Korean Journal of Anesthesiology最新文献_第8页

Receptor subtype-dependent effects of propofol on metalloproteinase activity, NKG2D ligand expression, and NK cell-mediated cytotoxicity in breast cancer: an in vitro study. 受体亚型依赖性丙泊酚对乳腺癌中金属蛋白酶活性、NKG2D配体表达和NK细胞介导的细胞毒性的影响：一项体外研究

IF 6.3 4区医学

Korean Journal of Anesthesiology Pub Date : 2025-05-07 DOI: 10.4097/kja.25011

Hyun-Su Ri, Hyeon Jeong Lee, Jaeho Bae, Ah-Reum Cho, Jae Rin Kim, Seungbin Park, Kah Young Lee, Soeun Jeon

{"title":"Receptor subtype-dependent effects of propofol on metalloproteinase activity, NKG2D ligand expression, and NK cell-mediated cytotoxicity in breast cancer: an in vitro study.","authors":"Hyun-Su Ri, Hyeon Jeong Lee, Jaeho Bae, Ah-Reum Cho, Jae Rin Kim, Seungbin Park, Kah Young Lee, Soeun Jeon","doi":"10.4097/kja.25011","DOIUrl":"https://doi.org/10.4097/kja.25011","url":null,"abstract":"Background: The effects of propofol, a commonly used intravenous anesthetic, on the breast cancer tumor microenvironment are not well understood. This study examined the influence of propofol on natural killer group 2, member D (NKG2D) ligand expression, matrix metalloproteinase (MMP)-mediated immune evasion, and natural killer (NK) cell-mediated cytotoxicity in breast cancer cells.Methods: We studied three human breast cancer cell lines representing distinct receptor subtypes: MCF-7 (estrogen receptor [ER]- and progesterone receptor [PR]-positive), MDA-MB-453 (human epidermal growth factor receptor 2 [HER2]-positive), and HCC-70 (triple-negative). Cells were treated with propofol at concentrations of 0 μg/ml (control; C), 4 μg/ml (P4), or 8 μg/ml (P8). Assessments included mRNA and protein expression of NKG2D ligands, NK cell cytotoxicity, protein levels of MMP-1 and MMP-2, and concentrations of soluble NKG2D ligands.Results: In MCF-7 and HCC-70 cell lines, propofol upregulated the mRNA and protein expression of NKG2D ligands in a dose-dependent manner, enhancing NK cell-mediated lysis. In contrast, in MDA-MB-453 cell lines, propofol downregulated the mRNA and protein expression of NKG2D ligands, resulting in diminished NK cell-mediated lysis. Across all receptor subtypes, propofol did not affect the expression of MMP-1 or MMP-2 or the concentration of soluble NKG2D ligands.Conclusions: Our results demonstrate that propofol exerts receptor subtype-dependent effects on NK cell-mediated immunosurveillance in breast cancer cell lines, potentially mediated by changes in the transcription of NKG2D ligands rather than by alterations in MMP expression or their proteolytic activity.","PeriodicalId":17855,"journal":{"name":"Korean Journal of Anesthesiology","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144775768","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 6.3 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":6.3,"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

Analgesic efficacy of the external oblique intercostal fascial plane block on postoperative acute pain in laparoscopic sleeve gastrectomy: a randomized controlled trial. 腹外斜肋间筋膜平面阻滞对腹腔镜袖胃切除术术后急性疼痛的镇痛效果：一项随机对照试验。

IF 4.2 4区医学

Korean Journal of Anesthesiology Pub Date : 2025-04-01 Epub Date: 2025-01-21 DOI: 10.4097/kja.24569

Elif Sarikaya Ozel, Cengiz Kaya, Esra Turunc, Yasemin B Ustun, Halil Cebeci, Burhan Dost

{"title":"Analgesic efficacy of the external oblique intercostal fascial plane block on postoperative acute pain in laparoscopic sleeve gastrectomy: a randomized controlled trial.","authors":"Elif Sarikaya Ozel, Cengiz Kaya, Esra Turunc, Yasemin B Ustun, Halil Cebeci, Burhan Dost","doi":"10.4097/kja.24569","DOIUrl":"10.4097/kja.24569","url":null,"abstract":"Background: Laparoscopic sleeve gastrectomy (LSG) causes significant postoperative pain, necessitating effective multimodal analgesia strategies. This study evaluated the efficacy of the external oblique intercostal block (EOIB) in this context.Methods: This prospective, randomized, controlled, single-blind study conducted between April and December 2023 included 60 patients who underwent LSG. Patients were divided into the EOIB (30 ml 0.25% bupivacaine/side) and control (no block) groups. The primary outcome was the cumulative intravenous morphine milligram equivalent (MME) consumption in the first 24 h postoperatively. Secondary outcomes included 12-h MME consumption, pain scores, intraoperative remifentanil use, rescue analgesia requirements, time to first analgesic request, nausea/vomiting scores, antiemetic use, and American Pain Society Patient Outcome Questionnaire-Revised Turkish Version (APS-POQ-R-TR) scores.Results: The control group had significantly higher median opioid consumption than the EOIB group at 12 (14.4 vs. 5.8 mg; P < 0.001) and 24 h (25.9 vs. 10.6 mg; P < 0.001) postoperatively. The need for rescue analgesics did not differ significantly (43.3 vs. 23.3%; P = 0.1). The EOIB group exhibited significantly higher patient satisfaction (APS-POQ-R-TR score 2.91 vs. 4.42; P < 0.001) and consistently lower pain scores across all time points (P < 0.001). The EOIB group had lower nausea/vomiting scores (P < 0.001), fewer patients requiring antiemetics (16.7% vs. 40%; P = 0.045), longer time to first morphine request (57.5 vs. 25 min; P < 0.001), and lower remifentanil use (850 vs. 1050 μg; P < 0.001).Conclusions: The preoperative EOIB, as a part of multimodal analgesia, provides effective analgesia for acute pain in patients undergoing LSG.","PeriodicalId":17855,"journal":{"name":"Korean Journal of Anesthesiology","volume":" ","pages":"159-170"},"PeriodicalIF":4.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12013990/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007848","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

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 : 2025-04-01 Epub 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":"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":"129-138"},"PeriodicalIF":4.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12013989/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Remimazolam - expectations and concerns. Remimazolam - 期望与担忧。

IF 4.2 4区医学

Korean Journal of Anesthesiology Pub Date : 2025-04-01 Epub Date: 2025-03-21 DOI: 10.4097/kja.25170

Jae Hoon Lee

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 : 2025-04-01 Epub 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":"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. We estimated the odds ratios (OR) and mean differences (MD) with 95% CIs using a random-effects model.Results: In total, 1295 patients from 11 randomized controlled trials 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 = 0.369, I2 = 32%). More favorable cognitive function, as assessed using the Mini-Mental State Examination, was observed in the remimazolam group compared to the propofol group (MD: 1.06, 95% CI [0.32-1.80], P = 0.005, I2 = 89%). Remimazolam lowered the incidence of hypotension (OR: 0.28, 95% CI [0.21-0.37], P = 0.000, 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":"118-128"},"PeriodicalIF":4.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12013991/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Comment on "Cardiac arrest due to coronary vasospasm after sugammadex administration -a case report-". 对“糖美德给药后冠状血管痉挛致心脏骤停1例报告”的评论。

IF 4.2 4区医学

Korean Journal of Anesthesiology Pub Date : 2025-04-01 Epub Date: 2025-01-08 DOI: 10.4097/kja.24915

Balaji Vaithialingam

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 : 2025-04-01 Epub Date: 2024-12-26 DOI: 10.4097/kja.24724

Wasimul Hoda, Khushboo Pandey

引用次数: 0

Modified approach to external oblique intercostal block: a proof-of-concept pilot case series and anatomical evaluation -a case series. 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 : 2025-04-01 Epub 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 -a case series.","authors":"Takashi Fujino, Koichiro Ichimura, Hidaka Anetai, Izumi Kawagoe","doi":"10.4097/kja.24832","DOIUrl":"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: 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":"171-176"},"PeriodicalIF":4.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12013986/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0