Korean Journal of Anesthesiology最新文献_第10页

Effect of magnesium sulfate on oxygenation and lung mechanics in morbidly obese patients undergoing bariatric surgery: a prospective double-blind randomized clinical trial. 硫酸镁对接受减肥手术的病态肥胖患者氧合和肺力学的影响:一项前瞻性双盲随机临床试验

IF 2.9 4区医学

Korean Journal of Anesthesiology Pub Date : 2023-12-01 Epub Date: 2022-12-21 DOI: 10.4097/kja.22446

Marwa M Mowafi, Marwa A K Elbeialy, Rasha Gamal Abusinna

{"title":"Effect of magnesium sulfate on oxygenation and lung mechanics in morbidly obese patients undergoing bariatric surgery: a prospective double-blind randomized clinical trial.","authors":"Marwa M Mowafi, Marwa A K Elbeialy, Rasha Gamal Abusinna","doi":"10.4097/kja.22446","DOIUrl":"10.4097/kja.22446","url":null,"abstract":"Background: Respiratory mechanics are often significantly altered in morbidly obese patients and magnesium sulfate (MgSO4) is a promising agent for managing several respiratory disorders. This study aimed to examine the effects of MgSO4 infusions on arterial oxygenation and lung mechanics in patients with morbid obesity undergoing laparoscopic bariatric surgery.Methods: Forty patients with morbid obesity aged 21-60 years scheduled for laparoscopic bariatric surgery under general anesthesia were randomly allocated to either the control (normal saline infusion) or MgSO4 group (30 mg/kg lean body weight [LBW] of 10% MgSO4 in 100 ml normal saline intravenously over 30 min as a loading dose, followed by 10 mg/kg LBW/h for 90 min). The primary outcome was intraoperative arterial oxygenation (ΔPaO2/FiO2). Secondary outcomes included intraoperative static and dynamic compliance, dead space, and hemodynamic parameters.Results: At 90 min intraoperatively, the Δ PaO2/FiO2 ratio and the Δ dynamic lung compliance were statistically significantly higher in the MgSO4 group (mean ± SE: 16.1 ± 1.0, 95% CI [14.1, 18.1] and 8.4 ± 0.5 ml/cmH2O, 95% CI [7.4, 9.4]), respectively), and the Δ dead space (%) was statistically significantly lower in the MgSO4 group (mean ± SE: -8.0 ± 0.3%, 95% CI [-8.6, -7.4]) (P < 0.001). No significant differences in static compliance were observed.Conclusions: Although MgSO4 significantly preserved arterial oxygenation and maintained dynamic lung compliance and dead space in patients with morbid obesity, the clinical relevance is minimal. This study failed to adequately reflect the clinical importance of these results.","PeriodicalId":17855,"journal":{"name":"Korean Journal of Anesthesiology","volume":" ","pages":"617-626"},"PeriodicalIF":2.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10718631/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10768244","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

Association between inflammation-based prognostic markers and mortality of non-cardiac surgery. 基于炎症的预后指标与非心脏手术死亡率之间的关系。

IF 2.9 4区医学

Korean Journal of Anesthesiology Pub Date : 2023-12-01 Epub Date: 2023-02-24 DOI: 10.4097/kja.23068

Ah Ran Oh, Jungchan Park, Jong-Hwan Lee, Kwangmo Yang, Joonghyun Ahn, Seung-Hwa Lee, Sangmin Maria Lee

{"title":"Association between inflammation-based prognostic markers and mortality of non-cardiac surgery.","authors":"Ah Ran Oh, Jungchan Park, Jong-Hwan Lee, Kwangmo Yang, Joonghyun Ahn, Seung-Hwa Lee, Sangmin Maria Lee","doi":"10.4097/kja.23068","DOIUrl":"10.4097/kja.23068","url":null,"abstract":"Background: To evaluate the association between inflammation and nutrition-based biomarkers and postoperative outcomes after non-cardiac surgery.Methods: Between January 2011 and June 2019, a total of 102,052 patients undergoing non-cardiac surgery were evaluated, with C-reactive protein (CRP), albumin, and complete blood count (CBC) measured within six months before surgery. We assessed their CRP-to-albumin ratio (CAR), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and modified Glasgow Prognostic Score (mGPS). We determined the best cut-off values by using the receiver operating characteristic (ROC) curves. Patients were divided into high and low groups according to the estimated threshold, and we compared the one-year mortality.Results: The one-year mortality of the entire sample was 4.2%. ROC analysis revealed areas under the curve of 0.796, 0.743, 0.670, and 0.708 for CAR, NLR, PLR, and mGPS, respectively. According to the estimated threshold, high CAR, NLR, PLR, and mGPS were associated with increased one-year mortality (1.7% vs. 11.7%, hazard ratio [HR]: 2.38, 95% CI [2.05, 2.76], P < 0.001 for CAR; 2.2% vs. 10.3%, HR: 1.81, 95% CI [1.62, 2.03], P < 0.001 for NLR; 2.6% vs. 10.5%, HR: 1.86, 95% CI [1.73, 2.01], P < 0.001 for PLR; and 2.3% vs. 16.3%, HR: 2.37, 95% CI [2.07, 2.72], P < 0.001 for mGPS).Conclusions: Preoperative CAR, NRL, PLR, and mGPS were associated with postoperative mortality. Our findings may be helpful in predicting mortality after non-cardiac surgery.","PeriodicalId":17855,"journal":{"name":"Korean Journal of Anesthesiology","volume":" ","pages":"550-558"},"PeriodicalIF":2.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10718634/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10758271","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: 1

Corrosive poisoning and its implications on pediatric airways. 腐蚀性中毒及其对儿童气道的影响。

IF 2.9 4区医学

Korean Journal of Anesthesiology Pub Date : 2023-12-01 Epub Date: 2023-06-20 DOI: 10.4097/kja.23445

Yashwant Singh Payal, Sachin Sogal P, Pooja Cs

引用次数: 0

Predicting optimal endotracheal tube size and depth in pediatric patients using demographic data and machine learning techniques. 使用人口统计数据和机器学习技术预测儿科患者的最佳气管插管尺寸和深度。

IF 2.9 4区医学

Korean Journal of Anesthesiology Pub Date : 2023-12-01 Epub Date: 2023-09-26 DOI: 10.4097/kja.23501

Hyeonsik Kim, Hyun-Kyu Yoon, Hyeonhoon Lee, Chul-Woo Jung, Hyung-Chul Lee

{"title":"Predicting optimal endotracheal tube size and depth in pediatric patients using demographic data and machine learning techniques.","authors":"Hyeonsik Kim, Hyun-Kyu Yoon, Hyeonhoon Lee, Chul-Woo Jung, Hyung-Chul Lee","doi":"10.4097/kja.23501","DOIUrl":"10.4097/kja.23501","url":null,"abstract":"Background: Use of endotracheal tubes (ETTs) with appropriate size and depth can help minimize intubation-related complications in pediatric patients. Existing age-based formulae for selecting the optimal ETT size present several inaccuracies. We developed a machine learning model that predicts the optimal size and depth of ETTs in pediatric patients using demographic data, enabling clinical applications.Methods: Data from 37,057 patients younger than 12 years who underwent general anesthesia with endotracheal intubation were retrospectively analyzed. Gradient boosted regression tree (GBRT) model was developed and compared with traditional age-based formulae.Results: The GBRT model demonstrated the highest macro-averaged F1 scores of 0.502 (95% CI 0.486, 0.568) and 0.669 (95% CI 0.640, 0.694) for predicting the uncuffed and cuffed ETT size (internal diameter [ID]), outperforming the age-based formulae that yielded 0.163 (95% CI 0.140, 0.196, P < 0.001) and 0.392 (95% CI 0.378, 0.406, P < 0.001), respectively. In predicting the ETT depth (distance from tip to lip corner), the GBRT model showed the lowest mean absolute error (MAE) of 0.71 cm (95% CI 0.69, 0.72) and 0.72 cm (95% CI 0.70, 0.74) compared to the age-based formulae that showed an error of 1.18 cm (95% CI 1.16, 1.20, P < 0.001) and 1.34 cm (95% CI 1.31, 1.38, P < 0.001) for uncuffed and cuffed ETT, respectively.Conclusions: The GBRT model using only demographic data accurately predicted the ETT size and depth. If these results are validated, the model may be practical for predicting optimal ETT size and depth for pediatric patients.","PeriodicalId":17855,"journal":{"name":"Korean Journal of Anesthesiology","volume":" ","pages":"540-549"},"PeriodicalIF":2.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10718635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41166681","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

Comparison of the pericapsular nerve group block with the intra-articular and quadratus lumborum blocks in primary total hip arthroplasty: a randomized controlled trial. 原发性全髋关节置换术中囊周神经组阻滞与关节内和腰方肌阻滞的比较:一项随机对照试验。

IF 2.9 4区医学

Korean Journal of Anesthesiology Pub Date : 2023-12-01 Epub Date: 2023-04-04 DOI: 10.4097/kja.23064

Tayfun Et, Muhammet Korkusuz

{"title":"Comparison of the pericapsular nerve group block with the intra-articular and quadratus lumborum blocks in primary total hip arthroplasty: a randomized controlled trial.","authors":"Tayfun Et, Muhammet Korkusuz","doi":"10.4097/kja.23064","DOIUrl":"10.4097/kja.23064","url":null,"abstract":"Background: The pericapsular nerve group (PENG) block, quadratus lumborum block (QLB), and intra-articular (IA) local anesthetic injection have been shown to provide effective analgesia in total hip arthroplasty (THA). This randomized study aimed to compare the analgesic efficacy, motor protection, and quality of recovery associated with the PENG block, QLB, and IA injection.Methods: Eighty-nine patients who underwent a unilateral primary THA under spinal anesthesia were randomly assigned to the PENG (n=30), QLB (n=30), or IA (n=29) group. The primary outcome was the numerical rating scale (NRS) score over the first 48 h postoperatively. The secondary outcomes were postoperative opioid consumption, quadriceps and adductor muscle strength, and quality of recovery (QoR-40).Results: The dynamic (with movement) NRS scores at 3 and 6 h postoperatively were significantly lower in the PENG and QLB groups compared to the IA group (P = 0.002 and P < 0.001, respectively). The time to first opioid analgesia requirement was longer in the PENG and QLB groups than in the IA group (P = 0.009 and P = 0.016, respectively). A provided better preservation was found in the the PENG group than in the QLB group in terms of quadriceps muscle strength at 3 h postoperatively (P = 0.007) and time to mobilization (P = 0.003). No significant differences in the QoR-40 scores were seen.Conclusions: The PENG and QLB groups showed similar analgesic effects and both showed more effective analgesia 6 h postoperatively than the IA group. All the groups showed similar postoperative quality of recovery.","PeriodicalId":17855,"journal":{"name":"Korean Journal of Anesthesiology","volume":" ","pages":"575-585"},"PeriodicalIF":2.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10718628/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9242756","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

The novel diagonal suprascapular canal block for shoulder surgery analgesia: a comprehensive technical report. 新型肩胛上管对角线阻滞用于肩部手术镇痛:综合技术报告。

IF 2.9 4区医学

Korean Journal of Anesthesiology Pub Date : 2023-12-01 Epub Date: 2023-09-06 DOI: 10.4097/kja.23473

Carlos Rodrigues Almeida

引用次数: 0

Pediatric perioperative fluid management. 儿科围手术期液体管理。

IF 2.9 4区医学

Korean Journal of Anesthesiology Pub Date : 2023-12-01 Epub Date: 2023-04-19 DOI: 10.4097/kja.23128

Hyungmook Lee, Jin Tae Kim

{"title":"Pediatric perioperative fluid management.","authors":"Hyungmook Lee, Jin Tae Kim","doi":"10.4097/kja.23128","DOIUrl":"10.4097/kja.23128","url":null,"abstract":"The purpose of perioperative fluid management in children is to maintain adequate volume status, electrolyte level, and endocrine system homeostasis during the perioperative period. Although hypotonic solutions containing glucose have traditionally been used as pediatric maintenance fluids, recent studies have shown that isotonic balanced crystalloid solutions lower the risk of hyponatremia and metabolic acidosis perioperatively. Isotonic balanced solutions have been found to exhibit safer and more physiologically appropriate characteristics for perioperative fluid maintenance and replacement. Additionally, adding 1-2.5% glucose to the maintenance fluid can help prevent children from developing hypoglycemia as well as lipid mobilization, ketosis, and hyperglycemia. The fasting time should be as short as possible without compromising safety; recent guidelines have recommended that the duration of clear fluid fasting be reduced to 1 h. The ongoing loss of fluid and blood as well as the free water retention induced by antidiuretic hormone secretion are unique characteristics of postoperative fluid management that must be considered. Reducing the infusion rate of the isotonic balanced solution may be necessary to avoid dilutional hyponatremia during the postoperative period. In summary, perioperative fluid management in pediatric patients requires careful attention because of the limited reserve capacity in this population. Isotonic balanced solutions appear to be the safest and most beneficial choice for most pediatric patients, considering their physiology and safety concerns.","PeriodicalId":17855,"journal":{"name":"Korean Journal of Anesthesiology","volume":" ","pages":"519-530"},"PeriodicalIF":2.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10718623/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9388877","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

Quality of recovery in hospital and disability-free survival at three months after major abdominal surgery. 腹部大手术后3个月的住院康复质量和无残疾生存。

IF 2.9 4区医学

Korean Journal of Anesthesiology Pub Date : 2023-12-01 Epub Date: 2023-05-10 DOI: 10.4097/kja.23082

Yuki Kinugasa, Mitsuru Ida, Shohei Nakatani, Kayo Uyama, Masahiko Kawaguchi

{"title":"Quality of recovery in hospital and disability-free survival at three months after major abdominal surgery.","authors":"Yuki Kinugasa, Mitsuru Ida, Shohei Nakatani, Kayo Uyama, Masahiko Kawaguchi","doi":"10.4097/kja.23082","DOIUrl":"10.4097/kja.23082","url":null,"abstract":"Background: The Quality of Recovery-15 (QoR-15) and 12-item World Health Organization Disability Assessment Schedule 2.0 scales are post-surgery patient-reported outcome measures. We aimed to evaluate the association between immediate in-hospital postoperative recovery and mid-term disability-free survival (DFS) after discharge.Methods: We conducted a prospective observational study at a university hospital and enrolled 260 patients aged ≥ 65 years with cancer who were undergoing elective major abdominal surgery. The association between poor postoperative recovery, defined as a QoR-15 score < 90 on postoperative day (POD) 2, and the DFS three months later was assessed using Fisher's exact test. The odds ratio of poor recovery on POD 2 to DFS was calculated using multiple logistic regression analysis adjusted for prominent factors (age, preoperative frailty, preoperative DFS, surgical duration, and intraoperative blood loss volume).Results: A total of 230 patients completed the 3-month follow-up. On POD 2, 27.3% of the patients (63/230) had poor recovery. A greater number of patients without poor recovery on POD 2 had DFS at three months after surgery (79.6%) than those with poor recovery (65.1%) (P = 0.026). The adjusted odds ratio of poor recovery on POD 2 to DFS at three months was 0.481 (95% CI [0.233, 0.994]).Conclusions: Patients with poor recovery on POD 2 were less likely to have DFS three months after abdominal surgery. These findings may allow for early and effective interventions to be initiated based on each patient's condition after abdominal surgery.","PeriodicalId":17855,"journal":{"name":"Korean Journal of Anesthesiology","volume":" ","pages":"567-574"},"PeriodicalIF":2.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10718636/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9498303","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

Effects of sevoflurane on metalloproteinase and natural killer group 2, member D (NKG2D) ligand expression and natural killer cell-mediated cytotoxicity in breast cancer: an in vitro study. 七氟醚对乳腺癌金属蛋白酶和自然杀伤组2、成员D (NKG2D)配体表达及自然杀伤细胞介导的细胞毒性影响的体外研究

IF 2.9 4区医学

Korean Journal of Anesthesiology Pub Date : 2023-12-01 Epub Date: 2023-08-21 DOI: 10.4097/kja.23323

Hyae Jin Kim, Soeun Jeon, Hyeon Jeong Lee, Jaeho Bae, Hyun-Su Ri, Jeong-Min Hong, Sung In Paek, Seul Ki Kwon, Jae-Rin Kim, Seungbin Park, Eun-Jung Yun

{"title":"Effects of sevoflurane on metalloproteinase and natural killer group 2, member D (NKG2D) ligand expression and natural killer cell-mediated cytotoxicity in breast cancer: an in vitro study.","authors":"Hyae Jin Kim, Soeun Jeon, Hyeon Jeong Lee, Jaeho Bae, Hyun-Su Ri, Jeong-Min Hong, Sung In Paek, Seul Ki Kwon, Jae-Rin Kim, Seungbin Park, Eun-Jung Yun","doi":"10.4097/kja.23323","DOIUrl":"10.4097/kja.23323","url":null,"abstract":"Background: We investigated the effects of sevoflurane exposure on the expression of matrix metalloproteinase (MMP), expression and ablation of natural killer group 2, member D (NKG2D) ligands (UL16-binding proteins 1-3 and major histocompatibility complex class I chain-related molecules A/B), and natural killer (NK) cell-mediated cytotoxicity in breast cancer cells.Methods: Three human breast cancer cell lines (MCF-7, MDA-MB-453, and HCC-70) were incubated with 0 (control), 600 (S6), or 1200 μM (S12) sevoflurane for 4 h. The gene expression of NKG2D ligands and their protein expression on cancer cell surfaces were measured using multiplex polymerase chain reaction (PCR) and flow cytometry, respectively. Protein expression of MMP-1 and -2 and the concentration of soluble NKG2D ligands were analyzed using western blotting and enzyme-linked immunosorbent assays, respectively.Results: Sevoflurane downregulated the mRNA and protein expression of the NKG2D ligand in a dose-dependent manner in MCF-7, MDA-MB-453, and HCC-70 cells but did not affect the expression of MMP-1 or -2 or the concentration of soluble NKG2D ligands in the MCF-7, MDA-MB-453, and HCC-70 cells. Sevoflurane attenuated NK cell-mediated cancer cell lysis in a dose-dependent manner in MCF-7, MDA-MB-453, and HCC-70 cells (P = 0.040, P = 0.040, and P = 0.040, respectively).Conclusions: Our results demonstrate that sevoflurane exposure attenuates NK cell-mediated cytotoxicity in breast cancer cells in a dose-dependent manner. This could be attributed to a sevoflurane-induced decrease in the transcription of NKG2D ligands rather than sevoflurane-induced changes in MMP expression and their proteolytic activity.","PeriodicalId":17855,"journal":{"name":"Korean Journal of Anesthesiology","volume":" ","pages":"627-639"},"PeriodicalIF":2.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10718625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10037088","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

Peripherally inserted central catheters placed by anesthesiologists: an analysis of complications among 146 insertions. 麻醉医师置入中心导管:146例置入并发症分析

IF 2.9 4区医学

Korean Journal of Anesthesiology Pub Date : 2023-12-01 Epub Date: 2023-05-26 DOI: 10.4097/kja.23328

Mark Alexander Burbridge, Richard Andrew Jaffe

引用次数: 0