Journal of Anesthesia最新文献

{"title":"Vasopressors against post-spinal anesthesia hypotension.","authors":"Christine T Vo, Grace Townsend, Alexandra L Regens, Amir L Butt","doi":"10.1007/s00540-024-03375-9","DOIUrl":"10.1007/s00540-024-03375-9","url":null,"abstract":"","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":"891-892"},"PeriodicalIF":2.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141558827","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":"Pulmonary vein stump thrombosis and organ infarction after lung lobectomy.","authors":"Teiji Sawa, Pipat Saeyup, Mao Kinoshita, Atsushi Kainuma, Satoru Ogawa, Fumimasa Amaya, Koichi Akiyama","doi":"10.1007/s00540-024-03389-3","DOIUrl":"10.1007/s00540-024-03389-3","url":null,"abstract":"<p><p>Lung resection surgery, which is performed as a treatment for lung cancer and metastatic lung tumors, is currently conducted via minimally invasive techniques such as video-assisted thoracoscopic surgery and robot-assisted methods. Postoperative complications related to this surgery, such as pulmonary vein thrombosis and cerebral and other organ infarctions, have been increasingly reported. The primary cause of these complications is thrombus formation in the pulmonary vein stump. Statistical data on the site of lung lobectomy have indicated that surgeries involving the left upper lobe are most frequently associated with embolic complications. Although this issue has not received considerable attention in anesthesiology, the importance of prevention and treatment in postoperative management is growing. The role of anesthesiologists in preventing these complications is critical. These roles involve careful fluid management to avoid hypercoagulable states, consideration of early postoperative anticoagulation therapy, assessment of the suitability of epidural anesthesia for postoperative anticoagulation, and improvement of hospital-wide safety systems and monitoring of high-risk patients. Anesthesiologists need to understand the pathology and risk factors involved and play an active role in preventing and treating these complications through effective collaboration with thoracic surgeons and the in-hospital stroke team.</p>","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":"866-878"},"PeriodicalIF":2.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141912787","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":"Agreement between non-invasive and invasive arterial blood pressure during surgery in the prone position: an error grid analysis.","authors":"Takashi Juri, Koichi Suehiro, Masayo Takai, Daisuke Nakada, Kanae Takahashi, Yohei Fujimoto, Takashi Mori","doi":"10.1007/s00540-024-03385-7","DOIUrl":"10.1007/s00540-024-03385-7","url":null,"abstract":"<p><strong>Purpose: </strong>Prone position has recently gained renewed importance as a treatment for acute respiratory distress syndrome and spine and brain surgeries. Our study aimed to perform an error grid analysis to examine the clinical discrepancies between arterial blood pressure (ABP) and non-invasive blood pressure (NIBP) in the prone position and to investigate the risk factors influencing these differences.</p><p><strong>Methods: </strong>Error grid analysis was performed retrospectively on 1389 pairs of 100 consecutive prone positioning cases. This analysis classifies the difference between the two methods into five clinically relevant zones, from \"no risk\" to \"dangerous risk\". Additionally, multivariable ordinal logistic regression analysis was conducted to evaluate the relationship between the risk zones of mean blood pressure (MBP), as classified by error grid analysis and the covariate of interest.</p><p><strong>Results: </strong>Error grid analysis showed that the proportions of measurement pairs in risk zones A-E for systolic blood pressure were 96.8%, 3.2%, 0.1%, 0%, and 0%, respectively. In contrast, the MBP proportions were 74.0%, 25.1%, 0.9%, 0.1%, and 0%. Multivariable ordinal logistic regression analysis revealed that the position of arms (next to the head) was a significant factor (adjusted odds ratio: 4.35, 95% CI: 2.38-8.33, P < 0.001).</p><p><strong>Conclusion: </strong>Error grid analysis revealed a clinically unacceptable discrepancy between ABP and NIBP for MBP during prone positioning surgery. The position of the arms next to the head was associated with increased clinical discrepancy between the two MBP measurement methods.</p>","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":"765-770"},"PeriodicalIF":2.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141975708","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":"The concept of \"fictitious weight\" in pharmacokinetic simulations and target-controlled infusion.","authors":"Shinju Obara","doi":"10.1007/s00540-024-03413-6","DOIUrl":"10.1007/s00540-024-03413-6","url":null,"abstract":"","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":"733-737"},"PeriodicalIF":2.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142347144","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":"A novel stimulating electrode attachment method designed to maintain electromyography-based neuromuscular monitoring detectability during laparoscopic surgery: a single-center randomized, double-blind, controlled pilot study.","authors":"Shohei Kaneko, Madoka Makino, Yurika Kawazoe, Shuntaro Sato, Akira Iwamizu, Ryu Narimatsu, Hikari Yamaguchi, Kana Miyagawa, Taiga Ichinomiya, Hiroaki Murata, Osamu Yoshitomi, Tetsuya Hara","doi":"10.1007/s00540-024-03397-3","DOIUrl":"10.1007/s00540-024-03397-3","url":null,"abstract":"<p><strong>Purpose: </strong>We evaluated the electromyography (EMG)-based neuromuscular monitoring detectability of our novel stimulating electrode attachment method compared to the original Nihon-Kohden (Tokyo, Japan) attachment method.</p><p><strong>Methods: </strong>This single-center randomized, double-blind, controlled pilot study enrolled 32 patients aged ≥ 18 years, undergoing scheduled laparoscopic surgery. The EMG electrode NM-345Y™ was attached to one forearm using the Nihon-Kohden method (Pattern N-K) and the other forearm using our novel method (Pattern Cross). The allocation to each attachment method was determined post-randomization. In Pattern Cross, the NM-345Y™ was attached such that the line connecting the anode and cathode crosses the ulnar nerve. Patients received 0.9 mg/kg rocuronium after calibration with the forearm in 90-degree supination. Following tracheal intubation, the forearm was positioned in 0-degree pronation. Intraoperatively, 0.2 mg/kg rocuronium was administered if the train-of-four (TOF) count one persisted for 1 min on either side. Post-surgery, the forearm position was returned to 90-degree supination, and rocuronium was antagonized with sugammadex. TOF and post-tetanic count (PTC) were simultaneously measured bilaterally every 15 s and 5 min, respectively, from post-calibration to tracheal extubation.</p><p><strong>Results: </strong>The time to first PTC appearance was significantly shorter by 33 min in the Pattern Cross group than in the Pattern N-K group (95% Confidence interval: 1-66, p = 0.043). Following sugammadex administration, TOF ratios ≥ 0.9 were achieved in 72% of patients in the Pattern N-K group and 97% of those in the Pattern Cross group (p = 0.025).</p><p><strong>Conclusions: </strong>Crossing the line connecting the anode and cathode with the ulnar nerve stabilizes EMG-based neuromuscular monitoring detectability.</p>","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":"811-820"},"PeriodicalIF":2.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142107681","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":"Letter to the article by Hassabelnaby et al.","authors":"Jing Yuan, Bin Shi, Lufei Huang","doi":"10.1007/s00540-024-03372-y","DOIUrl":"10.1007/s00540-024-03372-y","url":null,"abstract":"","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":"889"},"PeriodicalIF":2.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141893493","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":"Pregnancy ameliorates neuropathic pain through suppression of microglia and upregulation of the δ-opioid receptor in the anterior cingulate cortex in late-pregnant mice.","authors":"Atsushi Sawada, Michiaki Yamakage","doi":"10.1007/s00540-024-03402-9","DOIUrl":"10.1007/s00540-024-03402-9","url":null,"abstract":"<p><strong>Purpose: </strong>Pregnancy-induced analgesia develops in late pregnancy, but its mechanisms are unclear. The anterior cingulate cortex (ACC) plays a key role in the pathogenesis of neuropathic pain. The authors hypothesized that pregnancy-induced analgesia ameliorates neuropathic pain by suppressing activation of microglia and the expression of alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptors, and by upregulating opioid receptors in the ACC in late-pregnant mice.</p><p><strong>Methods: </strong>Neuropathic pain was induced in non-pregnant (NP) or pregnant (P) C57BL/6JJmsSlc female mice by partial sciatic nerve ligation (PSNL). The nociceptive response was evaluated by mechanical allodynia and activation of microglia in the ACC was evaluated by immunohistochemistry. The expressions of phosphorylated AMPA receptors and opioid receptors in the ACC were evaluated by immunoblotting.</p><p><strong>Results: </strong>In von Frey reflex tests, NP-PSNL-treated mice showed a lower 50% paw-withdrawal threshold than NP-Naïve mice on experimental day 9. No difference in 50% paw-withdrawal threshold was found among the NP-Naïve, NP-Sham, P-Sham, and P-PSNL-treated mice. The number of microglia in the ACC was significantly increased in NP-PSNL-treated mice compared to NP-Sham mice. Immunoblotting showed significantly increased expression of phosphorylated AMPA receptor subunit GluR1 at Ser831 in NP-PSNL-treated mice compared to NP-Sham mice. Immunoblotting also showed significantly increased δ-opioid receptor in the ACC in P-Sham and P-PSNL-treated mice compared to NP-Sham mice.</p><p><strong>Conclusion: </strong>Pregnancy-induced analgesia ameliorated neuropathic pain by suppressing activation of microglia and the expression of phosphorylated AMPA receptor subunit GluR1 at Ser831, and by upregulation of the δ-opioid receptor in the ACC in late-pregnant mice.</p>","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":"828-838"},"PeriodicalIF":2.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142154061","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":"High spinal block in cesarean section.","authors":"Ahmed M Hasanin, Rana M Zaki, Maha Mostafa","doi":"10.1007/s00540-024-03378-6","DOIUrl":"10.1007/s00540-024-03378-6","url":null,"abstract":"","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":"890"},"PeriodicalIF":2.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141620063","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":"Vasopressors in obstetrics: guidelines and good practice.","authors":"Ahmed M Hasanin, Rana M Zaki, Maha Mostafa","doi":"10.1007/s00540-024-03379-5","DOIUrl":"10.1007/s00540-024-03379-5","url":null,"abstract":"","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":"893-894"},"PeriodicalIF":2.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141620064","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":"Recommendation for the practice of total intravenous anesthesia.","authors":"Shinju Obara, Kotoe Kamata, Masakazu Nakao, Shigeki Yamaguchi, Shuya Kiyama","doi":"10.1007/s00540-024-03398-2","DOIUrl":"10.1007/s00540-024-03398-2","url":null,"abstract":"<p><p>This Recommendation was developed by the Japanese Society of Intravenous Anesthesia Recommendation Making Working Group (JSIVA-WG) to promote the safe and effective practice of total intravenous anesthesia (TIVA), tailored to the current situation in Japan. It presents a policy validated by the members of JSIVA-WG and a review committee for practical anesthesia management. Anesthesiologists should acquire and maintain the necessary knowledge and skills to be able to administer TIVA properly. A secure venous access is critically important for TIVA. To visualize and understand the pharmacokinetics of intravenous anesthetics, use of real-time pharmacokinetic simulations is strongly recommended. Syringe pumps are essential for the infusion of intravenous anesthetics, which should be prepared according to the rules of each individual anesthesia department, particularly with regard to dilution. Syringes should be clearly labeled with content and drug concentration. When managing TIVA, particularly with the use of muscle relaxants, monitoring processed electroencephalogram (EEG) is advisable. However, the depth of sedation/anesthesia must be assessed comprehensively using various parameters, rather than simply relying on a single EEG index. TIVA should be swiftly changed to an alternative method that includes inhalation anesthesia if necessary. Use of antagonists at emergence may be associated with re-sedation risk. Casual administration of antagonists and sending patients back to surgical wards without careful observation are not acceptable.</p>","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":"738-746"},"PeriodicalIF":2.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142107685","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}