Journal of Anesthesia最新文献_第7页

Comparison of patient-controlled epidural analgesia and epidural morphine for post-cesarean section analgesia: experience from a tertiary center in China. 患者自控硬膜外镇痛与硬膜外吗啡用于剖宫产术后镇痛的比较：来自中国一家三级医疗中心的经验。

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2024-07-09 DOI: 10.1007/s00540-024-03367-9

Huazhen Liu, Zhaojue Wang, Yuelun Zhang, Yangyang Zhang, Yu Zhang, Shuai Tang

{"title":"Comparison of patient-controlled epidural analgesia and epidural morphine for post-cesarean section analgesia: experience from a tertiary center in China.","authors":"Huazhen Liu, Zhaojue Wang, Yuelun Zhang, Yangyang Zhang, Yu Zhang, Shuai Tang","doi":"10.1007/s00540-024-03367-9","DOIUrl":"10.1007/s00540-024-03367-9","url":null,"abstract":"Purpose: To compare patient-controlled epidural analgesia (PCEA) and epidural morphine (EM) for post-cesarean section analgesia in real-world experience from China.Methods: Parturients receiving one dose of EM (1-2 mg), PCEA, or both EM and PCEA from Peking Union Medical College Hospital were retrospectively recruited. Logistic models were used to identify risk factors.Results: Of 1079 parturients enrolled, 919 (85.2%) parturients received only EM, 105 (9.7%) parturients received PCEA, and 55 (5.1%) parturients received both EM and PCEA. Significantly more parturients from EM group requested supplementary analgesia than those from PCEA and PCEA + EM group (583, 63.4% vs 52, 49.5% vs 25, 45.5%, P = 0.001) with more times of supplementary analgesia (1, IQR: 0-2 vs 0, IQR: 0-1 vs 0, IQR: 0-1 times, P < 0.001) and larger amounts of nonsteroidal anti-inflammatory drugs (NSAIDs) (50, IQR: 0-100 mg vs 0, IQR: 0-50 mg vs 0, IQR: 0-50 mg, P < 0.001). In multivariable Logistic regression for the supplementary analgesia risk, the application of PCEA (OR: 0.557, 95%CI 0.396-0.783, P = 0.001) and the use of NSAIDs intraoperatively (OR: 2.996, 95%CI 1.811-4.957, P < 0.001) were identified as independent predictors. A total of 1040 (96.4%) patients received prophylactic antiemetic therapy during surgery. Only 13 (1.2%) and 7 (0.6%) patients in our cohort requested antiemetic and antipruritic drugs, respectively.Conclusion: The use of PCEA was an independent protective factor for supplementary analgesia during the post-cesarean section. Prophylactic antiemetic therapy may reduce the side effects of post-cesarean analgesia.","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141558825","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

Real-time analgesic efficacy and factors determining drug requirements of combined spinal-epidural analgesia for labor: a prospective cohort study. 实时镇痛效果和决定脊柱硬膜外联合镇痛分娩药物需求的因素：一项前瞻性队列研究。

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2024-07-05 DOI: 10.1007/s00540-024-03368-8

Shuzhen Wu, Yaxin Lu, Zijing Zhang, Linjia Zhong, Hongfei Dai, Changping Fang, Minli Huang, Zifeng Liu, Lingling Wu

{"title":"Real-time analgesic efficacy and factors determining drug requirements of combined spinal-epidural analgesia for labor: a prospective cohort study.","authors":"Shuzhen Wu, Yaxin Lu, Zijing Zhang, Linjia Zhong, Hongfei Dai, Changping Fang, Minli Huang, Zifeng Liu, Lingling Wu","doi":"10.1007/s00540-024-03368-8","DOIUrl":"https://doi.org/10.1007/s00540-024-03368-8","url":null,"abstract":"Purpose: Combined spinal-epidural analgesia (CSEA) is effective but not sufficient for labor pain. This study was conducted to assess the real-time analgesic efficacy, side effects of anesthetic drug dosage, and maternal satisfaction in labor to provide reference for the optimization of labor analgesia.Methods: This was a prospective, cohort, single-center study that included 3020 women who received CSEA for labor analgesia. The visual analogue scale (VAS) for labor pain, real-time anesthetic drug dosage, side effects, adverse labor outcomes, factors influencing average drug dosage, and maternal satisfaction with CSEA were assessed.Results: Overall, the VAS labor pain score was lowest at the first hour after the anesthesia was given. After 4 h for primiparas and 3 h for multiparas, the VAS score was greater than 3 but the anesthetic drug dosage did not reach the maximum allowed dosage at the same time. The average anesthetic drug dosage was positively correlated with fever, urinary retention, uterine atony, prolonged active phase, prolonged second stage, assisted vaginal delivery, and postpartum hemorrhage. The average anesthetic drug dosage was the highest in women ≤ 20 years old, those with a body mass index (BMI) ≥ 24.9 kg/m2, and those with a primary or secondary education level.Conclusion: Appropriate age guidance and emphasis on education of labor analgesia, weight management during pregnancy, and real-time anesthetic dosage adjustment during labor based on VAS pain score may have positive effects on the satisfaction of labor analgesia.Clinical trial number and registry: Clinicaltrials.gov (ChiCTR2100051809).","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141534486","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

Quantitative and calculated estimated blood loss in cesarean deliveries for twin and singleton pregnancies: a retrospective analysis. 双胎和单胎剖宫产的定量和计算估计失血量：回顾性分析。

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2024-07-04 DOI: 10.1007/s00540-024-03370-0

Rikako Takahashi, Yoko Sakai, Michiko Kinoshita, Yako Matsumoto, Yoshimi Nakaji, Katsuya Tanaka

{"title":"Quantitative and calculated estimated blood loss in cesarean deliveries for twin and singleton pregnancies: a retrospective analysis.","authors":"Rikako Takahashi, Yoko Sakai, Michiko Kinoshita, Yako Matsumoto, Yoshimi Nakaji, Katsuya Tanaka","doi":"10.1007/s00540-024-03370-0","DOIUrl":"https://doi.org/10.1007/s00540-024-03370-0","url":null,"abstract":"Purpose: This study retrospectively assessed blood loss during cesarean deliveries for twin and singleton pregnancies using two distinct methods, quantitative estimation measured during cesarean sections and hematocrit-based calculated estimation.Methods: We included scheduled cesarean deliveries for twin or singleton pregnancies at ≥ 34 weeks of gestation. Quantitative blood loss was recorded based on the blood volume in the graduated collector bottle and by weighing the blood-soaked textiles during cesarean sections. The blood loss was calculated using the change in hematocrit levels before and after the cesarean delivery.Results: We evaluated 403 cases including 44 twins and 359 singletons. Quantitative blood loss during cesarean section was significantly higher in twin pregnancies than that in singleton pregnancies (1117 [440] vs 698 [378] mL; p < 0.001). However, no significant differences were observed in the calculated blood loss between the two groups on the day after delivery (487 mL [692 mL] vs 507 mL [522 mL]; p = 0.861). On post-delivery days 4-5, twin pregnancies were associated with a significantly higher calculated blood loss than singleton pregnancies (725 [868] mL vs 444 [565] mL, p = 0.041). Although a significant moderate correlation between quantitative and calculated blood loss was observed in singleton pregnancies (r = 0.473, p < 0.001), no significant correlation was observed between twin pregnancies (r = 0.053, p = 0.735).Conclusion: Quantitative blood loss measurements during cesarean section may be clinically insufficient in twin pregnancies. Incorporating blood tests and continuous assessments are warranted for enhanced blood loss evaluation, especially in twin pregnancies, owing to the risk of persistent bleeding.","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141498126","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. 回信。

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2024-07-04 DOI: 10.1007/s00540-024-03363-z

Duk Kyung Kim

引用次数: 0

Letter to the article by Shirozu K, et al. 致 Shirozu K 等人文章的信

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2024-07-03 DOI: 10.1007/s00540-024-03373-x

Muhammed Halit Satıcı

引用次数: 0

Obstetric and anesthetic management in parturients with ventriculoperitoneal shunt: a case series. 脑室腹腔分流术产妇的产科和麻醉管理：病例系列。

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2024-07-01 DOI: 10.1007/s00540-024-03369-7

Ashley A Wehrle, Tasha L Welch, Ingrid L Hirte, Jeffrey J Pasternak, Emily E Sharpe

{"title":"Obstetric and anesthetic management in parturients with ventriculoperitoneal shunt: a case series.","authors":"Ashley A Wehrle, Tasha L Welch, Ingrid L Hirte, Jeffrey J Pasternak, Emily E Sharpe","doi":"10.1007/s00540-024-03369-7","DOIUrl":"https://doi.org/10.1007/s00540-024-03369-7","url":null,"abstract":"Further study is needed to determine the safest mode of delivery and anesthetic management for parturients with ventriculoperitoneal shunts (VP). Prior recommendation for delivery in women with ventriculoperitoneal shunts was cesarean delivery. However, both vaginal delivery and neuraxial anesthesia have been shown to be safe in women with appropriately functioning VP shunts. We present a case series of parturients with VP shunt. Parturients with VP shunts were identified and VP shunt placement indications, neurologic symptoms during pregnancy, delivery mode, anesthetic type, and postpartum complications were reviewed. Forty patients were identified, and fifteen women with twenty deliveries were included. Two women experienced neurological symptoms during pregnancy and one required postpartum shunt revision for blurry vision and ataxia. There were ten cesarean deliveries and ten vaginal deliveries (eight normal spontaneous, one vacuum assisted, and one forceps assisted). Assisted vaginal deliveries were performed to decrease Valsalva including the patient with neurological symptoms related to shunt malfunction. Of the vaginal deliveries, six (60%) had epidural analgesia. Anesthesia for cesarean delivery included neuraxial anesthesia (n = 5) and general anesthesia (n = 5). In our cohort, women with VP shunt received neuraxial blockade without complication. Neuraxial techniques should be offered to women with appropriately functioning VP shunt.","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141492055","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

The key to success in blocking lateral cutaneous branches with re-modified thoracoabdominal nerves block through perichondrial approach: a newly discovered space between the endothoracic fascia, diaphragm, and costodiaphragmatic recess. 通过软骨周围入路，用重新改良的胸腹神经阻断术成功阻断侧皮分支的关键：胸廓内筋膜、膈肌和肋膈凹之间新发现的空间。

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2024-06-28 DOI: 10.1007/s00540-024-03366-w

Yuichi Ohgoshi, Hidaka Anetai, Sayako Hanai, Koichiro Ichimura, Izumi Kawagoe

{"title":"The key to success in blocking lateral cutaneous branches with re-modified thoracoabdominal nerves block through perichondrial approach: a newly discovered space between the endothoracic fascia, diaphragm, and costodiaphragmatic recess.","authors":"Yuichi Ohgoshi, Hidaka Anetai, Sayako Hanai, Koichiro Ichimura, Izumi Kawagoe","doi":"10.1007/s00540-024-03366-w","DOIUrl":"https://doi.org/10.1007/s00540-024-03366-w","url":null,"abstract":"Purpose: This study aimed to determine whether the administration of a modified thoracoabdominal nerves block through perichondrial approach (M-TAPA) could result in the blockade of the lateral cutaneous branches. This study focused on a newly discovered anatomical space/plane adjacent to the M-TAPA plane, which we termed \"space between the endothoracic fascia, diaphragm, and costodiaphragmatic recess: SEDIC.\"Methods: Thirteen sides of nine formalin-embalmed cadavers were macroscopically dissected to investigate the anatomical spaces related to the effects of M-TAPA. Furthermore, ten adult volunteers were administered 20 mL of 0.2% ropivacaine into the abdominal plane (corresponding to the M-TAPA plane) and the SEDIC, and a pinprick test was performed 1 h after the injection.Results: Cadaver macrodissection revealed the presence of the SEDIC adjacent to the M-TAPA plane. The SEDIC was completely spatially isolated from the M-TAPA plane by the presence of costal cartilage and/or tendinous structures. In the volunteer study, the administration of local anesthetics into the SEDIC effectively blocked the lateral cutaneous branches of T8-T12, in addition to the anterior branches.Conclusion: Our study revealed the presence of the SEDIC adjacent to the M-TAPA plane. Administration of local anesthetics into the SEDIC, named re-modified TAPA, may have the potential to enhance the analgesic effect in the abdominal region.","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141468173","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 nociception level-directed analgesic management on opioid usage in robot-assisted laparoscopic radical prostatectomy: a single-center, single-blinded, randomized controlled trial. 机器人辅助腹腔镜根治性前列腺切除术中痛觉水平定向镇痛管理对阿片类药物用量的影响：单中心、单盲、随机对照试验。

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2024-06-27 DOI: 10.1007/s00540-024-03365-x

Nobuhiro Tanaka, Yuma Kadoya, Takanori Suzuka, Takayuki Yamanaka, Mitsuru Ida, Yusuke Naito, Naoki Ozu, Shunta Hori, Masahiko Kawaguchi

{"title":"Effect of nociception level-directed analgesic management on opioid usage in robot-assisted laparoscopic radical prostatectomy: a single-center, single-blinded, randomized controlled trial.","authors":"Nobuhiro Tanaka, Yuma Kadoya, Takanori Suzuka, Takayuki Yamanaka, Mitsuru Ida, Yusuke Naito, Naoki Ozu, Shunta Hori, Masahiko Kawaguchi","doi":"10.1007/s00540-024-03365-x","DOIUrl":"https://doi.org/10.1007/s00540-024-03365-x","url":null,"abstract":"Purpose: To assess the importance of appropriate opioid administration methods according to nociceptive monitoring.Methods: We conducted a randomized controlled trial involving 54 patients who underwent robot-assisted laparoscopic radical prostatectomy at our hospital. Patients were randomly allocated to either receive nociception level (NOL)-directed intraoperative opioid management with a minimum flow of remifentanil (NOL group) or conventional intraoperative analgesic management (control group). The primary outcome was the mean intraoperative remifentanil infusion flow rate (intraoperative remifentanil usage [μg]/ideal body weight [kg]/operation time [min]). The main secondary outcomes were plasma concentrations of three perioperative inflammatory biomarkers (interleukin-6, C-reactive protein [CRP], and cortisol levels) and postoperative pain (Numeric Rating Scale [NRS]) scores 2 h postoperatively and on postoperative days 1, 2, 3, and 7.Results: Compared with standard analgesia management, NOL-directed analgesic management reduced remifentanil consumption by 20% ( - 0.038; 95% confidence interval, - 0.059 to - 0.017; p = 0.0007). NOL-directed management did not lead to an increase in IL-6, CRP, or cortisol levels compared with conventional analgesic management. Furthermore, this protocol led to improvements in the NRS scores at rest 2 h postoperatively and upon movement up to postoperative day 3.Conclusion: NOL-directed analgesic management reduced remifentanil consumption by 20% and the NRS scores at rest 2 h postoperatively and upon movement up to postoperative day 3 without an increase in inflammatory marker levels.Registry number: Japan Registry of Clinical Trials, JRCTs052220034.","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141457070","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}

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Reply to the letter. 回信。

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2024-06-24 DOI: 10.1007/s00540-024-03361-1

Taichi Kotani, Mitsuru Ida, Yusuke Naito, Masahiko Kawaguchi

引用次数: 0

McGRATH^™ MAC size 1 vs. 2 blades: infant intubation time. McGRATH™ MAC 1 号刀片与 2 号刀片：婴儿插管时间。

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2024-06-12 DOI: 10.1007/s00540-024-03357-x

Yuka Uchinami, Noriaki Fujita, Kazuyuki Mizunoya, Isao Yokota, Yuji Morimoto

引用次数: 0