Korean Journal of Anesthesiology最新文献

{"title":"An adjustment of fraction of inspired oxygen using the oxygen reserve index during one-lung ventilation in pediatric patients: a prospective, randomized controlled trial.","authors":"Jung-Bin Park, Pyoyoon Kang, Sang-Hwan Ji, Young-Eun Jang, Eun-Hee Kim, Jin-Tae Kim, Hee-Soo Kim, Ji-Hyun Lee","doi":"10.4097/kja.24857","DOIUrl":"https://doi.org/10.4097/kja.24857","url":null,"abstract":"<p><strong>Background: </strong>One-lung ventilation (OLV) during thoracic surgery frequently requires approximately 100% oxygen, imposing the risk of hyperoxemia. This study aimed to assess whether oxygen reserve index (ORI)-guided fraction of inspired oxygen (FiO2) adjustment can reduce the incidence of hyperoxemia in children undergoing lung resection.</p><p><strong>Methods: </strong>This prospective, randomized controlled trial enrolled children aged < 7 years scheduled for thoracoscopic lung resection. The participants were randomly assigned to either a conventional group (FiO2 adjusted based on arterial blood gas analysis [ABGA]) or an ORI group (FiO2 titrated to maintain an ORI target of 0.15). ABGA was performed 10 and 30 min after the start of OLV (T1 and T2). The primary outcome was the incidence of hyperoxemia 30 min after OLV (T2).</p><p><strong>Results: </strong>Data from 64 children (31 conventional, 33 ORI groups) were analyzed. The incidence rate of hyperoxemia at T2 was similar between the conventional and ORI groups (54.8% vs. 60.6%; P = 0.801). However, partial pressure of arterial oxygen at T1 was significantly lower in the ORI group than in the conventional group (214.61 ± 65.52 mmHg vs. 268.84 ± 92.71 mmHg; P = 0.014). The ORI group demonstrated a lower time-weighted average FiO2 during OLV (0.79 ± 0.12 vs. 0.87 ± 0.09; P = 0.004). The ORI group required more rescue interventions than the conventional group and experienced fewer episodes of hypoxia.</p><p><strong>Conclusions: </strong>ORI-guided FiO2 adjustment does not significantly reduce the incidence of hyperoxemia in children undergoing OLV but reduces time-weighted FiO2 and hypoxic events.</p>","PeriodicalId":17855,"journal":{"name":"Korean Journal of Anesthesiology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144150966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosis of flexor hallucis longus tenosynovitis using the cross-sectional area of the flexor hallucis longus tendon.","authors":"SoYoon Park, Young Uk Kim","doi":"10.4097/kja.24773","DOIUrl":"https://doi.org/10.4097/kja.24773","url":null,"abstract":"<p><strong>Background: </strong>Flexor hallucis longus tenosynovitis (FHLTS) is the inflammation of the sheath through which the flexor hallucis longus tendon (FHLT) passes. The FHLT thickness (FHLTT) is correlated with ankle pain. Thus, the FHLTT is considered a characteristic FHLTS feature. However, asymmetrical thickening of the FHLT can occur at any point. Therefore, we used the FHLT cross-sectional area (FHLTCSA) as a new morphological parameter to diagnose FHLTS.</p><p><strong>Methods: </strong>26 participants in the control group (Group 1) and 26 in the FHLTS group (Group 2) underwent magnetic resonance imaging. The FHLTCSA was calculated for the ligament based on the images showing the maximum hypertrophic changes. The FHLTT was measured based on the images showing the FHLT with the maximum thickness.</p><p><strong>Results: </strong>The mean FHLTCSA was 7.86 ± 1.88 mm2 and 13.11 ± 2.31 mm2 in Groups 1 and 2, respectively. The average FHLTT was 2.35 ± 0.55 mm and 2.91 ± 0.37 mm in Groups 1 and 2, respectively. The FHLTCSA (P < 0.001) and FHLTT (P < 0.001) in Group 2 were significantly greater than those in Group 1. Receiver operating characteristic (ROC) curve analysis revealed that the optimal cutoff value for the FHLTCSA was 10.37 mm2, with a sensitivity of 92.3%, a specificity of 92.3%, and an area under the curve (AUC) of 0.97. The optimal cutoff value for the FHLTT was 2.71 mm, with a sensitivity of 76.9%, a specificity of 76.9%, and an AUC of 0.84.</p><p><strong>Conclusion: </strong>The FHLTCSA is a sensitive morphological parameter for assessing FHLTS.</p>","PeriodicalId":17855,"journal":{"name":"Korean Journal of Anesthesiology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in pulse wave transit time variability after interscalene brachial plexus block placement.","authors":"Eun Joo Choi, Jung A Lim, Chang Hyuk Choi, Dong Hyuck Kim, Sungbin Jo, Jonghae Kim","doi":"10.4097/kja.24861","DOIUrl":"https://doi.org/10.4097/kja.24861","url":null,"abstract":"<p><strong>Background: </strong>The pulse wave transit time (PWTT) increases with decreased vascular tone resulting from sympathetic blockade caused by regional anesthesia. It oscillates, exhibiting variability due to the interaction between the autonomic nervous and cardiovascular systems. We hypothesized that interscalene brachial plexus block (ISBPB) placement increases the PWTT and reduces the low-frequency power of PWTT variability (LF).</p><p><strong>Methods: </strong>Fifty-six patients receiving an ISBPB were analyzed. The PWTT was defined as the difference in milliseconds (ms) between the R peak of the electrocardiogram and the peak of the second-derivative photoplethysmographic waveform. The LF was calculated by integrating from 0.04 to 0.15 Hz on the power spectrum obtained from fast Fourier transform. The two variables were collected during 5 min before the end of acclimatization (baseline), between 5 and 10 min after block needle insertion, and between 15 and 20 min after block needle insertion.</p><p><strong>Results: </strong>The PWTT increased significantly (P < 0.001) from baseline (mean [SD]: 155.3 [16.7] ms) to 5-10 min post-needle insertion (166.9 [15.4] ms) (mean difference [MD]: 11.6, 95% CI [9.2, 14.0], P < 0.001) and 15-20 min post-needle insertion (165.6 [16.1] ms) (MD: 10.3, 95% CI [7.3, 13.2], P < 0.001). The natural log-transformed LF (lnLF) decreased significantly (P < 0.01) from baseline (1.539 [0.560] ln[ms2/Hz]) to 5-10 min post-needle insertion (1.341 [0.617] ln[ms2/Hz]) (MD: -0.198, 95% CI [-0.356, -0.040], P < 0.01) and 15-20 min post-needle insertion (1.396 [0.548] ln[ms2/Hz]) (MD: -0.144, 95% CI [-0.274, -0.013], P = 0.03).</p><p><strong>Conclusions: </strong>The post-ISBPB decrease in lnLF and increase in PWTT may be attributable to ISBPB-induced sympathectomy.</p>","PeriodicalId":17855,"journal":{"name":"Korean Journal of Anesthesiology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond suction: should we consider post-aspiration recruitment maneuvers?","authors":"Cyril Pernod, Pierre-Julien Cungi, Hilaire de Malleray, Quentin Mathais, Michael Cardinale, Philippe Goutorbe","doi":"10.4097/kja.25153","DOIUrl":"https://doi.org/10.4097/kja.25153","url":null,"abstract":"","PeriodicalId":17855,"journal":{"name":"Korean Journal of Anesthesiology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Three pillars of artificial intelligence research in anesthesiology: welcoming address to the Korean Journal of Anesthesiology's new guidelines for machine learning and deep learning research.","authors":"Younsuk Lee","doi":"10.4097/kja.25318","DOIUrl":"https://doi.org/10.4097/kja.25318","url":null,"abstract":"","PeriodicalId":17855,"journal":{"name":"Korean Journal of Anesthesiology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Injectate distribution patterns with the posterior infrazygomatic and transoral approaches to the pterygopalatine fossa.","authors":"Anže Jerman, Luka Pušnik, Erika Cvetko, Nejc Umek, Žiga Snoj","doi":"10.4097/kja.24907","DOIUrl":"https://doi.org/10.4097/kja.24907","url":null,"abstract":"<p><strong>Background: </strong>Injectate distribution patterns in the pterygopalatine fossa may differ based on the drug administration approach used. This study primarily aimed to assess and compare injectate distribution following the posterior infrazygomatic and transoral approaches. The secondary aim was to evaluate the safety of both approaches.</p><p><strong>Methods: </strong>Injectate distribution patterns were evaluated in 13 cadaveric head specimens. The vessels were perfused with a gelatin-based solution containing an iodinated contrast agent. The ultrasound-guided posterior infrazygomatic approach and transoral approach were performed on contralateral sides, and needle placement was confirmed using computed tomography (CT). A methylene blue and iodinated contrast agent solution was administered following successful needle placement. Injectate distribution and injuries were assessed via CT and anatomical dissection.</p><p><strong>Results: </strong>With the posterior infrazygomatic approach, methylene blue consistently stained the maxillary artery and nerve, sphenopalatine ganglion, and lateral pterygoid muscle, whereas with the transoral approach, it most frequently surrounded the maxillary artery and structures within the greater palatine canal. The iodinated contrast agent was distributed predominantly along the needle trajectories for both approaches. Injuries to the maxillary artery and facial nerve were documented following the posterior infrazygomatic approach, whereas an injury to the lateral pterygoid plate was observed following the transoral approach.</p><p><strong>Conclusions: </strong>With the posterior infrazygomatic approach, contrast agent encompassed the entire pterygopalatine fossa, whereas the transoral approach yielded a more localized distribution, primarily within the inferior portion and greater palatine canal. These differences in distribution patterns should guide the selection of the most appropriate approach based on the specific clinical indication.</p>","PeriodicalId":17855,"journal":{"name":"Korean Journal of Anesthesiology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144017540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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 perioperative ketamine and esketamine administration on postoperative nausea and vomiting in patients undergoing general anesthesia: a systematic review and meta-analysis.","authors":"Kwon Hui Seo, Shu Chung Choi, Jueun Kwak, Na Jin Kim","doi":"10.4097/kja.24930","DOIUrl":"https://doi.org/10.4097/kja.24930","url":null,"abstract":"<p><strong>Background: </strong>The effects of perioperative ketamine and esketamine on postoperative nausea and vomiting (PONV) remain unclear. This study aimed to clarify their impact on PONV and related adverse events.</p><p><strong>Methods: </strong>We performed a meta-analysis of randomized controlled trials (RCTs) and observational studies comparing ketamine or esketamine with control agents. The primary outcome was a pooled analysis of PONV and nausea-only data. PONV, postoperative nausea (PON), and postoperative vomiting (POV) were also analyzed separately. Subgroup analyses were conducted by comparator type (placebo, opioid, or non-opioid) and dose categories. Meta-regression was used to assess dose-response relationships.</p><p><strong>Results: </strong>Fifty-five studies (n = 6,676) were included. Ketamine and esketamine did not significantly reduce the incidence of pooled PONV risk (risk ratio [RR]: 0.95, 95% CI [0.87, 1.04], P = 0.274). No benefit was found versus placebo. Compared with opioids, PONV was reduced (RR: 0.50, 95% CI [0.32, 0.77], P = 0.002), but not in the pooled analysis (RR: 0.69, 95% CI [0.43, 1.08], P = 0.107). Conversely, compared with non-opioid controls, ketamine/esketamine increased the pooled PONV risk (RR: 1.46, 95% CI [1.03, 2.05], P = 0.032). No significant dose-response relationship was found. Both agents increased hallucinations (RR: 1.73; 95% CI [1.35, 2.20], P = 0.0002) and drowsiness (RR: 2.18, 95% CI [1.13-4.21], P = 0.024).</p><p><strong>Conclusions: </strong>Ketamine and esketamine did not significantly reduce PONV overall. While they showed benefits compared with opioid-based regimens, they may be less effective than non-opioid adjuvants. However, their neuropsychiatric and sedative risks warrant cautious use.</p>","PeriodicalId":17855,"journal":{"name":"Korean Journal of Anesthesiology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Authors' reply to \"Comment on: 'Axillary serratus anterior plane block as a novel approach to anesthetizing the intercostobrachial nerve'\".","authors":"Chi Ho Chan, Jia Yin Lim, Abey M V Mathews","doi":"10.4097/kja.25275","DOIUrl":"https://doi.org/10.4097/kja.25275","url":null,"abstract":"","PeriodicalId":17855,"journal":{"name":"Korean Journal of Anesthesiology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144000854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on: \"Axillary serratus anterior plane block as a novel approach to anesthetizing the intercostobrachial nerve\".","authors":"Raghuraman M Sethuraman","doi":"10.4097/kja.25252","DOIUrl":"https://doi.org/10.4097/kja.25252","url":null,"abstract":"","PeriodicalId":17855,"journal":{"name":"Korean Journal of Anesthesiology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144028866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting neurological complications post clipping surgery in unruptured intracranial aneurysms using the NEURO score: a multi-center retrospective cohort study.","authors":"Yeon Ju Kim, Ah Ran Oh, Soo Jeong, Jungchan Park, Min-Ju Kim, Seong-Yoon Kim, Wonhyoung Park, Jae Sung Ahn, Chan-Sik Kim, Ji-Hoon Sim, Yong-Seok Park, Seungil Ha, Joung Uk Kim","doi":"10.4097/kja.24934","DOIUrl":"https://doi.org/10.4097/kja.24934","url":null,"abstract":"<p><strong>Background: </strong>Predicting fatal neurological complications after clipping surgery for unruptured intracranial aneurysms (UIAs) is crucial; however, existing scoring systems are limited by narrow consideration of factors. We aimed to develop and validate a comprehensive risk stratification scoring system that incorporates patient-, aneurysm-, and operation-specific variables for predicting postoperative neurological complications in UIA surgeries.</p><p><strong>Methods: </strong>This multi-center retrospective cohort study was conducted from September 2018 to October 2023. Patients undergoing clipping surgery for UIAs were divided into development and validation sets based on the treating institution. A predictive score for postoperative neurological complications was developed from a multivariate logistic regression analysis. The score, named NEURO, that incorporates variables like previous neurological disease, categorized aneurysm location and size, categorized operation time, and transfusion was validated externally.</p><p><strong>Results: </strong>The study included 2847 patients, with 1547 and 1300 in the development and validation sets, based on the institution of surgery, respectively. The incidence of neurological complications was 5.7% (88 / 1547) and 5.6% (73 / 1300) in the development and validation sets, respectively. The NEURO score showed good predictive ability with C-statistics of 0.720 (95% CI, 0.667-0.776) in the development set and 0.693 (95% CI, 0.631-0.754) in the validation set, demonstrating good calibration across the predicted probability range.</p><p><strong>Conclusions: </strong>The NEURO score, integrating multiple perioperative variables, may effectively predict the risk of neurological complications post UIA clipping surgery, aiding in identifying high-risk patients. This tool could enhance clinical decision-making and patient management in neurosurgical practice.</p>","PeriodicalId":17855,"journal":{"name":"Korean Journal of Anesthesiology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}