Journal of Anesthesia and Perioperative Medicine最新文献

{"title":"Decreased Cerebral Glucose Metabolism in Elderly Patients with Postoperative Delirium: A Case-Control Study","authors":"Hao Ma, Yan Liao, Yi Mo, Zuomin Li, Qin Liao, Yi-chun Wang, K. Duan, Ming-hua Chen, W. Ouyang","doi":"10.24015/JAPM.2017.0056","DOIUrl":"https://doi.org/10.24015/JAPM.2017.0056","url":null,"abstract":"","PeriodicalId":15018,"journal":{"name":"Journal of Anesthesia and Perioperative Medicine","volume":"21 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74229354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-Operative Delirium in the Elderly: Diagnosis, Risk Factors and Prevention","authors":"Zhen Liu, J. Zhao","doi":"10.24015/JAPM.2017.0052","DOIUrl":"https://doi.org/10.24015/JAPM.2017.0052","url":null,"abstract":"This is an open-access article, published by Evidence Based Communications (EBC). This work is licensed under the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium or format for any lawful purpose.To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/. From the Department of Anesthesiology, Peking Union Medical College Hospital, Beijing, China; Department of Anesthesiology, ChinaJapan Friendship Hospital, Beijing, China.","PeriodicalId":15018,"journal":{"name":"Journal of Anesthesia and Perioperative Medicine","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78680313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anesthesia Workforce and Workload in China: A National Survey","authors":"Y. Lei, Zhu Tao, Liu Jia-jin, Liu Jin","doi":"10.24015/JAPM.2017.0006","DOIUrl":"https://doi.org/10.24015/JAPM.2017.0006","url":null,"abstract":"Background: With the economy growth and medical reform, anaesthesia workforce and workload, as well as for other medical specialties in China changed dramatically, but the detail information have not been presented. A national off-line survey was designed to learn the current status for anaesthesiology, to analyze the related issues for medicine and to make suggestions for government to improve equity and quality of healthcare in China.Methods: From Mar 1 to Jun 30 in 2015, Chinese Society of Anaesthesiologits (CSA) released questionnaires containing hospital general information, anaesthesia-related information and surgical-related information to all the anaesthesiology departments in mainland China, except Hong Kong, Macao and Taiwan of China. Other relative data sources were searched from publications or website.Results: A total of 16280 questionnaires were released and 14076 copies (86.5%) were retrieved. There were 13489 copies (82.9%) identified as anaesthesia related data copies (ARDC) and 7026 copies (43.2%) identified as surgical related data copies (SRDC). In 2014, there were 77926 anaesthesiologists and its density was 5.7 per 100,000 population, 27.66 million inside operating room (OR) anaesthesia cases and 11.47 million outside OR anaesthesia cases were done. GDP per capita in each province was positively correlated with densities of physicians, anaesthesiologists and anaesthesia cases. One attending anaesthesiologist covered 634 inside OR and 263 outside OR anaesthesia cases in 2014. In SRDC, attending surgeons to attending anaesthesiologists ratio was 7.5 to 1. Each attending surgeon had 0.93 operation day per week and performed 86 operations in 2014. Generally, the higher-level and larger-sized hospitals had higher surgeons to anaesthesiologists ratio, higher surgeons to ORs ratio, less operation day per week for one surgeon, more operations and anesthesia cases done by one surgeon and one anaesthesiologist.Conclusions: China has the biggest number of anaesthesiologists in the world, but is still in shortage of anaesthesiologists. Economic level was positively correlated with anaesthesia workforce and anaesthesia service for all provinces in China. Significant misdistribution and imbalance in different provinces, sized hospitals and medical specialties were found in this survey. A national needs-based resident recruitment system along with the set-up of compulsory standardized resident training system should be taken into consideration and action. Citation:  Lei Yang, Tao Zhu, Jia-Jin Li, Jin Liu. Anesthesia workforce and workload in china: A national survey. J Anesth Perioper Med 2017; 4: 67-75. doi: 10.24015/JAPM.2017.0006This is an open-access article, published by Evidence Based Communications (EBC). This work is licensed under the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium or format for any lawful purpose. To view a copy of this license, ","PeriodicalId":15018,"journal":{"name":"Journal of Anesthesia and Perioperative Medicine","volume":"60 4","pages":"67-75"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91481726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pre-Procedure Neuraxial Ultrasound in Obstetric Anesthesia","authors":"M. Vallejo","doi":"10.24015/JAPM.2017.0050","DOIUrl":"https://doi.org/10.24015/JAPM.2017.0050","url":null,"abstract":"bstetric patients present unique challenges in providing neuraxial (spinal or epidural) blockade. Neuraxial anesthesia offers analgesia and anesthesia for labor, vaginal delivery, cesarean section, and is considered the gold standard because of its limited effects on both the mother and fetus. Neuraxial analgesia/anesthesia relies primarily on the palpation of anatomical landmarks, which can be obscured in the setting of obesity, edema, and anatomical variation (1). Pregnancy is associated with generalized tissue edema, weight gain, and an exaggerated lordosis which can make palpation and identification of anatomic landmarks very challenging. Further-more, the hormonal changes of pregnancy cause ligaments to soften which can alter the tactile sen-sation of the dural ligament making the epidural space harder to identify. These changes narrow the epidural space causing the intrathecal space to become smaller increasing the risk for inadver-tent dural puncture (2). Parturients may also have difficulty achieving and maintaining ade-quate flexion of the lumbar spine for neuraxial insertion because of the gravid uterus and/or severe pain from contractions (2). None-the-less, repeated needle insertions and redirections can further increase the pain and discomfort already experienced by the parturient in labor (1). Ultrasound imaging for clinical procedures popularity decade","PeriodicalId":15018,"journal":{"name":"Journal of Anesthesia and Perioperative Medicine","volume":"21 1","pages":"85-91"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73549317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insight into the Glucose Metabolism of Immune Cells in Sepsis","authors":"Liu Xu, Wu Shui-jing, F. Xiangming","doi":"10.24015/JAPM.2017.0005","DOIUrl":"https://doi.org/10.24015/JAPM.2017.0005","url":null,"abstract":"Aim of review: To provide a new direction for clarifying the pathogenesis of sepsis and seeking efficient prevention and treatment for sepsis. Methods: The articles and literature regarding metabolic change of immune cells and/or its role in sepsis published in the last five years were retrieved from PubMed and Web of Science. A basic search was performed using keywords of sepsis, immunity, immune cells, metabolism, etc. In addition, some classical researches and reviews were also referenced.Recent findings: The cellular metabolism dictates the fate and function of the immune cells, which plays a key role in the occurrence and development of sepsis. Since the immune cells are activated, the cellular metabolism switches from oxidative phosphorylation to aerobic glycolysis (the Warburg effect). The Warburg effect of monocytes/macrophages is the metabolic basis not only for stimulating the inflammatory response but also for trained immunity. In addition, the Warburg effect also contributes to the maturation of dendritic cells and the activation and differentiation of T cells. Studies have shown that the immune cells from septic patients had an impaired ability to stimulate the Warburg effect.Summary: The immune state of the host is closely related to the metabolism of immune cells. Since cellular metabolism is amenable to pharmacological modulation, further elucidation of this mechanism may provide novel treatment strategies for sepsis. Whether regulating the Warburg effect could help patients survive from sepsis that needs to be further researched. Citation: Xu Liu, Shui-Jing Wu, Xiang-Ming Fang. Insight into the glucose metabolism of immune cells in sepsis. J Anesth Perioper Med 2017; 4: 38-44. doi: 10.24015/JAPM.2017.0005This is an open-access article, published by Evidence Based Communications (EBC). This work is licensed under the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium or format for any lawful purpose. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.","PeriodicalId":15018,"journal":{"name":"Journal of Anesthesia and Perioperative Medicine","volume":"74 1","pages":"38-44"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88570233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Carbamylated Erythropoietin and Its Role of Tissue Protection","authors":"Hao Li, M. Diao, Yushan Ma, Xue-mei Lin","doi":"10.24015/JAPM.2017.0027","DOIUrl":"https://doi.org/10.24015/JAPM.2017.0027","url":null,"abstract":"","PeriodicalId":15018,"journal":{"name":"Journal of Anesthesia and Perioperative Medicine","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87778589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacological Cerebral Protection in Cardiac Surgery: An Update","authors":"L. Henry, T. Rayhan, L. Geoffrey, Y. Ling","doi":"10.24015/JAPM.2017.0004","DOIUrl":"https://doi.org/10.24015/JAPM.2017.0004","url":null,"abstract":"Aim of review: Postoperative cognitive dysfunction (POCD) remains a major issue in cardiovascular surgery, although advances have been made in anesthesia, surgery and neuroprotective measures. Pharmacological prevention and management of POCD has achieved some progress over the last one to two decades, yet no consensus or guideline being established.Method: The following key words in PubMed were searched: cerebral protection, brain protection, cardiac surgery, and postoperative cognitive decline, etc. Recent articles and literatures were searched and reviewed on the risk factors for POCD and the cerebral protective effects of pharmacological agents, in order to make a comprehensive review and offer an update.Recent findings: Risk factors for POCD reported in literatures include older age, male gender, cardiopulmonary bypass (CPB) use, cerebral embolization, pre-existing cognitive disturbance and genetic predisposition. The pharmacological agents with potential neuroprotective effects include volatile anesthetics, intravenous anesthetic agents, steroids, N-methyl-D-aspartate (NMDA) antagonists, nitric oxide carriers and some traditional Chinese herbal medicine such as gastrodin. Cerebral protection in current practice is achieved by a combination of different strategies including surgical (cerebral perfusion during CPB, aortic filter, carotid stents, avoidance of aortic atheroma) and nonsurgical measures (hypothermia, lumbar drain, management of mean arterial pressure, central venous pressure, cerebral perfusion pressure, pre- and post-conditioning, and cerebral regional oxygenation monitoring, etc).Summary: Multiple factors are associated with the incidence of POCD. Numerous pharmacological agents have been found to have certain degree of neuroprotective effects. Large-scale, randomized, multicenter clinical trials will be needed for the integration of these agents into our clinical practice. Citation: Henry Liu, Rayhan Tariq, Geoffrey Liu, Ling Yu. Pharmacological cerebral protection in cardiac surgery: an update. J Anesth Perioper Med 2017; 4: 23-37. doi: 10.24015/JAPM.2017.0004This is an open-access article, published by Evidence Based Communications (EBC). This work is licensed under the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium or format for any lawful purpose. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.","PeriodicalId":15018,"journal":{"name":"Journal of Anesthesia and Perioperative Medicine","volume":"221 1","pages":"23-37"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77446087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Emulsified Sevoflurane and Ulinastatin on Liver and Lung Injury Induced by Bile Duct Ligation in Rats","authors":"Chen Cai-Yang, Zhu Ming, W. Long, Wu Feixiang, Yang Li-qun, Yuan Weifeng","doi":"10.24015/JAPM.2017.0002","DOIUrl":"https://doi.org/10.24015/JAPM.2017.0002","url":null,"abstract":"Backgroud: To investigate the effects and their mechanisms of emulsified sevoflurane and ulinastatin on liver and lung injury induced by obstructive jaundice in rats.Methods: For the in vivo study, male Sprague-Dawley rats were randomized into two parts. Part 1: Sham group, bile duct ligation (BDL) group, BDL and lipid vehicle infusion (BDL+V) group, BDL+ulinastatin (BDL+U) group, BDL+emulsified sevoflurane (BDL+E) group; Liver and lung function was examined by the concentrations of Total Bilirubin (TBIL), Alanine Transaminase (ALT), and lung arterial blood gas analysis. Liver and lung damage was estimated histologically with haematoxylin and eosin (HE) staining in liver and lung samples. F4/80, the molecular marker of activated macrophages, was assessed by immunohistochemistry (IHC). Part 2: Sham+Gadolinium chloride (GdCl3)group, BDL+GdCl3 group, BDL+U+GdCl3 group, BDL+E+GdCl3 group. After the deletion of macrophages, liver and lung examinations were evaluated histologically with HE staining in GdCl3 treated rats. For the in vitro study, the RAW264.7 cell line was stimulated by the different treatments, then terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL staining), Hoechst 33342 staining and the expressions of apoptotic related genes were evaluated to further determine the protective effects of ulinastatin and emulsified sevoflurane.Results: Emulsified sevoflurane and ulinastatin therapies alleviated cholestatic liver and lung damage, inhibited the activation of macrophages in the liver and lung tissues, and improved the liver and lung functions. And they were also found to inhibit apoptosis pathways.Conclusions: Emulsified sevoflurane and ulinastatin treatments were proved to ameliorate BDL-induced cholestatic liver and lung injuries, which were related to the inactivation of the macrophages and the regulation of apoptosis pathways. The above-mentioned mechanisms show new promising approach for the multi-organs injuries in the perioperative management. Citation: Cai-Yang Chen, Ming Zhu, Long Wang, Fei-Xiang Wu, Li-Qun Yang, Wei-Feng Yu. Effects of emulsified sevoflurane and ulinastatin on liver and lung injury induced by bile duct ligation in rats. J Anesth Perioper Med 2017; 4: 7-16. doi: 10.24015/JAPM.2017.0002This is an open-access article, published by Evidence Based Communications (EBC). This work is licensed under the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium or format for any lawful purpose. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.","PeriodicalId":15018,"journal":{"name":"Journal of Anesthesia and Perioperative Medicine","volume":"21 1","pages":"7-16"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80186417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Sevoflurane or Propofol on Immune Function in Patients Undergoing Hepatectomy","authors":"Gao-feng Hao, S. Jinchao, Zhang Jinmin, Jiao Ying-Fu, Lu Zhi-Jie, Tao Tian-Zhu, Weiqing Yu","doi":"10.24015/JAPM.2017.0001","DOIUrl":"https://doi.org/10.24015/JAPM.2017.0001","url":null,"abstract":"Background: In this study, the effects of sevoflurane or propofol on immune function in patients undergoing partial hepatectomy were investigated during general anesthesia and after surgery.Methods: Seventy-two patients undergoing hepatectomy were randomized into sevoflurane group or propofol group. Sevoflurane or target-controlled infusion (TCI) of propofol was separately used to anesthesia induction and maintenance of two groups. Venous blood samples were taken before induction, 2 hours after anesthesia and 2 hours after surgery for measurement of the percentages of T lymphocyte (CD3+, CD4+, CD8+) and NK cells.Results: Compared with that before anesthesia induction, percentage change in CD3+ and CD4+ T cells to baseline was -0.7% and 3.8% in sevoflurane group, 10.2% and 20.2% in propofol group 2 hours after anesthesia (P=0.002 for CD3+ T cells and P=0.029 for CD4+ T cells ). Percentage change in NK cells was 17.6% in sevoflurane and -12.2% in propofol group 2 hours after anesthesia respectively (P=0.03). There was no significant difference in percentage change 2 hours after surgery of T cells and NK cells to baseline between two groups.Conclusions: Our study indicates that use of propofol during general anesthesia tend to increase the percentages of peripheral CD3+ and CD4+ cells, while sevoflurane increase the peripheral NK cells. Citation: Hao Gao, Jin-Chao Song, Jin-Min Zhang, Ying-Fu Jiao, Zhi-Jie Lu,Tian-Zhu Tao, et al. Effects of sevoflurane or propofol on immune function in patients undergoing hepatectomy. J Anesth Perioper Med  2017; 4: 1-6. doi: 10.24015/JAPM.2017.0001This is an open-access article, published by Evidence Based Communications (EBC). This work is licensed under the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium or format for any lawful purpose. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.","PeriodicalId":15018,"journal":{"name":"Journal of Anesthesia and Perioperative Medicine","volume":"50 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74369715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unanticipated Difficult Nasal Intubation Due to a Prominent Anterior Tubercle of the First Cervical Spine","authors":"Watton David, R. Orlando","doi":"10.24015/JAPM.2016.0037","DOIUrl":"https://doi.org/10.24015/JAPM.2016.0037","url":null,"abstract":"Nasal intubation is frequently used for airway management in patients undergoing many surgical procedures. This is a case report of an unanticipated difficult nasal intubation due to a prominent anterior tubercle of the first cervical spine vertebra (C1) resulting in aspiration of blood and hypoxemia following intubation. The subsequent airway management of the rescheduled elective case is also described. The specific difficulties in securing the airway for nasal intubation are described as well as the management strategies to circumvent this anatomical variant. This case report will be of interest to health care practitioners providing airway management via the nasal route for different populations. Citation: David Watton, Orlando R. Hung. Unanticipated difficult nasal intubation due to a prominent anterior tubercle of the first cervical spine. J Anesth Perioper Med 2016; 3: 276-9. doi: 10.24015/JAPM.2016.0037This is an open-access article, published by Evidence Based Communications (EBC). This work is licensed under the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium or format for any lawful purpose. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.","PeriodicalId":15018,"journal":{"name":"Journal of Anesthesia and Perioperative Medicine","volume":"113 1","pages":"276-279"},"PeriodicalIF":0.0,"publicationDate":"2016-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78959012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}