Current Opinion in Anesthesiology最新文献_第3页

Updates in Non-Operating Room Anesthesia. 非手术室麻醉的最新进展。

IF 2.3 3区医学

Current Opinion in Anesthesiology Pub Date : 2025-06-01 Epub Date: 2025-03-05 DOI: 10.1097/ACO.0000000000001472

Aaron Primm, Diana Anca

引用次数: 0

Point-of-care ultrasound in obstetric anesthesia clinical practice. 护理点超声在产科麻醉临床实践中的应用。

IF 2.3 3区医学

Current Opinion in Anesthesiology Pub Date : 2025-06-01 Epub Date: 2025-04-08 DOI: 10.1097/ACO.0000000000001501

Pedram Aleshi, Clemens M Ortner, Alexander J Butwick

{"title":"Point-of-care ultrasound in obstetric anesthesia clinical practice.","authors":"Pedram Aleshi, Clemens M Ortner, Alexander J Butwick","doi":"10.1097/ACO.0000000000001501","DOIUrl":"10.1097/ACO.0000000000001501","url":null,"abstract":"Purpose of the review: Point-of-care ultrasound (POCUS) is increasingly recognized as a valuable tool in obstetric anesthesia. This review synthesizes key studies and reviews published within the last 2 years on its application in clinical practice with relevant supporting literature.Recent findings: Handheld ultrasound-assisted neuraxial block placement modestly reduces periprocedure time compared with landmark-based techniques. Devices with integrated three-dimensional or artificial intelligence-guided software may improve first-attempt success, particularly in obese patients. Focused cardiac ultrasound has gained interest as a potential tool for predicting postspinal hypotension through predelivery inferior vena cava collapsibility assessment. POCUS is also valuable for evaluating shock and cardiovascular compromise, aiding in the diagnosis and clinical management of amniotic fluid embolism and maternal cardiomyopathy. Gastric ultrasound can be performed qualitatively, aids aspiration risk assessment, and can be used in studies evaluating drug effects on gastric contents and antral cross-sectional area. Robust training programs are essential to equip obstetric anesthesiologists with sustainable POCUS skill sets.Summary: POCUS is associated with reduced neuraxial block placement times, provides critical hemodynamic data in patients with amniotic fluid embolism and cardiomyopathy, and allows gastric content evaluation for aspiration risk assessment. Expanding structured training and research is crucial to maximizing its clinical utility.","PeriodicalId":50609,"journal":{"name":"Current Opinion in Anesthesiology","volume":" ","pages":"202-207"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144038969","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

Perioperative management of pediatric patients with obstructive sleep apnea syndrome presenting for adenotonsillectomy. 以腺扁桃体切除术为表现的儿童阻塞性睡眠呼吸暂停综合征的围手术期处理。

IF 2.3 3区医学

Current Opinion in Anesthesiology Pub Date : 2025-06-01 Epub Date: 2025-04-11 DOI: 10.1097/ACO.0000000000001492

Kristen K Penberthy, Nicholas M Dalesio

{"title":"Perioperative management of pediatric patients with obstructive sleep apnea syndrome presenting for adenotonsillectomy.","authors":"Kristen K Penberthy, Nicholas M Dalesio","doi":"10.1097/ACO.0000000000001492","DOIUrl":"10.1097/ACO.0000000000001492","url":null,"abstract":"Purpose of review: The prevalence and severity of pediatric obstructive sleep apnea syndrome (OSAS) is increasing, and patients with severe OSAS are at higher risk for perioperative adverse events because of an increased sensitivity to opioid medications. This review highlights new strategies for perioperative medication management for children presenting for adenotonsillectomy.Recent findings: Fewer than 10% of patients presenting for adenotonsillectomy have undergone testing to determine the severity of their OSAS, despite cost-effective and practical diagnostic alternatives to polysomnography, such as nocturnal oximetry. With an increasing incidence of severe OSAS, recent research is focusing on opioid-sparing perioperative management including the use of alternative surgical techniques, regional anesthesia, and use of nonsteroidal anti-inflammatory medications that provide optimal analgesia with minimal adverse complications.Summary: Severe OSAS increases perioperative risks for pediatric patients, but diagnostic techniques that stratify OSAS severity are underutilized preoperatively, leading to a lack of information on how best to care for patients on the day of surgery. Nonopioid analgesic adjuncts are becoming more common, improving safety for this patient population.","PeriodicalId":50609,"journal":{"name":"Current Opinion in Anesthesiology","volume":" ","pages":"253-260"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049059","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

An overview of sickle cell disease and chronic pain and perioperative considerations. 当前观点：镰状细胞病和慢性疼痛的综述及围手术期注意事项。

IF 2.3 3区医学

Current Opinion in Anesthesiology Pub Date : 2025-06-01 Epub Date: 2025-02-14 DOI: 10.1097/ACO.0000000000001461

Dolapo Akintunde, Ada Ezihe-Ejiofor, Janefrances Ogbah, Tolulope Oso

{"title":"An overview of sickle cell disease and chronic pain and perioperative considerations.","authors":"Dolapo Akintunde, Ada Ezihe-Ejiofor, Janefrances Ogbah, Tolulope Oso","doi":"10.1097/ACO.0000000000001461","DOIUrl":"10.1097/ACO.0000000000001461","url":null,"abstract":"Purpose: This review aims to provide the practicing anesthesiologist with information on the pathophysiology, physiology, and management of patients with sickle cell disease. This includes the evaluation of common intraoperative management issues as well as perioperative concerns related to the disease. This review will also discuss the outpatient care of sickle cell patients concerning disease-modifying agents and chronic pain management.Recent findings: There has been less funding for research on sickle cell disease and a relative deficit in treatment options for patients and their vaso-occlusive crises (VOC). In the chronic pain setting, adjuvants to therapy have been utilized, such as anti-inflammatories, neuropathic agents, and antihistamines; however, the mainstay of therapy for pain crises is the use of opioids. New medications for the treatment of VOCs include crinaluzimab and L-glutamine. In terms of intraoperative management, it is imperative to maintain homeostasis for the patients, and research does not show a benefit in preoperative blood transfusions when not clinically indicated.Summary: The sociopolitical context and pathophysiology of sickle cell disease make it a unique disease to manage for the practicing anesthesiologist. Tailoring management via developing a patient-specific approach to maintain homeostasis and minimize the perioperative prevalence of VOCs.","PeriodicalId":50609,"journal":{"name":"Current Opinion in Anesthesiology","volume":" ","pages":"281-286"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411372","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

Minimally invasive surgery in the operating rooms near you. 在你身边的手术室里进行微创手术。

IF 2.3 3区医学

Current Opinion in Anesthesiology Pub Date : 2025-06-01 Epub Date: 2025-04-10 DOI: 10.1097/ACO.0000000000001493

Matthew Strope, Annie Amin

引用次数: 0

Current opinion in anesthesiology: post-traumatic stress disorder following birth. 当前麻醉学观点：产后创伤后应激障碍。

IF 2.3 3区医学

Current Opinion in Anesthesiology Pub Date : 2025-06-01 Epub Date: 2025-02-17 DOI: 10.1097/ACO.0000000000001470

Lindsay Shea Tremper, Kaitlyn Elizabeth Neumann

{"title":"Current opinion in anesthesiology: post-traumatic stress disorder following birth.","authors":"Lindsay Shea Tremper, Kaitlyn Elizabeth Neumann","doi":"10.1097/ACO.0000000000001470","DOIUrl":"10.1097/ACO.0000000000001470","url":null,"abstract":"Purpose of review: Traumatic childbirth can lead to childbirth-related post-traumatic stress disorder (CB-PTSD) or retraumatize those with prior trauma, contributing to long-term maternal and neonatal morbidity and mortality. This condition affects approximately 4-7% of postpartum patients. Given the concerningly high maternal morbidity and mortality rates in the USA, it is crucial to further analyze the risk factors and clinical management recommendations for the prevention of CB-PTSD.Recent findings: Research highlights the negative outcomes and high costs associated with CB-PTSD. Studies have found that preexisting mental health conditions, patient perception of delivery, and certain obstetric and anesthetic complications may significantly impact CB-PTSD development.Additionally, screening tools are available, with some proven effective in this population.Summary: Recent literature underscores the anesthesiologist's role in preventing and detecting CB-PTSD. Although there is a lack of standardized screening practices for CB-PTSD, awareness of this disorder is on the rise. By adopting a trauma-informed care model including anesthesia consultation, providing effective analgesia and anesthesia, maintaining a clinical practice that minimizes anesthetic complications, and identifying patients who perceive their experience as traumatic, anesthesiologists can help mitigate the prevalence of CB-PTSD, and thus its associated maternal morbidity and mortality.","PeriodicalId":50609,"journal":{"name":"Current Opinion in Anesthesiology","volume":" ","pages":"186-194"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607118","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

Fluid management in hemorrhagic shock. 失血性休克的液体处理

IF 2.3 3区医学

Current Opinion in Anesthesiology Pub Date : 2025-06-01 Epub Date: 2025-03-05 DOI: 10.1097/ACO.0000000000001481

Andreas Markl-Le Levé, Ingrid Haller, Mirjam Bachler

{"title":"Fluid management in hemorrhagic shock.","authors":"Andreas Markl-Le Levé, Ingrid Haller, Mirjam Bachler","doi":"10.1097/ACO.0000000000001481","DOIUrl":"10.1097/ACO.0000000000001481","url":null,"abstract":"Purpose of review: Fluid management in hemorrhagic shock is a controversial topic, and there are evolving clinical guidelines and evidence-based practice. This review aims to highlight the physiological aspects in the light of current evidence on which volume replacement solution to use.Recent findings: Current evidence and international guidelines are shifting from a liberal to a restrictive volume resuscitation strategy, emphasizing the potential risks associated with aggressive fluid therapy. The 'lethal triad of trauma' (hypoperfusion, acidosis, and coagulopathy) plays a crucial role in the pathophysiology of hemorrhagic shock. While crystalloids are less effective at restoring intravascular volume, colloids (especially hydroxyethyl starch) have raised concerns about potential adverse effects on renal function and coagulation. Albumin remains controversial, as studies have shown no clear benefit and an increased mortality in traumatic brain injury patients. Fresh frozen plasma may be useful in massive transfusion situations but is not recommended for volume resuscitation.Summary: The management of volume resuscitation evolves, with a trend toward more restrictive strategies. Crystalloids, although less effective for severe volume depletion, remain a cornerstone of initial resuscitation. Among the colloids, gelatin-based solutions and albumin can be used when crystalloids are inadequate, while hydroxyethyl starch is no longer recommended.","PeriodicalId":50609,"journal":{"name":"Current Opinion in Anesthesiology","volume":" ","pages":"316-322"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607124","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

Pediatric enhanced recovery after surgery (ERAS): Advancements and outcomes in the last 5 years. 儿童手术后增强恢复（ERAS）：过去5年的进展和结果。

IF 2.3 3区医学

Current Opinion in Anesthesiology Pub Date : 2025-06-01 Epub Date: 2025-03-25 DOI: 10.1097/ACO.0000000000001486

Megan A Brockel, Vidya T Raman

{"title":"Pediatric enhanced recovery after surgery (ERAS): Advancements and outcomes in the last 5 years.","authors":"Megan A Brockel, Vidya T Raman","doi":"10.1097/ACO.0000000000001486","DOIUrl":"10.1097/ACO.0000000000001486","url":null,"abstract":"Purpose of review: The aim is to describe recent advances in pediatric enhanced recovery after surgery (ERAS) in all phases of care as well as the outcomes and impact of recent evidenced-based pathways in pediatric patients.Recent findings: While profoundly impactful in the care of adult patients for nearly 3 decades, ERAS had a slower start in pediatric care that began approximately 10 years ago. Early outcomes were promising, and the multidisciplinary approach to perioperative care has gained momentum, with recent single-center studies of ERAS for pediatric patients showing reductions in both complications and length of stay. The first ERAS Society recommendations for pediatric patients were published in 2024, and two multicenter trials of pediatric ERAS, Pediatric urology recovery after surgery endeavor and ENhanced Recvovery in CHildren Undergoing Surgery (ENRICH-US), have completed enrollment and are expected to publish results in 2025.Summary: ERAS in pediatric practice has made great strides in the past 5 years and has led to improved outcomes for young patients. Multicenter trial outcomes and the development of additional rigorous ERAS Society recommendations for children will guide future care.","PeriodicalId":50609,"journal":{"name":"Current Opinion in Anesthesiology","volume":" ","pages":"267-271"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744353","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

A roadmap for artificial intelligence in pain medicine: current status, opportunities, and requirements. 疼痛医学中人工智能的发展路线图：现状、机遇和需求。

IF 2.3 3区医学

Current Opinion in Anesthesiology Pub Date : 2025-04-24 DOI: 10.1097/ACO.0000000000001508

Meredith C B Adams, James S Bowness, Ariana M Nelson, Robert W Hurley, Samer Narouze

{"title":"A roadmap for artificial intelligence in pain medicine: current status, opportunities, and requirements.","authors":"Meredith C B Adams, James S Bowness, Ariana M Nelson, Robert W Hurley, Samer Narouze","doi":"10.1097/ACO.0000000000001508","DOIUrl":"10.1097/ACO.0000000000001508","url":null,"abstract":"Purpose of review: Artificial intelligence (AI) represents a transformative opportunity for pain medicine, offering potential solutions to longstanding challenges in pain assessment and management. This review synthesizes the current state of AI applications with a strategic framework for implementation, highlighting established adaptation pathways from adjacent medical fields.Recent findings: In acute pain, AI systems have achieved regulatory approval for ultrasound guidance in regional anesthesia and shown promise in automated pain scoring through facial expression analysis. For chronic pain management, machine learning algorithms have improved diagnostic accuracy for musculoskeletal conditions and enhanced treatment selection through predictive modeling. Successful integration requires interdisciplinary collaboration and physician coleadership throughout the development process, with specific adaptations needed for pain-specific challenges.Summary: This roadmap outlines a comprehensive methodological framework for AI in pain medicine, emphasizing four key phases: problem definition, algorithm development, validation, and implementation. Critical areas for future development include perioperative pain trajectory prediction, real-time procedural guidance, and personalized treatment optimization. Success ultimately depends on maintaining strong partnerships between clinicians, developers, and researchers while addressing ethical, regulatory, and educational considerations.","PeriodicalId":50609,"journal":{"name":"Current Opinion in Anesthesiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057569","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

Artificial intelligence in regional anesthesia. 区域麻醉中的人工智能。

IF 2.3 3区医学

Current Opinion in Anesthesiology Pub Date : 2025-04-21 DOI: 10.1097/ACO.0000000000001505

Joseph Harris, Damon Kamming, James S Bowness

{"title":"Artificial intelligence in regional anesthesia.","authors":"Joseph Harris, Damon Kamming, James S Bowness","doi":"10.1097/ACO.0000000000001505","DOIUrl":"https://doi.org/10.1097/ACO.0000000000001505","url":null,"abstract":"Purpose of review: Artificial intelligence (AI) is having an increasing impact on healthcare. In ultrasound-guided regional anesthesia (UGRA), commercially available devices exist that augment traditional grayscale ultrasound imaging by highlighting key sono-anatomical structures in real-time. We review the latest evidence supporting this emerging technology and consider the opportunities and challenges to its widespread deployment.Recent findings: The existing literature is limited and heterogenous, which impedes full appraisal of systems, comparison between devices, and informed adoption. AI-based devices promise to improve clinical practice and training in UGRA, though their impact on patient outcomes and provision of UGRA techniques is unclear at this early stage. Calls for standardization across both UGRA and AI are increasing, with greater clinical leadership required.Summary: Emerging AI applications in UGRA warrant further study due to an opaque and fragmented evidence base. Robust and consistent evaluation and reporting of algorithm performance, in a representative clinical context, will expedite discovery and appropriate deployment of AI in UGRA. A clinician-focused approach to the development, evaluation, and implementation of this exciting branch of AI has huge potential to advance the human art of regional anesthesia.","PeriodicalId":50609,"journal":{"name":"Current Opinion in Anesthesiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031167","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