Journal of Anesthesia最新文献_第5页

Five years of experience with skin testing for perioperative anaphylaxis: diagnostic challenges and the need for updated guidelines. 围手术期过敏反应皮肤试验的五年经验：诊断挑战和更新指南的需要

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2026-10-01 Epub Date: 2026-01-21 DOI: 10.1007/s00540-026-03656-5

Yasuhiro Amano, Takahiro Tamura

引用次数: 0

Factors associated with successful initiation of labor analgesia using the dural puncture epidural technique: a retrospective cohort study. 使用硬膜穿刺硬膜外技术成功启动分娩镇痛的相关因素：一项回顾性队列研究。

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2026-09-30 DOI: 10.1007/s00540-026-03918-2

Ayaka Kuwabata, Jun Takeshita, Kazuya Tachibana

{"title":"Factors associated with successful initiation of labor analgesia using the dural puncture epidural technique: a retrospective cohort study.","authors":"Ayaka Kuwabata, Jun Takeshita, Kazuya Tachibana","doi":"10.1007/s00540-026-03918-2","DOIUrl":"https://doi.org/10.1007/s00540-026-03918-2","url":null,"abstract":"Purpose: The dural puncture epidural (DPE) technique has been proposed as a modification of conventional epidural analgesia that may influence onset and block quality. However, factors associated with successful initiation of labor analgesia using the DPE technique remain unclear. We aimed to identify predictors for successful initiation of labor analgesia using the DPE technique.Methods: This retrospective study included parturients who received DPE for initiation of labor analgesia between April 2022 and March 2025. Success was defined as a composite outcome of epidural catheter placement within 15 min from initial skin puncture with the epidural needle and a numerical rating scale (NRS) pain score ≤ 3 recorded between 30 and 60 min after the first epidural bolus. Multivariable logistic regression was performed to identify independent predictors of success.Results: Among the 1037 parturients included in the analysis, success was achieved in 693 cases, whereas 344 were classified as failures. In the multivariable analysis, operator experience (per 10 procedures) (odds ratio 1.10, 95% confidence interval 1.04 to 1.15, P < 0.001), baseline NRS (P < 0.001), cervical dilation at initiation (P = 0.038), maternal age (P = 0.013), and spinal disorder (P = 0.034) were identified as independent predictors of success.Conclusion: Operator experience was independently associated with successful initiation of labor analgesia using the DPE technique and was the only factor associated with both procedural success and early analgesic effectiveness. Operator- and patient-related factors should be considered when predicting the likelihood of successful initiation of labor analgesia using the DPE technique.","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109871","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 the letter regarding "Artificial intelligence-generated color overlay for ultrasound identification of the brachial plexus in regional anesthesia: an external validation study". 回复关于“人工智能生成的彩色叠加用于臂丛区域麻醉超声识别：一项外部验证研究”的信函。

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2026-09-30 DOI: 10.1007/s00540-026-03915-5

Yuji Kamimura

引用次数: 0

Reply to comments on Jaju et al.: Quality of recovery following intraperitoneal bupivacaine with and without dexamethasone in laparoscopic cholecystectomy: a randomized controlled trial. 回复Jaju等人的评论：腹腔镜胆囊切除术中布比卡因加地塞米松和不加地塞米松腹腔注射后的恢复质量：一项随机对照试验。

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2026-09-30 DOI: 10.1007/s00540-026-03898-3

Rishabh Jaju, Jyotirmaya Prakash Pati, Pooja Bihani, Naveen Paliwal

引用次数: 0

Clarification of age-term coding in a pediatric tracheal tube prediction model, comment on 'Selection of endotracheal tube size and insertion depth according to pediatric growth charts and physique in Japan'. 澄清儿童气管管预测模型中的年龄期编码，评论“根据日本儿童生长图表和体格选择气管管尺寸和插入深度”。

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2026-09-30 DOI: 10.1007/s00540-026-03911-9

Mengyao Jiang

引用次数: 0

Anesthesia for acute ischemic stroke after the 2026 AHA/ASA guideline: a peri-thrombectomy practice framework. 2026 AHA/ASA指南后急性缺血性卒中的麻醉：围血栓切除术实践框架

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2026-09-29 DOI: 10.1007/s00540-026-03908-4

Vikas Chauhan

{"title":"Anesthesia for acute ischemic stroke after the 2026 AHA/ASA guideline: a peri-thrombectomy practice framework.","authors":"Vikas Chauhan","doi":"10.1007/s00540-026-03908-4","DOIUrl":"https://doi.org/10.1007/s00540-026-03908-4","url":null,"abstract":"The 2026 American Heart Association/American Stroke Association guideline for acute ischemic stroke expands eligibility for endovascular thrombectomy, broadens the role of tenecteplase, recommends against routine intensive post-reperfusion systolic blood pressure lowering, introduces an explicit recommendation against intensive glucose control to 80-130 mg/dL, and includes dedicated pediatric recommendations. Although the guideline is not written primarily for anesthesiologists, its implementation directly affects peri-thrombectomy care. This narrative review translates the 2026 guideline into an implementation-oriented practice framework for anesthesia teams. Recommendations are explicitly labeled as either guideline-derived or as pragmatic anesthesia implementation suggestions informed by supporting literature. Topics covered are rapid preprocedural assessment, choice between general anesthesia and procedural sedation (including triggers for conversion from sedation to general anesthesia), hemodynamic management before and after recanalization, ventilation and metabolic targets, anesthetic drug selection, neuromonitoring, post-thrombectomy handover, and pediatric considerations. Practice-model variation is acknowledged, and the framework distinguishes physiologic and escalation principles applicable across staffing models from elements specific to continuous anesthesia-led care. Areas of substantive uncertainty include posterior-circulation anesthetic technique, pediatric peri-procedural management, and the role of intraprocedural neuromonitoring.","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149080807","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

Applications of generative artificial intelligence in chronic pain: a scoping review. 生殖人工智能在慢性疼痛中的应用：范围综述。

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2026-09-28 DOI: 10.1007/s00540-026-03910-w

Yuriko Matsuoka, Masakazu Hamada

{"title":"Applications of generative artificial intelligence in chronic pain: a scoping review.","authors":"Yuriko Matsuoka, Masakazu Hamada","doi":"10.1007/s00540-026-03910-w","DOIUrl":"https://doi.org/10.1007/s00540-026-03910-w","url":null,"abstract":"Chronic pain is a complex biopsychosocial condition that imposes substantial clinical and socioeconomic burdens worldwide. Although digital health interventions increasingly support chronic pain management, the role of generative artificial intelligence (AI) remains insufficiently characterized. This scoping review mapped applications of generative AI in chronic pain and identified research gaps. PubMed, Scopus, and Web of Science were searched on October 19, 2025, using \"chronic pain\" combined with five named generative AI systems. Primary research studies published in English that focused on generative AI applications in chronic pain were included. Of 402 records identified, 25 studies met the eligibility criteria. The studies were classified into five areas: patient and family education and self-management support; evaluation of medical information quality, accuracy, and reliability; pain assessment, analysis, and monitoring; clinical and educational support for healthcare professionals; and interpretation of patient-drawn images. Studies demonstrated technical feasibility across several applications, but most evidence was based on model performance, expert ratings, or retrospective data rather than prospective clinical outcomes. Limitations included variable accuracy, readability, AI hallucinations, inconsistent reporting, and limited external validation. Therefore, generative AI may ultimately serve as an adjunct to clinical judgment, but its clinical benefit and safety remain to be established.","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149074729","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

Assessment of fluorescence interference in the basophil activation test: a case of indocyanine green-induced anaphylaxis. 嗜碱性粒细胞激活试验中荧光干扰的评估：吲哚菁绿致过敏反应1例。

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2026-09-27 DOI: 10.1007/s00540-026-03909-3

Shotaro Sakimura, Kotaro Kakehashi, Masatsugu Watanabe, Tomonori Takazawa, Ken Yamaura

{"title":"Assessment of fluorescence interference in the basophil activation test: a case of indocyanine green-induced anaphylaxis.","authors":"Shotaro Sakimura, Kotaro Kakehashi, Masatsugu Watanabe, Tomonori Takazawa, Ken Yamaura","doi":"10.1007/s00540-026-03909-3","DOIUrl":"https://doi.org/10.1007/s00540-026-03909-3","url":null,"abstract":"Indocyanine green (ICG) is increasingly used for fluorescence-guided surgery and can rarely cause perioperative anaphylaxis. The basophil activation test (BAT) is a safe in vitro tool for identifying culprit drugs, but its flow-cytometric readout could theoretically be confounded by the intrinsic near-infrared fluorescence of dyes such as ICG, and this potential interference has not been systematically examined. We describe a patient who developed intraoperative anaphylactic shock after ICG injection and assessed whether its intrinsic fluorescence confounds the BAT. In the patient, BAT showed a clear concentration-dependent increase in CD203c expression, supporting ICG as the culprit. Two complementary observations suggested that ICG fluorescence did not substantially confound the assay: whole-blood samples containing ICG without antibodies produced no detectable signal in the PE channel, and BAT in three control subjects who tolerated ICG showed no activation except a nonspecific increase at the highest concentration. As a proof of concept, this approach may help apply BAT to ICG and, potentially, to other fluorescent or chromogenic drugs.","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149069628","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

Long-term neurodevelopmental and psychiatric risks after general anesthesia in early childhood: a nationwide population-based cohort study. 儿童早期全身麻醉后的长期神经发育和精神风险：一项基于全国人群的队列研究。

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2026-09-27 DOI: 10.1007/s00540-026-03913-7

Tak Kyu Oh, In-Ae Song

{"title":"Long-term neurodevelopmental and psychiatric risks after general anesthesia in early childhood: a nationwide population-based cohort study.","authors":"Tak Kyu Oh, In-Ae Song","doi":"10.1007/s00540-026-03913-7","DOIUrl":"https://doi.org/10.1007/s00540-026-03913-7","url":null,"abstract":"Purpose: Pre-clinical evidence suggests that general anesthesia (GA) may have neurotoxic effects on the developing brain, but clinical findings remain inconsistent. Most studies have had limited follow-up or focused on selected neurodevelopmental outcomes, and residual confounding related to surgery remains difficult to address. We investigated the association between GA exposure before age 3 and a broad spectrum of neurodevelopmental disorders (NDDs) diagnosed through adolescence.Methods: Using the South Korean National Health Insurance Service database, we identified 1,116,195 children born between 2005 and 2007. We compared children exposed to GA before age 3 with unexposed controls. The primary outcome was a new NDD diagnosis from the third birthday through 2023. Statistical analyses included 1:5 propensity-score matching with stratified Cox proportional hazards regression and multivariable Cox regression incorporating Total Relative Value Units (TRVUs) as an administrative proxy for surgical complexity.Results: In the matched cohort (n = 131,699), GA exposure was associated with a higher risk of NDDs (hazard ratio [HR], 1.19; 95% confidence interval [CI], 1.12-1.26). The largest HRs were observed for intellectual disability (HR, 1.56; 95% CI, 1.32-1.85) and autism spectrum disorder (HR, 1.46; 95% CI, 1.17-1.82).Conclusions: Exposure to GA before age 3 was associated with a modestly higher risk of NDDs diagnosed through adolescence. Exploratory findings according to anesthetic and surgical burden should be interpreted cautiously because unmeasured confounding cannot be excluded.","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149069687","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

Conventional ultrafiltration increases viscoelastic clot firmness during cardiopulmonary bypass: a prospective observational study. 常规超滤增加体外循环期间粘弹性凝块硬度：一项前瞻性观察研究。

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2026-09-25 DOI: 10.1007/s00540-026-03899-2

Chung-Sik Oh, Kyungmi Kim, Dong-Kyu Lee, Klaus Görlinger, Kyeng-Whan Kim, Sun-Young Park, Won-Kyung Kwon, Tae-Yop Kim, In-Cheol Choi

{"title":"Conventional ultrafiltration increases viscoelastic clot firmness during cardiopulmonary bypass: a prospective observational study.","authors":"Chung-Sik Oh, Kyungmi Kim, Dong-Kyu Lee, Klaus Görlinger, Kyeng-Whan Kim, Sun-Young Park, Won-Kyung Kwon, Tae-Yop Kim, In-Cheol Choi","doi":"10.1007/s00540-026-03899-2","DOIUrl":"https://doi.org/10.1007/s00540-026-03899-2","url":null,"abstract":"Purpose: Ultrafiltration (UF) reduces dilution of all blood components during cardiopulmonary bypass (CPB), but its impact on coagulation performance remains unclear. We examined whether conventional UF mitigates the CPB-induced decline in extrinsic-pathway clot firmness (MCF-EXTEM; reference range 50-72 mm) measured by rotational thromboelastometry (ROTEM), a marker of coagulopathic bleeding risk in cardiac surgery.Methods: In a prospective observational study, we recruited adult cardiac surgery patients who received UF near the end of CPB (n=39) and included patients with Pre-UF MCF EXTEM ≤50 mm (n=27). Pre-UF versus Post-UF ROTEM parameters, including MCF-EXTEM, fibrin- and platelet-based clot firmness (MCF-FIBTEM and MCF-PLTEM, respectively), were compared (Wilcoxon signed-rank tests). Changes in MCF-EXTEM and their correlation with the volume of filtered free water (UF volume) were analyzed.Results: UF volume ranging 500-1200 mL increased hematocrit from 21.0% to 25.0% by 4.0% (median, P < 0.001, effect size r = 0.811). As the primary outcome, UF increased MCF-EXTEM from 45.0 mm to 49.0 mm by 4.0 mm (median, 95% confidence interval 2.5‒6.0 mm, P = 0.001, r = 0.755). UF also increased MCF-FIBTEM by 2.0 mm (median, P < 0.001, r = 0.824), but it did not affect MCF-PLTEM (P = 0.060). A moderate positive correlation between UF volume and MCF-EXTEM change was observed (Spearman's ρ = 0.41, P = 0.033).Conclusions: Conventional UF during CPB is associated with an attenuation of the CPB‑induced decline in MCF‑EXTEM, and the pattern of changes in FIBTEM and PLTEM is consistent with predominantly fibrin‑related contributions rather than platelet‑related contribution, with an apparent dependence on UF volume.","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149061275","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