Saudi Journal of Anaesthesia最新文献

{"title":"Understanding impact factor and citescore.","authors":"Nitin K Borkar, Abhijit S Nair, Shilpa Meshram","doi":"10.4103/sja.sja_928_25","DOIUrl":"https://doi.org/10.4103/sja.sja_928_25","url":null,"abstract":"","PeriodicalId":21533,"journal":{"name":"Saudi Journal of Anaesthesia","volume":"20 2","pages":"480-481"},"PeriodicalIF":1.4,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13099069/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147779672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adapting enhanced recovery after surgery protocols for day-care surgeries under general anesthesia at a tertiary care ophthalmic setting.","authors":"Sujata Rawlani, Priyanka P Karnik, Shalini Subramanian, Raja Narsingrao","doi":"10.4103/sja.sja_644_25","DOIUrl":"https://doi.org/10.4103/sja.sja_644_25","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the feasibility and benefits of implementing Enhanced Recovery After Surgery (ERAS) protocols in elective ophthalmic day-care surgeries conducted under general anesthesia at the tertiary care ophthalmic center.</p><p><strong>Methods: </strong>This prospective observational study included 70 patients aged above 1 month undergoing elective ophthalmic surgery under general anesthesia. Key ERAS elements were adapted, including structured preoperative counselling, optimized fasting, multimodal analgesia, prophylaxis for postoperative nausea and vomiting (PONV), early oral intake, and use of the Aldrete score for discharge readiness. Pain was assessed using age-appropriate scoring systems like Visual Analogue Scale (VAS), Face, Legs, Activity, Cry, Consolability (FLACC) and patient feedback was obtained using a validated questionnaire. Data were analyzed using SPSS.</p><p><strong>Results: </strong>Mean fasting durations were 7.04 ± 1.2 hours for solids and 3.02 ± 1.22 hours for clear liquids. A low-dose opioid regimen combined with paracetamol ensured effective pain control; only a small number of patients required rescue analgesia. The overall incidence of PONV was low (8.6%), and early oral fluid intake was well tolerated. Most participants reported high satisfaction with their perioperative experience, with 91.4% scoring 4 or 5 on a 5-point scale. No adverse events or delayed discharges were observed.</p><p><strong>Conclusion: </strong>Integrating ERAS principles into ophthalmic day-care anesthesia is feasible and associated with improved recovery, reduced discomfort, and high patient satisfaction. A structured, multidisciplinary approach tailored to the ambulatory context can enhance perioperative care without compromising safety.</p>","PeriodicalId":21533,"journal":{"name":"Saudi Journal of Anaesthesia","volume":"20 2","pages":"268-280"},"PeriodicalIF":1.4,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13099044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147779702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A unique method for one-lung ventilation in pediatric thoracic surgery: Suction catheter and single-lumen tube approach: A case report.","authors":"Deema Siraj Abid, Hossam Al Oufi","doi":"10.4103/sja.sja_873_25","DOIUrl":"https://doi.org/10.4103/sja.sja_873_25","url":null,"abstract":"<p><p>Effective one-lung ventilation (OLV) ensures optimal surgical exposure and isolation of the operative lung. This case describes a novel technique for achieving OLV in pediatric thoracic surgery using a suction catheter with a single-lumen endotracheal tube (SLT). An 11-year-old girl presented with a 2-day history of hemoptysis. Chest CT showed bronchial wall thickening and multifocal nodular opacities in the right upper lobe, suggesting pulmonary hemorrhage. After standard ASA monitoring, arterial and central venous lines were placed. The patient was intubated with a size 6.0 SLT and a size 10 suction catheter, guided into the left main bronchus under fiberoptic bronchoscopy. Tube position was confirmed by auscultation and chest X-ray. Intraoperatively, adhesions indicated prior embolization. The right upper lobe bronchus and vessels were ligated with LigaSure. Postoperative recovery was uneventful, and imaging on day five showed no pneumothorax. This simple, effective method facilitates safe OLV in pediatric thoracic surgery.</p>","PeriodicalId":21533,"journal":{"name":"Saudi Journal of Anaesthesia","volume":"20 2","pages":"467-469"},"PeriodicalIF":1.4,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13099038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147779727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative evaluation of artificial intelligence chatbots for real-time guidance during intraoperative anesthetic crises: A simulation-based study.","authors":"Abdallah Ahmed Mezel Al-Azzam, Zaid Alkhateeb, Ahmed Shahin, Isam Bsisu, Ramzi Alaqtash, Eyad Attoun, Hammam Rababa'a","doi":"10.4103/sja.sja_903_25","DOIUrl":"https://doi.org/10.4103/sja.sja_903_25","url":null,"abstract":"<p><strong>Background: </strong>Artificial intelligence (AI) chatbots are increasingly used in healthcare, but their ability to interpret anesthetic monitoring data during intraoperative crises remains unclear.</p><p><strong>Objective: </strong>To evaluate AI chatbots' responses to simulated anesthetic emergencies, with a focus on visual monitor interpretation compared to contextual case information.</p><p><strong>Methods: </strong>This simulation-based study was conducted using a high-fidelity patient monitor. Twenty intraoperative emergencies were designed as static monitor images with minimal clinical context. Five AI platforms, ChatGPT, Claude, Gemini, Copilot, and DeepSeek, were tested. Each scenario was submitted in a separate, new conversation with no advanced reasoning tools enabled. Six blinded evaluators scored 100 responses using the validated CLEAR tool. The primary outcome was the mean total score per chatbot; secondary outcomes included domain-specific scores and differences between visual and contextual scenarios.</p><p><strong>Results: </strong>ChatGPT achieved the highest mean score (4.4 ± 0.6), outperforming other platforms across all CLEAR domains (<i>P</i> < 0.001). Its accuracy was consistent between contextual (4.6 ± 0.3) and visual (4.1 ± 0.9) scenarios. DeepSeek scored the lowest overall score (2.7 ± 1.1), and had a mean 2.3 ± 1.1 in \"lack of false information\", often due to misinterpreting monitor values, reducing its visual scenario performance. Overall, contextual scenarios scores were higher than visual ones across all platforms.</p><p><strong>Conclusion: </strong>Among AI chatbots, ChatGPT demonstrated the most consistent and guideline-concordant responses to simulated anesthetic crises as of March 2025. This study provides a benchmark for evaluating clinical AI performance and supports the selective integration of such tools in anesthesia decision-making workflows.</p>","PeriodicalId":21533,"journal":{"name":"Saudi Journal of Anaesthesia","volume":"20 2","pages":"362-368"},"PeriodicalIF":1.4,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13099052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147779780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and risk factors of preoperative anxiety among surgical patients in King Abdulaziz University Hospital.","authors":"Ghader Jamjoum, Alwaleed Hesham Kaneetah, Fahad Mesfer Alghamdi, Abdulelah Abdulsalam M Albatati, Abdulaziz Othman M Alnahdi, Fawaz Saleh B Almuntashiri, Abdullah Mahmoud Masoud Mahmoud, Amani Hussain Alhebaishi, Ashraf Maghrabi","doi":"10.4103/sja.sja_617_25","DOIUrl":"https://doi.org/10.4103/sja.sja_617_25","url":null,"abstract":"<p><strong>Introduction: </strong>Anxiety is a feeling of discomfort that often involves emotions such as worry and fear. This feeling tends to intensify when someone is facing surgery. Preoperative anxiety (POA) is a common psychological condition among patients preparing for surgery, which can lead to adverse postoperative outcomes, including increased pain, delayed recovery, and a higher risk of infection. Despite its significant clinical impact, research on POA in Saudi Arabia, particularly in the Western region, is limited. This study aims to assess the incidence of POA and identify its risk factors among surgical patients at King Abdulaziz University Hospital (KAUH) in Jeddah, Saudi Arabia.</p><p><strong>Methodology: </strong>This single-center cross-sectional study was conducted in 2024 at KAUH in the Department of Surgery, a tertiary care center. The study included 70 adult inpatients scheduled for surgery under anesthesia. Data were collected using a structured questionnaire covering demographic characteristics, medical history, surgical experiences, and fears of pain or complications. A validated tool, the Amsterdam Preoperative Anxiety and Information Scale (APAIS), was used to assess anxiety levels. Statistical analysis was performed using SPSS version 26, applying Chi-square tests, Spearman's correlation, and logistic regression to determine significant predictors of preoperative anxiety (POA).</p><p><strong>Results: </strong>Among the 70 participants, 77.1% were female, with a mean age of 35-44. The incidence of preoperative anxiety (POA) was 41.4%. Female gender was significantly associated with higher anxiety levels (89.7% vs. 10.3% in males, <i>P</i> = 0.036). Other significant risk factors included fear of postoperative pain (62.1% vs. 31.7%, <i>P</i> = 0.01) and fear of surgical complications (58.6% vs. 39.3%, <i>P</i> = 0.041). No significant association was found between POA and factors such as chronic disease, previous surgical history, or ASA classification.</p><p><strong>Conclusion: </strong>POA affects 41.4% of patients, especially females and those worried about pain and complications. This highlights the need for psychological assessments and clear patient education before surgery. Interventions like counseling and straightforward discussions about pain management can help reduce anxiety and improve surgical outcomes. Future research should focus on long-term studies to investigate these connections further.</p>","PeriodicalId":21533,"journal":{"name":"Saudi Journal of Anaesthesia","volume":"20 2","pages":"380-388"},"PeriodicalIF":1.4,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13099059/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147779984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rectus sheath block as the sole anesthesia technique for open surgical repair of umbilical hernias: A retrospective cohort study.","authors":"Emma L Rispler, David L Bettan, Alexander Valerio, Sean D Jeffries, Avinash Sinha, Thomas M Hemmerling","doi":"10.4103/sja.sja_834_25","DOIUrl":"https://doi.org/10.4103/sja.sja_834_25","url":null,"abstract":"<p><strong>Background: </strong>The rectus sheath block is a regional anesthetic technique that provides effective analgesia for midline abdominal surgeries. This study evaluated the feasibility of the rectus sheath block as the sole anesthetic technique for open umbilical hernia repair.</p><p><strong>Methods: </strong>A retrospective observational cohort study was conducted at a single secondary care hospital between 2017 and 2024. A total of 201 adult patients who had an elective open umbilical hernia repair with a pre-operative rectus sheath block were included. Patients were stratified into two groups with respect to their anesthetic plan: rectus sheath block only and rectus sheath block with general anesthesia. Primary outcomes were conversion rate to general anesthesia in the rectus sheath block group, post-anesthesia care unit recovery times, and postoperative pain scores. Data were analyzed using non-parametric tests under the intention-to-treat principle, and a two-sided <i>P</i> < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>The conversion rate to general anesthesia was 1.19%. The rectus sheath block group had significantly shorter post-anesthesia care unit recovery times (26.67 ± 13.57 min vs. 49.64 ± 23.91 min; <i>P</i> < 0.001) and lower postoperative morphine milligram equivalent consumption (0.321 ± 1.513 mg vs. 2.955 ± 4.381 mg; <i>P</i> < 0.001) compared with the rectus sheath block with general anesthesia group. Postoperative pain scores were comparable between groups (<i>P</i> = 0.170).</p><p><strong>Conclusion: </strong>The rectus sheath block is an effective sole anesthetic technique for open umbilical hernia repair, with a low conversion rate to general anesthesia.</p>","PeriodicalId":21533,"journal":{"name":"Saudi Journal of Anaesthesia","volume":"20 2","pages":"261-267"},"PeriodicalIF":1.4,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13099025/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147780182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thoracic spinal anesthesia for emergency derivative colostomy in a turner syndrome patient.","authors":"Paolo Scimia, Antonio De Cato, Mattia Frischia, Luca Gentili","doi":"10.4103/sja.sja_124_26","DOIUrl":"https://doi.org/10.4103/sja.sja_124_26","url":null,"abstract":"","PeriodicalId":21533,"journal":{"name":"Saudi Journal of Anaesthesia","volume":"20 2","pages":"485-486"},"PeriodicalIF":1.4,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13099042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147779679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of the Raqeeb narcotic controlling system on tramadol prescriptions in surgical patients: A pre-post implementation study.","authors":"Yahya Almarhabi","doi":"10.4103/sja.sja_951_25","DOIUrl":"https://doi.org/10.4103/sja.sja_951_25","url":null,"abstract":"<p><strong>Background: </strong>Tramadol hydrochloride, a Schedule III opioid, is the primary take-home narcotic for postoperative pain in Saudi Arabia, with a misuse prevalence of 11.4%-20%. On February 1, 2024, the Saudi Food and Drug Authority implemented the Raqeeb electronic monitoring system for real-time prescription tracking to curb abuse while maintaining legitimate access.</p><p><strong>Objectives: </strong>To evaluate Raqeeb's impact on tramadol prescribing in surgical patients and compare outcomes with international prescription drug monitoring programs (PDMPs).</p><p><strong>Methods: </strong>Retrospective cohort study of all adult patients (≥18 years) receiving tramadol prescriptions at a tertiary hospital in Saudi Arabia (April 2023 to June 2025), divided into pre-Raqeeb and post-Raqeeb periods. All tramadol prescriptions (acute postoperative and chronic/non-surgical indications) were included. Monthly rates were normalized; comparisons used <i>t</i>-tests and chi-square tests.</p><p><strong>Results: </strong>Monthly tramadol prescription rates in surgical patients decreased 43% (from 10.6 to 6.1 prescriptions/month). Mean dispensed quantity increased from 17.0 ± 7.6 to 21.5 ± 12.9 tablets (<i>P</i> = 0.003). Prescriptions issued by the surgical team fell from 86% to 48% (<i>P</i> < 0.001); prescriptions linked to a recent surgical procedure declined from 67% to 51% (<i>P</i> = 0.033). Anorectal procedures dropped 81%, while breast surgery increased 117%. Mean patient age rose from 50 ± 16 to 56 ± 15 years (<i>P</i> = 0.012). Repeat prescriptions remained stable (33% vs. 29%).</p><p><strong>Conclusion: </strong>Raqeeb achieved a 43% reduction in tramadol prescriptions among surgical patients-exceeding typical PDMP postoperative reductions (5%-30%)-with a shift toward older patients and chronic indications, without apparent barriers to legitimate access.</p>","PeriodicalId":21533,"journal":{"name":"Saudi Journal of Anaesthesia","volume":"20 2","pages":"375-379"},"PeriodicalIF":1.4,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13099066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147779958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Randomized controlled trial to compare post operative analgesia between ultrasound guided quadratus lumborum and erector spinae plane block in children undergoing pyeloplasty.","authors":"Nainsheet Kaur, Maitree Pandey, Preeti G Varshney, Raksha Kundal","doi":"10.4103/sja.sja_801_25","DOIUrl":"https://doi.org/10.4103/sja.sja_801_25","url":null,"abstract":"<p><strong>Background: </strong>Erector spinae plane block (ESPB) and quadratus lumborum block (QLB) have demonstrated efficacy in providing postoperative analgesia following abdominal surgeries. However, evidence regarding their effectiveness in pediatric renal surgeries remain limited. The present study aimed to compare the duration of postoperative analgesia between ultrasound-guided quadratus lumborum and erector spinae plane blocks in children undergoing open pyeloplasty.</p><p><strong>Methods: </strong>Sixty children undergoing pyeloplasty, aged between 6 months and 7 years were randomized to receive ultrasound guided ESPB or QLB after induction of general anesthesia. Time to first rescue analgesia, total analgesic requirement, and time to perform the block were observed.</p><p><strong>Results: </strong>The time to first rescue analgesia was 1040 ± 99 min in QLB group as compared to 889 ± 67 min in ESPB group (<i>P</i> < 0.001). Mean total analgesic requirement (fentanyl) in 24 hours was lower in QLB group as compared to ESPB group (1.77 ± 1.36 μg/kg and 3.9 ± 0.80 μg/kg, respectively) (<i>P</i> < 0.001). The mean total time to perform block was 246 ± 107 sec in QLB group and 140 ± 80 sec in ESPB group (<i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>Ultrasound guided quadratus lumborum block provides longer duration of postoperative analgesia with lesser total analgesic requirement as compared to erector spinae plane block in children undergoing pyeloplasty, with marginally longer time to administer quadratus lumborum block.</p>","PeriodicalId":21533,"journal":{"name":"Saudi Journal of Anaesthesia","volume":"20 2","pages":"327-331"},"PeriodicalIF":1.4,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13099023/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147780178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The awake axillofemoral bypass.","authors":"Khalid Nasser Bin Ghali, Raed Sami Altowairki, Muzackir Abubaker Mohammed","doi":"10.4103/sja.sja_818_25","DOIUrl":"https://doi.org/10.4103/sja.sja_818_25","url":null,"abstract":"<p><p>Aortoiliac occlusive disease is the severe form of peripheral arterial disease requiring complex vascular reconstruction, typically performed under general anesthesia (GA). However, GA carries increased risks in patients with significant comorbidities. We report a case of a 61-year-old male with chronic aortoiliac occlusion, uncontrolled hypertension, sepsis, and heavy smoking, presenting with bilateral limb ischemia and sensory-motor deficits. He underwent axillary-to-bilateral femoral artery bypass and right above-knee amputation under thoracic epidural anesthesia (TEA) combined with peripheral nerve blocks (PNB) and light sedation. A T4-L2 sensory block was achieved with stable hemodynamics throughout the 7-hour surgery, with minor hypotension managed by ephedrine. Postoperative analgesia with continuous epidural bupivacaine-fentanyl infusion and multimodal therapy provides excellent pain control. The patient required only brief ICU monitoring and was transferred to the ward without complications. This case demonstrates the feasibility and safety of TEA with PNB as an alternative to GA in high-risk vascular patients, offering effective anesthesia, hemodynamic stability, and superior pain control while minimizing perioperative risks.</p>","PeriodicalId":21533,"journal":{"name":"Saudi Journal of Anaesthesia","volume":"20 2","pages":"456-458"},"PeriodicalIF":1.4,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13099029/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147779470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}