, type/indication of anesthetic, characteristics of airway management (GA group)/neuraxial anesthesia (RA group), and neonatal outcomes.Results: Abnormal fetal heart rate (aFHR) was the most common obstetrical indication for urgent/emergent CD amongst the cases (39%) and controls (39%). GA administration was most commonly due to \"limited time due to maternal/fetal compromise\" (56%), followed by \"maternal contraindication to RA\" (25%) and \"inadequate RA\" (17%). The most frequent modifiable anesthetic indication for GA was inadequate neuraxial anesthesia (17%). Anesthetic and obstetric predictors for GA included ASA classification [OR 0.11 (0.06-0.21)], emergency code activation [OR 13.55 (1.73-106.40)], failure to progress [OR 0.15 ((0.06-0.36)], labor in a patient scheduled for CD [OR 0.16 (0.05-0.57)], pregnancy-related illness [OR 8.63 (1.06-70.38)], cord/fetal prolapse [14.85(1.90-115.94)], and gestational age (OR 0.86 (0.81-0.92)).Conclusion: Abnormal fetal heart rate, specifically bradycardia, was the most common obstetrical indication of GA for urgent/emergent CD, while inadequate neuraxial anesthesia was the most modifiable anesthetic indication. Our data suggest aFHR and cord/fetal prolapse as potentially modifiable risk factors for GA in certain situations.","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142390782","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

Letter to the article by Daichi Fujimoto et al. 致 Daichi Fujimoto 等人文章的信

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2024-10-09 DOI: 10.1007/s00540-024-03414-5

Chui-Yu Li, Zhi-Yuan Chen

引用次数: 0