Journal of Anesthesia最新文献

{"title":"Reply to the comments by Mizutani et al. on \"Environmental and clinical rationale for the use of desflurane: a review of the literature\".","authors":"Takahiro Tamura","doi":"10.1007/s00540-026-03871-0","DOIUrl":"https://doi.org/10.1007/s00540-026-03871-0","url":null,"abstract":"","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793221","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":"Usefulness of the phase angle for inflammation criteria of the global leadership initiative on malnutrition in critically ill patients.","authors":"Akane Kariya, Naoki Kanda, Minoru Yoshida, Shinya Suganuma, Tomoka Miyagi, Shunsuke Takaki, Kensuke Nakamura","doi":"10.1007/s00540-026-03870-1","DOIUrl":"10.1007/s00540-026-03870-1","url":null,"abstract":"<p><strong>Background: </strong>The Global Leadership Initiative on Malnutrition (GLIM) is an international nutritional assessment approach, but its evaluation for reduced muscle mass and inflammation criteria remain undefined in critically ill patients. We hypothesize that the phase angle derived from a bioelectrical impedance analysis (BIA) may be used as a GLIM inflammation criterion.</p><p><strong>Methods: </strong>ICU patients expected to require ≥ 48 h of mechanical ventilation were stratified by the median phase angle. The primary outcomes were in-hospital mortality and the Barthel Index at discharge. Phase angle cut-off values were calculated for in-hospital death and the composite outcome of death or discharge with a Barthel Index < 70. Outcomes were compared between groups using the BIA-based GLIM (phase angle and skeletal muscle index) and the GLIM assessed by C-reactive protein (CRP) and computed tomography (CT).</p><p><strong>Results: </strong>Fifty-three patients were included. The phase angle was significantly associated with hospital stay and mechanical ventilation duration. The areas under the ROC curve of the phase angle for mortality and a Barthel Index < 70 were higher than those for SOFA, APACHE II and maximum CRP. The BIA-based GLIM identified malnourished patients with significantly poorer prognoses than CRP/CT-based GLIM. With phase angle thresholds of 2.67 and 4.03, the GLIM malnutrition showed a longer hospital stay, lower grip strength at discharge.</p><p><strong>Conclusion: </strong>The phase angle might be a suitable indicator for inflammation in the GLIM criteria, and appropriate BIA equipment providing both the phase angle and SMI might allow the initial assessment to be completed in a single step.</p>","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793377","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":"Overlapping IoC2 trajectories and interpretive considerations.","authors":"Jing Zhang, Rongjun Liu","doi":"10.1007/s00540-026-03877-8","DOIUrl":"10.1007/s00540-026-03877-8","url":null,"abstract":"","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793187","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":"Findings and limitations of cadaveric studies in plan A blocks: a narrative review.","authors":"Atsushi Sawada, Asako Nitta, Mami Muraki, Michiaki Yamakage","doi":"10.1007/s00540-026-03862-1","DOIUrl":"https://doi.org/10.1007/s00540-026-03862-1","url":null,"abstract":"<p><p>Cadaveric studies provide anatomical information unavailable from clinical investigations and have contributed to the development of regional anesthesia techniques. The Plan A framework comprises seven versatile techniques intended for routine clinical practice. However, related cadaveric evidence remains insufficiently synthesized. This narrative review summarizes and critically appraises cadaveric studies of Plan A blocks. A focused literature search identified 54 studies investigating the interscalene brachial plexus block, axillary brachial plexus block, femoral nerve block, adductor canal block, popliteal sciatic nerve block, erector spinae plane block (ESPB), and rectus sheath block. Studies of the six blocks other than ESPB clarified target anatomy, injectate distribution, and technical or safety considerations, but were generally limited by small numbers of studies and uncertain clinical applicability. The ESPB accounted for half of the included studies. These consistently demonstrated extensive craniocaudal spread within the erector spinae fascial plane, whereas anterior spread to the paravertebral space and ventral rami was inconsistent and was not reliably explained by injectate characteristics or volume. Cadaveric models cannot reproduce physiological conditions or establish clinical efficacy, but remain valuable for visualizing injectate spread and investigating anatomical mechanisms. Integration with imaging and clinical studies is required to translate these findings into clinical recommendations.</p>","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793439","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 \"Effect of IoC2-guided analgesic titration on intraoperative opioid consumption in older patients undergoing laparoscopic colorectal surgery: a randomized controlled trial\".","authors":"Ahmet Rıdvan Doğan","doi":"10.1007/s00540-026-03875-w","DOIUrl":"10.1007/s00540-026-03875-w","url":null,"abstract":"","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793458","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 \"Effect of IoC2-guided analgesic titration on intraoperative opioid consumption in older patients undergoing laparoscopic colorectal surgery: a randomized controlled trial\".","authors":"Abdul Basit Munir, Haider Imran, Nashmia Faraz","doi":"10.1007/s00540-026-03876-9","DOIUrl":"10.1007/s00540-026-03876-9","url":null,"abstract":"","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793513","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":"Prebiotic raffinose attenuates surgery-induced delirium-like behaviors through gut microbiota-mediated serotonergic signaling in frail senescence-accelerated mice: an experimental study using SAMP10 mice.","authors":"Noriaki Nishihara, Shunsuke Tachibana, Michiaki Yamakage","doi":"10.1007/s00540-026-03873-y","DOIUrl":"https://doi.org/10.1007/s00540-026-03873-y","url":null,"abstract":"<p><strong>Background: </strong>Postoperative delirium (POD) is a severe neuropsychiatric complication characterized by acute cognitive dysfunction and neuroinflammation, particularly prevalent in frail elderly patients. While the gut-brain axis is recognized as a regulator of neuroinflammation, specific preventive strategies remain limited. We investigated whether preoperative administration of raffinose, a prebiotic trisaccharide, prevents POD-like behaviors through gut microbiota-mediated neuroimmune modulation in frail senescence-accelerated mice.</p><p><strong>Methods: </strong>Twenty-six-week-old senescence-accelerated mice (SAMP10) were randomly assigned to control (N), surgery (O), or raffinose-treated surgery (R) groups (n = 5-6 per group, depending on the endpoint). Raffinose (5% w/v) was administered via drinking water for 4 weeks prior to laparotomy under general anesthesia. Delirium-like behaviors were assessed using the open field, Y-maze, and buried food tests at 6 h post-surgery. Serum biomarkers were quantified via ELISA. Gut microbiota composition was analyzed using 16S rRNA sequencing.</p><p><strong>Results: </strong>Surgery was associated with a numerical reduction in Y-maze spontaneous alternation that showed a large effect size but did not reach conventional statistical significance (O: 4.32 ± 3.46% vs. N: 10.71 ± 5.41%; p = 0.097, Cohen's d = 1.41, 95% CI -0.04 to 2.79), whereas a robust and statistically significant motivational deficit was observed in the Buried Food Test (O: 240.8 ± 116.7 s vs. N: 35.2 ± 25.6 s; p = 0.001, d = 2.52). Raffinose pretreatment was associated with higher Y-maze spontaneous alternation compared with the surgery group (R: 12.4 ± 4.20%; p = 0.034 vs. O, d = 2.10) and with restoration of motivational behavior in the BFT (R: 18.7 ± 4.74 s; p = 0.0006 vs. O, d = 2.77). Systemically, raffinose reduced circulating IL-6 by 56% and preserved gut microbial α- and β-diversity, with significant enrichment of Lactobacillus. Lactobacillus abundance was strongly correlated with preserved serum serotonin (r = 0.72, p = 0.003).</p><p><strong>Conclusions: </strong>Prebiotic raffinose attenuates surgery-induced systemic inflammation and preserves cognitive-attentional and motivational performance in frail mice, providing convergent behavioral, biochemical, and microbiome evidence consistent with a gut-microbiota-serotonergic mechanism, which requires direct causal validation in future studies. These findings provide a preclinical rationale for prehabilitation nutritional strategies targeting the gut-brain axis, while acknowledging that individual behavioral readouts differ in the strength of the surgery-induced control-vs-surgery contrast.</p>","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793149","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":"Nationwide trends in cardiac anesthesia requiring cardiopulmonary bypass and intraoperative transesophageal echocardiography use in Japan: a claims-based analysis, 2019-2023.","authors":"Masamitsu Kido, Yoshinobu Nakayama, Luying Yan, Yasufumi Nakajima, Atsuhiro Kitaura, Natsuki Anada, Urara Hirano, Takashi Mino, Toshikazu Yogai, Kengo Yoshii, Katsutoshi Shoda","doi":"10.1007/s00540-026-03869-8","DOIUrl":"10.1007/s00540-026-03869-8","url":null,"abstract":"<p><strong>Purpose: </strong>This study characterized nationwide trends, demographic distributions, and regional disparities in cardiac anesthesia and intraoperative transesophageal echocardiography (ITEE) in Japan.</p><p><strong>Methods: </strong>We conducted a retrospective observational study using the National Database of Health Insurance Claims (NDB) Open Data Japan (2019-2023). Cardiac anesthesia was defined using reimbursement codes for cardiac or thoracic great-vessel surgery requiring cardiopulmonary bypass. ITEE was evaluated using add-on claims classified into two categories: ITEE for cardiac/non-cardiac surgeries, and ITEE for percutaneous interventions. Trends were assessed using linear and Poisson regression models. Age- and sex-specific distributions and regional disparities (Gini coefficients) were assessed.</p><p><strong>Results: </strong>A total of 179,920 cardiac anesthesia events were identified (28.7 per 100,000 person-years), with a male predominance (male-to-female ratio, 1.6:1). Age distribution was bimodal, peaking at 0-4 and 75-79 years. Both cardiac anesthesia and ITEE use declined transiently during Japan's first coronavirus disease 2019 state of emergency in May 2020, followed by recovery in the latter half of fiscal year 2020. Age-adjusted rates of cardiac anesthesia demonstrated no significant annual change. In contrast, ITEE use increased significantly in both cardiac/non-cardiac surgeries (relative risk [RR], 1.011/year; P < 0.0001) and percutaneous interventions (RR, 1.117/year; P < 0.0001). Regional disparities in cardiac anesthesia decreased over time, with Gini coefficients declining from 0.20 to 0.15.</p><p><strong>Conclusion: </strong>Cardiac anesthesia remained generally stable in Japan from 2019 to 2023. Increasing ITEE, especially for percutaneous interventions, suggests evolving cardiovascular perioperative practice, although claims-based categories require cautious interpretation.</p>","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148766193","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":"Ultrasonographic confirmation of guidewire placement in the inferior vena cava during femoral venous cannulation.","authors":"Kei Takahashi, Katsuhide Masui, Takashi Asai","doi":"10.1007/s00540-026-03866-x","DOIUrl":"https://doi.org/10.1007/s00540-026-03866-x","url":null,"abstract":"","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148766091","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":"Prevention of postoperative nausea and vomiting with rapid sequence induction and intubation in patients undergoing thyroidectomy: a randomized controlled trial.","authors":"Chuhan Qiao, Yingcong Qian, Ziwei Zhu, Qianying Ni, Yan Liu, Mingzhu Guo, Bo Yang, Jianping Yang, Jian Li, Yongheng Hou","doi":"10.1007/s00540-026-03863-0","DOIUrl":"10.1007/s00540-026-03863-0","url":null,"abstract":"<p><strong>Purpose: </strong>Postoperative nausea and vomiting (PONV) remains a major clinical challenge undergoing thyroidectomy. The study aimed to investigate the effect of rapid sequence induction and intubation (RSI) on the incidence of PONV in patients undergoing thyroidectomy.</p><p><strong>Methods: </strong>Adult patients were randomized 1:1 to the RSI group (no assisted ventilation before endotracheal intubation) or the control group (face-mask pressure-controlled ventilation during induction). A standardized general anesthesia protocol and PONV prophylaxis strategy with dexamethasone and ondansetron was implemented for all patients. The primary outcome was the overall incidence of PONV in ward within 24h after surgery. Secondary outcomes were the incidence of PONV in post-anesthesia care unit (PACU), the use of rescue antiemetic, gastric antral cross-sectional area (CSA), and the incidence of adverse events. Sensitivity analysis includes intention-to-treat assessment to test robustness.</p><p><strong>Results: </strong>A total of 214 patients were included in the per-protocol analysis (RSI n=106, control n=108). The overall PONV incidence (13.2% vs. 28.7%, P=0.007) was significantly lower in the RSI group compared with the control group. Similarly, the post-induction antral CSA was significantly reduced in the RSI group (349.1 ± 131.7 mm² vs. 412.9 ± 144.8 mm², P<0.001). Within the control group, a positive association was suggested between post-induction CSA grade and PONV incidence (Spearman's ρ = 0.93, P = 0.023). There were no significant differences between groups in the incidence of PONV in PACU, transient desaturation or the need for rescue mask ventilation during induction.</p><p><strong>Conclusions: </strong>RSI was associated with reduced 24-hour PONV and decreased gastric antral distension, without increasing airway adverse events, when compared with standard mask-ventilated induction in elective thyroidectomy patients.</p><p><strong>Trial registration: </strong>This study was registered in the Chinese Clinical Trials Registry (ChiCTR2100042241, date of registration: 17/1/2021, prospectively registered).</p>","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148725525","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}