Journal of Clinical Anesthesia最新文献

{"title":"Factors associated with chronic postsurgical pain in robot-assisted laparoscopic radical prostatectomy: The planned secondary analysis of a randomized controlled trial","authors":"Nobuhiro Tanaka , Yuma Kadoya , Takanori Suzuka , Takayuki Yamanaka , Mitsuru Ida , Naoki Ozu , Shunta Hori , Masahiko Kawaguchi","doi":"10.1016/j.jclinane.2025.111827","DOIUrl":"10.1016/j.jclinane.2025.111827","url":null,"abstract":"","PeriodicalId":15506,"journal":{"name":"Journal of Clinical Anesthesia","volume":"103 ","pages":"Article 111827"},"PeriodicalIF":5.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143746829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of postoperative neurocognitive disorders in older non-cardiac surgical patients: A systematic review and meta-analysis","authors":"Wendy W.Y. Huang HBSc ,&nbsp;Shirley Fan ,&nbsp;Wei-Ya Li ,&nbsp;Vetri Thangavelu HBSc ,&nbsp;Aparna Saripella ,&nbsp;Marina Englesakis MLIS ,&nbsp;Ellene Yan HBSc ,&nbsp;Frances Chung MBBS MD","doi":"10.1016/j.jclinane.2025.111830","DOIUrl":"10.1016/j.jclinane.2025.111830","url":null,"abstract":"<div><h3>Study objective</h3><div>The growing number of older persons undergoing surgery are at a higher risk of neurocognitive disorder due to multimorbidity and age-related changes. Previous reviews estimated postoperative neurocognitive disorder or cognitive dysfunction (POCD) prevalence without accounting for the sample size or study quality. The prevalence of POCD in this population requires further investigation. This systematic review and meta-analysis applies systematic weighting to estimate the pooled prevalence of POCD in older non-cardiac surgical patients.</div></div><div><h3>Design</h3><div>Systematic review and meta-analysis.</div></div><div><h3>Setting</h3><div>MEDLINE, MEDLINE ePub, Embase, Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews for relevant articles.</div></div><div><h3>Patients</h3><div>Non-cardiac surgical patients aged ≥60 years old.</div></div><div><h3>Interventions</h3><div>Perioperative cognitive assessments.</div></div><div><h3>Measurement</h3><div>The primary outcome was the prevalence of POCD.</div></div><div><h3>Main results</h3><div>Thirty-nine studies (<em>n</em> = 12,921) were included with mean age of 70.0 ± 8.9 years and 44.3 % women. The overall prevalence of POCD was 23 % (95 % CI: 20 %, 27 %) at day 7, 16 % (95 % CI: 7 %, 25 %) at 1 month, 10 % (95 % CI: 8 %, 13 %) at 3 months and 3 % (95 % CI: 2 %, 4 %) at 1 year. Our meta-regression showed a higher prevalence of POCD in abdominal surgeries at day 7 (β = 0.13, 95 % CI: 0.03–0.22, <em>P</em> = 0.01) and 3 months (β = 0.49, 95 % CI: 0.40–0.58, <em>P</em> &lt; 0.001), versus orthopedic surgeries.</div></div><div><h3>Conclusions</h3><div>The overall prevalence of POCD in older non-cardiac surgical populations was 23 %, 16 %, 10 %, and 3 % at day 7, 1 month, 3 months, and 1 year, respectively. Abdominal surgery had a higher prevalence of POCD than orthopedic surgery. The substantial risk of POCD calls for cognitive screening, risk mitigation and interventions to improve surgical outcomes. Through routine preoperative cognitive screening and addressing modifiable risk factors, the incidence and impact of POCD can be markedly reduced, enhancing patient outcomes and recovery.</div></div>","PeriodicalId":15506,"journal":{"name":"Journal of Clinical Anesthesia","volume":"103 ","pages":"Article 111830"},"PeriodicalIF":5.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143785404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regional analgesia catheter-related infections and the effectiveness of antibiotic prophylaxis in immunocompromised patients: A retrospective multicenter registry analysis","authors":"Lukas M. Müller-Wirtz MD ,&nbsp;William M. Patterson MPH ,&nbsp;Sascha Ott MD MPHA ,&nbsp;Kurt Ruetzler MD ,&nbsp;Alparslan Turan MD ,&nbsp;Daniel I. Sessler MD ,&nbsp;Thomas Volk MD ,&nbsp;Christine Kubulus MD","doi":"10.1016/j.jclinane.2025.111826","DOIUrl":"10.1016/j.jclinane.2025.111826","url":null,"abstract":"<div><h3>Background</h3><div>The risk of regional analgesia catheter-related infections in immunocompromised patients remains uncertain. We therefore tested the hypotheses that catheter-related infections appear earlier and are more severe, and that antibiotic prophylaxis is more effective in immunocompromised than immunocompetent patients.</div></div><div><h3>Methods</h3><div>Data were extracted from the Network for Safety in Regional Anesthesia and Acute Pain Therapy (net-ra) registry from 2007 to 2022. We used multivariable cox and ordinal regression to assess the effect of immune function and antibiotic prophylaxis indicated by surgery on infection onset and severity.</div></div><div><h3>Results</h3><div>We analyzed data from 196,711 catheters, including 1347 in immunocompromised patients. Infection severities in immunocompetent patients were none (190,220 (97.4 %)), mild (4517 (2.3 %)), and moderate/severe (627 (0.3 %)). In immunocompromised patients, infection severities were none (1285 (95.4 %)), mild (58 (4.3 %)), and moderate/severe (4 (0.3 %)). Immunocompromised patients who were not given antibiotics had a 29 % greater infection hazard (HR 1.29 [95 %CI: 0.95, 1.76], <em>p</em> = 0.1) and 91 % greater odds of higher infection severities (OR 1.91 [95 %CI: 1.39, 2.63], <em>p</em> &lt; 0.001). Antibiotics were more effective in delaying infection onset (HR 0.65 [95 %CI: 0.38, 1.12], <em>p</em> = 0.12) and preventing infection (OR 0.54 [95 %CI: 0.31, 0.94], <em>p</em> = 0.029) in immunocompromised than immunocompetent patients. The number of patients needed-to-treat to prevent an infection with antibiotics was 55 in immunocompromised patients versus 83 in immunocompetent patients.</div></div><div><h3>Conclusions</h3><div>Regional analgesia catheter-related infections occur slightly earlier and are more frequent in immunocompromised patients. Antibiotics are marginally effective for catheter infection prophylaxis and should be restricted to patients who are severely immunocompromised with and at special risks.</div></div>","PeriodicalId":15506,"journal":{"name":"Journal of Clinical Anesthesia","volume":"103 ","pages":"Article 111826"},"PeriodicalIF":5.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143768846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Opioid-free anesthesia for quality of recovery score after surgery: A meta-analysis of randomized controlled trials","authors":"Di Wang M.D ,&nbsp;Zhi Liu M.D. ,&nbsp;Wenhui Zhang M.D. ,&nbsp;Siru Li M.D. ,&nbsp;Yutao Chen M.D. ,&nbsp;Xingguo Li M.D. ,&nbsp;Congjie Bi Ph.D.","doi":"10.1016/j.jclinane.2025.111823","DOIUrl":"10.1016/j.jclinane.2025.111823","url":null,"abstract":"<div><h3>Background</h3><div>This meta-analysis aimed to evaluate the impact of opioid-free anesthesia (OFA) on the postoperative subjective quality of recovery (QoR).</div></div><div><h3>Methods</h3><div>Our comprehensive literature search, spanning PubMed, Embase, Cochrane Library, and Google Scholar, targeted clinical trials that evaluated the effects of OFA versus opioid-based anesthesia (OBA) on postoperative QoR. The data were analyzed using Review Manager, STATA, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) profiler.</div></div><div><h3>Main results</h3><div>This meta-analysis included 13 randomized controlled trials (RCTs). OFA significantly improved the QoR-15 score (SMD 2.16; 95 % CI 0.13–4.20; I² = 98 %; 293 patients in 3 trials) and QoR-40 score (SMD 0.47; 95 % CI 0.18–0.77; I² = 82 %; 1464 patients in 236 trials). Furthermore, the incidence of nausea, vomiting, and hypotension was reduced, with no difference in the risk of bradycardia or time for extubation of the trachea.</div></div><div><h3>Conclusion</h3><div>This meta-analysis shows OFA improves early postoperative quality of recovery and reduces the occurrence of nausea, vomiting, and hypotension without increasing the risk of bradycardia or prolonging the time for extubation of the trachea.</div></div>","PeriodicalId":15506,"journal":{"name":"Journal of Clinical Anesthesia","volume":"103 ","pages":"Article 111823"},"PeriodicalIF":5.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143739144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In-hospital use of beta-blockers for critically ill patients with acute heart failure: Whether and when to initiate","authors":"Zeming Zhou MD ,&nbsp;Haixu Wang MD ,&nbsp;Wei Wang PhD ,&nbsp;Jingkuo Li BM ,&nbsp;Lubi Lei BM ,&nbsp;Lihua Zhang MD, PhD ,&nbsp;Haibo Zhang MD, PhD ,&nbsp;Jiamin Liu MD, PhD ,&nbsp;Xin Zheng MD, PhD","doi":"10.1016/j.jclinane.2025.111824","DOIUrl":"10.1016/j.jclinane.2025.111824","url":null,"abstract":"<div><h3>Background</h3><div>The use of beta-blockers during hospitalization for acute heart failure (AHF) remains controversial. This study aimed to investigate whether beta-blocker use is associated with a reduced risk of mortality in critically ill patients with AHF and to determine the optimal timing for initiating beta-blocker therapy.</div></div><div><h3>Methods</h3><div>Data from critically ill patients with AHF in the MIMIC-IV version 2.2 database were analyzed. Baseline characteristics, laboratory tests, comorbidities, vital signs, and medication usage at admission and during hospitalization were collected to perform inverse probability of treatment weighting (IPTW). IPTW-weighted logistic regression models were then used to examine the relationship between beta-blocker use and mortality.</div></div><div><h3>Results</h3><div>In the IPTW-weighted regression model, patients who newly started beta-blockers or continued their use had a lower risk of in-hospital mortality compared to those not treated with beta-blockers (odds ratio [OR]: 0.45; 95 % confidence interval [CI]: 0.34 to 0.61, and OR: 0.53; 95 % CI: 0.41 to 0.69, respectively). Conversely, those who had beta-blockers withdrawn showed a higher risk of in-hospital mortality (OR: 2.59; 95 % CI: 1.63 to 4.10). Among beta-blocker users, compared to patients treated before admission and who received their first dose within 48 h of admission, those who were not treated before admission but started after 48 h had a similar mortality risk (OR: 0.82; 95 % CI: 0.60 to 1.11; P = 0.202). However, patients previously treated with beta-blockers who initiated therapy after 48 h and those not treated before admission but started within 48 h had a lower risk of in-hospital mortality (OR: 0.44; 95 % CI: 0.30 to 0.64; P &lt; 0.001, and OR: 0.65; 95 % CI: 0.48 to 0.86; P = 0.003, respectively).</div></div><div><h3>Conclusion</h3><div>The use of beta-blockers during hospitalization for AHF is associated with a reduced risk of in-hospital mortality, and withdrawal was associated with an increased risk of mortality. Initiating beta-blockers within 48 h for beta-blocker-naïve patients and after 48 h for those previously treated with beta-blockers before admission may further decrease mortality risk.</div></div>","PeriodicalId":15506,"journal":{"name":"Journal of Clinical Anesthesia","volume":"103 ","pages":"Article 111824"},"PeriodicalIF":5.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143785403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of sodium-glucose transporter 2 inhibition on cardiac surgery-associated acute kidney injury: An open-label randomized pilot study","authors":"Lars I.P. Snel ,&nbsp;Maartina J.P. Oosterom-Eijmael ,&nbsp;Elena Rampanelli ,&nbsp;Yugeesh R. Lankadeva ,&nbsp;Mark P. Plummer ,&nbsp;Benedikt Preckel ,&nbsp;Jeroen Hermanides ,&nbsp;Daniel H. van Raalte ,&nbsp;Abraham H. Hulst","doi":"10.1016/j.jclinane.2025.111811","DOIUrl":"10.1016/j.jclinane.2025.111811","url":null,"abstract":"<div><h3>Background</h3><div>Sodium-glucose transporter-2 (SGLT2) inhibitors reduced the incidence of acute kidney injury in large cardiovascular outcome trials in patients with chronic heart and kidney failure. Acute kidney injury is a common complication following cardiac surgery. We hypothesized that perioperative SGLT2 inhibition could reduce kidney injury after cardiac surgery, measured with the biomarker neutrophil gelatinase-associated (NGAL).</div></div><div><h3>Methods</h3><div>In this open-label phase IV, randomized, parallel-group, pilot study, adult patients undergoing elective cardiac surgery with cardiopulmonary bypass were randomized to receive either an SGLT2 inhibitor, empagliflozin (10 mg; oral) once daily, from three days before surgery until postoperative day two, or standard-of-care. The primary outcome was the between-group difference of serum NGAL on the second postoperative day. Moreover, other biomarkers for acute kidney injury were measured, including serum kidney injury molecule-1 (KIM-1), hypoxia-inducible factor-1 alpha (HIF-1α), and urine NGAL/Creatinine and KIM-1/Creatinine ratios. Additional outcomes included acute kidney injury incidence within the first seven days following cardiac surgery according to Kidney Disease: Improving Global Outcomes criteria and metabolic parameters, including ketone body concentrations and glycemic control.</div></div><div><h3>Results</h3><div>Between March 2022 and April 2023, 55 patients were included (sex: 73 % male, age: 66 ± 10 years, BMI: 28 ± 4 kg/m², empagliflozin <em>n</em> = 25, control <em>n</em> = 30) in the intention-to-treat analysis. There were no significant between-group differences in serum and urine NGAL or KIM-1. However, empagliflozin significantly reduced the incidence of acute kidney injury (20 % vs 66.7 %; absolute difference 46.7 %, 95 % CI, −69.7 – -23.6; <em>P</em> &lt; .001). A significant increase in serum HIF-1α after surgery was solely observed in the control group. We observed no between-group differences in the incidence of (euglycemic) ketoacidosis or hypoglycemic events.</div></div><div><h3>Conclusions</h3><div>In this pilot study, perioperative SGLT2 inhibition was not associated with lower NGAL levels. We observed that SGLT2 inhibition reduced the incidence of acute kidney injury in this small study population. As the results of this pilot study are hypotheses-generating, further validation is needed in a large-scale, double-blind, placebo-controlled, randomized trial, which is currently ongoing.</div></div>","PeriodicalId":15506,"journal":{"name":"Journal of Clinical Anesthesia","volume":"103 ","pages":"Article 111811"},"PeriodicalIF":5.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143715709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of esketamine on postoperative depression in women with breast cancer and preoperative depressive symptoms: The EASE randomized trial","authors":"Qingfeng Wei MD ,&nbsp;Mengmeng Li MD ,&nbsp;Qiuling Du MD ,&nbsp;Huiwen Zhang MD ,&nbsp;Yongjie Liang MD ,&nbsp;Cen Cheng MD ,&nbsp;Bin Mei MD, PhD ,&nbsp;Xiaowei Yang MD, PhD ,&nbsp;Yinguang Fan PHD ,&nbsp;Jiajia Zhu MD, PhD ,&nbsp;Jingjie Zhang MD, PhD ,&nbsp;Yongqiang Yu MD, PhD ,&nbsp;Qiying Shen MD, PhD ,&nbsp;Xuesheng Liu MD, PhD ,&nbsp;Daniel I. Sessler MD","doi":"10.1016/j.jclinane.2025.111821","DOIUrl":"10.1016/j.jclinane.2025.111821","url":null,"abstract":"<div><h3>Study objective</h3><div>To determine whether intraoperative low-dose esketamine ameliorates depression in women having breast cancer surgery.</div></div><div><h3>Design</h3><div>A prospective single-center double blind randomized placebo-controlled trial.</div></div><div><h3>Setting</h3><div>Perioperative period, operating room, post anesthesia care unit and hospital ward.</div></div><div><h3>Patients</h3><div>108 women 18–65 years old who were scheduled for elective breast cancer surgery. All had preoperative depressive symptoms as defined by Montgomery-Åsberg depression scores ≥12 (range, 0–60; higher scores indicate more severe depression).</div></div><div><h3>Interventions</h3><div>Eligible participants were randomized to esketamine 0.25 mg/kg or saline placebo. Blinded trial drugs were given intravenously over the initial 40 min of anesthesia.</div></div><div><h3>Measurements</h3><div>Our primary outcome was the fraction of patients who had at least a 50 % reduction in the Montgomery-Åsberg depression score within 3 postoperative days. Secondary outcomes included the fraction of patients with depression remission defined as Montgomery-Åsberg scores ≤10, the numeric value of the Montgomery-Åsberg depression scores, postoperative severe pain, and anxiety as determined by the Generalized Anxiety Disorder 7-item score. Adverse events were monitored for 72 postoperative hours.</div></div><div><h3>Main results</h3><div>54 women each were randomized to esketamine and saline, and 104 were available for our intent-to-treat analysis. The mean age was 50 years. Esketamine non-significantly doubled the fraction of patients who had a 50 % reduction in their depressions scores: 27 % vs 13 %, odds ratio 2.4, [95 % CI 0.9 to 6.6], <em>P</em> = 0.087. Montgomery-Åsberg depression scores were nearly a factor-of-two and significantly lower (better) on postoperative days 1 to 5 in patients given esketamine. Montgomery-Åsberg scores decreased significantly more from baseline in patients randomized to esketamine: mean difference − 2.5 [95 % CI -4.5 to −0.6], <em>P</em> = 0.010. Esketamine treatment had no significant effect on other secondary outcomes or on adverse events.</div></div><div><h3>Conclusions</h3><div>Intraoperative administration of 0.25 mg/kg esketamine did not significantly improve the fraction of depressed women having breast cancer patients who had a 50 % reduction in their depression scores at 3 days postoperatively. However, the observed factor-of-two treatment effect was clinically meaningful and esketamine significantly reduced short-term postoperative depression scores without provoking complications. Robust trials are warranted.</div><div><strong>Registration Trial registry:</strong> <span><span>http://www.chictr.org.cn/;</span><svg><path></path></svg></span> Identifier: ChiCTR2300071062.</div></div>","PeriodicalId":15506,"journal":{"name":"Journal of Clinical Anesthesia","volume":"103 ","pages":"Article 111821"},"PeriodicalIF":5.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143705384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to \"Comparisons in analgesic effects between ultrasound-guided erector spinae plane block and surgical intercostal nerve block after video-assisted thoracoscopic surgery: A randomized controlled trial\" [Journal Title volume (year) Start page-End page/Article Number] [95 (2024) / 111448].","authors":"Chun-Sung Sung, Tzu-Jung Wei, Jung-Jyh Hung, Fu-Wei Su, Shih-I Ho, Mong-Wei Lin, Kuang-Cheng Chan, Chun-Yu Wu","doi":"10.1016/j.jclinane.2025.111820","DOIUrl":"https://doi.org/10.1016/j.jclinane.2025.111820","url":null,"abstract":"","PeriodicalId":15506,"journal":{"name":"Journal of Clinical Anesthesia","volume":" ","pages":"111820"},"PeriodicalIF":5.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hyperkalemia in liver transplantation","authors":"William Chang MD ,&nbsp;Ming-Ray Xu MD ,&nbsp;Alexander George MD ,&nbsp;Meredith Kingeter MD ,&nbsp;Christopher Patrick Henson DO ,&nbsp;Kelly Mishra MD ,&nbsp;Martin Montenovo MD ,&nbsp;Michael Rizzari MD ,&nbsp;Kara Siegrist MD","doi":"10.1016/j.jclinane.2025.111822","DOIUrl":"10.1016/j.jclinane.2025.111822","url":null,"abstract":"<div><div>Hyperkalemia commonly occurs in patients undergoing liver transplantation. The intraoperative course of liver transplant often involves hemodynamic and metabolic derangements leading up to liver reperfusion. Potassium levels can rise to dangerous levels immediately after reperfusion. The consequences of intraoperative hyperkalemia include risk of malignant arrhythmias and cardiac arrest. This review explores the numerous causes of hyperkalemia, including contributing surgical and anesthetic factors. The authors also discuss various treatment options and surgical techniques to manage perioperative hyperkalemia. It is important for anesthesiologists to understand the implications and management of hyperkalemia to optimize patients and reduce the risk of an intraoperative cardiac arrest.</div></div>","PeriodicalId":15506,"journal":{"name":"Journal of Clinical Anesthesia","volume":"103 ","pages":"Article 111822"},"PeriodicalIF":5.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143696627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comments on “Postoperative delirium under general anesthesia by remimazolam versus propofol: A systematic review and meta-analysis of randomised controlled trials” - Reply","authors":"Masafumi Suga ,&nbsp;Jun Yasuhara ,&nbsp;Atsuyuki Watanabe","doi":"10.1016/j.jclinane.2025.111813","DOIUrl":"10.1016/j.jclinane.2025.111813","url":null,"abstract":"","PeriodicalId":15506,"journal":{"name":"Journal of Clinical Anesthesia","volume":"103 ","pages":"Article 111813"},"PeriodicalIF":5.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143697880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}