Best Practice & Research-Clinical Anaesthesiology最新文献_第2页

Point of care ultrasound: lung and diaphragm 护理点超声：肺和膈

IF 2.8 3区医学

Best Practice & Research-Clinical Anaesthesiology Pub Date : 2025-12-01 Epub Date: 2025-11-05 DOI: 10.1016/j.bpa.2025.11.002

Beyza Büyükgebiz Yeşil , Rosemary M.G. Hogg

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引用次数: 0

Procedural sedation in older adults: A narrative review of pharmacological challenges, cognitive risks, and patient-centred approaches 老年人的程序性镇静：药理学挑战、认知风险和以患者为中心的方法的叙述性回顾

IF 2.8 3区医学

Best Practice & Research-Clinical Anaesthesiology Pub Date : 2025-09-01 Epub Date: 2025-08-28 DOI: 10.1016/j.bpa.2025.08.011

Lina Puodziukaite , Marco Perikar Dimaano , Steve Coppens , Danny Feike Hoogma

{"title":"Procedural sedation in older adults: A narrative review of pharmacological challenges, cognitive risks, and patient-centred approaches","authors":"Lina Puodziukaite , Marco Perikar Dimaano , Steve Coppens , Danny Feike Hoogma","doi":"10.1016/j.bpa.2025.08.011","DOIUrl":"10.1016/j.bpa.2025.08.011","url":null,"abstract":"<div><div>Procedural sedation in older adults presents distinct clinical challenges due to age-related changes in physiology and pharmacology. As patients age, they experience reduced cardiopulmonary and functional reserve, altered drug distribution and clearance, increased sensitivity to anaesthetics, and a higher burden of comorbidities and polypharmacy. These factors contribute to a heightened risk of complications such as hypotension, hypoxemia, and cognitive dysfunction.</div><div>Commonly used sedatives and opioids require careful dose adjustment and monitoring due to their variable and potentially unpredictable haemodynamic and cognitive effects. Emerging evidence supports the safety and predictability of newer agents like remimazolam and dexmedetomidine, while regional anaesthesia combined with light sedation may offer additional protection against cognitive complications. Effective patient-centred care, including thorough preoperative assessment, informed consent, and enhanced intra- and post-procedural monitoring, is essential to improve outcomes.</div><div>This review highlights the need for tailored, evidence-based sedation strategies that address the unique pharmacologic and cognitive risks in the older population.</div></div>","PeriodicalId":48541,"journal":{"name":"Best Practice & Research-Clinical Anaesthesiology","volume":"39 3","pages":"Pages 226-235"},"PeriodicalIF":2.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145536962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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

Advances in procedural sedation: From traditional agents to novel pharmacologic approaches 程序性镇静的进展：从传统药物到新型药理学方法

IF 2.8 3区医学

Best Practice & Research-Clinical Anaesthesiology Pub Date : 2025-09-01 Epub Date: 2025-09-17 DOI: 10.1016/j.bpa.2025.09.006

Stijn Diels , Steffen Rex , Layth Al tmimi

{"title":"Advances in procedural sedation: From traditional agents to novel pharmacologic approaches","authors":"Stijn Diels , Steffen Rex , Layth Al tmimi","doi":"10.1016/j.bpa.2025.09.006","DOIUrl":"10.1016/j.bpa.2025.09.006","url":null,"abstract":"<div><div>Procedural sedation and analgesia (PSA) have undergone significant development over the years and are now considered an essential component of care for patients undergoing diagnostic or therapeutic interventions in various clinical settings. Many traditional and newer sedative agents are used daily, each with a distinct pharmacokinetic and pharmacodynamic profile.</div><div>While sedative agents are well known to anaesthesiologists, they remain less familiar to many non-anaesthesiology care providers who are increasingly involved in delivering PSA. Established agents such as midazolam, propofol, and ketamine remain commonly used because of their well-known pharmacokinetic and -dynamic profile. Nevertheless, these agents have several side effects, including respiratory depression, haemodynamic instability, and emergence reactions in a particular group of patients. In response to these shortcomings, novel agents such as remimazolam, dexmedetomidine, esketamine, and ciprofol have been introduced. These sedatives show promising improvements in safety and procedural predictability. In contrast, etomidate analogues like ABP-700 and ET-26 are still largely investigational. They aim to minimise organ-specific adverse effects, while keeping the favourable effects of the products from which they are derived.</div><div>Despite encouraging findings, direct comparisons across agents are limited. The latter is due to heterogeneity between study methods, population, and outcome measures. The current review aims to provide anaesthesiologists and other healthcare providers with a complete overview of established and novel agents used for PSA, focusing on their pharmacologic properties, clinical application, and safety considerations.</div></div>","PeriodicalId":48541,"journal":{"name":"Best Practice & Research-Clinical Anaesthesiology","volume":"39 3","pages":"Pages 206-214"},"PeriodicalIF":2.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145536913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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

Non-pharmacological sedation techniques: The role of hypnosis, virtual reality, and other strategies 非药物镇静技术：催眠、虚拟现实和其他策略的作用

IF 2.8 3区医学

Best Practice & Research-Clinical Anaesthesiology Pub Date : 2025-09-01 Epub Date: 2025-09-11 DOI: 10.1016/j.bpa.2025.09.004

Kristof Nijs , Charlotte Jorissen , An Teunkens , Marc Van de Velde , Björn Stessel

{"title":"Non-pharmacological sedation techniques: The role of hypnosis, virtual reality, and other strategies","authors":"Kristof Nijs , Charlotte Jorissen , An Teunkens , Marc Van de Velde , Björn Stessel","doi":"10.1016/j.bpa.2025.09.004","DOIUrl":"10.1016/j.bpa.2025.09.004","url":null,"abstract":"<div><div>Non-pharmacological sedation techniques are increasingly recognised as valuable adjuncts in modern perioperative care. This narrative review explores the clinical applications of hypnosis, virtual reality, music therapy, aromatherapy, and mindfulness-based interventions in various settings, including regional anaesthesia, paediatrics, obstetrics, and ambulatory surgery. These strategies aim to reduce perioperative anxiety, enhance patient comfort, and lower reliance on pharmacological sedatives. Hypnosis and virtual reality are supported by growing evidence from randomised trials, while simpler interventions such as music and aromatherapy are easily implementable with minimal training. Mindfulness and breathing exercises show promise but remain underexplored in anaesthesia-specific settings. Successful implementation requires selecting appropriate patients, developing effective protocols, and providing staff education. These techniques are most effective when used as part of a multimodal approach to sedation. Further research is needed to assess long-term outcomes, cost-effectiveness, and standardisation across institutions. Non-pharmacological sedation offers a patient-centred, low-risk contribution to safe and personalised anaesthesia care. Their use during procedural sedation, either as standalone strategies or in combination with pharmacological agents, is increasingly recognised across a range of interventional and diagnostic settings.</div></div>","PeriodicalId":48541,"journal":{"name":"Best Practice & Research-Clinical Anaesthesiology","volume":"39 3","pages":"Pages 196-205"},"PeriodicalIF":2.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145536912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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

Procedural sedation outside the operating room: Challenges, guidelines, and future directions 手术室外程序性镇静：挑战、指南和未来方向

IF 2.8 3区医学

Best Practice & Research-Clinical Anaesthesiology Pub Date : 2025-09-01 Epub Date: 2025-08-28 DOI: 10.1016/j.bpa.2025.08.003

Andres Brenes Bastos , Ronny Munoz-Acuna , Andrew P. Notarianni

引用次数: 0

Procedural sedation and analgesia in clinical practice: From historical development to modern care 程序性镇静镇痛在临床中的应用：从历史发展到现代护理

IF 2.8 3区医学

Best Practice & Research-Clinical Anaesthesiology Pub Date : 2025-09-01 Epub Date: 2025-09-17 DOI: 10.1016/j.bpa.2025.09.008

Nikhil Chawla , Layth Al Tmimi

引用次数: 0

Procedural sedation in high-risk patients 高危患者的程序性镇静

IF 2.8 3区医学

Best Practice & Research-Clinical Anaesthesiology Pub Date : 2025-09-01 Epub Date: 2025-10-30 DOI: 10.1016/j.bpa.2025.10.005

Claudia R. Fernandez Robles, Adriana D. Oprea

引用次数: 0

PeRLS for procedural sedation: A specialized resuscitation framework enhanced by EASy-ALS ultrasound integration PeRLS用于程序性镇静：一个由EASy-ALS超声整合增强的专业复苏框架

IF 2.8 3区医学

Best Practice & Research-Clinical Anaesthesiology Pub Date : 2025-09-01 Epub Date: 2025-11-05 DOI: 10.1016/j.bpa.2025.11.003

Nibras F. Bughrara , Rosie Gaylor , William Hsu , Chelsey Santino , Mohamed Shembesh , Aliaksei Pustavoitau

引用次数: 0

"Point-of-care gastric ultrasound for assessing fasting status prior to procedural sedation: A narrative" 护理点胃超声评估手术镇静前的禁食状态：叙述

IF 2.8 3区医学

Best Practice & Research-Clinical Anaesthesiology Pub Date : 2025-09-01 Epub Date: 2025-08-30 DOI: 10.1016/j.bpa.2025.08.010

Jonathan Molina Cifuentes, Ronny Munoz-Acuna, Nikhil Chawla

引用次数: 0

Airway management during procedural sedation: Strategies for prevention and complication management 镇静过程中的气道管理：预防和并发症处理策略

IF 2.8 3区医学

Best Practice & Research-Clinical Anaesthesiology Pub Date : 2025-09-01 Epub Date: 2025-09-17 DOI: 10.1016/j.bpa.2025.09.005

Rebecca Jones , Antonogiannakis Anastasios , Roxaan Jappie , Omar Al-Rawi , Neil Coulson , Layth Al Tmimi

引用次数: 0