Korean Journal of Anesthesiology最新文献

{"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":"10.4097/kja.24914","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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 h postoperatively. Secondary outcomes included opioid consumption and Quality of Recovery-15 (QoR-15K) scores at discharge.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":17855,"journal":{"name":"Korean Journal of Anesthesiology","volume":" ","pages":"69-81"},"PeriodicalIF":4.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12933392/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sevoflurane degradation is accelerated by ozone: water trap removal of degradation products.","authors":"Shinji Oshima, Hiroshi Suzuki, Soichiro Mimuro, Tadayoshi Kurita, Yoshiki Nakajima","doi":"10.4097/kja.25534","DOIUrl":"https://doi.org/10.4097/kja.25534","url":null,"abstract":"<p><strong>Background: </strong>Halogenated anesthetics such as sevoflurane have a high global warming potential (GWP) and should be degraded before atmospheric release. We hypothesized that sevoflurane undergoes oxidative degradation when mixed with ozone and some degradation products can be captured using a water trap.</p><p><strong>Methods: </strong>In Experiment 1, sevoflurane and its degradation products were monitored in real-time using liquid chromatography-mass spectrometry under three conditions: air control, ozone mixing, and ozone mixing followed by passage through a water trap. In Experiment 2, sevoflurane (7-8%) was delivered into a closed anesthesia circuit, and concentration changes were recorded every 10 s under ozone-present and ozone-absent conditions (six trials each). In Experiment 3, proton nuclear magnetic resonance (¹H NMR, Bruker Ascend 400, 20.1°C) was performed on heavy-water samples from the water trap used in Experiment 2 to assess the solubility of ozone-exposed sevoflurane.</p><p><strong>Results: </strong>In Experiment 1, ozone accelerated sevoflurane degradation; however, the concentration of the degradation products was not increased in the water trap. In Experiment 2, ozone mixing caused a rapid decline in sevoflurane concentration, decreasing from 7.3% to < 1% within 25-28 s and reaching 0% within 265-288 s, whereas no decrease was found in the ozone-absent trials (P < 0.001). In Experiment 3, ¹H NMR spectra showed clearer sevoflurane signals and minor new peaks after ozone exposure, suggesting enhanced apparent solubility and limited decomposition.</p><p><strong>Conclusion: </strong>Ozone mixing accelerated sevoflurane degradation and increased its water solubility, suggesting a practical approach for reducing the environmental impact of sevoflurane.</p>","PeriodicalId":17855,"journal":{"name":"Korean Journal of Anesthesiology","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2025-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145794340","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":"Methods for achieving equilibration during expiration in a modified Rapid-O2 oxygen insufflation device.","authors":"Darhae Eum, Hyun Joo Kim, Wyun Kon Park","doi":"10.4097/kja.25396","DOIUrl":"10.4097/kja.25396","url":null,"abstract":"","PeriodicalId":17855,"journal":{"name":"Korean Journal of Anesthesiology","volume":" ","pages":"601-602"},"PeriodicalIF":6.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12660032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144760442","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}

{"title":"A novel method of ultrasound-guided zygomaticotemporal nerve block for awake craniotomy.","authors":"Takehito Sato, Masashi Takakura, Kanako Ozeki, Koichi Akiyama","doi":"10.4097/kja.25643","DOIUrl":"10.4097/kja.25643","url":null,"abstract":"","PeriodicalId":17855,"journal":{"name":"Korean Journal of Anesthesiology","volume":" ","pages":"602-604"},"PeriodicalIF":6.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12660030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030173","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}

{"title":"Comparison of remimazolam and sevoflurane on arterial oxygenation during one-lung ventilation in thoracoscopic surgery: a randomized controlled trial.","authors":"Hong-Sik Shon, Hee Young Kim, Ji-Uk Yoon, Hye-Jin Kim, Seyeon Park, Yeong Min Yoo, Hyeonsoo Park, Jung-Pil Yoon","doi":"10.4097/kja.25376","DOIUrl":"10.4097/kja.25376","url":null,"abstract":"<p><strong>Background: </strong>One-lung ventilation (OLV) during thoracoscopic surgery can impair oxygenation due to increased intrapulmonary shunts. Remimazolam has gained attention for its hemodynamic stability and rapid recovery profile; however, its effects on arterial oxygenation during OLV remain unclear. This study aimed to compare the effects of remimazolam and sevoflurane on arterial oxygenation during OLV.</p><p><strong>Methods: </strong>In this prospective, randomized controlled trial, 58 adult patients undergoing thoracoscopic surgery were assigned to receive either sevoflurane or remimazolam for anesthesia maintenance. Arterial blood gas analysis and hemodynamic parameters were measured at four time points: 10 min after lateral positioning during two-lung ventilation (TLV10) and 15, 30, and 60 min after initiating OLV (OLV15, OLV30, and OLV60). The primary outcome was arterial partial pressure of oxygen (PaO2) at OLV30. Secondary outcomes included time-dependent changes in PaO2, hemodynamic variables, and serum lactate levels.</p><p><strong>Results: </strong>No significant difference in PaO2 at OLV30 was observed between groups (108.9 ± 37.9 vs. 107.0 ± 37.8 mmHg, 95% CI [-21.8 to 18.0], P = 0.815). In within-group analysis, PaO2 at OLV60 increased significantly from TLV10 in the remimazolam group (95% CI [0.3-36.8], P = 0.044), while no such improvement was observed in the sevoflurane group. Serum lactate levels exhibited a significant time-by-group interaction with a greater reduction in the remimazolam group (P = 0.021).</p><p><strong>Conclusions: </strong>Remimazolam provided arterial oxygenation and hemodynamic stability comparable to sevoflurane during OLV. The greater reduction in serum lactate levels with remimazolam suggests its potential metabolic or immunomodulatory advantages that warrant further investigation.</p>","PeriodicalId":17855,"journal":{"name":"Korean Journal of Anesthesiology","volume":" ","pages":"524-534"},"PeriodicalIF":6.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12660034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145308418","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}

{"title":"Influence of psychological factors on the benefit from interpectoral and pectoserratus plane block for recovery after partial mastectomy: a randomized controlled trial.","authors":"Sung Yeon Ham, Jooyoung Oh, Ji Yeong Kim, Juyeong Park, Hye Sun Lee, Soong June Bae, Seung Ho Baek, Yoonwon Kook, Joon Jeong, Sung Gwe Ahn, Young Song","doi":"10.4097/kja.24469","DOIUrl":"10.4097/kja.24469","url":null,"abstract":"<p><strong>Background: </strong>The interpectoral and pectoserratus plane (PECs) blocks have been reported to provide favorable postoperative analgesia after mastectomy. However, studies have reported controversial data regarding its effect on the quality of recovery (QoR). We aimed to evaluate the effect of the PECs block in light of baseline psychological factors and pain sensitivity.</p><p><strong>Methods: </strong>Patients undergoing partial mastectomy were randomly assigned to receive either a PECs block (PECs group, n = 69) or no block (Control group, n = 70). We assessed the preoperative psychosocial factors and pain recognition using the Hospital Anxiety Depression Scale (HADS), Pain Catastrophizing Scale, Breast Cancer Pain Questionnaire, temporal pain summation (TPS), and pressure pain threshold and tolerance; we then conducted the interaction test to evaluate the moderating role of these factors on the efficacy of the PECs block.</p><p><strong>Results: </strong>The global QoR-15 score 1 day after surgery did not differ between the groups (136.50 [124.00, 144.00] vs. 141.00 [127.00, 148.00], P = 0.061); however, the score was enhanced in patients who were depressed, did not ruminate pain aberrantly, and did not have pre-existing pain. The pain Verbal Numeric Rating Scale 1 day after surgery was not different between the groups; however, the TPS score showed an interaction, indicating that the PECs block could reduce pain intensity in patients with high pain sensitivity.</p><p><strong>Conclusions: </strong>The PECs block did not enhance the QoR-15 score or pain intensity after mastectomy, but its efficacy was pronounced in patients with several specific emotional traits and pain perception.</p>","PeriodicalId":17855,"journal":{"name":"Korean Journal of Anesthesiology","volume":" ","pages":"583-591"},"PeriodicalIF":6.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12660035/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145015777","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}

{"title":"Injectate distribution patterns in 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":"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 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":"592-600"},"PeriodicalIF":6.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12660036/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Isolated iron deficiency in off-pump coronary artery bypass grafting.","authors":"Jae-Woo Ju","doi":"10.4097/kja.251011","DOIUrl":"10.4097/kja.251011","url":null,"abstract":"","PeriodicalId":17855,"journal":{"name":"Korean Journal of Anesthesiology","volume":"78 6","pages":"511-512"},"PeriodicalIF":6.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12660031/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145635118","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}

{"title":"Sex-specific associations of preoperative serum uric acid levels with mortality and morbidity in non-cardiac surgeries: a single-center retrospective study.","authors":"Ji-Hoon Sim, Chan-Sik Kim, Bumwoo Park","doi":"10.4097/kja.25517","DOIUrl":"10.4097/kja.25517","url":null,"abstract":"<p><strong>Background: </strong>The sex-specific association between serum uric acid (SUA) levels and postoperative outcomes in elective non-cardiac surgery remains unclear. This study aimed to identify sex-specific SUA thresholds and their impact on short- and long-term outcomes.</p><p><strong>Methods: </strong>A retrospective analysis of 295 267 patients (2012-2021) undergoing non-cardiac surgery was conducted. Patients were stratified by preoperative SUA levels: for males (< 4 to ≥ 9 mg/dl) and females (< 3 to ≥ 8 mg/dl), with mid-range levels as reference. Mortality (30-day to overall) and complications were assessed using Cox and logistic regression. Cubic splines evaluated nonlinear trends, with subgroup analyses by age and surgical risk.</p><p><strong>Results: </strong>SUA levels exhibited a nonlinear, sex-specific association with postoperative outcomes. The estimated lower-risk SUA range was 5.08-7.63 mg/dl in males and 3.34-5.35 mg/dl in females. In Cox and spline analyses, a U-shaped association between SUA and mortality was observed in both sexes, with significant risks at both low (< 4 mg/dl) and high (≥ 9 mg/dl) levels in males, and predominantly at low levels (< 3 mg/dl) in females. The types of complications varied subtly between sexes. Within SUA ranges of 4-6 mg/dl (males) and 3-4 mg/dl (females), composite and specific complication risks were lower than at either extreme, showing a protective effect, with reduced risk of acute kidney injury in males and pneumonia in females. Additionally, extreme SUA levels were significantly associated with increased mortality and complications, particularly in low-risk surgical patients.</p><p><strong>Conclusions: </strong>Preoperative SUA levels show a nonlinear, sex-specific association with postoperative outcomes, highlighting the need for sex- and risk-based perioperative stratification.</p>","PeriodicalId":17855,"journal":{"name":"Korean Journal of Anesthesiology","volume":" ","pages":"569-582"},"PeriodicalIF":6.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12660039/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144959172","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}

{"title":"Role of frailty in predicting postoperative pulmonary complications in older patients undergoing major abdominal surgery: a retrospective cohort study.","authors":"Chun-Qing Li, Jia-Hui Ma, Zhen-Zhen Liu, Jun Li","doi":"10.4097/kja.24933","DOIUrl":"10.4097/kja.24933","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to determine the association between frailty, as measured by the five-item modified frailty index (mFI-5), and postoperative pulmonary complications (PPCs) in older patients undergoing major abdominal surgery and to explore the predictive value of frailty beyond traditional PPC risk factors.</p><p><strong>Methods: </strong>In this retrospective cohort study, we collected baseline and perioperative data of older patients (aged ≥ 65 years) undergoing major abdominal surgery in a tertiary hospital. The association between the mFI-5 score and PPCs was examined using multivariate logistic regression analysis. Additionally, the predictive value of the mFI-5 beyond the four basic PPC risk models was estimated using discrimination (areas under receiver operating characteristic curve [AUROCs]; DeLong's test), calibration (Hosmer-Lemeshow test), goodness of fit (likelihood ratio χ2 test), explained variance (Nagelkerke R2), and reclassification (categorical and continuous net reclassification improvement and integrated discrimination improvement).</p><p><strong>Results: </strong>A total of 3298 patients were included, of whom 351 (10.6%) developed PPCs. After adjusting for confounding factors, higher mFI-5 scores were independently associated with an increased risk of PPCs compared with a score of 0 (all P < 0.05). Incorporating the mFI-5 score into the basic PPC risk models significantly improved the AUROC, goodness of fit, and risk reclassification (all P < 0.001); enhanced or maintained calibration (all P > 0.05); and increased explained variance.</p><p><strong>Conclusions: </strong>Frailty, measured using the mFI-5, was independently associated with an increased risk of PPCs and improved the predictive performance of conventional risk factors for PPCs in older patients undergoing major abdominal surgery.</p>","PeriodicalId":17855,"journal":{"name":"Korean Journal of Anesthesiology","volume":" ","pages":"547-559"},"PeriodicalIF":6.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12665396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675186","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}