Anaesthesiology intensive therapy最新文献

{"title":"Superior trunk versus interscalene brachial plexus block in humerus surgery: a randomised controlled trial.","authors":"Chandni Sinha, Poonam Kumari, Ajeet Kumar, Amarjeet Kumar, Abhyuday Kumar, Ditipriya Bhar, Arun S K, Chethan Vamshi","doi":"10.5114/ait.2024.142772","DOIUrl":"10.5114/ait.2024.142772","url":null,"abstract":"<p><strong>Introduction: </strong>Ultrasound (US)-guided interscalene (IS) block is a commonly performed block for shoulder and humerus surgery. Though it provides excellent analgesia, it is associated with hemidiaphragmatic paralysis and dyspnoea. Superior trunk (ST) block has been described, wherein the local anaesthetic is deposited around the ST block (formed by fusion of C5 and C6 nerve roots). This study aimed to determine whether ST block provides similar analgesic efficacy with lower incidence of diaphragmatic paresis in patients undergoing proximal humerus surgery.</p><p><strong>Material and methods: </strong>A total of 62 patients scheduled to undergo unilateral internal fixation (plating) for proximal or mid shaft humerus fracture were randomised to 2 groups. Patients in group I received US-guided ST block while those in group II received US-guided IS block. Both groups received 15 mL of 0.5% bupivacaine. Diaphragmatic excursion was noted at baseline and after 30 minutes after the block. Postoperatively, the numerical rating scale score and requirement of opioids were documented.</p><p><strong>Results: </strong>The incidence of complete/incomplete paresis was statistically significantly lower in the ST group. Thirty eight percent of the patients (11) had complete paresis in the IS group, compared to none in the ST group. Partial paresis was observed in 62% of patients in the IS block group and 19% in the ST block group ( P < 0.001). The percentage reduction of movement was significantly higher in the IS group vs. the ST group ( P < 0.001). There was no difference in pain scores or the amount of opioid consumption between groups.</p><p><strong>Conclusions: </strong>ST block provides similar analgesia to IS block for proximal/mid humerus surgery with better preservation of diaphragmatic function. This could be a viable alternative in patients with compromised respiratory functions scheduled for such surgery.</p>","PeriodicalId":7750,"journal":{"name":"Anaesthesiology intensive therapy","volume":"56 3","pages":"194-198"},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11484482/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142492969","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":"Remote, automatic, digital preanesthetic evaluation - are we there yet?","authors":"Michał Pasternak, Wojciech Szczeklik, Szymon Białka, Paweł Andruszkiewicz, Marta Szczukocka, Aleksandra Pawlak, Elżbieta Rypulak, Dawid Pytliński, Michał Borys, Mirosław Czuczwar","doi":"10.5114/ait.2024.138959","DOIUrl":"10.5114/ait.2024.138959","url":null,"abstract":"<p><p>Recent years have witnessed multiple advancements in the field of information technology in medicine. The need to ensure patient and doctor safety during COVID-19 resulted in improved telemedicine adaptation across various fields, including anaesthesiology. In this review, the authors examine the current state of the elements of preanesthetic evaluation and their remote execution using current and future telemedical facilities and technologies, as well as the potential of future advancements in this field.</p>","PeriodicalId":7750,"journal":{"name":"Anaesthesiology intensive therapy","volume":"56 2","pages":"91-97"},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11284583/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142016142","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":"Inhaled milrinone for the management of severe pulmonary hypertension in non-cardiac surgery.","authors":"Philip Stamov, Malcolm Howard, Craig Railton, Wilfredo Puentes","doi":"10.5114/ait.2024.145310","DOIUrl":"10.5114/ait.2024.145310","url":null,"abstract":"","PeriodicalId":7750,"journal":{"name":"Anaesthesiology intensive therapy","volume":"56 4","pages":"261-263"},"PeriodicalIF":1.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11736909/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143363308","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 in a patient with glucose-6-phosphate-dehydrogenase deficiency undergoing adenoidectomy and tonsillectomy: a case report.","authors":"Denada Haka, Begüm Nemika Gökdemir, Nedim Çekmen","doi":"10.5114/ait.2024.142679","DOIUrl":"https://doi.org/10.5114/ait.2024.142679","url":null,"abstract":"","PeriodicalId":7750,"journal":{"name":"Anaesthesiology intensive therapy","volume":"56 3","pages":"212-214"},"PeriodicalIF":1.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11483271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142493062","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":"Can't intubate, can't oxygenate? What is the preferred surgical strategy? A retrospective analysis.","authors":"Akiva Nachshon, Shimon Firman, Baruch Mark Batzofin, Bala Miklosh, Peter Vernon van Heerden","doi":"10.5114/ait.2024.138437","DOIUrl":"10.5114/ait.2024.138437","url":null,"abstract":"<p><strong>Introduction: </strong>Cricothyrotomy (CTM) is currently recommended as the preferred method due to its ease, speed, and safety in life-threatening airway emergencies where standard tracheal intubation and mask ventilation fail.</p><p><strong>Material and methods: </strong>This retrospective study analyzed 33 cases of \"can't intubate, can't oxygenate or ventilate\" (CICOV): 12 of percutaneous dilatational tracheostomy (PDT) and 21 of CTM. The CTM group was younger (median age 44) and mainly consisted of trauma patients. The PDT group was more diverse and procedures were performed by anesthesia and critical care consultants.</p><p><strong>Results: </strong>Initial success rates were 100% for PDT (12/12) and 86% for CTM (18/21), with one conversion from CTM to PDT. No perioperative complications occurred in the PDT group, while the CTM group experienced two cases of false tracts requiring re-do and three cases of bleeding. Immediate mortality within 24 hours was reported in 5/19 CTM patients and none in the PDT group. Successful liberation from mechanical ventilation at hospital discharge was achieved in 6/12 PDT patients and 11/21 CTM patients. Among the 21 CTM cases, all 16 survivors underwent subsequent tracheostomy. Tracheal decannulation occurred in 4/12 PDT patients and 10/21 CTM patients. Favorable immediate neurological outcomes (GCS ≥ 11T) were observed in 8/12 PDT patients and 8/21 CTM patients, while 3 PDT patients remained anesthetized until death and 7 CTM patients died within the first 72 hours without recovery attempts.</p><p><strong>Conclusions: </strong>In experienced hands, PDT could be a legitimate clinical option for the surgical airway in cases of CICOV. CTM may be more suitable for practitioners who encounter CICOV infrequently.</p>","PeriodicalId":7750,"journal":{"name":"Anaesthesiology intensive therapy","volume":"56 1","pages":"37-46"},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11022633/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140915652","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":"Assessment of feasibility of opioid-free anesthesia combined with preoperative thoracic paravertebral block and postoperative intravenous patient-controlled analgesia oxycodone with non-opioid analgesics in the perioperative anesthetic management for video-assisted thoracic surgery.","authors":"Maja Magdalena Copik, Dominika Sadowska, Jacek Smereka, Damian Czyzewski, Hanna Dorota Misiołek, Szymon Białka","doi":"10.5114/ait.2024.141279","DOIUrl":"10.5114/ait.2024.141279","url":null,"abstract":"<p><strong>Introduction: </strong>This study, conducted between December 2015 and March 2018 at a single university hospital, explored the feasibility and safety of opioid-free anesthesia combined with preoperative thoracic paravertebral block (ThPVB) for patients undergoing elective video-assisted thoracoscopic surgery (VATS). The aim was to assess the impact of this approach on postoperative pain levels and opioid consumption.</p><p><strong>Material and methods: </strong>Sixty-four patients scheduled for elective VATS were randomly assigned to either the intervention group, receiving opioid-free anesthesia with ThPVB, or the control group, managed with standard general anesthesia. Postoperatively, both groups received oxycodone patient-controlled analgesia along with non-opioid analgesics. Pain intensity was measured using the Numeric Pain Rating Scale (NRS) and Prince Henry Hospital Pain Score (PHHPS). The total dose of postoperative oxycodone and the occurrence of opioid-related adverse events were recorded during the 24-hour follow-up period.</p><p><strong>Results: </strong>Patients in the intervention group showed significantly lower pain levels at 20 and 24 hours post-procedure ( P = 0.015, P = 0.021, respectively) compared to the control group. Notably, oxycodone consumption at 24 hours was significantly higher in the control group ( p < 0.0001). No serious adverse events were observed during the study period.</p><p><strong>Conclusions: </strong>This study demonstrates the feasibility and safety of opioid-free anesthesia combined with ThPVB for elective VATS. The approach significantly reduces postoperative pain and the need for opioids, supporting its potential as an effective and balanced perioperative anesthetic strategy.</p>","PeriodicalId":7750,"journal":{"name":"Anaesthesiology intensive therapy","volume":"56 2","pages":"98-107"},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11284581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142016111","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":"Preoperative dental assessment for the reduction of periprosthetic joint infections in patients undergoing total joint replacement: a systematic review and meta-analysis.","authors":"Zbigniew Putowski, Magdalena Miłobędzka, Michał Kisiołek, Wojciech Szczeklik, Roman Jaeschke, Piotr Puc, Katarzyna Szczeklik","doi":"10.5114/ait.2024.145278","DOIUrl":"10.5114/ait.2024.145278","url":null,"abstract":"<p><p>The requirement for preoperative dental assessment (PDA) to prevent periprosthetic joint infection (PJI) after total joint arthroplasty (TJA) seems to be a common practice at least in some orthopaedic centres. There are few studies which have examined this intervention. Routine referral of patients for routine PDA increases costs and potentially prolongs the time to the procedure. In order to investigate the effect of PDA on the frequency of PJI after TJA, we conducted a systematic review with meta-analysis of observational studies including adult patients undergoing TJA. The search for eligible studies was performed across MEDLINE, EMBASE, Web of Science, and Google Scholar databases. The intervention group consisted of patients who had undergone PDA, while the control group consisted of patients without PDA. The main outcome was the presence of PJI. In addition to traditional meta-analysis, a Bayesian analysis and trial sequential analysis were performed. The analysis included five observational studies. Considering PJI as an outcome, the total risk of bias was assessed as serious. A total of 23 175 patients were included in those studies, of whom 12 324 had a PDA. There was no effect of PDA versus no PDA on the incidence of PJI (OR 0.86, 95% CI: 0.50-1.49; I² = 42%). Bayesian analysis showed that the posterior probability of PDA reducing the frequency of PJI was 69.1%. Thus it was concluded that, in patients undergoing TJA, it remains unknown whether PDA influences the occurrence of postoperative PJI. There is insufficient evidence to support performing this intervention routinely. The health care systems and individual organisations will likely need to make decisions on continuation of such programmes on the basis of this limited amount of information.</p>","PeriodicalId":7750,"journal":{"name":"Anaesthesiology intensive therapy","volume":"56 4","pages":"217-223"},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11736908/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143363311","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":"Overview of artificial intelligence in point-of-care ultrasound. New horizons for respiratory system diagnoses.","authors":"Sławomir Mika, Wojciech Gola, Monika Gil-Mika, Mateusz Wilk, Hanna Misiołek","doi":"10.5114/ait.2024.136784","DOIUrl":"10.5114/ait.2024.136784","url":null,"abstract":"<p><p>Throughout the past decades ultrasonography did not prove to be a procedure of choice if regarded as part of the routine bedside examination. The reason was the assumption defining the lungs and the bone structures as impenetrable by ultrasound. Only during the recent several years has the approach to the use of such tool in clinical daily routines changed dramatically to offer so-called point-of-care ultrasonography (POCUS). Both vertical and horizontal artefacts became valuable sources of information about the patient's clinical condition, assisting therefore the medical practitioner in differential diagnosis and monitoring of the patient. What is important is that the information is delivered in real time, and the procedure itself is non-invasive. The next stage marking the progress made in this area of diagnostic imaging is the development of arti-ficial intelligence (AI) based on machine learning algorithms. This article is intended to present the available, innovative solutions of the ultrasound systems, including Smart B-line technology, to ensure automatic identification process, as well as interpretation of B-lines in the given lung area of the examined patient. The article sums up the state of the art in ultrasound artefacts and AI applied in POCUS.</p>","PeriodicalId":7750,"journal":{"name":"Anaesthesiology intensive therapy","volume":"56 1","pages":"1-8"},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11022635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140915689","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 randomised controlled trial to compare blind intubation success through LMA Blockbuster® and I-Gel® LMA.","authors":"Nazia Nazir, Anupriya Saxena","doi":"10.5114/ait.2024.138562","DOIUrl":"10.5114/ait.2024.138562","url":null,"abstract":"<p><strong>Introduction: </strong>Laryngeal mask airway-blockbuster (LMA-BT) is a relatively new supraglottic airway device (SGAD). In this study, we compared LMA-BT with I-Gel LMA for efficacy of blind tracheal intubation.</p><p><strong>Material and methods: </strong>We conducted a single-blind prospective study after ethical approval. One hundred American Society of Anesthesiology (ASA) Grade I-III (age 18-60 years) patients scheduled for elective surgery under general anaesthesia with endotracheal intubation were included and randomly divided into 2 groups. Blind tracheal intubation was performed through LMA-BT ( n = 50) and I-Gel ( n = 50) in groups 1 and 2, respectively. The primary aim was to evaluate the first pass success rate of blind tracheal intubation through the LMAs. The secondary objectives noted were attempts and ease of LMA insertion, total time taken for LMA insertion, airway seal pressure of LMA, ease of NGT insertion through LMA, fibre-optic grading of laryngeal view through LMA, overall success rate and time of intubation through LMA, time for LMA removal, and complications, if any.</p><p><strong>Results: </strong>In the LMA-BT group, the first pass success rate ( P < 0.019) and the overall success rate of intubation ( P < 0.005) were significantly higher than in the I-Gel group. Using LMA-BT also resulted in statistically significant shorter intubation time ( P < 0.0001) with higher airway seal pressure as compared to I-Gel ( P < 0.001). The difference in the first attempt insertion, number of insertion attempts, ease and time of LMA insertion and removal after intubation, and postoperative complications were comparable among the groups.</p><p><strong>Conclusions: </strong>LMA-BT is a superior device as compared to I-Gel LMA as a conduit for blind tracheal intubation.</p>","PeriodicalId":7750,"journal":{"name":"Anaesthesiology intensive therapy","volume":"56 1","pages":"47-53"},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11022640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140915602","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":"Asystolic cardiac arrest secondary to sugammadex administration in a young patient.","authors":"Scott Weerasuriya, Dale Seddon, Vishal Salota","doi":"10.5114/ait.2024.141235","DOIUrl":"10.5114/ait.2024.141235","url":null,"abstract":"","PeriodicalId":7750,"journal":{"name":"Anaesthesiology intensive therapy","volume":"56 2","pages":"160-163"},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11284579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142016112","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}