Anaesthesiology intensive therapy最新文献

{"title":"Volatile anesthetics in the intensive care unit.","authors":"Alexander Morrison-Nozik, Marcin Wąsowicz","doi":"10.5114/ait/207183","DOIUrl":"10.5114/ait/207183","url":null,"abstract":"<p><p>The use of volatile anesthetics as an alternative sedation modality in the intensive care unit (ICU) has gained traction over the last several years. Volatile agents such as sevoflurane and isoflurane possess favorable pharmacokinetic and pharmacodynamic properties that make them suitable choices for titration of sedation in patients requiring mechanical ventilation. Several studies have continued to demonstrate their efficacy and safety particularly when assessing wake-up times and times to extubation in contrast to various intravenous sedatives. Leveraging the pharmacodynamic properties of the volatile agents may also be beneficial in certain disease states. As there are devices currently available to enable delivery of volatile anesthetics to patients in the ICU, ongoing studies exist to determine how to best use this sedation modality. This review outlines the recent evidence and discusses perspectives on volatile-based sedation for critically ill patients.</p>","PeriodicalId":7750,"journal":{"name":"Anaesthesiology intensive therapy","volume":"57 1","pages":"165-169"},"PeriodicalIF":1.7,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12329490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144688665","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":"Effect of preoperative intranasal dexmedetomidine on characteristics of spinal anesthesia with hyperbaric bupivacaine for lower limb orthopedic surgery: a double-blinded randomized control study.","authors":"Sandeep Gade, Jitendra V Kalbande, Swati K Vijapurkar, Samarjit Dey, Nandkishore Agrawal","doi":"10.5114/ait/200240","DOIUrl":"10.5114/ait/200240","url":null,"abstract":"<p><strong>Introduction: </strong>Dexmedetomidine is administered intravenously, intrathecally, and intramuscularly to enhance the effect of subarachnoid anesthesia. In this study, we investigated the effect of intranasal dexmedetomidine on the characteristics of spinal anesthesia.</p><p><strong>Material and methods: </strong>In this double-blinded randomized control study, 60 patients undergoing orthopedic surgery under spinal anesthesia were allocated to two groups. Group A received intranasal dexmedetomidine 1 μg kg^-1 20 minutes (min) before the subarachnoid block. Group B received intranasal normal saline 20 min before the subarachnoid block. Time for the onset of sensory and motor blockade, two-segment regression time, and request of first rescue analgesia were noted. Sedation scores using the Ramsay Sedation Scale (RSS), adverse effect and hemodynamic parameters were assessed.</p><p><strong>Results: </strong>The onset of sensory block and motor block did not differ significantly between the groups. However, two-segment regression time was significantly longer in Group A than in Group B (113.17 ± 14.11 min vs. 94.13 ± 9.59 min, respectively; <i>P</i> < 0.001), and the time for first rescue analgesia was significantly longer in Group A than in Group B (3.97 ± 1.56 min vs. 2.56 ± 0.76 min, respectively; <i>P</i> < 0.001). The overall mean heart rate and mean arterial pressure were comparable between the two groups with stable hemodynamics. The visual analogue scale score in Group A was low (P < 0.001). Intraoperatively, at 30 min and 60 min, the change in RSS score was found to be statistically significant (<i>P</i> < 0.001).</p><p><strong>Conclusions: </strong>Intranasal dexmedetomidine prolongs the effect of subarachnoid anesthesia, provides stable hemodynamics with arousable sedation, and offers a noninvasive, better-tolerated alternative compared to other invasive routes of administration.</p>","PeriodicalId":7750,"journal":{"name":"Anaesthesiology intensive therapy","volume":"57 1","pages":"139-147"},"PeriodicalIF":1.7,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12329496/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144688663","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":"Noninferiority of ultrasound-guided lumbar disc block versus fluoroscopy-controlled lumbar discography for diagnosis of discogenic low back pain.","authors":"Wenxing Zhao, Liangliang He, Zhi Dou, Hongyan Wang, Liqiang Yang","doi":"10.5114/ait/203492","DOIUrl":"10.5114/ait/203492","url":null,"abstract":"<p><strong>Introduction: </strong>Evaluation of ultrasound (US)-guided disc block used to diagnose discogenic pain, as described in case reports. The study aimed to ascertain the noninferiority of US-guided lumbar disc block to conventional discography in the diagnosis of discogenic low back pain (DLBP).</p><p><strong>Material and methods: </strong>The reports of 418 patients undergoing lumbar fusion for DLBP were stratified into a US group receiving US-guided lumbar disc block and a control group receiving fluoroscopy (FL)-assistant discography via a propensity-score matched method in a 1 : 1 ratio. The primary endpoint was the confirmatory rate defined as the rate of clinical success following surgery measured by a numerical pain rating scale score ≤ 2 and an Oswestry Disability Index score ≤ 15 at the 1-month follow-up point. Secondary outcomes included needle insertions until contrast given, procedure time, radiation dosages and adverse events.</p><p><strong>Results: </strong>The confirmatory rates for disc block and discography were 71.8% and 73.2% (difference = -1.3%, 95% confidence interval [CI]: -9.9%, 7.2%, <i>P</i> = 0.353). The lower bound of 95% CI did not cross the noninferiority margin of 10%. There were fewer needle insertions (median 2, IQR: 1-3 vs. 5, IQR: 4-6, <i>P</i> < 0.001), shorter procedure times (8.94 ± 2.28 vs. 16.13 ± 3.39 min, <i>P</i> < 0.001) and lower radiation dosage (1689.56 ± 898.54 vs. 8293.50 ± 1039.09 μGy m² , <i>P</i> < 0.001) in the US group than the control group. No serious adverse events were observed.</p><p><strong>Conclusions: </strong>US-guided lumbar disc block was not inferior to conventional discography as a diagnostic modality in the evaluation of DLBP being considered for surgery. Given that the sonographic method provided advantages in terms of facilitation of needle insertion, reduced procedure time, and attenuated radiation exposure, it might be an alternative option for surgery decision making.</p>","PeriodicalId":7750,"journal":{"name":"Anaesthesiology intensive therapy","volume":"57 1","pages":"148-156"},"PeriodicalIF":1.7,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12329494/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144688664","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":"Shock in the post-operative ICU: the etomidate enigma.","authors":"Renjith Viswanath, Sryma Pb, Krishnendu S","doi":"10.5114/ait/200293","DOIUrl":"10.5114/ait/200293","url":null,"abstract":"","PeriodicalId":7750,"journal":{"name":"Anaesthesiology intensive therapy","volume":"57 1","pages":"136-138"},"PeriodicalIF":1.7,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12329495/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144574664","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":"Overtube-assisted removal of an enteral feed bezoar: a case report.","authors":"Grazia Ianigro, Sila Cocciolillo","doi":"10.5114/ait/204834","DOIUrl":"10.5114/ait/204834","url":null,"abstract":"","PeriodicalId":7750,"journal":{"name":"Anaesthesiology intensive therapy","volume":"57 1","pages":"132-135"},"PeriodicalIF":1.7,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12329492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144574663","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":"Surgical treatment of bilateral pheochromocytoma unresponsive to doxazosin in a patient with type 1 neurofibromatosis - a case report.","authors":"Martyna Halszka Łukasiewicz, Monika Berendt-Obołończyk, Irmina Anna Śmietańska, Paweł Topolewski, Maciej Śledziński, Renata Świątkowska-Stodulska, Andrzej Rafał Hellmann","doi":"10.5114/ait/200871","DOIUrl":"10.5114/ait/200871","url":null,"abstract":"","PeriodicalId":7750,"journal":{"name":"Anaesthesiology intensive therapy","volume":"57 1","pages":"128-129"},"PeriodicalIF":1.6,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12210378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144504530","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":"Bronchospasm after timolol administration.","authors":"Michal Kalina, Eva Wittenbergova, Marcela Bíslká","doi":"10.5114/ait/200233","DOIUrl":"10.5114/ait/200233","url":null,"abstract":"","PeriodicalId":7750,"journal":{"name":"Anaesthesiology intensive therapy","volume":"57 1","pages":"130-131"},"PeriodicalIF":1.6,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12210362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144504529","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":"Effect of clinically uneventful carotid endarterectomy on pentraxin 3 concentration: relationships between cognitive functions, local inflammation, and duration of brain ischemia.","authors":"Anna Renata Rękas-Dudziak, Joanna Rojek, Anna Blacha, Ewa Pruszynska-Oszmałek, Paweł Kołodziejski, Przemysław Matuła","doi":"10.5114/ait/203169","DOIUrl":"10.5114/ait/203169","url":null,"abstract":"<p><strong>Introduction: </strong>The pentraxins are a superfamily of proteins characterized by the presence of a pentraxin domain at the C-terminal. One of them is pentraxin 3 (PTX3), which is of great interest to scientists, primarily due to its function as an endogenous modulator of the inflammatory response. Local inflammation is a common phenomenon during various types of surgery and procedures, and its causes, among others, are local ischemia or tissue irritation. One such procedure is carotid plaque removal by carotid endarterectomy (CEA), which is performed to reduce the risk of stroke.</p><p><strong>Material and methods: </strong>The purpose of this study was to investigate the effect of CEA on PTX3 concentration and the relationship between cognitive functions and the duration of brain ischemia in patients. We evaluated the relationships using blood collected from patients undergoing CEA, the Mini-Mental State Examination (MMSE) questionnaire, and commercially available ELISA tests.</p><p><strong>Results: </strong>Results: We found that the concentration of PTX3 increased after surgery (from 0.59 ± 0.11 to 1.29 ± 0.29 ng mL^-1; <i>P</i> < 0.01). Also, a decrease in the MMSE score was observed 24 hours after the procedure (<i>P</i> < 0.01). However, just one month after the procedure, it significantly increased compared to the day of admission to the hospital (<i>P</i> < 0.01). Our results did not demonstrate any interactions between the tested parameters. It can be concluded that neither the changes in PTX3 concentration following the procedure nor the timing of these changes directly contribute to the temporary deterioration of cognitive functions observed after CEA.</p><p><strong>Conclusions: </strong>PTX3 increases independently of the duration of cerebral hypoxemia/ hypercapnia after clamping the carotid artery. This rise is an inflammatory marker that occurs independently within the central nervous system.</p>","PeriodicalId":7750,"journal":{"name":"Anaesthesiology intensive therapy","volume":"57 1","pages":"121-127"},"PeriodicalIF":1.7,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12210376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144315668","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":"Intranasal dexmedetomidine versus intranasal midazolam as a standard of care for pediatric patients undergoing transcatheter perimembranous ventricular septal defect (VSD) closure: a randomized controlled trial.","authors":"Mohammed Saed Shorbagy, Ramy Mahrose, Amr A Kasem, Yasmin Abdelrazik Ali, Sally Hamdy Abdelaziz","doi":"10.5114/ait/200231","DOIUrl":"10.5114/ait/200231","url":null,"abstract":"<p><strong>Introduction: </strong>Sedative premedication may hold notable significance in pediatric patients undergoing diagnostic and interventional cardiac catheterization, as it minimizes anxiety, facilitates parental separation, and allows for the acceptance of inhalational induction. The intranasal route is a reliable method for administering sedatives as pre- medication in pediatric patients. This study compared and evaluated the sedative effects of intranasal dexmedetomidine versus intranasal midazolam as premedication in pediatric patients undergoing transcatheter closure of ventricular septal defects.</p><p><strong>Material and methods: </strong>This prospective, randomized, double-blind study included 40 pediatric patients aged 3 to 6 years scheduled for transcatheter perimembranous VSD closure under general anesthesia. The subjects were randomly assigned to receive either intranasal midazolam at 0.2 mg kg^-1 body mass or intranasal dexmedetomidine at 0.5 μg kg^-1 body mass. The primary outcome measured was the effect of preoperative sedatives on the Ramsay sedation score. Secondary outcomes included the child-parent separation score, child emergence agitation level, effects on hemodynamics, and oxygen saturation.</p><p><strong>Results: </strong>This study included 40 individuals with similar demographic profiles and comparable duration of the procedure (<i>P</i> = 0.152) in both groups. No statistically significant differences were detected in the Ramsay sedation score (<i>P</i> = 0.582), child-parent separation score (<i>P</i> = 1.000) 20 minutes after drug administration, or postoperative child emergence agitation level (<i>P</i> = 0.351). No statistically significant difference was observed in terms of blood pressure, heart rate and oxygen saturation between the two groups.</p><p><strong>Conclusions: </strong>Pediatric patients were successfully and effectively sedated with both intranasal dexmedetomidine and intranasal midazolam, with stable hemodynamics and oxygen saturation.</p>","PeriodicalId":7750,"journal":{"name":"Anaesthesiology intensive therapy","volume":"57 1","pages":"115-120"},"PeriodicalIF":1.7,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12210370/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144309382","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":"An analysis of cases referred to Polish prosecutor's offices involving suspected medical errors directly and indirectly connected with the COVID-19 pandemic.","authors":"Anna Smędra, Katarzyna Wochna, Rafał Kubiak, Jarosław Berent","doi":"10.5114/ait/203166","DOIUrl":"10.5114/ait/203166","url":null,"abstract":"<p><strong>Introduction: </strong>The healthcare system is one of the areas most affected by the COVID-19 pandemic in Poland. This resulted in a higher occurrence of medical errors at diffe-rent stages of diagnosis and patient treatment. This study aimed to determine how the COVID-19 pandemic affected the number and type of medical errors in Poland and the type of medical facility where the irregularity occurred.</p><p><strong>Material and methods: </strong>We reviewed inquiries into the correctness of medical proceedings related to COVID-19; these were received by our department from prosecutor's offices throughout Poland during the pandemic and after its end: from the beginning of January 2020 to the end of December 2023. During the examined period (48 months), the department received a total of 4,483 inquiries, i.e. approximately 4.5 per day (approximately 1,000 working days). Of these, 293 were related to the COVID-19 pandemic (6.54%) and were further analyzed according to the selected criteria. Inquiries regarding \"COVID\" cases concerned all aspects of medical procedures, all medical professions, and all healthcare entities.</p><p><strong>Results: </strong>A clear correlation was found: most inquiries raising doubts about the correctness of medical procedures were received during the peaks (waves) of the pandemic: autumn 2020, spring 2021, late autumn 2021, and winter 2021/2022.</p><p><strong>Conclusions: </strong>Despite the introduction of legal regulations intended to decriminalize consequences of medical errors related to the COVID-19 pandemic, such cases were still submitted to prosecutors' offices; prosecutors initiated proceedings and then commissioned expert opinions on the correctness of the medical procedure.</p>","PeriodicalId":7750,"journal":{"name":"Anaesthesiology intensive therapy","volume":"57 1","pages":"108-114"},"PeriodicalIF":1.7,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12210359/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144309381","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}