Journal of Clinical Anesthesia最新文献

{"title":"Comment on \"Incidence of delirium post cardiac surgery discrepancy between clinical observation, DOS scores, and single‑lead EEG\".","authors":"Jinyan Guo, Fen Pan, Ke Chen, Weifeng Yao","doi":"10.1016/j.jclinane.2025.111952","DOIUrl":"10.1016/j.jclinane.2025.111952","url":null,"abstract":"","PeriodicalId":15506,"journal":{"name":"Journal of Clinical Anesthesia","volume":"106 ","pages":"111952"},"PeriodicalIF":5.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144804215","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":"Beyond oxygen delivery: Do stroke volume maximization and preoperative cardiac index maintenance truly improve clinical-relevant perfusion in major abdominal surgery?","authors":"Jinyan Guo, Ke Chen, Xue Han, Weifeng Yao","doi":"10.1016/j.jclinane.2025.111951","DOIUrl":"10.1016/j.jclinane.2025.111951","url":null,"abstract":"","PeriodicalId":15506,"journal":{"name":"Journal of Clinical Anesthesia","volume":"106 ","pages":"111951"},"PeriodicalIF":5.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144804214","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":"From autonomy to augmentation: Rethinking AI's role in perioperative care.","authors":"Qingli Li, Yuanqiong Duan, Rutie Yin","doi":"10.1016/j.jclinane.2025.111957","DOIUrl":"10.1016/j.jclinane.2025.111957","url":null,"abstract":"","PeriodicalId":15506,"journal":{"name":"Journal of Clinical Anesthesia","volume":"106 ","pages":"111957"},"PeriodicalIF":5.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144804216","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 effect of postoperative hypotension on surgical patients' adverse clinical outcomes: A systematic review and meta-analysis","authors":"Shunyu Han ,&nbsp;Tao Zeng ,&nbsp;Yumei Xie ,&nbsp;Chang Liu ,&nbsp;Lina Yang ,&nbsp;Mengchang Yang","doi":"10.1016/j.jclinane.2025.111987","DOIUrl":"10.1016/j.jclinane.2025.111987","url":null,"abstract":"<div><h3>Introduction</h3><div>Postoperative hypotension (POH) represents an independent predictor of multiorgan morbidity. Emerging evidence indicates its risks exceed those associated with intraoperative hypotension (IOH). Considering the ubiquitous presence of this pathophysiological disturbance across surgical settings, our meta-analysis evaluates associations between POH and major adverse outcomes.</div></div><div><h3>Methods</h3><div>We systematically searched PubMed, Web of Science, Cochrane Library, and Embase for clinical studies investigating POH and adverse outcomes, with literature coverage through 7 February 2025. Mortality during follow-up was designated as the primary outcome. Secondary outcomes included acute kidney injury (AKI), myocardial injury, delirium, stroke, and postoperative length of stay (LOS). Publication bias was assessed using Egger's test and trim-and-fill analysis; sensitivity analyses employed the leave-one-out method; and subgroup analysis was performed to explore heterogeneity.</div></div><div><h3>Results</h3><div>This meta-analysis incorporated 23 studies involving 262,435 patients. Significant associations were identified between POH and adverse outcomes, including mortality (OR = 2.51, 95 % confidence interval [CI] 1.86–3.38), AKI (OR = 1.72, 95 % CI 1.25–2.36), myocardial injury (OR = 2.52, 95 % CI 1.71–3.69), and stroke (OR = 1.82, 95 % CI 1.09–3.05). However, publication bias detected by the trim-and-fill method compromised the robustness of AKI findings, while the stroke association demonstrated instability in leave-one-out sensitivity analyses. Subgroup analyses identified multiple POH thresholds as the primary source of heterogeneity.</div></div><div><h3>Conclusion</h3><div>These findings establish POH as a clinically significant correlate of postoperative mortality and myocardial injury. However, POH associations with AKI and stroke exhibit limited robustness, requiring further investigation. Future studies must delineate the impact of POH depth, duration, and measurement method.</div></div>","PeriodicalId":15506,"journal":{"name":"Journal of Clinical Anesthesia","volume":"107 ","pages":"Article 111987"},"PeriodicalIF":5.1,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144920013","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":"Bibliometric analysis of research on nerve block in the field of anesthesiology over the past 25 years","authors":"Lina Lang ,&nbsp;Guanghan Wu","doi":"10.1016/j.jclinane.2025.111982","DOIUrl":"10.1016/j.jclinane.2025.111982","url":null,"abstract":"<div><div>This bibliometric analysis examines the evolution of nerve block research in anesthesiology over the past 25 years (2000–2024). Using the Web of Science database, 5804 relevant publications were analyzed with bibliometric tools (Bibliometrix in R and VOSviewer) to identify research trends, key contributors, and thematic developments. Results show a steady rise in publications, particularly after 2012, with the United States, China, and India leading research output. Core topics include nerve block safety, postoperative pain management, continuous nerve block techniques, adjuncts for analgesia, emerging block methods, and applications in dentistry and prostate procedures. Keyword analysis highlights recent research focuses on ultrasound-guided techniques, ERAS protocols, multimodal analgesia, and personalized anesthesia strategies. This study provides a comprehensive overview of nerve block research, offering insights into its intellectual structure and future directions. Future studies should further explore precision anesthesia, novel drug applications, and individualized pain management strategies to enhance clinical practice.</div></div>","PeriodicalId":15506,"journal":{"name":"Journal of Clinical Anesthesia","volume":"107 ","pages":"Article 111982"},"PeriodicalIF":5.1,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144917097","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":"Erratum to \"Removal of EpCAM-positive tumor cells during intraoperative blood salvage- A pivotal multicenter clinical study (REMOVE)\" [Journal of Clinical Anesthesia 106 (2025) 111972 (9 pages)].","authors":"Patrick Meybohm, Suma Choorapoikayil, Sebastian Zinn, Simone Lindau, Markus Heiss, Jerome Defosse, Eva Wittenmeier, Marion Ferner, Maximillian Kriegmair, Niklas Westhoff, Sebastian Hottenrott, Tobias Haas, Peter Kranke, Tom-Philipp Zucker, Andreas Schnitzbauer, Luis Kluth, Frank Wappler, Nina Walossek, Michael Schuster, Anna Lotz, Axel Müll, Roxana Schwab, Jens Mittler, Ivette Betka, Jochen Johannes Schoettler, Hubert Kübler, Anna Seitz, Horst Lindhofer, Kai Zacharowski","doi":"10.1016/j.jclinane.2025.111986","DOIUrl":"10.1016/j.jclinane.2025.111986","url":null,"abstract":"","PeriodicalId":15506,"journal":{"name":"Journal of Clinical Anesthesia","volume":" ","pages":"111986"},"PeriodicalIF":5.1,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955306","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":"Associations of driving pressure and mechanical power with postoperative pulmonary complications in one-lung ventilated surgery","authors":"Hyun-Lim Yang Ph.D ,&nbsp;Seong-A Park B·S ,&nbsp;Hong Yeul Lee M.D., Ph.D ,&nbsp;Hyeonhoon Lee Ph.D ,&nbsp;Ho-Geol Ryu M.D., Ph.D ,&nbsp;Hyung-Chul Lee M.D., Ph.D ,&nbsp;Sang-Min Lee M.D., Ph.D ,&nbsp;Jinwoo Lee M.D., Ph.D","doi":"10.1016/j.jclinane.2025.111981","DOIUrl":"10.1016/j.jclinane.2025.111981","url":null,"abstract":"<div><h3>Background</h3><div>The potential clinical value of driving pressure (DP) and mechanical power (MP) as digital biomarkers for predicting postoperative pulmonary complications (PPC) has been emphasized. Although several studies have explored this association, evidence from clinical cohorts involving large patient populations remains limited.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted between October 2004 and May 2023 on patients who underwent OLV surgery. The association between time-weighted median dynamic DP or MP and PPC was analyzed using multivariate logistic regression models adjusted for confounders. Additionally, risk threshold analysis was conducted to propose thresholds for an increased risk of PPC.</div></div><div><h3>Results</h3><div>Among the 3386 (using plateau pressure; Pplat) or 4951 (using peak inspiratory pressure; PIP) patients included, PPC occurrence was 19.31 % and 17.43 %, respectively. The mean of the time-weighted median DP derived from Pplat (DP-Pplat) and MP derived from Pplat (MP-Pplat) were 14.6 cmH₂O and 7.1 J/min, while DP-PIP and MP-PIP were 17.2 cmH₂O and 6.4 J/min. Both calculation methods showed that DP had an independent association with the occurrence of PPC, with an odds ratio of 1.047 [95 % CI 1.019–1.075, <em>p</em> &lt; 0.05] and 1.036 [95 % CI 1.013–1.059, p &lt; 0.05] using Pplat and PIP, respectively. However, MP was not found to be independently associated with PPC using either method, with an odds ratio of 1.033 [95 % CI 0.980–1.089, <em>p</em> = 0.226] and 1.048 [95 % CI 0.992–1.106, <em>p</em> = 0.092] using Pplat and PIP, respectively. The risk threshold for DP-Pplat was 15 cmH₂O, whereas for DP-PIP, it was 18 cmH₂O.</div></div><div><h3>Conclusions</h3><div>In this OLV surgery population, a DP-Pplat-limited mechanical ventilation strategy of 15 cmH₂O or DP-PIP of 18 cmH₂O was associated with lower risk of PPC.</div></div>","PeriodicalId":15506,"journal":{"name":"Journal of Clinical Anesthesia","volume":"106 ","pages":"Article 111981"},"PeriodicalIF":5.1,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144908463","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":"Leadership at the epicenter: Professionalism and purpose in an era of seismic change.","authors":"Markus M Luedi","doi":"10.1016/j.jclinane.2025.111985","DOIUrl":"https://doi.org/10.1016/j.jclinane.2025.111985","url":null,"abstract":"","PeriodicalId":15506,"journal":{"name":"Journal of Clinical Anesthesia","volume":" ","pages":"111985"},"PeriodicalIF":5.1,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955909","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":"Response to letter to the editor: “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 PharmD ,&nbsp;Wei-Ya Li MD ,&nbsp;Vetri Thangavelu HBSc ,&nbsp;Aparna Saripella MSc ,&nbsp;Marina Englesakis MLIS ,&nbsp;Ellene Yan HBSc ,&nbsp;Frances Chung MBBS MD","doi":"10.1016/j.jclinane.2025.111973","DOIUrl":"10.1016/j.jclinane.2025.111973","url":null,"abstract":"","PeriodicalId":15506,"journal":{"name":"Journal of Clinical Anesthesia","volume":"106 ","pages":"Article 111973"},"PeriodicalIF":5.1,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144893376","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":"Respiratory-related safety profiles of ciprofol (cipepofol) for anesthesia/sedation in Chinese elderly patients undergoing gastroscopy: a multicenter, parallel controlled clinical trial (REST trial)","authors":"Xiang Zhang ,&nbsp;Tao Zhu ,&nbsp;Guo Chen ,&nbsp;He Huang ,&nbsp;Guangyou Duan ,&nbsp;Zhaoyang Xiao ,&nbsp;Jinxia Gao ,&nbsp;Cunming Liu ,&nbsp;Yahui Huang ,&nbsp;Jiajia Hu ,&nbsp;Jiang Hu ,&nbsp;Jinpeng Qiu ,&nbsp;Yanling Liao ,&nbsp;Cansheng Gong ,&nbsp;Yanran Ma ,&nbsp;Haiqing Zhong ,&nbsp;Lvyi Yuan","doi":"10.1016/j.jclinane.2025.111976","DOIUrl":"10.1016/j.jclinane.2025.111976","url":null,"abstract":"<div><h3>Background</h3><div>A post-marketing, parallel-controlled clinical trial (REST trial) was conducted to evaluate the safety and efficacy of cipepofol versus propofol for the induction of anesthesia/sedation in Chinese elderly patients undergoing gastroscopy.</div></div><div><h3>Methods</h3><div>All enrolled patients aged ≥65 years were assigned randomly in a 1:1 ratio to be administered intravenous cipepofol-0.3 mg/kg or propofol-1.5 mg/kg. The primary endpoint was incidence of respiratory-related adverse events (AEs) including respiratory depression (respiratory rate &lt; 8 breaths/min lasting for &gt;30 s), apnea (loss of thoracic movement for &gt;15 s) and hypoxemia (SpO₂ &lt; 93 % lasting for &gt;15 s). Secondary endpoints included: success rates of the gastroscopy procedure and gastroscope insertion; gastroscopy-related duration (successful anesthesia/sedation induction duration; time to full alertness; time to leaving the post-anesthesia care unit; gastroscope insertion duration); satisfaction rate for the anesthesia/sedation process and anesthetics.</div></div><div><h3>Results</h3><div>Among 890 randomized patients, 871 were finally included in the full analysis set (FAS), with 431 receiving cipepofol and 440 receiving propofol. Patients treated with cipepofol had a significantly lower incidence of respiratory-related AEs compared to propofol treatment (FAS: 22.3 % vs. 33.9 %, per-protocol set: 20.6 % vs. 34.5 %, all <em>P</em> &lt; 0.001), regardless of sex. Multivariable analysis revealed that the risk of patients experiencing respiratory-related AEs was 1.82 times higher in the propofol group compared to cipepofol group (<em>P</em> &lt; 0.001). The success rates of the gastroscopy procedure and gastroscope insertion were both 100 % in the two groups. Gastroscopy procedure-related durations were shorter in propofol group compared to cipepofol group (all <em>P</em> &lt; 0.05). Patients treated with cipepofol exhibited a significantly lower rate of treatment-emergent AEs (TEAEs) (55.0 % vs. 67.7 %, <em>P</em> &lt; 0.001), TEAEs of special interest (53.4 % vs. 65.2 %, <em>P</em> &lt; 0.001) and injection pain (2.6 % vs. 28.4 %, <em>P</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Cipepofol-0.3 mg/kg is a safe and effective intravenous anesthetic for Chinese elderly patients undergoing gastroscopy, especially complimented by lower incidences of respiratory-related AEs and injection pain.</div><div><strong>Clinical trials registration:</strong> Chinese Clinical Trial Registry, ChiCTR2100052299, registered on October 24, 2021.</div></div>","PeriodicalId":15506,"journal":{"name":"Journal of Clinical Anesthesia","volume":"106 ","pages":"Article 111976"},"PeriodicalIF":5.1,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144890452","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}