Anaesthesiology intensive therapy最新文献_第3页

Is locoregional anesthesia for hip fracture a valid third option for high-risk patients?

IF 1.6

Anaesthesiology intensive therapy Pub Date : 2024-01-01 DOI: 10.5114/ait.2024.146746

Marco Giudice, Riccardo Pulitanò, Enrico Di Sabatino, Francesca La Verde

引用次数: 0

Can't intubate, can't oxygenate? What is the preferred surgical strategy? A retrospective analysis. 无法插管，无法吸氧？首选手术策略是什么？回顾性分析。

IF 1.7

Anaesthesiology intensive therapy Pub Date : 2024-01-01 DOI: 10.5114/ait.2024.138437

Akiva Nachshon, Shimon Firman, Baruch Mark Batzofin, Bala Miklosh, Peter Vernon van Heerden

{"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":"Introduction: 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.Material and methods: 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.Results: 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.Conclusions: 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.","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}

引用次数: 0

Anesthetic management in a patient with glucose-6-phosphate-dehydrogenase deficiency undergoing adenoidectomy and tonsillectomy: a case report. 接受腺样体切除术和扁桃体切除术的葡萄糖-6-磷酸脱氢酶缺乏症患者的麻醉管理：病例报告。

IF 1.6

Anaesthesiology intensive therapy Pub Date : 2024-01-01 DOI: 10.5114/ait.2024.142679

Denada Haka, Begüm Nemika Gökdemir, Nedim Çekmen

引用次数: 0

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. 评估无阿片类药物麻醉结合术前胸椎旁阻滞和术后静脉注射患者自控镇痛剂羟考酮与非阿片类药物镇痛剂在视频辅助胸腔手术围手术期麻醉管理中的可行性。

IF 1.6

Anaesthesiology intensive therapy Pub Date : 2024-01-01 DOI: 10.5114/ait.2024.141279

Maja Magdalena Copik, Dominika Sadowska, Jacek Smereka, Damian Czyzewski, Hanna Dorota Misiołek, Szymon Białka

{"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":"Introduction: 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.Material and methods: 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.Results: 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.Conclusions: 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.","PeriodicalId":7750,"journal":{"name":"Anaesthesiology intensive therapy","volume":"56 2","pages":"98-107"},"PeriodicalIF":1.6,"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}

引用次数: 0

Inhaled milrinone for the management of severe pulmonary hypertension in non-cardiac surgery.

IF 1.6

Anaesthesiology intensive therapy Pub Date : 2024-01-01 DOI: 10.5114/ait.2024.145310

Philip Stamov, Malcolm Howard, Craig Railton, Wilfredo Puentes

引用次数: 0

Preoperative dental assessment for the reduction of periprosthetic joint infections in patients undergoing total joint replacement: a systematic review and meta-analysis.

IF 1.6

Anaesthesiology intensive therapy Pub Date : 2024-01-01 DOI: 10.5114/ait.2024.145278

Zbigniew Putowski, Magdalena Miłobędzka, Michał Kisiołek, Wojciech Szczeklik, Roman Jaeschke, Piotr Puc, Katarzyna Szczeklik

{"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":"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.","PeriodicalId":7750,"journal":{"name":"Anaesthesiology intensive therapy","volume":"56 4","pages":"217-223"},"PeriodicalIF":1.6,"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}

引用次数: 0

Process optimisation: spinal versus general anaesthesia for endourological surgery. A randomised, controlled trial and machine-learning approach.

IF 1.6

Anaesthesiology intensive therapy Pub Date : 2024-01-01 DOI: 10.5114/ait.2024.146716

Kornel Skitek, Gregor A Schittek, Jens Soukup

{"title":"Process optimisation: spinal versus general anaesthesia for endourological surgery. A randomised, controlled trial and machine-learning approach.","authors":"Kornel Skitek, Gregor A Schittek, Jens Soukup","doi":"10.5114/ait.2024.146716","DOIUrl":"10.5114/ait.2024.146716","url":null,"abstract":"Introduction: Data concerning anaesthesia for endourology are rare, and options for it are numerous. Thus, identifying the optimal anaesthesia regimen remains challenging. With this study we aimed to provide the means for selecting optimal anaesthesia for endourology procedures.Material and methods: This was a randomised, open-label, controlled study conducted in a single tertiary hospital. Inclusion criteria: American Society of Anesthesiologists (ASA) physical status/risk category I-III, and scheduled surgery time < 60 minutes. Exclusion criteria: contraindications or lack of consent for one of the anaesthesia types, intellectual disabilities, pregnancy, breastfeeding, and refusal to participate. The participants were divided into 3 groups: G1, spinal anaesthesia (SPA) with bupivacaine; G2, SPA with prilocaine; G3, total intravenous anaesthesia (TIVA) with remifentanil and propofol. The primary outcome measure was time to ambulation, while the secondary outcome measures included perioperative hypotension. The results are presented as mean ± SD or median [IQR].Results: In total, 117 patients completed the study. The time to ambulation (minutes) was significantly different between all groups: 187.95 ± 49.82, 161.05 ± 46.28, and 129.14 ± 63.75 min, for G1, G2 and G3, respectively. The mean arterial pressure drop from baseline during the procedure was most pronounced in G3 (35% [30-44], P < 0.001) and lowest in G2 (18% [12-27], P < 0.001 vs. G3, NS vs. bupivacaine). Machine-learning models were trained and demonstrated satisfactory performance in predicting the time spent in recovery.Conclusions: In the context of endourological surgery, the time required for ambulation was shortest when using TIVA, while SPA with hyperbaric prilocaine provides the closest approximation to optimal anaesthesia.","PeriodicalId":7750,"journal":{"name":"Anaesthesiology intensive therapy","volume":"56 5","pages":"285-294"},"PeriodicalIF":1.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11781304/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143363525","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}

引用次数: 0

A randomised controlled trial to compare blind intubation success through LMA Blockbuster® and I-Gel® LMA. 通过 LMA Blockbuster® 和 I-Gel® LMA 比较盲插成功率的随机对照试验。

IF 1.7

Anaesthesiology intensive therapy Pub Date : 2024-01-01 DOI: 10.5114/ait.2024.138562

Nazia Nazir, Anupriya Saxena

{"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":"Introduction: 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.Material and methods: 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.Results: 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.Conclusions: LMA-BT is a superior device as compared to I-Gel LMA as a conduit for blind tracheal intubation.","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}

引用次数: 0

Overview of artificial intelligence in point-of-care ultrasound. New horizons for respiratory system diagnoses. 护理点超声中的人工智能概述。呼吸系统诊断的新视野。

IF 1.7

Anaesthesiology intensive therapy Pub Date : 2024-01-01 DOI: 10.5114/ait.2024.136784

Sławomir Mika, Wojciech Gola, Monika Gil-Mika, Mateusz Wilk, Hanna Misiołek

{"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":"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.","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}

引用次数: 0

A retrospective assessment of the effectiveness of pulsed radiofrequency ablation in the treatment of chronic pain caused by advanced knee osteoarthritis. 对脉冲射频消融治疗晚期膝关节骨性关节炎引起的慢性疼痛效果的回顾性评估。

IF 1.6

Anaesthesiology intensive therapy Pub Date : 2024-01-01 DOI: 10.5114/ait.2024.139860

Anna Rękas-Dudziak, Krzysztof Brzeziński, Edyta Kotlińska-Hasiec, Wojciech Dąbrowski, Przemysław Matuła, Włodzimierz Płotek

{"title":"A retrospective assessment of the effectiveness of pulsed radiofrequency ablation in the treatment of chronic pain caused by advanced knee osteoarthritis.","authors":"Anna Rękas-Dudziak, Krzysztof Brzeziński, Edyta Kotlińska-Hasiec, Wojciech Dąbrowski, Przemysław Matuła, Włodzimierz Płotek","doi":"10.5114/ait.2024.139860","DOIUrl":"10.5114/ait.2024.139860","url":null,"abstract":"Introduction: Patients suffering from severe chronic pain often have problems finding an appropriate combination of painkillers. We retrospectively evaluated the effectiveness and safety of pulsed radiofrequency ablation (pRFA) of the genicular nerves in 96 patients with knee osteoarthritis (KO). We hypothesized that age, sex, and body mass index (BMI) may influence the quality of the pRFA treatment.Material and methods: A diagnostic blockade with total volume of 9 ml of 1% lidocaine (WZF, Poland) combined with 4 mg of dexamethasone with subsequent pRFA with a radio frequency of 300-500 kHz under ultrasound guidance was used during the procedure. The study participants were assessed during regular monthly visits until 12 months.Results: The nerves' ultrasound identification was successful in 90.62% of the cases. According to the numeric rating scale (NRS), pain was reduced by 50% or more in 64.06% of the cases. The average pain relief period lasted just over 7 and a half months. There were no pRFA-related complications or side effects of the drugs used.Conclusions: pRFA seems to be safe and effective for the treatment of chronic pain in KO. The outcome of the treatment may be related to the patient's age (block duration increased with patient age) and sex (in women, the therapeutic effect was more effectively prolonged) in our study group. There was also higher effectiveness of pRFA in high-BMI patients, which was close to statistical significance ( P = 0.053).","PeriodicalId":7750,"journal":{"name":"Anaesthesiology intensive therapy","volume":"56 2","pages":"151-159"},"PeriodicalIF":1.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11284582/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142016110","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}

引用次数: 0