Korean Journal of Anesthesiology最新文献

Effects of a virtual reality digital twin of the operating theatre on anxiety in pediatric surgery patients: a randomized controlled trial.

IF 4.2 4区医学

Korean Journal of Anesthesiology Pub Date : 2025-04-02 DOI: 10.4097/kja.24874

Jiyoun Lee, Jung-Hee Ryu, Jin-Hee Kim, Sung-Hee Han, Jin-Woo Park

{"title":"Effects of a virtual reality digital twin of the operating theatre on anxiety in pediatric surgery patients: a randomized controlled trial.","authors":"Jiyoun Lee, Jung-Hee Ryu, Jin-Hee Kim, Sung-Hee Han, Jin-Woo Park","doi":"10.4097/kja.24874","DOIUrl":"https://doi.org/10.4097/kja.24874","url":null,"abstract":"Background: Sevoflurane-based volatile induction and maintenance of anesthesia (VIMA) is common in pediatric outpatient surgery but can elevate preoperative anxiety in unfamiliar settings. This study compared the effects of immersive 3D virtual reality (VR) digital twin that precisely simulated the operating theatre environment with those of two-dimensional (2D) video education on preoperative anxiety in pediatric patients undergoing VIMA.Methods: In total, 102 pediatric patients undergoing elective ambulatory surgery were randomly assigned to either the VR or tablet group. Identical preoperative education was provided through a 3D VR digital twin or tablet video. Preoperative anxiety, induction compliance, and procedural behavior during anesthesia induction were assessed using the modified Yale Preoperative Anxiety Scale (mYPAS), induction compliance checklist (ICC), and procedural behavior rating scale (PBRS), respectively. The VIMA induction times, and parental satisfaction were recorded.Results: Children in the VR group exhibited lower mYPAS (33.3 [23.3-49.2] versus 46.7 [33.3-55.8], P = 0.022), higher ICC (P = 0.007), and lower PBRS (0.0 [0.0-1.0] versus 1.0 [0.0-2.0], P = 0.009) scores than those in the tablet group. The VIMA induction time was also shorter in the VR group (305.0 [253.5-392.5] versus 382.0 [329.0-480.0] s, P = 0.002), although parental satisfaction was comparable between the two groups.Conclusions: Compared with video education, preoperative education utilizing an immersive 3D VR digital twin enhanced the efficacy of VIMA process, resulting in reduced preoperative anxiety, increased compliance, lower distress during anesthetic induction, and shorter induction time.","PeriodicalId":17855,"journal":{"name":"Korean Journal of Anesthesiology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764239","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}

引用次数: 0

'Think Drink' approach to minimize unnecessary preoperative fasting: 18 years audit experience.

IF 4.2 4区医学

Korean Journal of Anesthesiology Pub Date : 2025-03-31 DOI: 10.4097/kja.24489

Katarzyna A R MacDougall, Shahnoor E S Bushra, Santhana G Kannan

{"title":"'Think Drink' approach to minimize unnecessary preoperative fasting: 18 years audit experience.","authors":"Katarzyna A R MacDougall, Shahnoor E S Bushra, Santhana G Kannan","doi":"10.4097/kja.24489","DOIUrl":"https://doi.org/10.4097/kja.24489","url":null,"abstract":"Background: Fasting guidelines have long recommended that patients can have clear fluids until 2 h prior to surgery. Multiple audits in our institution showed that patients had prolonged fluid fasting duration, despite being given preoperative instructions. This paper presents the results of audits in our institution relating to fasting since 2004 and the outcome of interventions undertaken.Methods: Audits conducted in 2004, 2008, 2018, 2021, and 2022 were reviewed, with a focus on fasting duration for clear fluids. Interventions that led to significant improvements were identified.Results: The median fasting duration for clear fluids was 8 h, 8 h 42 min, and 7 h 42 min in 2004, 2008, and January 2018, respectively. The approach of giving patients a 'welcome drink' of water and allowing sips of water up to the time of being called upon to the theater was introduced in 2018 (Think Drink). This resulted in dramatic reduction of fasting duration to 2 h 15 min. However, repeat audit in 2021 showed slippage requiring additional interventions in the form of staff education for newcomers and reinforcement at staff huddles that reduced the fasting duration down to 2 h. There were no instances of aspiration or regurgitation after the introduction of Think Drink.Conclusions: Allowing sips of water until being called to the theater with a Think Drink approach successfully reduced unnecessary fasting by patients. Staff and patient education were also required to sustain success. Fasting duration should be considered a 'Quality of Service Indicator' and periodic audit should be mandated.","PeriodicalId":17855,"journal":{"name":"Korean Journal of Anesthesiology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752834","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}

引用次数: 0

Liver transplantation outcomes in patients with primary tricuspid regurgitation with coaptation defects: A retrospective analysis in a high-volume transplant center.

IF 4.2 4区医学

Korean Journal of Anesthesiology Pub Date : 2025-03-26 DOI: 10.4097/kja.24540

Kyoung-Sun Kim, Sun-Young Ha, Seong-Mi Yang, Hye-Mee Kwon, Sung-Hoon Kim, In-Gu Jun, Jun-Gol Song, Gyu-Sam Hwang

{"title":"Liver transplantation outcomes in patients with primary tricuspid regurgitation with coaptation defects: A retrospective analysis in a high-volume transplant center.","authors":"Kyoung-Sun Kim, Sun-Young Ha, Seong-Mi Yang, Hye-Mee Kwon, Sung-Hoon Kim, In-Gu Jun, Jun-Gol Song, Gyu-Sam Hwang","doi":"10.4097/kja.24540","DOIUrl":"https://doi.org/10.4097/kja.24540","url":null,"abstract":"Background: Cardiovascular diseases are the leading cause of mortality after liver transplantation(LT). Although the impact of secondary tricuspid regurgitation (TR) with severe pulmonary hypertension(PH) is well investigated, the impact of primary TR with tricuspid valve incompetence(TVI) on LT outcomes remains unclear. We aimed to investigate the prevalence and impact of primary TR with TVI on LT outcomes in a large-volume LT center.Methods: We retrospectively examined 5,512 consecutive LT recipients who underwent routine pretransplant echocardiography between 2008 and 2020. Patients were categorized based on the presence of anatomical TVI, specifically defined by incomplete coaptation, coaptation failure, prolapse, and flail leaflets of tricuspid valve(TV). Propensity score (PS)-based inverse probability weighting(IPW) was used to balance clinical and cardiovascular risk variables. The outcomes were one-year cumulative all-cause mortality and 30-day major adverse cardiovascular events(MACE).Results: Anatomical TVI was identified in 14 patients(0.3%). Although rare, these patients exhibited significantly lower post-LT one-year survival rates (64.3% vs. 91.5%, P < 0.001) and higher 30-day MACE rates(42.9% vs. 16.9%, P = 0.026) than patients without TVI. They also had worse survival irrespective of echocardiographic evidence of PH (P < 0.001) and exhibited higher one-year mortality(IPW-adjusted hazard ratio [HR]: 4.09, P = 0.002) and increased 30-day MACE rates(IPW-adjusted odds ratio [OR]: 1.24, P = 0.048).Conclusions: Primary TR with anatomical TVI was associated with significantly reduced one-year survival and increased post-LT MACE rates. These patients should be prioritized similarly to those with secondary TR with severe PH, with appropriate pretransplant evaluations and treatments to improve survival outcomes.","PeriodicalId":17855,"journal":{"name":"Korean Journal of Anesthesiology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710428","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}

引用次数: 0

Remimazolam - expectations and concerns. Remimazolam - 期望与担忧。

IF 4.2 4区医学

Korean Journal of Anesthesiology Pub Date : 2025-03-21 DOI: 10.4097/kja.25170

Jae Hoon Lee

引用次数: 0

Revisiting anesthesia-induced preconditioning for neuroprotection in the aging brain-a narrative review.

IF 4.2 4区医学

Korean Journal of Anesthesiology Pub Date : 2025-03-20 DOI: 10.4097/kja.25073

Tao Zhang, Woosuk Chung, Beverley A Orser

{"title":"Revisiting anesthesia-induced preconditioning for neuroprotection in the aging brain-a narrative review.","authors":"Tao Zhang, Woosuk Chung, Beverley A Orser","doi":"10.4097/kja.25073","DOIUrl":"https://doi.org/10.4097/kja.25073","url":null,"abstract":"The growing number of older adults undergoing surgery necessitates means to address the adverse effects of overt and covert perioperative stroke. Preclinical studies have suggested that anesthesia-induced preconditioning may provide neuroprotection by preserving mitochondrial function, activating cytosolic signaling pathways, and reducing neuroinflammation. However, these promising findings from animal studies have not yet translated into improved clinical outcomes. The discordance between preclinical and clinical outcomes may be due to age-related mitochondrial dysfunction and other comorbidities in older populations, which reduce the effectiveness of anesthetic preconditioning. Mitochondria, which are central to the effectiveness of preconditioning, may be therapeutic targets to restore the neuroprotective effects of anesthetic preconditioning in the aging brain. Emerging evidence suggests that physical prehabilitation, a key component of Enhanced Recovery After Surgery programs, may influence mitochondrial function and could thus restore anesthesia-induced preconditioning. Although further research is needed to determine the impact of physical prehabilitation on mitochondrial function and thereby on anesthetic preconditioning, incorporating physical prehabilitation into perioperative care might enhance neurological outcomes for older patients undergoing surgery.","PeriodicalId":17855,"journal":{"name":"Korean Journal of Anesthesiology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670280","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}

引用次数: 0

A modified hip pericapsular nerve block on postoperative pain and functional outcomes after total hip arthroplasty: a prospective, double-blind, randomized controlled study.

IF 4.2 4区医学

Korean Journal of Anesthesiology Pub Date : 2025-03-13 DOI: 10.4097/kja.24593

Jian Hu, Qiuru Wang, Jie Hu, Chunyu Gong, Jing Yang

{"title":"A modified hip pericapsular nerve block on postoperative pain and functional outcomes after total hip arthroplasty: a prospective, double-blind, randomized controlled study.","authors":"Jian Hu, Qiuru Wang, Jie Hu, Chunyu Gong, Jing Yang","doi":"10.4097/kja.24593","DOIUrl":"https://doi.org/10.4097/kja.24593","url":null,"abstract":"Background: This study aimed to explore the efficacy and safety of the hip pericapsular nerve block (hip-PNB), which combines the anterior pericapsular nerve group (PENG) and posterior pericapsular deep-gluteal (PPD) blocks, on postoperative pain and functional outcomes after total hip arthroplasty (THA) via the posterolateral approach.Methods: Seventy patients undergoing THA were allocated to either the nerve block group (Group N, hip-PNB + sham local infiltration analgesia [LIA]) or the control group (Group C, sham hip-PNB + LIA). The primary outcome was cumulative morphine consumption in the first 24 h postoperatively. Secondary outcomes included visual analog scale pain scores at rest and during movement postoperatively, time to first rescue analgesia, cumulative morphine consumption during hospitalization, opioid consumption during surgery, postoperative recovery, and postoperative complications.Results: Compared with Group C, Group N consumed significantly less morphine in the first 24 h (10 [0-10] mg vs. 10 [10-20] mg; P < 0.001) and throughout hospitalization (10 [0-20] mg vs. 20 [20-30] mg; P < 0.001) and had less opioid consumption perioperatively. Group N also had significantly lower pain scores at rest and during movement in the first 24 h, required rescue analgesia later, and had faster recovery postoperatively than Group C. No significant intergroup differences were observed in quadriceps muscle strength or postoperative complication rates.Conclusions: Compared to LIA, Hip-PNB has better postoperative analgesia and enhances recovery in patients undergoing THA.","PeriodicalId":17855,"journal":{"name":"Korean Journal of Anesthesiology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143615803","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}

引用次数: 0

Axillary serratus anterior plane block as a novel approach to anesthetizing the intercostobrachial nerve for upper arm arteriovenous fistula creation surgery-three case reports.

IF 4.2 4区医学

Korean Journal of Anesthesiology Pub Date : 2025-03-06 DOI: 10.4097/kja.24893

Chi Ho Chan, Jia Yin Lim, Abey M V Mathews

{"title":"Axillary serratus anterior plane block as a novel approach to anesthetizing the intercostobrachial nerve for upper arm arteriovenous fistula creation surgery-three case reports.","authors":"Chi Ho Chan, Jia Yin Lim, Abey M V Mathews","doi":"10.4097/kja.24893","DOIUrl":"https://doi.org/10.4097/kja.24893","url":null,"abstract":"Background: Current regional anesthesia techniques used to anesthetize the intercostobrachial nerve (ICBN) for upper arm surgery either lack reliability or have increased procedural risks. Safer and more reliable regional anesthetic techniques are required to block the ICBN effectively. Here, we introduce a novel \"axillary serratus anterior plane (A-SAP) block\" for anesthetizing the ICBN to allow surgical anesthesia for upper arm arteriovenous fistula (UA-AVF) creation.Case: We present three cases involving a 79-year-old Chinese male, a 73-year-old Malay female, and a 38-year-old Chinese male, in which the A-SAP block was utilized in UA-AVF creation surgeries. In all three cases, the A-SAP block was performed in combination with a supraclavicular brachial plexus block. None of the patients required local anesthetic supplementation intraoperatively.Conclusions: The A-SAP block reliably and safely anesthetized the ICBN for UA-AVF creation surgery and is a reliable alternative to higher-risk block techniques, such as paravertebral block or neuraxial block.","PeriodicalId":17855,"journal":{"name":"Korean Journal of Anesthesiology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573358","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}

引用次数: 0

Successful removal of a large intratracheal tumor using the injection-time-controllable manual jet ventilator via translaryngeal approach-a case report.

IF 4.2 4区医学

Korean Journal of Anesthesiology Pub Date : 2025-03-05 DOI: 10.4097/kja.24918

Darhae Eum, Hyun Joo Kim, Wyun Kon Park

引用次数: 0

Impossible ventilation in a neonate after TEF repair - A lesson learned!

IF 4.2 4区医学

Korean Journal of Anesthesiology Pub Date : 2025-02-25 DOI: 10.4097/kja.25027

Harshini Medikondu, Dhruv Jain, Anju Gupta, Vignesh Venkatesan, Mrityunjay Kumar

引用次数: 0

Efficacy of Pectoral Nerve II Block for Flap Dissection-Related Pain Following Robot-Assisted Transaxillary Thyroidectomy: A Prospective, Randomized Controlled Trial.

IF 4.2 4区医学

Korean Journal of Anesthesiology Pub Date : 2025-02-24 DOI: 10.4097/kja.24914

Min Suk Chae, Kwangsoon Kim

{"title":"Efficacy of Pectoral Nerve II Block for Flap Dissection-Related Pain Following Robot-Assisted Transaxillary Thyroidectomy: A Prospective, Randomized Controlled Trial.","authors":"Min Suk Chae, Kwangsoon Kim","doi":"10.4097/kja.24914","DOIUrl":"https://doi.org/10.4097/kja.24914","url":null,"abstract":"Background: Robot-assisted transaxillary thyroidectomy (RATT) involves extensive flap dissection, leading to significant postoperative pain. This study evaluated the efficacy of pectoral nerve II (PECS II) block in pain relief, opioid reduction, and recovery enhancement.Methods: This prospective, randomized controlled trial included 83 patients undergoing elective RATT for thyroid conditions. Patients were assigned to the block group (n = 42) or non-block group (n = 41). Pain was assessed using the visual analog scale (VAS) at 1, 4, 24, and 48 hours postoperatively. Secondary outcomes included opioid consumption and Quality of Recovery-15 (QoR-15K) scores at discharge.Results: The PECS II block group had significantly lower VAS scores at 1 h (3.6 ± 2.5 vs. 6.3 ± 2.3, P < 0.001), 4 h (2.6 ± 2.1 vs. 4.3 ± 2.5, P = 0.002), and 24 h (2.0 ± 1.6 vs. 3.2 ± 2.0, P = 0.002). Opioid consumption was significantly lower in the block group (median: 1 [0.75, 3] vs. 3 [2, 3.5], P = 0.001). QoR-15K pain subdimension scores were higher in the block group (14.5 [12, 17] vs. 10 [8, 14], P < 0.001), while other recovery aspects were comparable.Conclusions: The PECS II block significantly reduces pain and opioid use in RATT patients, enhancing recovery quality. This opioid-sparing approach supports multimodal pain management, ensuring safer and more comfortable postoperative recovery.","PeriodicalId":17855,"journal":{"name":"Korean Journal of Anesthesiology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483396","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}

引用次数: 0