Journal of anesthesia and translational medicine最新文献

{"title":"Frontiers and emerging trends of psychotherapy applications in anesthesiology: A comprehensive bibliometric analysis.","authors":"Yanyan Zhang, Huan Liu, Kaixin Wang, Yu Wang, Shiqian Huang, Pu Chen, Xinxin Yang, Yuanyuan Ding, Sanawaer Tuerhong, Li Huang, Xiangdong Chen","doi":"10.1016/j.jatmed.2024.12.002","DOIUrl":"10.1016/j.jatmed.2024.12.002","url":null,"abstract":"<p><strong>Background: </strong>Psychological therapy can mitigate preoperative negative emotions in patients and facilitate postoperative recovery, all while avoiding the side effects associated with sedative medications. However, there is currently a dearth of literature on the bibliometric analysis of the application of psychological therapy during the perioperative period of anesthesia. This study aims to assess the scientific achievements and emerging themes related to the application of psychological therapy in the domain of anesthesia.</p><p><strong>Methods: </strong>Retrieve studies on the application of psychological therapy in the field of anesthesia published from 2003 to October 31, 2023, from the Web of Science Core Collection database. Utilize VOS Viewer and CiteSpace to create visual bibliometric maps.</p><p><strong>Results: </strong>A total of 287 articles were included for analysis. Research on psychological therapy in the field of anesthesia has shown an increasing trend, particularly after 2011. The United States leads in terms of publication volume and collaborations. The <i>Journal of Perianesthesia Nursing</i> is the most prolific journal for publications, with Schreiber KL having the highest H-index. The most common keywords are <i>anesthesia</i> and <i>pain</i>, while aromatherapy has emerged as a newly focused therapy in recent years.</p><p><strong>Conclusions: </strong>Over the past two decades, psychological therapy has experienced rapid development. The United States has maintained a global leadership position in relevant research, making significant contributions. The focus of research has gradually shifted from the effectiveness of psychological therapy in controlling preoperative patient negativity to the development of various therapy methods and their impact on postoperative patient recovery.</p>","PeriodicalId":519929,"journal":{"name":"Journal of anesthesia and translational medicine","volume":"3 4","pages":"215-223"},"PeriodicalIF":0.0,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13001753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147611254","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 regulatory role of dexmedetomidine in NLRP3 inflammasome-related organ protection.","authors":"Xiang Wang, Xiang Chen, E Wang, Hui Luo","doi":"10.1016/j.jatmed.2024.12.001","DOIUrl":"10.1016/j.jatmed.2024.12.001","url":null,"abstract":"<p><p>Organ protection is paramount during the perioperative period. Dexmedetomidine, a commonly used anesthetic, has gained attention for its potential anti-inflammatory and organ-protective properties. The NLRP3 inflammasome, a key inflammatory signaling molecule, contributes to organ dysfunction. This review examines recent research investigating dexmedetomidine's ability to protect organs by inhibiting NLRP3 inflammasome activation. A deeper understanding of these mechanisms could lead to novel therapeutic strategies for improving patient outcomes.</p>","PeriodicalId":519929,"journal":{"name":"Journal of anesthesia and translational medicine","volume":"3 4","pages":"209-214"},"PeriodicalIF":0.0,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13001778/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147611263","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":"Efficacy and safety of anrikefon injection for postoperative analgesia in specific patient groups (elderly, liver damage, renal damage) after abdominal surgery.","authors":"Younian Xu, Tianhao Zhang, Xin Huang, Sanawaer Tuerhong, Xiangdong Chen","doi":"10.1016/j.jatmed.2024.11.002","DOIUrl":"10.1016/j.jatmed.2024.11.002","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;This study aims to evaluate the efficacy and safety of anrikefon for postoperative analgesia following abdominal surgery in specific populations, including elderly patients and those with mild to moderate kidney or liver injury.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A total of 387 patients aged 18-70, with a BMI of 18-40 kg/m&lt;sup&gt;2&lt;/sup&gt;, without severe systemic diseases, relative allergies, or recent analgesics use, and scheduled for abdominal surgery under general anesthesia between June and September 2022, were enrolled. Participants with a postoperative static pain score (numerical rating scale, NRS) of no less than 4 were randomly assigned to one of three groups: the anrikefon group (group A, anrikefon 1 µg/kg), the tramadol group (group T, tramadol 1 mg/kg) or the control group (group C). Three doses were administered every 8 hours. Subgroup analyses were specifically conducted for 46 elderly patients aged 65-70, 158 patients with mild to moderate kidney injury, and 83 patients with mild liver injury. General information of patients was recorded. NRS scores at 15 min, 30 min, 1 h, 2 h, 4 h, 8 h, 12 h, 16 h, 20 h, 24 h after first dose were documented. The primary outcome measure was the sum of pain intensity difference over 24 h (SPID&lt;sub&gt;0-24h&lt;/sub&gt;). Other measures include SPID&lt;sub&gt;0-12h&lt;/sub&gt;, pain intensity difference (PID), the ratio and accumulated doses as well as start time of rescue analgesia, incidence of nausea and vomiting, patient and researcher satisfaction scores, ratio of patients with NRS ≤ 3 at each time point during 12 h and 24 h periods.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In elderly patients aged 65-70, pain reduction, as measured by SPID&lt;sub&gt;0-24h&lt;/sub&gt;, and SPID&lt;sub&gt;0-12h,&lt;/sub&gt; were significantly higher in group A compared to group C (P &lt; 0.05), and the patient and researcher satisfaction scores were also significantly higher in group A (P &lt; 0.05). In patients with mild to moderate kidney injury, SPID&lt;sub&gt;0-24h&lt;/sub&gt; and SPID&lt;sub&gt;0-12h&lt;/sub&gt; showed significant difference between group A and group C (P &lt; 0.01). However, no statistical difference of SPID was observed between group A and T. Ratio and accumulated doses of rescue analgesia in group A and T were significantly lower than those in group C. Rescue analgesia was administered later in group A and T as compared to group C (P &lt; 0.01). Ratio of patients with NRS ≤ 3 at each time point and researcher satisfaction score were higher in group A and C (P &lt; 0.01). Patient satisfaction score in group A was higher than that in group T (P &lt; 0.01). In patients with mild liver injury, SPID&lt;sub&gt;0-24h&lt;/sub&gt; and SPID&lt;sub&gt;0-12h&lt;/sub&gt; showed no statistical difference among three groups. However, the ratio and accumulated doses of rescue analgesia in group A were significantly lower than those in group C (P &lt; 0.05). The proportion of patients with NRS ≤ 3 at each time point was higher in group A. Additionally, the incidence of nausea and vomiting in group A w","PeriodicalId":519929,"journal":{"name":"Journal of anesthesia and translational medicine","volume":"3 4","pages":"202-208"},"PeriodicalIF":0.0,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13001774/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147611291","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":"Relationship between diet and postoperative pain: A scoping review.","authors":"Harshika Chowdhary, Robert M Chow, Jinlei Li, Kanishka Rajput","doi":"10.1016/j.jatmed.2024.11.004","DOIUrl":"10.1016/j.jatmed.2024.11.004","url":null,"abstract":"<p><p>Poorly controlled postoperative pain is a risk factor for persistent post-surgical pain. Inflammation, as influenced by diet, has been incriminated as a significant factor in pain sensitivity and persistent pain. While the role of diet in chronic pain conditions has been explored, its influence on acute postoperative pain remains understudied. This scoping review aims to collate available evidence on the impact of diet on acute post-surgical pain and identify areas for future research. We performed a comprehensive search from the year 2000 onwards in PubMed, Scopus, and Cochrane databases. Our mesh terms included \"diet\", \"inflammation\", \"post-surgical pain\", and \"post-operative pain\". Both animal and human studies were included. There is a dearth of literature regarding the impact of diet on acute postoperative pain in humans. The few studies performed in surgical populations point to a beneficial effect of polyamine-deficient and immunonutrition diets on postoperative pain. Mechanisms include N-methyl-D-aspartate (NMDA) receptor modulation, increased responsiveness to morphine, and reduction of inflammation. Although animal data suggests intermittent fasting to be helpful and high-fat diets to be linked with worsened pain sensitivity, there are no studies in humans investigating the association of intermittent fasting and high-fat diets with postoperative pain. More human studies are expected to understand the effect of diet on postoperative pain in diverse surgical populations.</p>","PeriodicalId":519929,"journal":{"name":"Journal of anesthesia and translational medicine","volume":"3 4","pages":"181-187"},"PeriodicalIF":0.0,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13001791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147611212","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":"Neoadjuvant chemotherapy and perioperative cardiotoxicity.","authors":"Yingzhou Tu, Suli Zhou, Haoran Wang, Peiyao Zhang, Cunming Liu, Changmao Zhu, Chun Yang","doi":"10.1016/j.jatmed.2024.11.003","DOIUrl":"10.1016/j.jatmed.2024.11.003","url":null,"abstract":"<p><p>Malignant tumors constitute a major threaten to human health and are among the most serious public health challenges both in China and globally. Many patients with malignancy require neoadjuvant chemotherapy prior to surgery. Neoadjuvant chemotherapy, which involves administering systemic chemotherapy before local treatment (such as surgery or radiotherapy) for malignant tumors, offers several benefits. These include tumor shrinkage, the reduction of the pathological stage of primary lesions and metastatic lymph nodes, and the early elimination of possible smile metastases. This pre-operative therapy is advantageous as it paves the way for more successful surgical treatment. Nonetheless, research indicates that neoadjuvant chemotherapy may lead to cardiotoxicity, resulting in myocardial ischemia, arrhythmia, arterial hypertension, and even heart failure. Therefore, the use of precision anesthesia, combined with cardioprotective strategies during surgery, is essential. By employing these measures, the surgical procedure can be performed more effectively, ultimately contributing to improved long-term survival outcomes for patients. The focus of this review is to discuss the typical treatment protocols for neoadjuvant chemotherapy, the underlying mechanisms of cardiotoxicity, and the importance of monitoring, assessing, and safeguarding perioperative cardiac function in surgical patients who have undergone neoadjuvant chemotherapy. By examining these aspects, this review aims to offer insights that can guide anesthesia management during the perioperative period for cancer surgery patients.</p>","PeriodicalId":519929,"journal":{"name":"Journal of anesthesia and translational medicine","volume":"3 4","pages":"171-180"},"PeriodicalIF":0.0,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13001760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147611214","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 role of ketamine and its enantiomer in managing depression and pain in cancer patients: A narrative review.","authors":"Michael S Bodnar, Sierra Barber, Heather S L Jim, Jeffery Huang","doi":"10.1016/j.jatmed.2024.10.005","DOIUrl":"10.1016/j.jatmed.2024.10.005","url":null,"abstract":"<p><p>Depression and pain are common comorbidities in cancer patients, and ketamine, a dissociative anesthetic, has shown potential in managing both. This review summarizes current literature on ketamine and its enantiomer, esketamine, in managing depression and pain in the oncologic population. Studies indicate that sub-anesthetic doses of intravenous ketamine and esketamine can alleviate postoperative depressive symptoms in cancer patients with a tolerable safety profile. Research into non-intravenous routes for depression management in the oncologic population remains limited. Ketamine has also proven effective in managing acute postoperative pain, particularly through intravenous administration. While alternative administration routes, such as local infiltration and intramuscular methods, show mixed results, they may provide viable options for patients averse to intravenous (IV). However, the effectiveness of ketamine for chronic cancer pain remains inconsistent. Overall, ketamine offers a promising approach for managing depression and pain in oncologic patients.</p>","PeriodicalId":519929,"journal":{"name":"Journal of anesthesia and translational medicine","volume":"3 4","pages":"155-165"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11770367/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054219","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 environmental effects of anesthetic agents and anesthesia practices.","authors":"Ramy Khalil, Zhengmin Ma, David Lubarsky, Ke Peng, Fuhai Ji, Hong Liu","doi":"10.1016/j.jatmed.2024.10.004","DOIUrl":"10.1016/j.jatmed.2024.10.004","url":null,"abstract":"<p><p>Anesthesia is a critical domain with considerable capacity to reduce the carbon footprint of healthcare on the environment, particularly in terms of climate change. Volatile anesthetics are halogenated gases that function as potent greenhouse gases and contribute to the greenhouse effect, depletion of the ozone layer, and progression of global warming. However, the use of volatile anesthetics can be decreased significantly through the adoption of more environmentally conscious practices. Regional anesthesia, including intravenous and neuraxial anesthesia, reduces the harmful effects of inhaled anesthetics and has shown to have positive perioperative effects in certain patient populations. Combining total intravenous anesthesia with target-controlled infusion results in optimized infusion rates, thereby reducing both anesthetic use and waste. Techniques such as processed electroencephalogram monitoring can be used to assess the sedation of a patient and prevent over-anesthetizing and consequently decreasing anesthetic use, which may contribute to improved surgical outcomes. Additionally, actively promoting education on low-flow administration practices can enhance the recycling of anesthetic gases and decrease the release of volatile anesthetics into the atmosphere, thereby reducing the carbon footprint of this field. Finally, by refining existing techniques and scavenging systems, xenon, with its physiological stability and minimal environmental impact, could emerge as a leading inhaled anesthetic agent in the future.</p>","PeriodicalId":519929,"journal":{"name":"Journal of anesthesia and translational medicine","volume":"3 4","pages":"166-170"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12330893/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144802134","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":"Evaluation of needle to nerve interaction for neurological complications in ultrasound-guided interscalene brachial plexus blocks.","authors":"Adam Coridan, Hitesh Shivalingappa, Wai-Man Liu, Jonelle Thomas, Stephen Polanski, Sanjib Adhikary","doi":"10.1016/j.jatmed.2024.11.001","DOIUrl":"10.1016/j.jatmed.2024.11.001","url":null,"abstract":"<p><strong>Background: </strong>The use of regional anesthesia techniques carries a well-known risk of perioperative neurological complications. The interscalene approach to brachial plexus block (ISB) is associated with the largest risk of neurological complications of any peripheral nerve block. The reported incidence of nerve injury after ISB varies, with estimates ranging from 0.5 % to 3 % of cases. In this prospective study, we sought to correlate the needle-to-nerve interaction during ISB procedures with the development of post-operative neurological outcomes.</p><p><strong>Methods: </strong>A novel grading system was developed to categorize various needle tip positions during ISB procedures. De-identified ultrasound recordings were graded post-procedure by two independent radiologists. These video grades were correlated with the incidence of post-procedural numbness or paresthesia and post-operative pain scores in the PACU and 24 hours postoperatively.</p><p><strong>Results: </strong>108 patient videos were included for analysis. Zero videos received grade 1 (intraneural injection), 20 % received grade 2 (injection with needle against nerve root), 68 % received grade 3 (injection inside brachial plexus sheath), and 12 % received grade 4 (injection external to sheath). There was no statistical difference in terms of post-operative neurological complications or pain scores across the grades. Only four patients experienced post-operative neurologic complications on day one, and seven patients had neurological symptoms on day two. All symptoms resolved by post-operative day five.</p><p><strong>Conclusions: </strong>Our scoring system did not reveal relationship between more aggressive needling techniques and adverse post-procedural neurological symptoms. There was also no difference in pain scores across video grades, indicating that injection within the nerve sheath did not lead to better postoperative pain scores compared to injection outside the sheath. Since no procedures were found to be intraneural by the reviewing radiologists, no relationship between intraneural needling and adverse neurological outcomes could be elucidated. Larger studies in diverse settings may be required to capture greater variation in the block grades for more statistical power.</p>","PeriodicalId":519929,"journal":{"name":"Journal of anesthesia and translational medicine","volume":"3 4","pages":"150-154"},"PeriodicalIF":0.0,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13001740/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147611199","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":"Roles of orexinergic and noradrenergic neuronal activity in ketamine-induced analgesia: A study using an orexin/ataxin-3 transgenic rat model.","authors":"Mitsuru Tonosaki, Tetsuya Kushikata, Yoshikazu Nikaido, Daiki Takekawa, Hirotaka Kinoshita, Jyunichi Saito, Kazuyoshi Hirota","doi":"10.1016/j.jatmed.2024.10.003","DOIUrl":"10.1016/j.jatmed.2024.10.003","url":null,"abstract":"<p><strong>Background: </strong>Orexin, a neuropeptide, physiologically interacts with locus coeruleus noradrenergic (LC-NA) activity. We hypothesized that this interaction affects ketamine-induced acute analgesia.</p><p><strong>Methods: </strong>We assessed ketamine-induced acute analgesia in transgenic (TG) and wild-type (WT) rats with genetically degraded orexinergic neurons using hotplate and tail-flick tests. We examined the effect of the LC-NA toxin, <i>N</i>-(2-Chloroethyl)-<i>N</i>-ethyl-2-bromobenzylamine hydrochloride (DSP4) on ketamine-induced acute analgesia in separate WT and TG groups. Rats received intra-peritoneal ketamine and intracerebroventricular (ICV) treatments, including saline, orexin, orexin + SB-334867 (an orexin type-1 receptor antagonist), or SB-334867. We measured orexin and noradrenaline levels in the brain regions of untreated WT and TG rats (n = 7 and 5, respectively).</p><p><strong>Results: </strong>TG exhibited a decreased percentage of maximum possible effect area under the curve (AUC) for hotplate latency (WT: 1315.0 ± 1026.0; TG: 439.6 ± 831.5; P = 0.016) but not tail-flick latency (WT: 1203.0 ± 332.4; TG: 1127.0 ± 512.4; P = 0.732). Orexin (10 nmol, ICV) increased hotplate latency AUC in DSP4-free WT (control: 220.2 ± 227.2; orexin 10: 1575.0 ± 760.2; P = 0.004), DSP4-free TG (control: 119.9 ± 197.1; orexin 10: 866.5 ± 213.2; P = 0.001), DSP4-treated WT (control: -20.0 ± 350.5; orexin 10: 775.4 ± 485.2; P = 0.048), and DSP4-treated TG (control: -181.3 ± 272.6; orexin: 1038.0 ± 652.6; P = 0.040) rats. AUC with orexin 10 was lower in DSP4-treated WT rats than in DSP4-free WT rats (1575.0 ± 760.2 vs. 775.4 ± 485.2; P = 0.025). Co-administration of SB-334867 (20 nmol, ICV) with orexin blocked the effect of orexin on hotplate latency in DSP4-free but not DSP4-treated rats. TG rats had lower noradrenaline contents (pg/mg tissue) in the pons (WT: 341.9 ± 36.3; TG: 279.6 ± 54.4; P=0.038) and cerebral cortex (WT: 1195.1 ± 36.1; TG: 120.1 ± 32.6; P=0.042), but not in the hypothalamus (WT: 895.6 ± 130.4; TG 822.3 ± 1140.3; P=0.373). Orexin levels decreased in all brain regions of TG rats (pons: WT: 7.6 ± 3.2; TG: 1.1 ± 0.3, P = 0.001; hypothalamus: WT: 12.6 ± 2.9; TG: 2.8 ± 1.4, P<0.0001; cerebral cortex: WT: 2.1 ± 0.6; TG: 0.7 ± 0.3, P = 0.001).</p><p><strong>Conclusions: </strong>The role of orexin in ketamine-induced acute analgesia partly depends on LC-NA activity.</p>","PeriodicalId":519929,"journal":{"name":"Journal of anesthesia and translational medicine","volume":"3 4","pages":"143-149"},"PeriodicalIF":0.0,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13001767/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147611256","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 impact of esketamine combined with butorphanol on postoperative analgesia and maternal psychological status after cesarean section: A randomized controlled study.","authors":"Siqi Ma, Hao Guo, Xiaoyan Ran, Xuelian Pan, Xinjun Luo, Yun Xiao, Rui Xue, Ran Ran","doi":"10.1016/j.jatmed.2024.10.001","DOIUrl":"10.1016/j.jatmed.2024.10.001","url":null,"abstract":"<p><strong>Background: </strong>Cesarean delivery is a highly invasive procedure that causes moderate to severe pain. Persistent postoperative pain affects the parturients' rapid postoperative recovery. Therefore, we aim to investigate the efficacy and safety of esketamine in postoperative analgesia after cesarean section.</p><p><strong>Methods: </strong>This clinical study, conducted from January 2022 to August 2022, was randomized, controlled, double-blind and approved by the Ethics Committee of Shiyan Renmin Hospital. Group S received intraoperative esketaimine infusion with 0.15 mg/kg/h and postoperative 0.2 mg/kg butorphanol + 2 mg/kg esketaimine for patient-controlled intravenous analgesia (PCIA). Group C received the same volume of 5 % glucose infusion and postoperative butorphanol 0.2 mg/kg for PCIA. The primary outcome was postoperative analgesic effectiveness as reflected by the number of analgesic pumps pressed during 24 h postoperative period by patients. The secondary outcomes included the VAS scores of postoperative pain, Edinburgh Postnatal Depression Scale (EPDS) scores, neonatal Apgar scores, the time to first ambulation, the gut functional recovery time, the rescue analgesic treatments, and adverse effects.</p><p><strong>Results: </strong>A total of 160 parturients participated in the study, and ultimately, 155 patients were included in the final analysis. There was no statistically significant difference in the number of PCA presses between group C [12 (6-18)] and group S [10 (5-22.25)] during 24 h after surgery [P = 0.98, 95 % CI (-3-3)]. The differences in VAS scores between the two groups were not statistically significant at 8 h [P = 0.07, 95 % CI (0-1)], 24 h [P = 0.06, 95 % CI (0-1)], and 96 h [P = 0.09, 95 % CI (0-0)] postoperatively. The EPDS scores of Group S at postoperative 8 h, 24 h, 96 h, and one week were lower than those of the group C (P < 0.001). The incidence of dizziness was higher in Group S [P < 0.05, RR = 0.270, 95 % CI (0.09-0.78)].</p><p><strong>Conclusions: </strong>The Supplementation of esketamine during the perioperative period does not improve postoperative analgesia after a cesarean section. But esketamine may improve maternal emotional state up to one week after surgery.</p>","PeriodicalId":519929,"journal":{"name":"Journal of anesthesia and translational medicine","volume":"3 4","pages":"133-137"},"PeriodicalIF":0.0,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13001788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147611234","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}