Korean Journal of Anesthesiology最新文献_第2页

Effect of low-dose volatile anesthetics on intraoperative neurophysiological monitoring during anesthesia with remimazolam. 低剂量挥发性麻醉剂对雷马唑仑麻醉术中神经生理监测的影响。

IF 4.2 4区医学

Korean Journal of Anesthesiology Pub Date : 2025-04-22 DOI: 10.4097/kja.24598

Hee-Sun Park, Wonho Choi, Dong-Ho Lee, Yong Seo Koo, Se Keun Oh, Won Uk Koh

{"title":"Effect of low-dose volatile anesthetics on intraoperative neurophysiological monitoring during anesthesia with remimazolam.","authors":"Hee-Sun Park, Wonho Choi, Dong-Ho Lee, Yong Seo Koo, Se Keun Oh, Won Uk Koh","doi":"10.4097/kja.24598","DOIUrl":"https://doi.org/10.4097/kja.24598","url":null,"abstract":"Background: Remimazolam is a novel short-acting benzodiazepine. We investigated the effects of low doses of volatile anesthetic agents on motor evoked potentials (MEPs) and somatosensory evoked potentials (SSEPs) during remimazolam-remifentanil anesthesia.Methods: Thirty-nine patients undergoing cervical spine surgery were randomly assigned to either the sevoflurane (n = 20) or desflurane (n = 19) groups. Volatile anesthetic agents were administered at 0.3, 0.6, and 0.8 minimum alveolar concentration (MACs) during remimazolam-remifentanil anesthesia. Significant changes were considered as more than 50% amplitude suppression and more than 10% latency increase from baseline values. The primary outcome was MEP amplitude change. Secondary outcomes included MEP latency, SSEP amplitude and latency, and group comparisons.Results: The MEP amplitudes were slightly reduced at 0.3 MAC; however, a suppression of more than 50% from baseline values at 0.3 MAC, particularly in the upper limbs, was observed in a notable proportion of participants; 30.0% and 47.4% in the sevoflurane and desflurane groups, respectively. The corresponding percentages for the lower limbs were 15.0% and 15.8%, respectively. MEP amplitude suppression was more than 50% in the majority of participants at 0.6 and 0.8 MAC. No significant difference was observed between the groups. SSEPs exhibited no significant amplitude suppression or latency prolongation across all MAC levels.Conclusions: Notable MEP amplitude suppression was observed in many patients when 0.3 MAC volatile anesthetics were used as adjuncts. Therefore, even low doses of volatile anesthetics must be added cautiously to remimazolam-based anesthesia to prevent confounding. The SSEPs were relatively preserved, regardless of MAC.","PeriodicalId":17855,"journal":{"name":"Korean Journal of Anesthesiology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144064013","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

Effect of mild hypercapnia during the recovery period on the emergence time from total intravenous anesthesia: a randomized controlled trial. 恢复期轻度高碳酸血症对全静脉麻醉苏醒时间的影响：一项随机对照试验。

IF 4.2 4区医学

Korean Journal of Anesthesiology Pub Date : 2025-04-17 DOI: 10.4097/kja.24363

Lan Liu, Xiangde Chen, Qingjuan Chen, Xiuyi Lu, Lili Fang, Jinxuan Ren, Yue Ming, Dawei Sun, Pei Chen, Weidong Wu, Lina Yu

{"title":"Effect of mild hypercapnia during the recovery period on the emergence time from total intravenous anesthesia: a randomized controlled trial.","authors":"Lan Liu, Xiangde Chen, Qingjuan Chen, Xiuyi Lu, Lili Fang, Jinxuan Ren, Yue Ming, Dawei Sun, Pei Chen, Weidong Wu, Lina Yu","doi":"10.4097/kja.24363","DOIUrl":"https://doi.org/10.4097/kja.24363","url":null,"abstract":"Background: Intraoperative hypercapnia reduces the time to emergence from volatile anesthetics, but few clinical studies have explored the effect of hypercapnia on the emergence time from intravenous (IV) anesthesia. We investigated the effect of inducing mild hypercapnia during the recovery period on the emergence time after total IV anesthesia (TIVA).Methods: Adult patients undergoing transurethral lithotripsy under TIVA were randomly allocated to normocapnia group (end-tidal carbon dioxide [ETCO2] 35-40 mmHg) or mild hypercapnia group (ETCO2 50-55 mmHg) during the recovery period. The primary outcome was the extubation time. The spontaneous breathing-onset time, voluntary eye-opening time, and hemodynamic data were collected. Changes in the cerebral blood flow velocity in the middle cerebral artery were assessed using transcranial Doppler ultrasound.Results: In total, 164 patients completed the study. The extubation time was significantly shorter in the mild hypercapnia (13.9 ± 5.9 min, P = 0.024) than in the normocapnia group (16.3 ± 7.6 min). A similar reduction was observed in spontaneous breathing-onset time (P = 0.021) and voluntary eye-opening time (P = 0.008). Multiple linear regression analysis revealed that the adjusted ETCO2 level was a negative predictor of extubation time. Middle cerebral artery blood flow velocity was significantly increased after ETCO2 adjustment for mild hypercapnia, which rapidly returned to baseline, without any adverse reactions, within 20 min after extubation.Conclusions: Mild hypercapnia during the recovery period significantly reduces the extubation time after TIVA. Increased ETCO2 levels can potentially enhance rapid recovery from IV anesthesia.","PeriodicalId":17855,"journal":{"name":"Korean Journal of Anesthesiology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144033491","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

Evaluation of the efficacy of M-TAPA and EXORA block application for analgesia after laparoscopic cholecystectomy: a prospective, single-blind, observational study. 评价M-TAPA和EXORA阻滞应用于腹腔镜胆囊切除术后镇痛的疗效：一项前瞻性、单盲、观察性研究。

IF 4.2 4区医学

Korean Journal of Anesthesiology Pub Date : 2025-04-15 DOI: 10.4097/kja.24563

Korgün Ökmen, Durdu Kahraman Yıldız, Gökberk Kürşat Ülker

{"title":"Evaluation of the efficacy of M-TAPA and EXORA block application for analgesia after laparoscopic cholecystectomy: a prospective, single-blind, observational study.","authors":"Korgün Ökmen, Durdu Kahraman Yıldız, Gökberk Kürşat Ülker","doi":"10.4097/kja.24563","DOIUrl":"https://doi.org/10.4097/kja.24563","url":null,"abstract":"Background: Different field block methods are used for analgesia following abdominal surgery. In this study, we evaluated the efficacy of a modified thoracoabdominal nerve block via the perichondrial approach (M-TAPA) and that of an external oblique and rectus abdominis plane (EXORA) block for anterolateral upper abdominal analgesia.Methods: This study included 90 patients undergoing laparoscopic cholecystectomy. Patients were divided into three groups (n = 30 per group): a control group, which received intravenous patient-controlled analgesia (IV.PCA); an EXORA block group, which received an EXORA block with 0.25% bupivacaine + IV.PCA; and an M-TAPA block group, which received an M-TAPA with 0.25% bupivacaine + IV.PCA. The primary outcome was postoperative pain (at rest and on movement), evaluated using numerical rating scale (NRS) scores at 2-, 4-, 6-, 12-, and 24-h postoperatively. Secondary outcomes included tramadol use, the side effect profile, dermatomal spread, and additional analgesic use at 12-h and 24-h postoperatively.Results: NRS scores as well as the mean tramadol consumption at 12-h and 24-h postoperatively were significantly lower in the EXORA and M-TAPA groups than in the control group (all P < 0.001). Sensory block was recorded in the lateral and anterior abdomen from T7 to T11 after both EXORA block and M-TAPA application.Conclusions: EXORA block and M-TAPA application provided similar levels of analgesia to the upper abdominal wall after laparoscopic cholecystectomy. Further data should be obtained from cadaveric and other types of studies.","PeriodicalId":17855,"journal":{"name":"Korean Journal of Anesthesiology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144007573","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

Hypotension after induction of anesthesia with remimazolam or etomidate: a non-inferiority randomized controlled trial in patients undergoing coronary artery bypass grafting. 雷马唑仑或依托咪酯诱导麻醉后的低血压：冠状动脉旁路移植术患者的非劣效性随机对照试验。

IF 4.2 4区医学

Korean Journal of Anesthesiology Pub Date : 2025-04-15 DOI: 10.4097/kja.24537.e1

Jeong-Jin Min, Eun Jung Oh, Hyun Ji Hwang, Sungwoo Jo, Hyunsung Cho, Chungsu Kim, Jong-Hwan Lee

引用次数: 0

Laparotomy and burst suppression-inducing sevoflurane induce subtle long-term changes in anxiety and social behavior in late postnatal mice. 剖腹手术和诱发爆发抑制的七氟醚可引起晚期产后小鼠焦虑和社会行为的微妙长期变化。

IF 4.2 4区医学

Korean Journal of Anesthesiology Pub Date : 2025-04-09 DOI: 10.4097/kja.24768

Tao Zhang, Yulim Lee, Xianshu Ju, Jiho Park, Boohwi Hong, Jianchen Cui, Yeonsu Kim, Seongeun Kim, Chul Hee Choi, Jun Young Heo, Woosuk Chung

{"title":"Laparotomy and burst suppression-inducing sevoflurane induce subtle long-term changes in anxiety and social behavior in late postnatal mice.","authors":"Tao Zhang, Yulim Lee, Xianshu Ju, Jiho Park, Boohwi Hong, Jianchen Cui, Yeonsu Kim, Seongeun Kim, Chul Hee Choi, Jun Young Heo, Woosuk Chung","doi":"10.4097/kja.24768","DOIUrl":"https://doi.org/10.4097/kja.24768","url":null,"abstract":"Background: Despite strong preclinical evidence, clinical studies have reported minimal effects of early anesthesia on neurodevelopment. This discrepancy may be due to limitations of preclinical studies, including the absence of clear criteria for appropriate anesthetic depth, lack of physiological monitoring, and absence of a surgical insult. Therefore, we aimed to evaluate the effects of sevoflurane in a more clinically relevant setting by addressing these known limitations.Methods: After confirming robust burst suppression (BS) at 2.5% sevoflurane, postnatal day 17 (PND17) mice were assigned to three groups: a Control group, no intervention; BS (-) group, surgery with 1.4% sevoflurane; and a BS (+) group, surgery with 1.4-2.5% sevoflurane. Total duration of anesthesia was 2 h, and blood pressure was non-invasively measured in a subset of mice. Long-term behavioral changes were evaluated from PND56 to PND62 at a two-day interval.Results: We found subtle but significant changes in anxiety and sociability only in BS (+) group mice. Change in anxiety level was observed in the light/dark box test, with the number of transitions between chambers significantly lower in the BS (+) group (P = 0.025). Reduced sociability was observed in the three-chamber test, as mice in the BS (+) group did not significantly prefer the chamber containing a stranger mouse (P = 0.065).Conclusions: Both surgery and excessive anesthesia depth are necessary to induce subtle yet long-term behavioral changes in young mice. Future preclinical studies should reconsider sevoflurane concentration and account for surgical trauma as a significant factor when investigating anesthesia-induced neurotoxicity.","PeriodicalId":17855,"journal":{"name":"Korean Journal of Anesthesiology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029642","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

Association between preoperative anemia and postoperative delirium in elderly patients undergoing non-cardiac surgery: a retrospective observational study. 老年非心脏手术患者术前贫血与术后谵妄的关系：一项回顾性观察研究。

IF 4.2 4区医学

Korean Journal of Anesthesiology Pub Date : 2025-04-07 DOI: 10.4097/kja.24701

Ah Ran Oh, Jungchan Park, Chung Soo Kim, Sangmin Maria Lee, Seung Yeon Yoo

{"title":"Association between preoperative anemia and postoperative delirium in elderly patients undergoing non-cardiac surgery: a retrospective observational study.","authors":"Ah Ran Oh, Jungchan Park, Chung Soo Kim, Sangmin Maria Lee, Seung Yeon Yoo","doi":"10.4097/kja.24701","DOIUrl":"https://doi.org/10.4097/kja.24701","url":null,"abstract":"Background: The association between preoperative anemia and postoperative delirium (POD) is unclear. We sought to evaluate the effect of preoperative anemia on the risk of POD in elderly patients after non-cardiac surgery.Methods: We retrospectively analyzed 62,600 patients aged over 60 years undergoing non-cardiac surgery between January 2011 and June 2019. The patients were divided into two groups according to the presence of preoperative anemia defined as hemoglobin < 13 g/L for men and < 12 g/dl for women. Anemia was further categorized into mild or moderate-to-severe anemia based on a cutoff of 11 g/dl. The primary outcome was POD within 7 d after surgery. The secondary outcomes included one- and three-year mortality after surgery. The inverse probability of treatment weighting (IPTW) method was used to adjust for confounders between the two groups.Results: The overall incidence of POD was 3.9% (2,447 / 62,600) within 7 d after surgery. After IPTW, preoperative anemia was significantly associated with increased risk of POD (odds ratio [OR], 1.42; 95% CI, 1.30-1.55; P < 0.001). Also, the risk of POD increased with the severity of anemia (OR, 1.32; 95% CI, 1.18-1.47; P < 0.001 for mild anemia; and OR, 1.70; 95% CI, 1.50-1.93; P < 0.001 for moderate-to-severe anemia). This association was similar for one- and three-year mortality.Conclusions: Preoperative anemia was associated with an increased risk of POD in elderly patients after non-cardiac surgery. Further investigations are required to verify whether preoperative anemia is a modifiable risk factor for POD.","PeriodicalId":17855,"journal":{"name":"Korean Journal of Anesthesiology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803195","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

Comparison of combined intranasal dexmedetomidine and ketamine versus chloral hydrate for pediatric procedural sedation: a randomized controlled trial. 右美托咪定联合氯胺酮与水合氯醛用于小儿手术镇静的比较：一项随机对照试验。

IF 4.2 4区医学

Korean Journal of Anesthesiology Pub Date : 2025-04-04 DOI: 10.4097/kja.24815

Young-Eun Jang, Eun-Young Joo, Jung-Bin Park, Sang-Hwan Ji, Eun-Hee Kim, Ji-Hyun Lee, Hee-Soo Kim, Jin-Tae Kim

{"title":"Comparison of combined intranasal dexmedetomidine and ketamine versus chloral hydrate for pediatric procedural sedation: a randomized controlled trial.","authors":"Young-Eun Jang, Eun-Young Joo, Jung-Bin Park, Sang-Hwan Ji, Eun-Hee Kim, Ji-Hyun Lee, Hee-Soo Kim, Jin-Tae Kim","doi":"10.4097/kja.24815","DOIUrl":"https://doi.org/10.4097/kja.24815","url":null,"abstract":"Background: We hypothesized that intranasal combination of dexmedetomidine (2 μg/kg) and ketamine (3 mg/kg) (IN DEXKET) improves the success rate of sedation in pediatric patients compared with chloral hydrate (CH; 50 mg/kg).Methods: This prospective, two-center, single-blinded, randomized controlled trial involved 136 pediatric patients (aged < 7 years) requiring procedural sedation. The participants were randomized to receive CH or IN DEXKET via a mucosal atomizer device. The primary outcome was the success rate of sedation (Pediatric Sedation State Scale, scores 1-3) within 15 min. The secondary outcomes included sedation failure at 30 min and overall complications of first-attempt sedation.Results: After excluding eight patients, 128 were included (CH = 66, IN DEXKET = 62). IN DEXKET showed a similar sedation success rate (75.8% [47/62] vs. 66.7% [44/66]; P = 0.330) but a lower complication rate (3.2% [2/62] vs. 16.7% [11/66]; P = 0.017) than CH. In the subgroup analysis for patients aged < 1 year, IN DEXKET showed a reduced complication rate than CH (2.6% [1/38] vs. 22.9% [8/35]; P = 0.012). In the subgroup analysis of children aged 1-7 years, IN DEXKET showed a higher sedation success rate within 15 min (79.2% [19/24] vs. 51.6% [16/31]; P = 0.049) and a lower sedation failure after 30 min (0% vs. 29.0% [9/31]; P = 0.003) than CH.Conclusions: The intranasal combination of dexmedetomidine (2 μg/kg) and ketamine (3 mg/kg) is a safe and effective alternative to CH (50 mg/kg) for sedation in pediatric patients aged < 7 years.","PeriodicalId":17855,"journal":{"name":"Korean Journal of Anesthesiology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780373","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

How to construct analysis of covariance in clinical trials : ANCOVA with one covariate in a completely randomized design structure. 如何在临床试验中构建协方差分析：在完全随机设计结构中，单协变量的ANCOVA。

IF 4.2 4区医学

Korean Journal of Anesthesiology Pub Date : 2025-04-04 DOI: 10.4097/kja.24820

WooJin Jung, Kwan Lee, Hyung-Hwan Kim, Chiyeon Lim

{"title":"How to construct analysis of covariance in clinical trials : ANCOVA with one covariate in a completely randomized design structure.","authors":"WooJin Jung, Kwan Lee, Hyung-Hwan Kim, Chiyeon Lim","doi":"10.4097/kja.24820","DOIUrl":"https://doi.org/10.4097/kja.24820","url":null,"abstract":"Analysis of covariance (ANCOVA) is a statistical method used to assess mean differences between groups by considering factors such as covariates or fixed effects and is often used to assess efficacy endpoints in clinical trials. When performing ANCOVA, the slope of the regression model should be the same for all treatment groups, with no interaction between the group and the covariate. Therefore, before analysis, the significance of the full ANCOVA model with interactions must be tested. If the interaction in the full model is statistically significant, the model that includes the interaction should be used; otherwise, ANCOVA using a reduced model without the interaction should be performed. If the ANCOVA model is not significant, this analysis method is not appropriate and a multivariate analysis or individual regression line estimation can be considered. If the difference in means between the groups is tested by ANCOVA, the confidence interval for the adjusted mean (least-squares mean) should be calculated and tested. Because the results may change depending on the covariates used in the ANCOVA model, the covariates should be predefined before performing the analysis. If a new covariate must be defined after a clinical trial is initiated, it should be specified in the statistical analysis plan. This is considered a major amendment; thus, the covariates must be redefined before clinical trial completion and must be described in the clinical study report. A clear report describing whether the redefinition of the covariates affected the sample size or decision-making is also necessary.","PeriodicalId":17855,"journal":{"name":"Korean Journal of Anesthesiology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780376","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

Effects of a virtual reality digital twin of the operating theatre on anxiety in pediatric surgery patients: a randomized controlled trial. 手术室的虚拟现实数字双胞胎对儿科手术患者焦虑的影响：一项随机对照试验。

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

Hypotension after induction of anesthesia with remimazolam or etomidate: a non-inferiority randomized controlled trial in patients undergoing coronary artery bypass grafting. 雷马唑仑或依托咪酯诱导麻醉后的低血压：冠状动脉旁路移植术患者的非劣效性随机对照试验。

IF 4.2 4区医学

Korean Journal of Anesthesiology Pub Date : 2025-04-01 Epub Date: 2025-01-03 DOI: 10.4097/kja.24537

Jeong-Jin Min, Eun Jung Oh, Hyun Ji Hwang, Sungwoo Jo, Hyunsung Cho, Chungsu Kim, Jong-Hwan Lee

{"title":"Hypotension after induction of anesthesia with remimazolam or etomidate: a non-inferiority randomized controlled trial in patients undergoing coronary artery bypass grafting.","authors":"Jeong-Jin Min, Eun Jung Oh, Hyun Ji Hwang, Sungwoo Jo, Hyunsung Cho, Chungsu Kim, Jong-Hwan Lee","doi":"10.4097/kja.24537","DOIUrl":"10.4097/kja.24537","url":null,"abstract":"Background: Remimazolam is a novel ultra-short-acting benzodiazepine known for its hemodynamic stability over propofol. However, its hemodynamic effects compared to those of etomidate are not well established. This study aimed to determine whether the use of remimazolam is non-inferior to etomidate with regard to the occurrence of post-induction hypotension in patients undergoing coronary artery bypass grafting.Methods: Patients were randomly assigned to either the remimazolam group (6 mg/kg/h) or the etomidate group (0.3 mg/kg) for induction of anesthesia. Anesthetic depth was adjusted based on the bispectral index. Primary outcome was the incidence of post-induction hypotension, defined as a mean arterial pressure less than 65 mmHg within 15 min after endotracheal intubation, with a non-inferiority margin of 12%.Results: A total of 144 patients were finally analyzed. Incidence of post-induction hypotension was 36/71 (50.7%) in the remimazolam group and 25/73 (34.2%) in the etomidate group, with a rate difference of 16.5% (95% CI [3.0-32.6]) between the two groups that was beyond the prespecified non-inferiority margin of 12.0%. The number of patients who needed vasopressors was similar in the two groups.Conclusions: In this non-inferiority trial, remimazolam failed to show non-inferiority to etomidate in terms of post-induction hypotension when used as an induction drug for general anesthesia in patients undergoing coronary artery bypass grafting. However, different doses or infusion techniques of remimazolam should be compared with etomidate in various patient groups to fully assess its hemodynamic non-inferiority during induction of anesthesia.","PeriodicalId":17855,"journal":{"name":"Korean Journal of Anesthesiology","volume":" ","pages":"139-147"},"PeriodicalIF":4.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12013985/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142922009","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