Saudi Journal of Anaesthesia最新文献

{"title":"Erector spinae plane block complementary analgesic to enhance recovery after cardiac surgery: A prospective double-blinded randomized controlled trial.","authors":"Ibrahim A Zabani, Dareen Alamoudi, Khalid Alhroub, Abdulkareem Alhassoun, Gamal Tawfik, Adel Alzanbagi, Faisal Alzahrani, Faizan Zia, Reem Almuqati, Abdullah Tayeb, Zakaria Alsayouri, Hasan Saad","doi":"10.4103/sja.sja_662_24","DOIUrl":"10.4103/sja.sja_662_24","url":null,"abstract":"<p><strong>Background: </strong>Post-sternotomy pain is a significant challenge in cardiac surgeries. Effective pain management can reduce opioid reliance and lower pain scores, contributing to shorter hospital stays. The erector spinae plane block (ESPB) has shown promise as an analgesic for various surgical procedures. Given the frequency of sternotomies in our center and the associated prolonged pain that delays intensive care unit (ICU) discharge, we aimed to assess the impact of ESPB on postoperative opioid (fentanyl) use and pain levels up to 48 h after extubation.</p><p><strong>Methods: </strong>This study was a prospective, double-blind, randomized controlled trial involving 80 adult patients (ASA III) scheduled for cardiac surgery. Participants were randomized into two groups: the ESPB group (<i>n</i> = 40; bilateral 0.25% bupivacaine, 20 mL) and a control group (<i>n</i> = 40; no ESPB). The main outcomes measured were fentanyl use post-surgery and pain scores using the visual analog scale (VAS). Secondary outcomes included intraoperative fentanyl use, time to first analgesic dose, extubation timing, and ICU stay duration. SPSS v.26 was used for statistical analysis.</p><p><strong>Results: </strong>The ESPB group had significantly reduced fentanyl consumption during intubation (150 [0-800] vs. 950 [30-5260], <i>P</i> < 0.0001), at 3 h post-extubation (25 [0-50] vs. 0 [0-200], <i>P</i> = 0.034), 12 h post-extubation (0 [0-80] vs. 0 [0-200], <i>P</i> = 0.002), over 12 h total (0 [0-100] vs. 30 [0-600], <i>P</i> = 0.01), at 24 h (0 [0-100] vs. 30 [0-900], <i>P</i> = 0.003), and at 48 h (0 [0-100] vs. 50 [0-1200], <i>P</i> = 0.001). VAS scores were consistently lower for the ESPB group at rest at multiple points up to 48 h (<i>P</i> < 0.0001). Additionally, the ESPB group required less intraoperative fentanyl (<i>P</i> = 0.001), had shorter ICU stays (<i>P</i> = 0.009), and faster extubation times (<i>P</i> = 0.013). The time to first analgesic and paracetamol use did not differ significantly (<i>P</i> = 0.97 and 0.255, respectively).</p><p><strong>Conclusions: </strong>The findings suggest that ESPB is an effective addition to multimodal anesthesia for cardiac surgery, significantly reducing pain and opioid use, and improving postoperative outcomes.</p>","PeriodicalId":21533,"journal":{"name":"Saudi Journal of Anaesthesia","volume":"19 3","pages":"327-333"},"PeriodicalIF":1.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12240509/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609297","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":"Neurogenic pulmonary edema in a child with traumatic epidural hematoma and brain herniation.","authors":"Genrui Guo, Hongbin Cao, Zhiguo Yang, Lei Shi","doi":"10.4103/sja.sja_561_24","DOIUrl":"10.4103/sja.sja_561_24","url":null,"abstract":"<p><p>Traumatic epidural hematoma is a common pathological condition following traumatic brain injury (TBI). Neurogenic pulmonary edema (NPE) is a rare but life-threatening complication, typically occurring in association with acute severe intracranial pathologies. Cases of pediatric traumatic epidural hematoma complicated by NPE are exceedingly rare. This case report describes a 1.5-year-old boy who suffered a large acute temporoparietal-occipital epidural hematoma with brain herniation after falling from a bed. Following an emergency epidural hematoma evacuation, the child developed high fever, respiratory distress, and copious pink frothy sputum, with chest CT showing large areas of high-density shadows in both lungs, leading to a diagnosis of NPE. Through aggressive supportive care, including mechanical ventilation, pharmacological treatment, and other supportive measures, the patient's respiratory function gradually improved, and pulmonary imaging abnormalities resolved rapidly within 48 hours, resulting in a favorable outcome. This case underscores the critical role of early recognition and timely intervention in managing acute traumatic epidural hematoma complicated by NPE, providing valuable insights for the clinical management of similar cases.</p>","PeriodicalId":21533,"journal":{"name":"Saudi Journal of Anaesthesia","volume":"19 3","pages":"406-409"},"PeriodicalIF":1.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12240494/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609313","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":"Optimizing perioperative airway management in TMJ ankylosis: Addressing challenges and opportunities.","authors":"Reddy S Poornima, Aspari M Azeez, Mrinal K Mandal","doi":"10.4103/sja.sja_94_25","DOIUrl":"10.4103/sja.sja_94_25","url":null,"abstract":"","PeriodicalId":21533,"journal":{"name":"Saudi Journal of Anaesthesia","volume":"19 3","pages":"458-459"},"PeriodicalIF":1.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12240527/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609315","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":"Post-ESOphagectomy patients presenting for General Anesthesia INduction: A systematic review of the literature (PESO-GAIN-R).","authors":"Nika Samadzadeh Tabrizi, Alexander D Shapeton, Jamel Ortoleva, Michelle Burmistova, Riley A Demos, Sridhar R Musuku, Roman Schumann","doi":"10.4103/sja.sja_738_24","DOIUrl":"10.4103/sja.sja_738_24","url":null,"abstract":"<p><strong>Purpose: </strong>Immediately following esophagectomy, aspiration is responsible for most direct postoperative complications, largely attributed to anatomical alterations from the surgical procedure. The long-term risk of aspiration following successful esophagectomy has not been systematically investigated, and there are no guidelines for the anesthetic management of postesophagectomy patients who require elective surgeries involving general anesthesia (GA).</p><p><strong>Methods: </strong>PubMed/MEDLINE, Embase, and Web of Science were systematically searched from inception through January 1, 2024 to identify studies involving patients ≥90 days postesophagectomy and undergoing elective surgery unrelated to their esophagectomy status, where GA was required. Data on perioperative anesthetic management were extracted. The primary outcomes assessed were perioperative gastrointestinal and pulmonary complications. Secondary outcomes included the approach to induction of GA and author recommendations.</p><p><strong>Results: </strong>Of the 4097 studies, ten studies involving 131 patients met inclusion criteria. Intraoperatively, adverse events during induction occurred in 13.0% of 131 cases, including regurgitation of gastric contents in 5.3% and pulmonary aspiration in 9.9%. The airway was managed with an endotracheal tube in 95.6%. Induction was performed in the semi-Fowler position in 92.9% and performed using the rapid sequence and standard induction techniques in 58.7% and 41.3%, respectively.</p><p><strong>Conclusions: </strong>Patients who have undergone esophagectomy may remain at high risk for aspiration during GA even in the long term, necessitating enhanced vigilance in anesthetic management. We offer evidence-informed suggestions for elective induction of GA in patients with a history of successful esophagectomy to enhance safe practice for these patients.</p>","PeriodicalId":21533,"journal":{"name":"Saudi Journal of Anaesthesia","volume":"19 3","pages":"334-344"},"PeriodicalIF":1.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12240513/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609318","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":"Awareness and practices regarding local anesthetic usage and toxicity among OB-GYN and anesthesiology professionals in Saudi Arabia.","authors":"Jumana Baaj, Maysoon Alhaizan, Reem Alsafar, Abdullah Bin Muammar, Mansor Aldaijy, Rakan Alfaifi","doi":"10.4103/sja.sja_557_24","DOIUrl":"10.4103/sja.sja_557_24","url":null,"abstract":"<p><strong>Background: </strong>Local anesthetics (LAs) are commonly used in obstetrics and gynecology (OB-GYN); however, inappropriate administration can cause local anesthetic systemic toxicity (LAST), a life-threatening condition. For safe medical practice, healthcare providers should carefully follow the guidelines for administering LAs for early identification and proper management of LAST when it occurs.</p><p><strong>Methods: </strong>This nationwide study used a 36-item self-administered questionnaire administered to healthcare professionals in OB-GYN and anesthesiology. The survey assessed the knowledge, attitudes, and practices of commonly used LA agents, their appropriate dosage, and awareness of LAST's management.</p><p><strong>Results: </strong>A study of 391 Saudi healthcare professionals, between OB-GYN (51.2%) and anesthesiology (48.8%), reported greater engagement in anesthetic training and usage among anesthesiologists (88% trained, 58.1% daily use) than among OB-GYNs (38.5% trained, 30.5% daily use). OB-GYNs most commonly performed perineal tear repairs (88.5%), whereas anesthesiologists mainly performed paracervical blocks (89.5%). Lidocaine was the preferred local anesthetic for OB-GYNs at 93.5%, with anesthesiologists also favoring lidocaine but showing a higher use of bupivacaine (75.4%). Furthermore, the knowledge, attitudes, and practices scores of OB-GYN participants were significantly lower scores in all parameters compared to the anesthesiology participants (<i>P</i> < 0.001).</p><p><strong>Conclusions: </strong>Healthcare professionals in OB-GYN lack adequate knowledge of the safe and effective use of LA agents. Their knowledge must be increased through education to ensure safe practices.</p>","PeriodicalId":21533,"journal":{"name":"Saudi Journal of Anaesthesia","volume":"19 3","pages":"277-285"},"PeriodicalIF":1.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12240512/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609286","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":"Predatory journals: Next round, same problem in persistently threatening the research integrity.","authors":"Paulo R Z Antas","doi":"10.4103/sja.sja_78_25","DOIUrl":"10.4103/sja.sja_78_25","url":null,"abstract":"","PeriodicalId":21533,"journal":{"name":"Saudi Journal of Anaesthesia","volume":"19 3","pages":"461-462"},"PeriodicalIF":1.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12240515/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609320","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":"Anesthetic management for Birt-Hogg-Dubé syndrome case.","authors":"Ramy Mahmoud","doi":"10.4103/sja.sja_612_24","DOIUrl":"10.4103/sja.sja_612_24","url":null,"abstract":"<p><p>Birt-Hogg-Dubé (BHD) syndrome is a rare syndrome which is usually inherited but may occur <i>de novo</i>. It usually presents with cutaneous manifestations, pneumothorax, and, most importantly, renal tumors. Spinal anesthesia was used in this case to avoid respiratory complications such as pneumothorax.</p>","PeriodicalId":21533,"journal":{"name":"Saudi Journal of Anaesthesia","volume":"19 3","pages":"419-421"},"PeriodicalIF":1.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12240490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609284","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":"Development of spontaneous subarachnoid-cutaneous fistula after the removal of epidural catheter and its management: A case report.","authors":"Bhanupreet Kaur, Minnu Panditrao, Nitin Bansal, Aayleeta Gupta","doi":"10.4103/sja.sja_341_24","DOIUrl":"10.4103/sja.sja_341_24","url":null,"abstract":"<p><p>Continuous epidural catheter technique is generally a safe modality. A rare occurrence of development of subarachnoid-cutaneous fistula (SACF), postremoval of epidural catheter, is described. It can be potentially challenging to diagnose and treat. A watchful and patient conservative approach is highly recommended for successful outcomes.</p>","PeriodicalId":21533,"journal":{"name":"Saudi Journal of Anaesthesia","volume":"19 3","pages":"403-405"},"PeriodicalIF":1.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12240498/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609294","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":"Perineural dexamethasone: A concern!","authors":"Chitta R Mohanty, Amiya K Barik, Rakesh V Radhakrishnan, Ipsita Subhadarshini, Sangeeta Sahoo","doi":"10.4103/sja.sja_3_25","DOIUrl":"10.4103/sja.sja_3_25","url":null,"abstract":"","PeriodicalId":21533,"journal":{"name":"Saudi Journal of Anaesthesia","volume":"19 3","pages":"450-451"},"PeriodicalIF":1.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12240493/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609317","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":"Combined sacral erector spinae and supra-inguinal fascia iliaca blocks in total hip arthroplasty pain.","authors":"Saverio Paventi, Francesco Marrone, Simone Failli, Carmine Pullano","doi":"10.4103/sja.sja_604_24","DOIUrl":"10.4103/sja.sja_604_24","url":null,"abstract":"","PeriodicalId":21533,"journal":{"name":"Saudi Journal of Anaesthesia","volume":"19 3","pages":"446-447"},"PeriodicalIF":1.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12240522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609288","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}