Journal of Anesthesia最新文献

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Comparison of high-flow nasal cannula and conventional nasal cannula during deep sedation for endoscopic submucosal dissection: a randomized controlled trial. 内窥镜粘膜下剥离术深度镇静期间高流量鼻插管与传统鼻插管的比较:随机对照试验。
IF 2.8 3区 医学
Journal of Anesthesia Pub Date : 2024-10-01 Epub Date: 2024-06-02 DOI: 10.1007/s00540-024-03352-2
Seungwon Lee, Ji Won Choi, In Sun Chung, Tae Jun Kim, Woo Seog Sim, Seojin Park, Hyun Joo Ahn
{"title":"Comparison of high-flow nasal cannula and conventional nasal cannula during deep sedation for endoscopic submucosal dissection: a randomized controlled trial.","authors":"Seungwon Lee, Ji Won Choi, In Sun Chung, Tae Jun Kim, Woo Seog Sim, Seojin Park, Hyun Joo Ahn","doi":"10.1007/s00540-024-03352-2","DOIUrl":"10.1007/s00540-024-03352-2","url":null,"abstract":"<p><strong>Purpose: </strong>Adequate oxygenation and airway management during deep sedation can be challenging. We investigated the effect of high-flow nasal cannula (group HF) and conventional nasal cannula (group CO) during sedation for endoscopic submucosal dissection (ESD).</p><p><strong>Methods: </strong>Patients undergoing ESD with deep sedation were enrolled. The primary outcome was difference in lowest oxygen saturation (SpO<sub>2</sub>) between the groups. Incidence of hypoxia (SpO<sub>2</sub> < 90%), patients with SpO<sub>2</sub> < 95%, hypercapnia, and airway interventions; operator satisfaction; and adverse events were recorded.</p><p><strong>Results: </strong>Thirty-two patients in each group completed the study. The mean of minimum SpO<sub>2</sub> values was significantly higher in group HF than in group CO (96.8% ± 4.2% vs. 93.3% ± 5.3%, p = 0.005). The incidence of hypoxia was comparable between the groups (4 [12.5%] vs. 6 [18.8%], p = 0.491); however, patients with SpO<sub>2</sub> < 95% were significantly less in group HF (5 [15.6%] vs. 18 [56.3%], p = 0.003). Incidence of hypercapnia was higher in group HF than in group CO (14 [46.7%] vs. 5 [16.7%], p = 0.013). Airway rescue interventions were significantly less common in group HF. Satisfaction of operators and post-procedural complications were comparable between the two groups. In multivariable analysis, group CO and higher body mass index were risk factors for airway managements (odds ratio [95% confidence interval]: 6.204 [1.784-21.575], p = 0.004; 1.337 [1.043-1.715], p = 0.022, respectively).</p><p><strong>Conclusions: </strong>Compared to conventional nasal cannula, high-flow nasal cannula maintained higher minimum SpO<sub>2</sub> value during deep sedation with propofol-remifentanil for ESD.</p><p><strong>Trial registration: </strong>Clinical Trial Registry of the Republic of Korea (KCT0006618, https://cris.nih.go.kr ; registered September 29, 2021; principal investigator: Ji Won Choi).</p>","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":"591-599"},"PeriodicalIF":2.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141186050","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
Remimazolam for anesthesia and sedation in pediatric patients: a scoping review. 用于儿科患者麻醉和镇静的雷马唑仑:范围界定综述。
IF 2.8 3区 医学
Journal of Anesthesia Pub Date : 2024-10-01 Epub Date: 2024-06-07 DOI: 10.1007/s00540-024-03358-w
Marina Pieri, Jacopo D'Andria Ursoleo, Ambra Licia Di Prima, Samuele Bugo, Gaia Barucco, Margherita Licheri, Rosario Losiggio, Giovanna Frau, Fabrizio Monaco
{"title":"Remimazolam for anesthesia and sedation in pediatric patients: a scoping review.","authors":"Marina Pieri, Jacopo D'Andria Ursoleo, Ambra Licia Di Prima, Samuele Bugo, Gaia Barucco, Margherita Licheri, Rosario Losiggio, Giovanna Frau, Fabrizio Monaco","doi":"10.1007/s00540-024-03358-w","DOIUrl":"10.1007/s00540-024-03358-w","url":null,"abstract":"<p><p>Anesthetic management of pediatric patients poses several challenges and the optimal anesthetic agent for use in this population is still a matter of debate. We systematically searched PubMed/MEDLINE and Google Scholar from their inception for studies that investigated the role and potential applications of remimazolam, a novel ultra-short-acting benzodiazepine, in pediatric patients. Furthermore, in March 2024, an update of the literature search along with an additional post-hoc search on the EMBASE database were performed. A total of fourteen pertinent studies which spanned the 2021-2023 period explored remimazolam as either the primary or adjuvant hypnotic agent for inducing and/or maintaining general anesthesia or sedation. Preliminary evidence derived from these studies highlighted that remimazolam is a safe and effective option for both sedation and general anesthesia in pediatric patients, particularly those with concurrent mitochondrial disorders, myopathic diseases, or at risk for malignant hyperthermia. Moreover, the current evidence suggested that remimazolam may contribute to reducing preoperative anxiety and postoperative delirium in children. Its favorable pharmacodynamic and pharmacokinetic profile demonstrated potential safety, effectiveness, and ease-of-use in various perioperative pediatric contexts, making it suitable for integration into specific protocols, such as intraoperative monitoring of evoked potentials and management of difficult intubation. Notwithstanding these promising findings, further research is essential to determine optimal dosages, establish conclusive evidence of its superiority over other benzodiazepines, and elucidate the impact of genetic factors on drug metabolism.</p>","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":"692-710"},"PeriodicalIF":2.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141283780","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
Clinical relevance of different responses of elastic and muscular arteries in acute hemorrhage-perspectives from anesthesiologists. 急性大出血时弹性动脉和肌肉动脉不同反应的临床意义--来自麻醉师的观点。
IF 2.8 3区 医学
Journal of Anesthesia Pub Date : 2024-10-01 Epub Date: 2024-07-09 DOI: 10.1007/s00540-024-03371-z
Keisuke Yoshida, Shinju Obara, Tatsumi Yakushiji, Takahiro Hakozaki, Satoki Inoue
{"title":"Clinical relevance of different responses of elastic and muscular arteries in acute hemorrhage-perspectives from anesthesiologists.","authors":"Keisuke Yoshida, Shinju Obara, Tatsumi Yakushiji, Takahiro Hakozaki, Satoki Inoue","doi":"10.1007/s00540-024-03371-z","DOIUrl":"10.1007/s00540-024-03371-z","url":null,"abstract":"","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":"725-726"},"PeriodicalIF":2.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141558824","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
Development of long-acting local anesthetics: a long way from basic research to clinical application. 长效局部麻醉剂的开发:从基础研究到临床应用的漫长道路。
IF 2.8 3区 医学
Journal of Anesthesia Pub Date : 2024-10-01 Epub Date: 2024-08-09 DOI: 10.1007/s00540-024-03387-5
Yutaka Oda
{"title":"Development of long-acting local anesthetics: a long way from basic research to clinical application.","authors":"Yutaka Oda","doi":"10.1007/s00540-024-03387-5","DOIUrl":"10.1007/s00540-024-03387-5","url":null,"abstract":"","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":"581-583"},"PeriodicalIF":2.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141906701","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 Oh et al. 致 Oh 等人文章的信
IF 2.8 3区 医学
Journal of Anesthesia Pub Date : 2024-10-01 Epub Date: 2024-06-01 DOI: 10.1007/s00540-024-03353-1
Mengjun Wu, Bin Shi
{"title":"Letter to the article by Oh et al.","authors":"Mengjun Wu, Bin Shi","doi":"10.1007/s00540-024-03353-1","DOIUrl":"10.1007/s00540-024-03353-1","url":null,"abstract":"","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":"717-718"},"PeriodicalIF":2.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141186051","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
Association between general anesthesia in early childhood and neurodevelopment up to 4 years of age: the Japan Environment and Children's Study. 幼儿期全身麻醉与 4 岁前神经发育的关系:日本环境与儿童研究。
IF 2.8 3区 医学
Journal of Anesthesia Pub Date : 2024-10-01 Epub Date: 2024-06-07 DOI: 10.1007/s00540-024-03359-9
Takahisa Nagai, Yoshiko Yoda, Narumi Tokuda, Yasuhiro Takeshima, Munetaka Hirose, Masayuki Shima
{"title":"Association between general anesthesia in early childhood and neurodevelopment up to 4 years of age: the Japan Environment and Children's Study.","authors":"Takahisa Nagai, Yoshiko Yoda, Narumi Tokuda, Yasuhiro Takeshima, Munetaka Hirose, Masayuki Shima","doi":"10.1007/s00540-024-03359-9","DOIUrl":"10.1007/s00540-024-03359-9","url":null,"abstract":"<p><strong>Purpose: </strong>The effects of general anesthesia on neurodevelopment in children remain controversial. We explored the relationship between general anesthesia and neurodevelopment in children participating in the Japan Environment and Children's Study (JECS).</p><p><strong>Methods: </strong>This study enrolled children born between 37 and 41 weeks of pregnancy via single-vaginal delivery to pregnant women registered in the JECS between January 2011 and March 2014. Data were collected from mother-completed questionnaires and medical transcripts. Neurodevelopment in five domains was assessed every 6 months between 12 and 48 months of age, using the Ages and Stages Questionnaires. The associations between general anesthesia exposure during early childhood and neurodevelopment in children were evaluated at each time point. Adjusted odds ratios and 95% confidence intervals were estimated after covariate adjustment using logistic regression models.</p><p><strong>Results: </strong>Children who received general anesthesia before age 1 year had higher risks of neurodevelopmental delay in all five domains throughout the observational period. The largest risk was for gross motor delay at 18 months (adjusted odds ratio: 3.51; 95% confidence interval: 2.75-4.49). The effects on the incidence of neurodevelopmental delays after age 3 were not observed except for problem solving at 48 months. The risk of neurodevelopmental delay in children who first received general anesthesia after age 1 was considerably small.</p><p><strong>Conclusions: </strong>This study suggests that general anesthesia administration before age 1 is associated with neurodevelopmental delay during 1-4 years of age. The risk of general anesthesia after age 1 may be small.</p>","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":"609-621"},"PeriodicalIF":2.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11415522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141283779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Is remimazolam superior to propofol in TAVR procedure? 在 TAVR 手术中,瑞马唑仑是否优于异丙酚?
IF 2.8 3区 医学
Journal of Anesthesia Pub Date : 2024-10-01 Epub Date: 2024-05-31 DOI: 10.1007/s00540-024-03356-y
Shingo Kawashima, Tetsuro Kimura, Hiroyuki Kinoshita
{"title":"Is remimazolam superior to propofol in TAVR procedure?","authors":"Shingo Kawashima, Tetsuro Kimura, Hiroyuki Kinoshita","doi":"10.1007/s00540-024-03356-y","DOIUrl":"10.1007/s00540-024-03356-y","url":null,"abstract":"","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":"721-722"},"PeriodicalIF":2.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141183674","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 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 : 2024-10-01 Epub Date: 2024-07-03 DOI: 10.1007/s00540-024-03373-x
Muhammed Halit Satıcı
{"title":"Letter to the article by Shirozu K, et al.","authors":"Muhammed Halit Satıcı","doi":"10.1007/s00540-024-03373-x","DOIUrl":"10.1007/s00540-024-03373-x","url":null,"abstract":"","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":"729"},"PeriodicalIF":2.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141492054","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
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 : 2024-10-01 Epub 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":"<p><strong>Purpose: </strong>To compare patient-controlled epidural analgesia (PCEA) and epidural morphine (EM) for post-cesarean section analgesia in real-world experience from China.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":"650-655"},"PeriodicalIF":2.8,"publicationDate":"2024-10-01","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
Relationship between epidural catheter migration beneath the skin and subcutaneous fat thickness assessed using postoperative CT imaging: a retrospective cross-sectional study. 利用术后 CT 成像评估硬膜外导管向皮下移位与皮下脂肪厚度之间的关系:一项回顾性横断面研究。
IF 2.8 3区 医学
Journal of Anesthesia Pub Date : 2024-10-01 Epub Date: 2024-07-11 DOI: 10.1007/s00540-024-03374-w
Natsumi Sakamoto, Mitsuhiro Matsuo, Tomonori Takazawa
{"title":"Relationship between epidural catheter migration beneath the skin and subcutaneous fat thickness assessed using postoperative CT imaging: a retrospective cross-sectional study.","authors":"Natsumi Sakamoto, Mitsuhiro Matsuo, Tomonori Takazawa","doi":"10.1007/s00540-024-03374-w","DOIUrl":"10.1007/s00540-024-03374-w","url":null,"abstract":"<p><strong>Purpose: </strong>The causes of epidural catheter migration beneath the skin have not been previously investigated. We hypothesized that greater subcutaneous fat thickness might be associated with increased catheter migration beneath the skin.</p><p><strong>Methods: </strong>We conducted a retrospective cross-sectional study of patients who had undergone combined general and epidural anesthesia, selecting individuals who received thoracic and abdominal CT scans within the first 5 postoperative days. Needle depth was defined as the distance from the needle tip to the skin surface when the anesthesiologist determined that the needle tip had reached the epidural space. We measured the length of the epidural catheter from the skin surface to the epidural space (catheter length), and subcutaneous fat thickness (fat thickness) using CT imaging. Migration distance was calculated by subtracting needle depth from catheter length.</p><p><strong>Results: </strong>We analyzed 127 patients (72 males), all undergoing epidural catheter insertion in the left lateral decubitus position via a paramedian approach. The median age of the patients was 71 years. Epidural catheters were postoperatively found to substantially curve beneath the skin. Regression analysis revealed no significant influence of fat thickness on catheter length (regression coefficient 0.10, 95% confidence interval [CI]: - 0.17, 0.38). However, it indicated a positive correlation between fat thickness and needle depth (regression coefficient 0.50, 95% CI: 0.30, 0.70), and a negative correlation between fat thickness and migration distance (regression coefficient - 0.40, 95% CI: - 0.65, - 0.14).</p><p><strong>Conclusion: </strong>We found a negative correlation between epidural catheter migration beneath the skin and subcutaneous fat thickness. Anesthesiologists should be aware of the possibility of substantial subcutaneous curving of the catheter, especially in patients with scant subcutaneous fat.</p>","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":"674-680"},"PeriodicalIF":2.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141579753","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
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