Journal of Anesthesia最新文献_第9页

Does the oxygen reserve index play a role in oxygen therapy? 氧储备指数在氧疗中起作用吗？

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2024-08-01 Epub Date: 2021-10-25 DOI: 10.1007/s00540-021-03014-7

Shingo Kawashima, Hiroyuki Kinoshita

引用次数: 0

Incidence of sodium-glucose cotransporter-2 inhibitor-associated perioperative ketoacidosis in surgical patients: a prospective cohort study. 手术患者围术期酮症酸中毒与钠-葡萄糖共转运体-2 抑制剂相关的发生率：一项前瞻性队列研究。

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2024-08-01 Epub Date: 2024-03-17 DOI: 10.1007/s00540-024-03335-3

Hiroyuki Seki, Norifumi Kuratani, Toshiya Shiga, Yudai Iwasaki, Kanae Karita, Kazuki Yasuda, Natsuko Yamamoto, Yuko Nakanishi, Kenji Shigematsu, Kensuke Kobayashi, Junichi Saito, Ichiro Kondo, Nozomu Yaida, Hidenobu Watanabe, Midoriko Higashi, Tetsuro Shirasaka, Akira Doshu-Kajiura, Mitsutaka Edanaga, Satoshi Tanaka, Saori Ikumi, Shingo Ito, Masayuki Okada, Tomoko Yorozu

{"title":"Incidence of sodium-glucose cotransporter-2 inhibitor-associated perioperative ketoacidosis in surgical patients: a prospective cohort study.","authors":"Hiroyuki Seki, Norifumi Kuratani, Toshiya Shiga, Yudai Iwasaki, Kanae Karita, Kazuki Yasuda, Natsuko Yamamoto, Yuko Nakanishi, Kenji Shigematsu, Kensuke Kobayashi, Junichi Saito, Ichiro Kondo, Nozomu Yaida, Hidenobu Watanabe, Midoriko Higashi, Tetsuro Shirasaka, Akira Doshu-Kajiura, Mitsutaka Edanaga, Satoshi Tanaka, Saori Ikumi, Shingo Ito, Masayuki Okada, Tomoko Yorozu","doi":"10.1007/s00540-024-03335-3","DOIUrl":"10.1007/s00540-024-03335-3","url":null,"abstract":"Purpose: Sodium-glucose cotransporter 2 inhibitors (SGLT2is) are commonly prescribed anti-diabetic medications with various beneficial effects; however, they have also been associated with ketoacidosis. The aim of this study was to determine the incidence of SGLT2i-associated perioperative ketoacidosis (SAPKA) in surgical patients.Methods: We conducted a multicenter, prospective cohort study across 16 centers in Japan, enrolling surgical patients with diabetes who were prescribed SGLT2is between January 2021 and August 2022. Patients were monitored until the third postoperative day to screen for SAPKA, defined as urine ketone positivity with a blood pH of < 7.30 and HCO3 level ≤ 18.0 mEq/L, excluding cases of respiratory acidosis.Results: In total, 759 of the 762 evaluated patients were included in the final analysis. Among these, three patients (0.40%) had urine ketones with a blood pH of < 7.30; however, blood gas analysis revealed respiratory acidosis in all three, and none of them was considered to have SAPKA. The estimated incidence of SGLT2i-associated postoperative ketoacidosis was 0% (95% confidence interval, 0%-0.4%).Conclusions: The observed incidence of SAPKA in our general surgical population was lower than expected. However, given that the study was observational in nature, interpretation of study results warrants careful considerations for biases.","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11284185/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140143453","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

Understanding three standard study designs for randomized controlled trials. 了解随机对照试验的三种标准研究设计。

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2024-08-01 Epub Date: 2024-06-24 DOI: 10.1007/s00540-024-03355-z

Naoko Niimi, Alan Yang, Makoto Sumie, Jason Hayes, Jason T Maynes, Kazuyoshi Aoyama

引用次数: 0

Effectiveness of remimazolam in preventing postoperative delirium in elderly patients with proximal femoral fractures. 雷马唑仑对预防股骨近端骨折老年患者术后谵妄的效果。

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2024-08-01 Epub Date: 2024-03-26 DOI: 10.1007/s00540-024-03339-z

Daichi Fujimoto, Norihiko Obata, Satoshi Mizobuchi

{"title":"Effectiveness of remimazolam in preventing postoperative delirium in elderly patients with proximal femoral fractures.","authors":"Daichi Fujimoto, Norihiko Obata, Satoshi Mizobuchi","doi":"10.1007/s00540-024-03339-z","DOIUrl":"10.1007/s00540-024-03339-z","url":null,"abstract":"Purpose: Elderly patients with proximal femoral fractures are known to be a high-risk group for postoperative delirium (POD). The aim of this study was to determine the association of the benzodiazepine drug remimazolam with POD in elderly patients with proximal femoral fractures.Methods: In this single-center retrospective observational study, we included patients aged 65 years or older who underwent general anesthesia for proximal femoral fractures. We collected data for the incidence of POD within 3 days after surgery. We also obtained data for complications, preoperative blood examinations, maintenance anesthetic and intraoperative vital data. The occurrence of POD in patients who received remimazolam for general anesthesia (remimazolam group) was compared to that in patients who received general anesthesia with other anesthetic agents (other group). We finally conducted a multivariate analysis to assess the independent association of remimazolam with the risk of POD.Results: A total of 230 patients, including 54 patients who received remimazolam for maintenance anesthesia, were included in this study. The incidence of POD in the patients was 26.1%. The incidence of delirium within 3 days after surgery was significantly lower in the remimazolam group than in the other group (14.8% vs. 29.5%, p = 0.03). The multivariate analysis showed that the use of remimazolam independently reduced the occurrence of POD (adjusted odds ratio = 0.42, p = 0.04).Conclusion: This retrospective observational study showed that the use of remimazolam is independently associated with a reduced incidence of POD. Remimazolam may be considered as an option to reduce POD in elderly patients with proximal femoral fractures.","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140293567","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

How long elective surgery should be delayed from COVID-19 infection in pediatric patients? 小儿患者因COVID-19感染应延迟多长时间进行择期手术?

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2024-08-01 Epub Date: 2023-11-17 DOI: 10.1007/s00540-023-03284-3

Naohiro Shioji, Makoto Sumie, Kazuyoshi Aoyama

引用次数: 0

Regarding the risk factors for the emergence delirium in pediatric patients after tonsillectomy and adenoidectomy. 扁桃体和腺样体切除术后儿童患者出现谵妄的风险因素。

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2024-08-01 Epub Date: 2024-03-01 DOI: 10.1007/s00540-024-03320-w

Weiwei Chen

引用次数: 0

Comparison of leak fraction between the laryngeal mask airway and endotracheal tube during anesthesia: a single-center retrospective study. 麻醉期间喉罩通气道和气管插管泄漏率的比较：一项单中心回顾性研究。

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2024-08-01 Epub Date: 2024-06-22 DOI: 10.1007/s00540-024-03364-y

Seiichi Azuma, Masaaki Asamoto, Shinichi Akabane, Mariko Ezaka, Mikiya Otsuji, Kanji Uchida

{"title":"Comparison of leak fraction between the laryngeal mask airway and endotracheal tube during anesthesia: a single-center retrospective study.","authors":"Seiichi Azuma, Masaaki Asamoto, Shinichi Akabane, Mariko Ezaka, Mikiya Otsuji, Kanji Uchida","doi":"10.1007/s00540-024-03364-y","DOIUrl":"10.1007/s00540-024-03364-y","url":null,"abstract":"The use of the laryngeal mask airway (LMA), which offers the benefits of ease in insertion and prevention of tracheal damage, is associated with a risk of flow leakage. This study analyzed our extensive database to compare leakage associated with the use of LMA and endotracheal tube (ETT). Adult patients who underwent chest wall, abdominal wall, inguinal region, limb, transurethral, or transvaginal surgery and received either LMA or ETT between January 2007 and March 2020 were included. The leak fraction was calculated as (inspiratory tidal volume-expiratory tidal volume)/(inspiratory tidal volume) × 100% every minute during intraoperative stable positive pressure ventilation. The median leak fraction was calculated for each case. The leak fraction in the LMA group demonstrated a left-skewed distribution with a larger proportion of excessive leak fraction. The leak fraction in the LMA group (median, 7.9%; interquartile range, 4.8-11.4%) was significantly lower than that in the ETT group (median, 9.1%; interquartile range: 5.5-12.4%; P < 0.001). This tendency was consistent across subgroups divided by sex, age, type of surgery, and ventilation mode. We propose that LMA provides leakage comparable to or less than ETT in most cases if stable positive pressure ventilation is achieved.","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11284178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141440496","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

Analgesia mode after cesarean section: PCEA or EM? 剖腹产后的镇痛模式：PCEA 还是 EM？

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2024-07-28 DOI: 10.1007/s00540-024-03381-x

Liang Sun, Xiaoning Li, Yanchao Yang, Yi Feng

引用次数: 0

Pediatric cardiac surgery: machine learning models for postoperative complication prediction. 小儿心脏手术：预测术后并发症的机器学习模型。

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2024-07-19 DOI: 10.1007/s00540-024-03377-7

Rémi Florquin, Renaud Florquin, Denis Schmartz, Philippe Dony, Giovanni Briganti

{"title":"Pediatric cardiac surgery: machine learning models for postoperative complication prediction.","authors":"Rémi Florquin, Renaud Florquin, Denis Schmartz, Philippe Dony, Giovanni Briganti","doi":"10.1007/s00540-024-03377-7","DOIUrl":"https://doi.org/10.1007/s00540-024-03377-7","url":null,"abstract":"Purpose: Managing children undergoing cardiac surgery with cardiopulmonary bypass (CPB) presents a significant challenge for anesthesiologists. Machine Learning (ML)-assisted tools have the potential to enhance the recognition of patients at risk of complications and predict potential issues, ultimately improving outcomes.Methods: We evaluated the prediction capacity of six models, ranging from logistic regression to support vector machine, using a dataset comprising 33 variables and 1364 subjects. The Area Under the Curve (AUC) and the F1 score served as the primary evaluation metrics. Our primary objectives were twofold: first, to develop an effective prediction model, and second, to create a user-friendly comprehensive model for identifying high-risk patients.Results: The logistic regression model demonstrated the highest effectiveness, achieving an AUC of 83.65%, and an F1 score of 0.7296, with balanced sensitivity and specificity of 77.94% and 76.47%, respectively. In comparison, the comprehensive three-layer decision tree model achieved an AUC of 72.84%, with sensitivity (79.41%) comparable to more complex models.Conclusion: Our machine learning-assisted tools provide an additional perspective and enhance the predictive capabilities of traditional scoring methods. These tools can assist anesthesiologists in making well-informed decisions. Furthermore, we have successfully demonstrated the feasibility of creating a practical white-box model. The next steps involve conducting clinical validation and multicenter cross-validation.Trial registration: NCT05537168.","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141723637","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

High spinal block in cesarean section. 剖宫产手术中的高位脊髓阻滞。

IF 2.8 3区医学

Journal of Anesthesia Pub Date : 2024-07-15 DOI: 10.1007/s00540-024-03378-6

Ahmed M Hasanin, Rana M Zaki, Maha Mostafa

引用次数: 0