Saudi Journal of Anaesthesia最新文献

{"title":"Parental knowledge and attitudes about the impact of childhood obesity on perioperative outcomes.","authors":"Sibelle Aurelie Yemele Kitio, Ifeoluwa C Olakunle, Sandra Tay, Joseph D Tobias, Olubukola O Nafiu","doi":"10.4103/sja.sja_8_25","DOIUrl":"10.4103/sja.sja_8_25","url":null,"abstract":"<p><strong>Introduction: </strong>Addressing childhood obesity remains a significant public health concern due to the lack of effective intervention programs and policies. While efforts are ongoing to evaluate perioperative complications related to childhood obesity, there has been limited exploration of parents' and caregivers' knowledge and attitudes toward the perioperative risks associated with their children's obesity. This prospective survey evaluated parents' beliefs and practices related to childhood obesity and determined if these influenced their knowledge of obesity-related perioperative complications.</p><p><strong>Methods: </strong>We performed a prospective survey of parents of children aged 2-17 years scheduled for elective operations at a US quaternary academic medical center. The survey instrument was pretested. The frequency of obesity-related perceptions, beliefs, and practices were assessed, stratified by child weight status. Group comparisons were made with appropriate statistical tests.</p><p><strong>Results: </strong>The study included 129 parents, of whom 87 (67.4%) were married, and 102 (79.1%) were women. Most parents, regardless of perceived child weight, agreed that child overweight/obesity can cause serious illness (95%) and that they should be concerned (90%). Notably, 40% of parents failed to recognize obesity in their own children. About 40% of parents were unsure about the impact of childhood obesity on postoperative pain control, and 29% were uncertain about its effect on anesthesia risks. Additionally, 20% of parents were uncertain about the potential for serious surgical complications related to obesity, and 5% believed that being overweight or obese does not lead to significant surgical risks.</p><p><strong>Conclusions: </strong>While awareness of child overweight/obesity as a modifiable health risk is high, many parents failed to recognize it in their own children and were unaware of its potential contribution to anesthesia-related complications. Additional efforts to help parents understand their role in facilitating behavior change and to assist them in identifying at-risk children as well as the perioperative implications of childhood obesity are required.</p>","PeriodicalId":21533,"journal":{"name":"Saudi Journal of Anaesthesia","volume":"19 3","pages":"345-352"},"PeriodicalIF":1.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12240519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609316","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 rare case of Doege-Potter syndrome: Anesthesia considerations for the surgical removal of a benign solitary lung fibrous tumor.","authors":"J Indragandhi, R Krishnaprabu","doi":"10.4103/sja.sja_626_24","DOIUrl":"10.4103/sja.sja_626_24","url":null,"abstract":"<p><p>Non-Islet Cell Tumor Hypoglycemia (NICTH) associated with solitary fibrous tumor is referred to as Doege-potter syndrome (DPS). Non-Islet Cell Tumor Hypoglycemia (NICTH) is a paraneoplastic syndrome characterized by hypoglycemia from secretion of insulin-like growth factor type 2 (IGF-2). Surgical resection of massive Solitary Fibrous Tumor of Pleura (SFTP) can be complicated by airway collapse, vascular compression, hemodynamic instability and hemorrhage. SFTP patients present with metabolic derangements secondary to paraneoplastic processes. We present a case of successful removal of massive right-sided SFTP via posterolateral thoracotomy and discuss the perioperative considerations for which providers should be familiar.</p>","PeriodicalId":21533,"journal":{"name":"Saudi Journal of Anaesthesia","volume":"19 3","pages":"422-424"},"PeriodicalIF":1.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12240528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609253","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":"Adrenaline rush: Unsuspicious dispensing error causing life threatening wrong drug infusion during living donor liver transplantation.","authors":"Amer Majeed, Yazan Chaiah, Abdelrahman Hammad, Salma Alkhani, Mohammed Abduhu Amer, Dieter Clemens Broering","doi":"10.4103/sja.sja_602_24","DOIUrl":"10.4103/sja.sja_602_24","url":null,"abstract":"<p><p>Medication errors carry the potential for serious patient harm and even death. Prescription and medication administration errors are common, while the incidence of dispensing errors is less consistent due to difficulties in detection and under-reporting. This case report describes an incident in which a busy pharmacy in a quaternary care hospital dispensed a norepinephrine infusion that actually contained epinephrine. The error became apparent only after the patient, undergoing living donor liver transplantation surgery, developed unexpected, dramatic, and potentially fatal instability, which worsened with progressively higher doses of norepinephrine. The differentials of the presentation were sequentially excluded, leading to the realisation that the contents of the dispensed medicine might have been inaccurate. When a freshly prepared infusion of norepinephrine replaced the pharmacy-supplied bag, the adverse parameters reversed, and the patient stabilised. This case underscores the importance of maintaining a high index of suspicion for medication dispensing errors, as doing so helped identify the cause and ultimately saved the patient's life.</p>","PeriodicalId":21533,"journal":{"name":"Saudi Journal of Anaesthesia","volume":"19 3","pages":"416-418"},"PeriodicalIF":1.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12240530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609280","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":"Analyzing outcomes for peripheral versus central administration of vasopressors: A narrative review.","authors":"Jack Dryden, Jose Navas-Blanco","doi":"10.4103/sja.sja_211_25","DOIUrl":"10.4103/sja.sja_211_25","url":null,"abstract":"<p><p>There is an emerging body of evidence to suggest that the peripheral administration of vasopressors is safe and effective in many clinical contexts and often superior to central administration. Vasopressors are a class of medications used to create vasoconstriction in patients with shock to increase systemic arterial blood pressure and tissue perfusion. Certain clinical circumstances require the use of these vasoactive drugs immediately for which the need to administer these drugs peripherally becomes paramount, although controversial. The authors present a narrative review dedicated to describing the current practice of the route of administration of vasopressors, comparing peripheral versus central administration, and explaining the advantages and drawbacks of each route as well as potential complications associated with them.</p>","PeriodicalId":21533,"journal":{"name":"Saudi Journal of Anaesthesia","volume":"19 3","pages":"375-383"},"PeriodicalIF":1.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12240503/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609281","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":"Intraoperative Sonoclot analysis in oncosurgical massive hemorrhage: A case series of coagulation curve abnormalities.","authors":"Thrivikrama P Tantry, Milan Hande, Pooja K Rao, Sunil P Shenoy","doi":"10.4103/sja.sja_773_24","DOIUrl":"10.4103/sja.sja_773_24","url":null,"abstract":"<p><p>Reports on intraoperative coagulation monitoring using viscoelastic testing methods are scarce in oncosurgical patients. Evidence-based clinical reports with the use of Sonoclot and subsequent corrections of coagulation abnormalities in above population are not available in the literature. We report here records of altered coagulation in 10 subjects with massive hemorrhage. Detection of intraoperative coagulation abnormalities was done using activated clotting time, clot rate, and platelet function. The most common Sonoclot signature abnormality found in our series was a poorly formed, dull, and rounded \"peak,\" indicative of irregularities of fibrin formation. Dilutional coagulopathy and hyper-fibrinolysis events too were recorded in few subjects. Appropriate transfusions with blood products were considered based on Sonoclot curve assessment. All subjects had adequate recovery. We conclude that the Sonoclot analysis demonstrates potential for optimizing blood product use in oncosurgical patients with massive hemorrhage, warranting further research to establish standardized protocols and quantify its impact.</p>","PeriodicalId":21533,"journal":{"name":"Saudi Journal of Anaesthesia","volume":"19 3","pages":"432-436"},"PeriodicalIF":1.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12240518/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609310","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":"Neuroprotective effect of intravenous lipid emulsion after bupivacaine-induced cardiac toxicity.","authors":"Mevlüt Doğukan, Nezir Yılmaz, Ahmet Türk, Fadime Tosun, Mehmet Duran, Zeliha Bozkurt","doi":"10.4103/sja.sja_810_24","DOIUrl":"10.4103/sja.sja_810_24","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to investigate the protective effects of intravenous lipid emulsion (ILE) against bupivacaine-induced cardiac toxicity, using histopathological analyses.</p><p><strong>Methods: </strong>Twenty-eight adult male Wistar-Albino rats were divided into four groups: Sham (Group A), ILE (Group B), Bupivacaine (Group C), and Bupivacaine + ILE (Group D). Neurotoxicity was induced in Groups C and D with continuous bupivacaine infusion. ILE was administered to Groups B and D. Histological examination of brain tissues, and apoptotic index were evaluated.</p><p><strong>Results: </strong>The apoptotic index was significantly higher in Group C, but ILE administration in Group D markedly decreased these parameters (<i>P</i> < 0.05). Histopathological analysis revealed that ILE reduced edema and neuronal degeneration in Group D.</p><p><strong>Conclusion: </strong>ILE demonstrated a neuroprotective effect against bupivacaine-induced cardiac toxicity by improving hemodynamic stability and reducing cellular damage. This suggests a potential therapeutic role of ILE in managing local anesthetic systemic toxicity.</p>","PeriodicalId":21533,"journal":{"name":"Saudi Journal of Anaesthesia","volume":"19 3","pages":"363-367"},"PeriodicalIF":1.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12240504/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609314","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":"Regulatory mechanisms of fospropofol on cerebral blood flow and metabolism and its clinical applications: Recent advances.","authors":"Luying Huang, Hui Yang","doi":"10.4103/sja.sja_230_25","DOIUrl":"10.4103/sja.sja_230_25","url":null,"abstract":"<p><p>Fospropofol is a water-soluble prodrug of propofol that has gained increasing attention in the field of anesthesia due to its gentle modulation of cerebral blood flow and metabolism. This review summarizes the pharmacological mechanisms by which fospropofol regulates cerebral hemodynamics, including direct effects on vascular smooth muscle and indirect modulation via suppression of neural metabolic activity. The article also discusses its ability to reduce cerebral metabolic rate, inhibit neuronal excitability, and modulate energy balance, all of which contribute to its potential neuroprotective properties, particularly in ischemia-reperfusion injury. Preclinical and clinical studies suggest that fospropofol exerts antioxidant and anti-inflammatory effects that may further support neural preservation. Clinically, fospropofol has shown value in various scenarios requiring precise neuromanagement, including neurosurgery, anesthesia in elderly patients, intensive care sedation, and perioperative neuroprotection. Despite promising results, further high-quality, large-scale studies are needed to clarify its neuroprotective efficacy across diverse patient populations and surgical contexts. With its favorable pharmacokinetics, controllable depth of sedation, and multitargeted neural effects, fospropofol is poised to become an important tool in individualized neuroanesthesia and brain-protective strategies.</p>","PeriodicalId":21533,"journal":{"name":"Saudi Journal of Anaesthesia","volume":"19 3","pages":"387-394"},"PeriodicalIF":1.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12240524/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609322","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":"Comment on: \"Pulsed radiofrequency treatment for the management of trigeminal neuropathic pain\".","authors":"Pranjali Kurhekar, Raghuraman M Sethuraman","doi":"10.4103/sja.sja_67_25","DOIUrl":"10.4103/sja.sja_67_25","url":null,"abstract":"","PeriodicalId":21533,"journal":{"name":"Saudi Journal of Anaesthesia","volume":"19 3","pages":"455-456"},"PeriodicalIF":1.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12240495/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609291","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":"Correspondence: Hypertensive anaphylaxis with heparin.","authors":"Diana Thomas","doi":"10.4103/sja.sja_14_25","DOIUrl":"10.4103/sja.sja_14_25","url":null,"abstract":"","PeriodicalId":21533,"journal":{"name":"Saudi Journal of Anaesthesia","volume":"19 3","pages":"453-454"},"PeriodicalIF":1.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12240511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609292","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":"Effective anesthesia management for super obesity-related compartment syndrome with ultrasound and Doppler guidance: A different strategy.","authors":"Luca Gentili, Gianclaudio Guerriero, Fabio Nania, Chiara Angeletti","doi":"10.4103/sja.sja_782_24","DOIUrl":"10.4103/sja.sja_782_24","url":null,"abstract":"<p><p>Acute compartment syndrome (ACS) arises from increased pressure within a confined osteofascial compartment, leading to tissue ischemia, metabolic deficits, and potential irreversible damage if untreated. Although trauma is the most common cause, obesity-especially when combined with immobility-can increase the risk of ACS, presenting significant challenges in anesthetic management. This case report details the anesthesiological management of a 42-year-old man with severe obesity (BMI 78 kg/m²), classified as super-super obese, who presented with ACS in his right lower limb. Given his complex airway and the limitations of performing general anesthesia (GA), a regional anesthetic approach was selected. Due to anatomical challenges posed by the patient's obesity, an adductor canal block was performed using ultrasound and Doppler guidance to identify key structures and achieve a successful block. The patient was sedated, remained hemodynamically stable during surgery, and required minimal analgesics postoperatively. This case highlights the critical role of regional anesthesia in super obese patients, overcoming challenges like difficult anatomical landmarks and limited equipment, and underscores the importance of personalized, adaptive approaches to achieve optimal outcomes. Despite the technical difficulties, this successful use of regional anesthesia provides valuable insights into the management of high-risk super obese patients with ACS and reinforces the need for anesthesiologists to employ creative and flexible techniques, including advanced imaging tools, to ensure safe anesthesia care.</p>","PeriodicalId":21533,"journal":{"name":"Saudi Journal of Anaesthesia","volume":"19 3","pages":"428-431"},"PeriodicalIF":1.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12240496/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609295","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}