Korean Journal of Anesthesiology最新文献_第3页

Modified approach to external oblique intercostal block: a proof-of-concept pilot case series and anatomical evaluation. 改良的外斜肋间阻滞入路：概念验证的试点病例系列和解剖学评价。

IF 4.2 4区医学

Korean Journal of Anesthesiology Pub Date : 2025-01-20 DOI: 10.4097/kja.24832

Takashi Fujino, Koichiro Ichimura, Hidaka Anetai, Izumi Kawagoe

{"title":"Modified approach to external oblique intercostal block: a proof-of-concept pilot case series and anatomical evaluation.","authors":"Takashi Fujino, Koichiro Ichimura, Hidaka Anetai, Izumi Kawagoe","doi":"10.4097/kja.24832","DOIUrl":"https://doi.org/10.4097/kja.24832","url":null,"abstract":"Background: Regional anesthesia techniques that provide analgesia to the entire lateral abdomen are limited. We present a modified external oblique intercostal block for complete lateral abdominal analgesia with a single injection.Case: We performed a modified version of the external oblique intercostal block unilaterally at the tenth rib along the mid-axillary line in three patients undergoing robot-assisted partial nephrectomy (two single injections, one catheter placement) and tested the technique on a cadaver with 20 ml of dye bilaterally. All patients reported good postoperative pain relief without complications and had consistent sensory coverage of the T8-T12 dermatomes from the anterior-to-posterior axillary line. Anatomical assessment confirmed consistent bilateral staining of the lateral cutaneous branches T8-T12.Conclusions: The initial clinical success and anatomical findings of the modified approach to the external oblique intercostal block suggest that this technique may be an effective option for lateral abdominal analgesia.","PeriodicalId":17855,"journal":{"name":"Korean Journal of Anesthesiology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007853","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

Efficacy of light-transmitting eye shields for wound dressing in preventing pediatric emergence agitation following bilateral strabismus surgeries: a randomized clinical trial. 一项随机临床试验：用于伤口敷料的透光眼罩预防双侧斜视手术后儿童出现躁动的疗效。

IF 4.2 4区医学

Korean Journal of Anesthesiology Pub Date : 2025-01-16 DOI: 10.4097/kja.24603

Rui Zhang, Ting Huang, Peiting Fan, Zhubin Xie, Yanling Zhu, Xiaoliang Gan

{"title":"Efficacy of light-transmitting eye shields for wound dressing in preventing pediatric emergence agitation following bilateral strabismus surgeries: a randomized clinical trial.","authors":"Rui Zhang, Ting Huang, Peiting Fan, Zhubin Xie, Yanling Zhu, Xiaoliang Gan","doi":"10.4097/kja.24603","DOIUrl":"https://doi.org/10.4097/kja.24603","url":null,"abstract":"Background: Emergence agitation (EA) occurs in preschool children after ophthalmic surgery as eye shields induce visual disturbance. We aimed to investigate the efficacy of light-transmitting eye shields as an alternative to traditional medical gauze eye shields for wound dressing in terms of EA incidence following strabismus surgery.Methods: We randomly assigned 70 preschool children undergoing bilateral strabismus surgery to receive either light-transmitting (LT group, n = 35) or medical gauze (MG group, n = 35) eye shields upon the completion of surgery. The primary outcome was the difference in EA incidence between the groups.Results: After adjusting the data for age and sex, children in the LT group were less likely to develop EA than those in the MG group (5 of 35 children [14.3%] vs 15 of 35 children [42.9%]; adjusted odds ratio [OR], 95% CI: 0.28, 0.08-0.94; P = 0.040). Compared with the MG group, a significant reduction in the median score of the peak Aono's four-point scale was observed in the LT group (P = 0.024; Benjamini-Hochberg [BH] critical value = 0.050). Additionally, the incidences of agitation (peak Pediatric Anesthesia Emergence Delirium score ≥ 16) and propofol administration in the LT group were significantly lower than those in the MG group (P = 0.022; BH critical value = 0.038 and P = 0.017; B-H critical value = 0.025, respectively).Conclusions: The application of light-transmitting eye shields for wound dressing could help prevent EA after pediatric bilateral strabismus surgery under sevoflurane anesthesia.","PeriodicalId":17855,"journal":{"name":"Korean Journal of Anesthesiology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007851","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

Extended reality in anesthesia: a narrative review. 麻醉中的延伸现实：叙事回顾。

IF 4.2 4区医学

Korean Journal of Anesthesiology Pub Date : 2025-01-15 DOI: 10.4097/kja.24687

Sung Hee Han, Kristen L Kiroff, Sakura Kinjo

{"title":"Extended reality in anesthesia: a narrative review.","authors":"Sung Hee Han, Kristen L Kiroff, Sakura Kinjo","doi":"10.4097/kja.24687","DOIUrl":"https://doi.org/10.4097/kja.24687","url":null,"abstract":"The application of extended reality (XR) technology is rapidly expanding in the medical field, including anesthesia. This review aims to introduce the current literature on XR utilization to help anesthesiologists adopt this technology in education and clinical practice. XR is useful for both knowledge acquisition and skill training in a wide range of settings, from students to medical professionals. One of its major benefits is harm reduction through simulation scenarios that allow for immersion in clinical situations and opportunities to practice procedures and tasks. These scenarios often involve both technical and non-technical skills, enabling clinicians to enhance their capabilities without risking patient safety. In clinical settings, XR can also be used with patients to increase familiarity with medical procedures, provide education, and reduce anxiety. XR can also serve as a distraction technique, diverting the patient's attention from medical procedures and enhancing comfort, which may contribute to reduced opioid use. Although the potential benefits of XR in anesthesia have been reported in various educational and clinical contexts, challenges, such as limited financial reimbursement and restricted technical accessibility, remain. With further research and technological advancements, XR technology has the potential for widespread adoption in anesthesia practice.","PeriodicalId":17855,"journal":{"name":"Korean Journal of Anesthesiology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142983567","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 : 2025-01-03 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":"https://doi.org/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 arterial bypass grafting.Methods: Patients were randomly assigned to either the remimazolam group (6 m/kg/h) or the etomidate group (0.3 mg/kg) for induction of anesthesia. Anesthetic depth was adjusted based on the bispectral index (BIS). Primary outcome was the incidence of post-induction hypotension, defined as a mean arterial pressure (MAP) 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 arterial bypass grafting. However, different doses or infusion techniques of remimazolam must 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":""},"PeriodicalIF":4.2,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Effect of remimazolam on postoperative delirium and cognitive function in adults undergoing general anesthesia or procedural sedation: a meta-analysis of randomized controlled trials. 雷马唑仑对全麻或程序性镇静成人术后谵妄和认知功能的影响：随机对照试验的荟萃分析

IF 4.2 4区医学

Korean Journal of Anesthesiology Pub Date : 2025-01-03 DOI: 10.4097/kja.24493

Ji-In Park, Hyo-Seok Na, Ji-Na Kim, Jung-Hee Ryu, Howon Jang, Hyun-Jung Shin

{"title":"Effect of remimazolam on postoperative delirium and cognitive function in adults undergoing general anesthesia or procedural sedation: a meta-analysis of randomized controlled trials.","authors":"Ji-In Park, Hyo-Seok Na, Ji-Na Kim, Jung-Hee Ryu, Howon Jang, Hyun-Jung Shin","doi":"10.4097/kja.24493","DOIUrl":"https://doi.org/10.4097/kja.24493","url":null,"abstract":"Background: Remimazolam is a novel short-acting benzodiazepine. This study compared the effects of remimazolam and propofol on cognitive function in adult patients after surgery or other procedures.Methods: We searched electronic databases, including PubMed, EMBASE, CENTRAL, Web of Science, and SCOPUS, for relevant studies. The primary outcome was the proportion of participants who experienced delirium or impaired cognitive function postoperatively. Secondary outcomes included the incidence of hypotension, bradycardia, and postoperative nausea and vomiting (PONV). We estimated the odds ratios (OR) and mean differences (MD) with 95% CIs using a random-effects model.Results: In total, 1,295 patients from 11 randomized controlled trials (RCTs) were included. The incidence of postoperative delirium was 8.0% in the remimazolam group and 10.4% in the propofol group that was not significantly different (OR, 0.74; 95% CI [0.39, 1.42]; P = 0.3692; I² = 32%). More favorable cognitive function, as assessed using the Mini-Mental State Examination (MMSE), was observed in the remimazolam group compared to the propofol group (MD: 1.06, 95% CI [0.32, 1.80], P = 0.0050, I² = 89%). Remimazolam lowered the incidence of hypotension (OR: 0.28, 95% CI [0.21, 0.37], P = 0.0000, I² = 0%) compared to propofol.Conclusions: Remimazolam did not increase the risk of postoperative delirium and maintained cognitive function well, providing hemodynamic stability during surgery compared to propofol.","PeriodicalId":17855,"journal":{"name":"Korean Journal of Anesthesiology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142922004","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

The emerging role of fluoroscopy-guided high-intensity focused ultrasound ablation in lumbar facet joint pain management. 透视引导下高强度聚焦超声消融在腰椎小关节关节疼痛治疗中的新作用。

IF 4.2 4区医学

Korean Journal of Anesthesiology Pub Date : 2024-12-26 DOI: 10.4097/kja.24724

Wasimul Hoda, Khushboo Pandey

引用次数: 0

Post-anesthesia care unit delirium in children with moyamoya disease undergoing indirect revascularization: incidence and risk factors. 接受间接血运重建手术的 moyamoya 病患儿在麻醉科后出现的谵妄：发生率和风险因素。

IF 4.2 4区医学

Korean Journal of Anesthesiology Pub Date : 2024-12-20 DOI: 10.4097/kja.24481

Kun Liu, Lin He

{"title":"Post-anesthesia care unit delirium in children with moyamoya disease undergoing indirect revascularization: incidence and risk factors.","authors":"Kun Liu, Lin He","doi":"10.4097/kja.24481","DOIUrl":"https://doi.org/10.4097/kja.24481","url":null,"abstract":"Background: Delirium in the post-anesthesia care unit (PACU) may be associated with worse outcomes in children with moyamoya disease (MMD). This retrospective study aimed to describe the prevalence of PACU delirium in children with MMD and investigate its risk factors.Methods: Patients with MMD aged < 15 years who underwent indirect revascularization between January 2014 and October 2023 were included in this study. Delirium was assessed using the Pediatric Anesthesia Emergence Delirium Scale. Potential risk factors for PACU delirium were evaluated using multivariate logistic regression.Results: PACU delirium occurred in 245 (33%) of the 750 hemispheric procedures performed in 522 patients. Delirium was associated with a higher incidence in patients undergoing the first revascularization (37%) than in those undergoing the second (25%; P = 0.002). Cerebral infarction as the initial presentation (odds ratio [OR] 4.64, first revascularization), high pediatric moyamoya magnetic resonance imaging (MRI) score (OR 2.75, first revascularization; OR 3.50, second revascularization), and high intraoperative mean arterial pressure variability (mmHg/min) (OR 9.17, first revascularization; OR 8.82, second revascularization) were associated with PACU delirium. Conversely, total intravenous anesthesia (TIVA) was associated with a lower incidence of PACU delirium (OR 0.46, first revascularization; OR 0.25, second revascularization).Conclusions: A significant proportion of patients with MMD developed delirium in the PACU. High intraoperative blood pressure variability and preoperative MRI lesions are independent risk factors for PACU delirium in children with MMD. TIVA may exert a protective effect against PACU delirium. Further studies are required to clarify the causality of these associations.","PeriodicalId":17855,"journal":{"name":"Korean Journal of Anesthesiology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A comprehensive analysis of propofol abuse and addiction and neuropharmacological aspects: an updated review. 异丙酚滥用和成瘾以及神经药理学方面的全面分析：最新综述。

IF 4.2 4区医学

Korean Journal of Anesthesiology Pub Date : 2024-12-16 DOI: 10.4097/kja.24707

Tayfun Uzbay, Andleeb Shahzadi

{"title":"A comprehensive analysis of propofol abuse and addiction and neuropharmacological aspects: an updated review.","authors":"Tayfun Uzbay, Andleeb Shahzadi","doi":"10.4097/kja.24707","DOIUrl":"https://doi.org/10.4097/kja.24707","url":null,"abstract":"This review aims to assess the existing studies on propofol, a relatively new intravenous anesthetic, related to its abuse and addictive potential and to explain the neurobiological and neuropharmacological aspects of propofol addiction. Several neurobiological factors related to complex processes in the brain influence propofol abuse and addiction. In this review, we assessed the literature regarding propofol abuse and addiction, including both experimental and clinical studies. We selected articles from animal studies, case reports, clinical trials, meta-analyses, narrative reviews, and systemic reviews to extract all relevant crucial quantitative data with a measure of neurobiological and neuropharmacological aspects. Thus, the main goal of this study was to investigate the current literature and discuss the association between the central nervous system and propofol abuse and addiction in the context of addictive behavior. Current data suggest that propofol has a strong addictive potential and produces prominent addiction in both animals and humans. Thus, medical practitioners should exercise caution with propofol use, and we argue that this drug should be added to the list of controlled substances.","PeriodicalId":17855,"journal":{"name":"Korean Journal of Anesthesiology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829265","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

Achieving relief from nausea and vomiting: from intraoperative to postoperative management. 缓解恶心和呕吐：从术中到术后处理。

IF 4.2 4区医学

Korean Journal of Anesthesiology Pub Date : 2024-12-01 Epub Date: 2024-11-29 DOI: 10.4097/kja.24779

Bon-Wook Koo

引用次数: 0

Effects of opioid-sparing general anesthesia on postoperative nausea and vomiting in laparoscopic gynecological surgery. 节省阿片类药物的全身麻醉对腹腔镜妇科手术术后恶心和呕吐的影响。

IF 4.2 4区医学

Korean Journal of Anesthesiology Pub Date : 2024-12-01 Epub Date: 2024-08-23 DOI: 10.4097/kja.24336

Sun Woo Nam, Sang-Hwan Do, Jung-Won Hwang, Insun Park, Insung Hwang, Hyo-Seok Na

{"title":"Effects of opioid-sparing general anesthesia on postoperative nausea and vomiting in laparoscopic gynecological surgery.","authors":"Sun Woo Nam, Sang-Hwan Do, Jung-Won Hwang, Insun Park, Insung Hwang, Hyo-Seok Na","doi":"10.4097/kja.24336","DOIUrl":"10.4097/kja.24336","url":null,"abstract":"Background: In this study, we aimed to investigate whether opioid-sparing anesthesia (OSA) reduces postoperative nausea and vomiting (PONV) in patients undergoing laparoscopic gynecological surgery.Methods: Adult patients undergoing elective laparoscopic gynecological surgery were randomly assigned to either the opioid-using anesthesia (OUA) or the OSA groups. In the OUA group, remifentanil was administered as an opioid during general anesthesia. In the OSA group, apart from a single dose of 5 μg/kg of alfentanil for tracheal intubation, no other opioids were used. In both groups, a multimodal intravenous non-opioid analgesic regimen was used preferentially in the post-anesthesia care unit (PACU). The primary outcome was the incidence of PONV, assessed by symptoms until the postoperative day 1.Results: A total of 120 patients were included in this study. The incidence of nausea in the PACU was significantly lower in the OSA group compared to in the OUA group (31.7% in the OSA group vs. 51.7% in the OUA group, P = 0.026). Pain scores and the incidence of opioid analgesic administration were lower in the OSA group during PACU stay, resulting in a significantly lower number of patients requiring rescue opioid analgesics (3.3% vs. 18.3%, P = 0.008). There were no significant differences in intraoperative vital signs, hemodynamic interventions, or duration of PACU and hospital stay between the two groups.Conclusions: OSA significantly reduced postoperative nausea, pain scores, and the need for rescue analgesics in the PACU without increasing hemodynamic instability in patients undergoing laparoscopic gynecological surgery.","PeriodicalId":17855,"journal":{"name":"Korean Journal of Anesthesiology","volume":" ","pages":"605-613"},"PeriodicalIF":4.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11637591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142055928","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