Journal of Anesthesia最新文献

{"title":"Comments on Jaju et al.: Quality of recovery following intraperitoneal bupivacaine with and without dexamethasone in laparoscopic cholecystectomy.","authors":"Nicole DerSahakian, Min Uk Jang, Amir L Butt, Hamid Reza Vahabzadeh-Monshie","doi":"10.1007/s00540-026-03893-8","DOIUrl":"10.1007/s00540-026-03893-8","url":null,"abstract":"","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148976907","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":"Repeated perioperative hypersensitivity reactions and positive challenge testing strongly suggest sevoflurane hypersensitivity: a clinical report with supportive basophil activation testing.","authors":"Tatsuo Horiuchi, Yuri Oshima, Hisashi Shimotori, Naoko Suzuki, Ryosuke Funabiki, Daichi Sadato, Yuka Harada, Hiroshi Sato","doi":"10.1007/s00540-026-03895-6","DOIUrl":"https://doi.org/10.1007/s00540-026-03895-6","url":null,"abstract":"<p><p>A 75-year-old man repeatedly developed immediate hypersensitivity reactions during general anesthesia. Because sevoflurane was suspected as the causative agent based on reproducible reactions during multiple anesthetic procedures, further diagnostic evaluation was performed. Skin testing for other perioperative agents was negative. A sevoflurane challenge test reproduced similar clinical symptoms. Basophil activation testing (BAT) showed basophil activation following sevoflurane exposure. Although methodological limitations were present, the combined clinical reproducibility, positive challenge testing, and supportive BAT findings strongly suggested sevoflurane hypersensitivity. This case suggests that BAT may provide supportive additional information when evaluating suspected hypersensitivity reactions to volatile anesthetics.</p>","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148944654","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":"Intraoperative hypotensive burden with remimazolam versus propofol during ambulatory dental anesthesia in adults with intellectual disabilities: a retrospective within-subject study.","authors":"Jieun Kim, Myong-Hwan Karm, Sooyoung Jeon","doi":"10.1007/s00540-026-03896-5","DOIUrl":"https://doi.org/10.1007/s00540-026-03896-5","url":null,"abstract":"<p><strong>Purpose: </strong>Intraoperative hypotension is common during general anesthesia and may be poorly tolerated by adults with intellectual disabilities, who often require general anesthesia for dental care. We compared intraoperative hypotensive burden during propofol- versus remimazolam-based maintenance in this population.</p><p><strong>Methods: </strong>We retrospectively analyzed 150 ambulatory dental general anesthesia episodes from 47 adults with intellectual disabilities who received both propofol- and remimazolam-based maintenance. The primary outcome was the percentage of maintenance-phase time with mean arterial pressure (MAP) below 80% of the episode-specific baseline. Outcomes were analyzed using linear mixed-effects models with a patient-level random intercept. Sensitivity analyses included covariate adjustment, a patient fixed-effects model, an anesthesia-time-matched paired comparison, alternative outcome models, and analyses of temporal confounding.</p><p><strong>Results: </strong>The percentage of maintenance-phase time with MAP below 80% of baseline was lower during remimazolam-based maintenance than during propofol-based maintenance (median, 0.0% vs. 23.3%; estimated difference, -21.4 percentage points; 95% confidence interval, -29.2 to -13.7; P < 0.001). Remimazolam-based maintenance was also associated with a higher mean maintenance MAP (+ 4.6 mmHg; P < 0.001). The remimazolam-with-flumazenil-reversal strategy was associated with a shorter postanesthesia care unit stay (- 14.4 min; P < 0.001). The primary association remained directionally consistent across sensitivity analyses but was attenuated after calendar-time adjustment. Time-weighted average measures did not differ significantly.</p><p><strong>Conclusion: </strong>In adults with intellectual disabilities undergoing ambulatory dental anesthesia, remimazolam-based maintenance was associated with less time below the prespecified relative MAP threshold than propofol-based maintenance. Because residual temporal and procedure-related confounding precludes causal inference, this finding should be considered hypothesis-generating.</p><p><strong>Trial registration: </strong>Clinical Research Information Service (CRIS), Republic of Korea; registration number KCT0011046; registered on September 19, 2025.</p>","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148930003","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 comments on IoC2-guided analgesic titration.","authors":"Tianran Gang, Airin Usui, Xiaowen Liu","doi":"10.1007/s00540-026-03891-w","DOIUrl":"https://doi.org/10.1007/s00540-026-03891-w","url":null,"abstract":"","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148919816","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":"Use of high-flow nasal oxygenation in minimizing the occurrence of hypotension during induction of anesthesia with remimazolam in elderly patients.","authors":"Ryosuke Osawa, Reo Uchida, Takashi Asai","doi":"10.1007/s00540-026-03894-7","DOIUrl":"https://doi.org/10.1007/s00540-026-03894-7","url":null,"abstract":"<p><p>Remimazolam is said to have minimum inhibitory effect on blood pressure during induction of anesthesia, but in elderly patient, hypotension may frequently occur. We assessed if avoidance of facemask ventilation (by using high-flow nasal oxygenation) after induction of anesthesia with remimazolam was associated with a low incidence of hypotension in elderly patients. With the ethics committee's approval of the study and patients' written informed consent, we studied ten patients aged ≧ 70 yr-old to obtain the incidence of hypotension (defined as the lowest mean arterial pressure of ≦ 60 mmHg) after induction of anesthesia with remimazolam (6 mg/kg/h, which was reduced to 1 mg/kg/h after the loss of consciousness), with high-flow nasal oxygenation (40 L/min, which was increased to 70 L/min after the loss of consciousness). The mean blood pressure significantly decreased after induction of anesthesia (P < 0.0001; mean decrease: 29% [95%CI 22 - 35%]), and hypotension was observed in 1 of 10 patients (10%; 95%CI 0 - 40%). None of the patients developed hypoxemia or required positive pressure ventilation via a facemask. In conclusion, avoidance of facemask ventilation (by using high-flow nasal oxygenation) after induction of anesthesia with remimazolam would be associated with a low incidence of hypotension in elderly patients.</p>","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148912034","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":"In reply: interpreting an IoC2-guided analgesic titration protocol.","authors":"Tianran Gang, Xiaowen Liu","doi":"10.1007/s00540-026-03892-9","DOIUrl":"https://doi.org/10.1007/s00540-026-03892-9","url":null,"abstract":"","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148912097","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":"Comment on \"Esketamine versus dexmedetomidine for oxygenation and postoperative quality of recovery in thoracoscopic surgery: a randomized, double-blind, non-inferiority controlled trial\" by Feng et al.","authors":"Yeşim Şerife Bayraktar","doi":"10.1007/s00540-026-03881-y","DOIUrl":"10.1007/s00540-026-03881-y","url":null,"abstract":"","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148912102","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-brightness anti-reflective monitor for videolaryngoscopic tracheal intubation under direct sunlight: a mannequin study.","authors":"Naoi Tsurumachi, Ryosuke Osawa, Shuse Matsuyama, Ne-Hooi Will Loh, Takashi Asai","doi":"10.1007/s00540-026-03884-9","DOIUrl":"https://doi.org/10.1007/s00540-026-03884-9","url":null,"abstract":"","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148906373","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":"Comment on \"The effect of intravenous low-dose steroids on post-operative delirium in older adult patients undergoing non-cardiac surgery: a retrospective cohort analysis\" by Hsu et al.","authors":"Sheridan Rodrigues, Grant Manion, Amir L Butt, Aimee Pak","doi":"10.1007/s00540-026-03890-x","DOIUrl":"https://doi.org/10.1007/s00540-026-03890-x","url":null,"abstract":"","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900658","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":"Comment on \"Usefulness of the phase angle for inflammation criteria of the global leadership initiative on malnutrition in critically ill patients\" by Kariya et al.","authors":"Yaqin Huang, Zhuo Chen, Yin Li","doi":"10.1007/s00540-026-03889-4","DOIUrl":"10.1007/s00540-026-03889-4","url":null,"abstract":"","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900651","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}