Korean Journal of Anesthesiology最新文献_第10页

Serratus posterior superior intercostal plane block: novel block for minimal invasive cardiac surgery -A report of three cases. 肋间肌后上平面阻滞：微创心脏手术的新型阻滞；三个案例的报告。

IF 2.9 4区医学

Korean Journal of Anesthesiology Pub Date : 2024-02-01 Epub Date: 2023-10-18 DOI: 10.4097/kja.23542

Bora Bilal, Bahadir Ciftci, Selcuk Alver, Ali Ahiskalioglu, Serkan Tulgar

引用次数: 0

Perioperative cardiovascular assessment for noncardiac surgery in elderly patients. 老年患者非心脏手术的围手术期心血管评估。

IF 2.9 4区医学

Korean Journal of Anesthesiology Pub Date : 2024-02-01 Epub Date: 2024-01-25 DOI: 10.4097/kja.24038

Eunsoo Kim

引用次数: 0

Perioperative adverse cardiac events and mortality after non-cardiac surgery: a multicenter study. 非心脏手术后围手术期不良心脏事件和死亡率：一项多中心研究。

IF 4.2 4区医学

Korean Journal of Anesthesiology Pub Date : 2024-02-01 Epub Date: 2023-05-10 DOI: 10.4097/kja.23043

Byungjin Choi, Ah Ran Oh, Jungchan Park, Jong-Hwan Lee, Kwangmo Yang, Dong Yun Lee, Sang Youl Rhee, Sang-Soo Kang, Seung Do Lee, Sun Hack Lee, Chang Won Jeong, Bumhee Park, Soobeen Seol, Rae Woong Park, Seunghwa Lee

{"title":"Perioperative adverse cardiac events and mortality after non-cardiac surgery: a multicenter study.","authors":"Byungjin Choi, Ah Ran Oh, Jungchan Park, Jong-Hwan Lee, Kwangmo Yang, Dong Yun Lee, Sang Youl Rhee, Sang-Soo Kang, Seung Do Lee, Sun Hack Lee, Chang Won Jeong, Bumhee Park, Soobeen Seol, Rae Woong Park, Seunghwa Lee","doi":"10.4097/kja.23043","DOIUrl":"10.4097/kja.23043","url":null,"abstract":"Background: Perioperative adverse cardiac events (PACE), a composite of myocardial infarction, coronary revascularization, congestive heart failure, arrhythmic attack, acute pulmonary embolism, cardiac arrest, and stroke during 30-day postoperative period, is associated with long-term mortality, but with limited clinical evidence. We compared long-term mortality with PACE using data from nationwide multicenter electronic health records.Methods: Data from 7 hospitals, converted to Observational Medical Outcomes Partnership Common Data Model, were used. We extracted records of 277,787 adult patients over 18 years old undergoing non-cardiac surgery for the first time at the hospital and had medical records for more than 180 days before surgery. We performed propensity score matching and then an aggregated meta‑analysis.Results: After 1:4 propensity score matching, 7,970 patients with PACE and 28,807 patients without PACE were matched. The meta‑analysis showed that PACE was associated with higher one-year mortality risk (hazard ratio [HR]: 1.33, 95% CI [1.10, 1.60], P = 0.005) and higher three-year mortality (HR: 1.18, 95% CI [1.01, 1.38], P = 0.038). In subgroup analysis, the risk of one-year mortality by PACE became greater with higher-risk surgical procedures (HR: 1.20, 95% CI [1.04, 1.39], P = 0.020 for low-risk surgery; HR: 1.69, 95% CI [1.45, 1.96], P < 0.001 for intermediate-risk; and HR: 2.38, 95% CI [1.47, 3.86], P = 0.034 for high-risk).Conclusions: A nationwide multicenter study showed that PACE was significantly associated with increased one-year mortality. This association was stronger in high-risk surgery, older, male, and chronic kidney disease subgroups. Further studies to improve mortality associated with PACE are needed.","PeriodicalId":17855,"journal":{"name":"Korean Journal of Anesthesiology","volume":" ","pages":"66-76"},"PeriodicalIF":4.2,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10834726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9501406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Reduced side effects and improved pain management by continuous ketorolac infusion with patient-controlled fentanyl injection compared with single fentanyl administration in pelviscopic gynecologic surgery: a randomized, double-blind, controlled study. 在盆腔粘连妇科手术中持续输注酮咯酸并注射由患者控制的芬太尼与单次注射芬太尼相比，可减少副作用并改善疼痛控制：一项随机、双盲、对照研究。

IF 2.9 4区医学

Korean Journal of Anesthesiology Pub Date : 2024-02-01 Epub Date: 2023-06-14 DOI: 10.4097/kja.23217

Insun Park, Seukyoung Hong, Su Yeon Kim, Jung-Won Hwang, Sang-Hwan Do, Hyo-Seok Na

{"title":"Reduced side effects and improved pain management by continuous ketorolac infusion with patient-controlled fentanyl injection compared with single fentanyl administration in pelviscopic gynecologic surgery: a randomized, double-blind, controlled study.","authors":"Insun Park, Seukyoung Hong, Su Yeon Kim, Jung-Won Hwang, Sang-Hwan Do, Hyo-Seok Na","doi":"10.4097/kja.23217","DOIUrl":"10.4097/kja.23217","url":null,"abstract":"Background: A combination of opioids and adjunctive drugs can be used for intravenous patient-controlled analgesia (PCA) to minimize opioid-related side effects. We investigated whether two different analgesics administered separately via a dual-chamber PCA have fewer side effects with adequate analgesia than a single fentanyl PCA in gynecologic pelviscopic surgery.Methods: This prospective, double-blind, randomized, and controlled study included 68 patients who underwent pelviscopic gynecological surgery. Patients were allocated to either the dual (ketorolac and fentanyl delivered by a dual-chamber PCA) or the single (fentanyl alone) group. Postoperative nausea and vomiting (PONV) and analgesic quality were compared between the two groups at 2, 6, 12, and 24 h postoperatively.Results: The dual group showed a significantly lower incidence of PONV during postoperative 2-6 h (P = 0.011) and 6-12 h (P = 0.009). Finally, only two patients (5.7%) in the dual group and 18 (54.5%) in the single group experienced PONV during the entire postoperative 24 h and could not maintain intravenous PCA (odds ratio: 0.056, 95% CI [0.007, 0.229], P < 0.001). Despite the administration of less fentanyl via intravenous PCA during the postoperative 24 h in the dual group than in the single group (66.0 ± 77.8 vs. 383.6 ± 70.1 μg, P < 0.001), postoperative pain had no significant intergroup difference.Conclusions: Two different analgesics, continuous ketorolac and intermittent fentanyl bolus, administered via dual-chamber intravenous PCA, showed fewer side effects with adequate analgesia than conventional intravenous fentanyl PCA in gynecologic patients undergoing pelviscopic surgery.","PeriodicalId":17855,"journal":{"name":"Korean Journal of Anesthesiology","volume":" ","pages":"77-84"},"PeriodicalIF":2.9,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10834721/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9618567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

European anesthesiologists' experiences with gender-based mistreatment in the workplace: a secondary multilevel regression analysis. 欧洲麻醉师在工作场所遭受性别虐待的经历：二级多层次回归分析。

IF 2.9 4区医学

Korean Journal of Anesthesiology Pub Date : 2024-02-01 Epub Date: 2023-12-13 DOI: 10.4097/kja.23392

Joana Berger-Estilita, Luana Fritsche, Kariem El-Boghdadly, Claudia Camila Dias, Marko Zdravkovic

{"title":"European anesthesiologists' experiences with gender-based mistreatment in the workplace: a secondary multilevel regression analysis.","authors":"Joana Berger-Estilita, Luana Fritsche, Kariem El-Boghdadly, Claudia Camila Dias, Marko Zdravkovic","doi":"10.4097/kja.23392","DOIUrl":"10.4097/kja.23392","url":null,"abstract":"Background: Workplace gender-based mistreatment (GBM) refers to negative or harmful behaviors directed towards employees. In healthcare settings, this can lead to job dissatisfaction and underperformance and potentially compromise patient outcomes. The aim of this study was to examine workplace GBM among European anesthesiologists and produce the first European Gender-based Mistreatment Rank in Anesthesiology.Methods: We conducted a secondary analysis from a worldwide cross-sectional survey database consisting of a 46-item questionnaire exploring, among other outcomes, gender bias attributable to workplace attitudes. The survey completion rate was 80.8%. All respondents were selected from European countries. Associations between mistreatment and the remaining variables were analyzed using univariate and multivariate logistic regression analyses. A generalized linear mixed model was then used to quantify the impact of mistreatment in each European country. Statistical significance was set at P < 0.05.Results: This study included 5,795 respondents from 43 European countries. The independent predictors of GBM were as follows: female gender, younger age, perceiving gender as a disadvantage for leadership, and perceiving gender as a disadvantage for research. The full model was statistically significant, indicating an ability to distinguish between those who experienced GBM and those who did not (P < 0.001). Thus, 26 European countries were ranked based on the prevalence of mistreatment, with Italy showing the best performance (lowest prevalence).Conclusions: The aim of our study was to provide preliminary insight into GBM in anesthesiology in Europe, function as a key benchmark for gender equity, and chart the evolution of disparities over time.","PeriodicalId":17855,"journal":{"name":"Korean Journal of Anesthesiology","volume":" ","pages":"46-57"},"PeriodicalIF":2.9,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10834715/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138806577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Programmed intermittent epidural bolus as an ideal method for labor analgesia: a randomized controlled trial. 将程序化间歇硬膜外栓剂作为分娩镇痛的理想方法：随机对照试验。

IF 2.9 4区医学

Korean Journal of Anesthesiology Pub Date : 2024-02-01 Epub Date: 2023-06-14 DOI: 10.4097/kja.23173

Doyeon Kim, Jeayoun Kim, Hyeonju Choo, Duck Hwan Choi

{"title":"Programmed intermittent epidural bolus as an ideal method for labor analgesia: a randomized controlled trial.","authors":"Doyeon Kim, Jeayoun Kim, Hyeonju Choo, Duck Hwan Choi","doi":"10.4097/kja.23173","DOIUrl":"10.4097/kja.23173","url":null,"abstract":"Background: Although programmed intermittent epidural bolus (PIEB) is effective for labor analgesia, an appropriate flow rate has not been established. Therefore, we investigated the analgesic effect based on different epidural injection flow rates.Methods: Nulliparous women scheduled for spontaneous labor were enrolled in this randomized trial. After injection of intrathecal 0.2% ropivacaine 3 mg with fentanyl 20 μg, participants were randomized to three study groups. Epidural analgesics, 10 ml during one hour, were administered with patient controlled epidural analgesia as follows (0.2% ropivacaine 60 ml, fentanyl 180 μg, and 0.9% saline 40 ml): continuous (n = 28, 10 ml/h for continuous infusion), PIEB (n = 29, 240 ml/h for bolus infusion of 10 ml), or manual (n = 28, 1200 ml/h for bolus injection of 10 ml). The primary outcome was hourly consumption of the epidural solution. The time interval between labor analgesia and the first breakthrough pain was investigated.Results: The median (Q1, Q3) hourly consumption of epidural anesthetics was significantly different among the groups (continuous: 14.3 [8.7, 16.9] ml, PIEB: 9.4 [6.2, 9.8] ml, manual: 8.6 [7.6, 9.9] ml; P < 0.001). The time to breakthrough pain for the PIEB group was longer than that for the other groups (continuous: 78.5 [35.8, 185.0] min, PIEB: 200.0 [88.5, 441.5] min, manual: 60.5 [37.3, 162.0] min, P = 0.027).Conclusions: PIEB, with a low-flow rate, provided more adequate labor analgesia than a continuous epidural infusion or manual injection with a high-flow rate.","PeriodicalId":17855,"journal":{"name":"Korean Journal of Anesthesiology","volume":" ","pages":"106-114"},"PeriodicalIF":2.9,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10834717/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9618569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Electroencephalographic spectrogram-guided total intravenous anesthesia using dexmedetomidine and propofol prevents unnecessary anesthetic dosing during craniotomy: a propensity score-matched analysis. 使用右美托咪定和丙泊酚的脑电频谱图引导全静脉麻醉可避免开颅手术中不必要的麻醉剂量：倾向评分匹配分析。

IF 2.9 4区医学

Korean Journal of Anesthesiology Pub Date : 2024-02-01 Epub Date: 2023-05-22 DOI: 10.4097/kja.23118

Feng-Sheng Lin, Po-Yuan Shih, Chao-Hsien Sung, Wei-Han Chou, Chun-Yu Wu

{"title":"Electroencephalographic spectrogram-guided total intravenous anesthesia using dexmedetomidine and propofol prevents unnecessary anesthetic dosing during craniotomy: a propensity score-matched analysis.","authors":"Feng-Sheng Lin, Po-Yuan Shih, Chao-Hsien Sung, Wei-Han Chou, Chun-Yu Wu","doi":"10.4097/kja.23118","DOIUrl":"10.4097/kja.23118","url":null,"abstract":"Background: The bispectral index (BIS) may be unreliable to gauge anesthetic depth when dexmedetomidine is administered. By comparison, the electroencephalogram (EEG) spectrogram enables the visualization of the brain response during anesthesia and may prevent unnecessary anesthetic consumption.Methods: This retrospective study included 140 adult patients undergoing elective craniotomy who received total intravenous anesthesia using a combination of propofol and dexmedetomidine infusions. Patients were equally matched to the spectrogram group (maintaining the robust EEG alpha power during surgery) or the index group (maintaining the BIS score between 40 and 60 during surgery) based on the propensity score of age and surgical type. The primary outcome was the propofol dose. Secondary outcome was the postoperative neurological profile.Results: Patients in the spectrogram group received significantly less propofol (1585 ± 581 vs. 2314 ± 810 mg, P < 0.001). Fewer patients in the spectrogram group exhibited delayed emergence (1.4% vs. 11.4%, P = 0.033). The postoperative delirium profile was similar between the groups (profile P = 0.227). Patients in the spectrogram group exhibited better in-hospital Barthel's index scores changes (admission state: 83.6 ± 27.6 vs. 91.6 ± 17.1; discharge state: 86.4 ± 24.3 vs. 85.1 ± 21.5; group-time interaction P = 0.008). However, the incidence of postoperative neurological complications was similar between the groups.Conclusions: EEG spectrogram-guided anesthesia prevents unnecessary anesthetic consumption during elective craniotomy. This may also prevent delayed emergence and improve postoperative Barthel index scores.","PeriodicalId":17855,"journal":{"name":"Korean Journal of Anesthesiology","volume":" ","pages":"122-132"},"PeriodicalIF":2.9,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10834723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9499005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Lipophilicity of drugs, including local anesthetics, and its association with lipid emulsion resuscitation. 药物的亲脂性，包括局部麻醉剂，及其与脂乳复苏的关系。

IF 2.9 4区医学

Korean Journal of Anesthesiology Pub Date : 2024-02-01 Epub Date: 2023-11-29 DOI: 10.4097/kja.23825

Susanne K Wiedmer, Ju-Tae Sohn

引用次数: 0

Surgical pleth index monitoring in perioperative pain management: usefulness and limitations. 围手术期疼痛管理中的手术胸廓指数监测：实用性和局限性。

IF 2.9 4区医学

Korean Journal of Anesthesiology Pub Date : 2024-02-01 Epub Date: 2023-03-17 DOI: 10.4097/kja.23158

Seok Kyeong Oh, Young Ju Won, Byung Gun Lim

{"title":"Surgical pleth index monitoring in perioperative pain management: usefulness and limitations.","authors":"Seok Kyeong Oh, Young Ju Won, Byung Gun Lim","doi":"10.4097/kja.23158","DOIUrl":"10.4097/kja.23158","url":null,"abstract":"Surgical pleth index (SPI) monitoring is a representative, objective nociception-monitoring device that measures nociception using photoplethysmographic signals. It is easy to apply to patients and the numerical calculation formula is intuitively easy to understand; therefore, its clinical interpretation is simple. Several studies have demonstrated its efficacy and utility. Compared with hemodynamic parameters, the SPI can detect the degree of nociception during surgery under general anesthesia with greater accuracy, and therefore can provide better guidance for the administration of various opioids, including remifentanil, fentanyl, and sufentanil. Indeed, SPI-guided analgesia is associated with lower intraoperative opioid consumption, faster patient recovery, and comparable or lower levels of postoperative pain and rates of adverse events compared with conventional analgesia. In addition, SPI monitoring allows for the degree of postoperative pain and analgesic requirements to be predicted through the SPI values immediately before patient arousal. However, because patient age, effective circulating volume, position, concomitant medication and anesthetic regimen and level of consciousness may be confounding factors in SPI monitoring, clinicians must be careful when interpreting SPI values. In addition, as SPI values can differ depending on anesthetic and analgesic regimens and the underlying disease, an awareness of the effects of these variables with an understanding of the advantages and disadvantages of SPI monitoring compared to other nociception monitoring devices is essential. Therefore, this review aimed to help clinicians perform optimal SPI-guided analgesia and to assist with the establishment of future research designs through clarifying current usefulness and limitations of SPI monitoring in perioperative pain management.","PeriodicalId":17855,"journal":{"name":"Korean Journal of Anesthesiology","volume":" ","pages":"31-45"},"PeriodicalIF":2.9,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10834712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9180499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Total postoperative opioid dose is an independent risk factor for prolonged postoperative ileus after laparoscopic colorectal surgery: a case-control study. 腹腔镜结直肠手术后阿片类药物总剂量是导致术后回肠时间延长的独立风险因素：一项病例对照研究。

IF 2.9 4区医学

Korean Journal of Anesthesiology Pub Date : 2024-02-01 Epub Date: 2023-04-25 DOI: 10.4097/kja.22792

Hui Ju, Kai Shen, Jiaxin Li, Yi Feng

{"title":"Total postoperative opioid dose is an independent risk factor for prolonged postoperative ileus after laparoscopic colorectal surgery: a case-control study.","authors":"Hui Ju, Kai Shen, Jiaxin Li, Yi Feng","doi":"10.4097/kja.22792","DOIUrl":"10.4097/kja.22792","url":null,"abstract":"Background: Prolonged postoperative ileus (PPOI) is a major complication of colorectal surgery. Increased opioid consumption has been proposed to increase the risk of PPOI. This study aimed to test the hypothesis that an increased total postoperative opioid dose (TPOD) is associated with the increased incidence of PPOI.Methods: For this matched case-control study, patients who underwent elective laparoscopic colorectal procedures at the Peking University People's Hospital between January 2018 and June 2020 were retrospectively reviewed. Patients with PPOI were assigned to the ileus group, while patients without PPOI (control group) were matched at a 1:1 ratio to the ileus group according to age, American Society of Anesthesiologists physical status score, and type of surgical procedure. The primary outcome was the TPOD between the ileus and control groups. The secondary outcome was risk factors of PPOI.Results: A total of 267 participants were included in the final analysis. No differences in baseline or operative factors were found between the two groups. The TPOD, intravenous sufentanil dose on postoperative day 1 (POD1), and the use of patient-controlled analgesia with basal infusion were associated with PPOI (P < 0.05). Multivariate logistic regression analysis revealed that an increased TPOD was an independent risk factor for developing PPOI after laparoscopic colorectal procedures (Odd ratio: 1.67, 95% CI [1.03, 2.71], P = 0.04).Conclusions: The TPOD is an independent risk factor for PPOI after laparoscopic colorectal surgery. We need to explore new strategies of postoperative analgesia to reduce the dosage of TPOD.","PeriodicalId":17855,"journal":{"name":"Korean Journal of Anesthesiology","volume":" ","pages":"133-138"},"PeriodicalIF":2.9,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10834719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9383874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0