Anesthesia and analgesia最新文献

{"title":"The Dark Side of the Moon: Awe and Our Well-Being.","authors":"K Elliott Higgins, Jasmine A Macias, Maxime P Cannesson","doi":"10.1213/ANE.0000000000007213","DOIUrl":"10.1213/ANE.0000000000007213","url":null,"abstract":"","PeriodicalId":7784,"journal":{"name":"Anesthesia and analgesia","volume":" ","pages":"e19"},"PeriodicalIF":4.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142118770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Randomized, Controlled Trial of Palonosetron Versus Ondansetron for Nausea, Vomiting, and Pruritus in Cesarean Delivery with Intrathecal Morphine.","authors":"Tarvit Worravitudomsuk, Somrat Charuluxananan, Wasin Sukumpanumet, Pin Sriprajittichai","doi":"10.1213/ANE.0000000000007091","DOIUrl":"10.1213/ANE.0000000000007091","url":null,"abstract":"<p><strong>Background: </strong>Spinal anesthesia is the preferred anesthetic technique for cesarean deliveries. Postoperative nausea and vomiting (PONV) and pruritus occur in up to 80% and 83% of patients, respectively, after cesarean delivery with intrathecal opioids. Ondansetron is the recommended medication for PONV prophylaxis, but palonosetron, a second-generation 5-HT3 receptor antagonist, has a higher receptor affinity and a longer half-life. However, studies on palonosetron use in cesarean deliveries are limited. This study aimed to determine whether palonosetron was more effective than ondansetron in preventing intrathecal morphine-induced PONV and pruritus in cesarean deliveries.</p><p><strong>Methods: </strong>Parturients who underwent cesarean delivery under spinal anesthesia were randomized into 3 groups: P (palonosetron 0.075 mg), O (ondansetron 4 mg), and N (normal saline). The study drug was intravenously administered after the umbilical cord was clamped. The primary outcome measures were the 48-hour incidence of PONV and pruritus. The secondary outcome measures were the PONV and pruritus scores at the postanesthesia care unit (PACU) and ward, rescue medications, satisfaction scores, and adverse events. Ordinal data were analyzed using the Kruskal-Wallis test. Continuous and categorical data were analyzed using a 1-way analysis of variance, Kruskal-Wallis test, and Pearson's χ 2 test, respectively. A value of P < .05 was considered significant. Post hoc analysis pairwise comparisons with Bonferroni correction were also performed.</p><p><strong>Results: </strong>Overall, 300 parturients were enrolled, and 297 parturients completed the study. One patient in the P group and 2 in the O group were excluded because of conversion to general anesthesia after failed spinal anesthesia. The baseline patient characteristics were comparable between the groups. The PONV incidence rates in the P, O, and N groups were 26.3% (95% confidence interval [CI], 17.4-35.1), 34.7% (95% CI, 25.1-44.3), and 50.0% (95% CI, 40.0-59.9), respectively ( P = .002). The incidence rates of pruritus in the P, O, and N groups were 69.7% (95% CI, 60.5-78.9), 76.5% (95% CI, 67.9-85.1), and 87.0% (95% CI, 80.3-93.7), respectively ( P = .013). Pairwise comparisons revealed significantly lower incidences of PONV and pruritus in the P group than in the N group ( P < .001 and P = .003, respectively). However, no significant differences were observed between the P and O groups or between the O and N groups. Additionally, the P group required significantly less nalbuphine rescue for pruritus than the N group ( P = .004 and P = .005 for the PACU and ward, respectively). PONV rescue, satisfaction scores, and adverse events were not significantly different among the 3 groups.</p><p><strong>Conclusions: </strong>Palonosetron effectively prevents intrathecal morphine-induced PONV and pruritus during cesarean delivery. However, the efficacy of palonosetron is not significantly dif","PeriodicalId":7784,"journal":{"name":"Anesthesia and analgesia","volume":" ","pages":"628-635"},"PeriodicalIF":4.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When the Drip Stops: The Intravenous Fluid Shortage.","authors":"Soobin Song, MaKayla Hoggard, Rafael Ortega","doi":"10.1213/ANE.0000000000007372","DOIUrl":"10.1213/ANE.0000000000007372","url":null,"abstract":"","PeriodicalId":7784,"journal":{"name":"Anesthesia and analgesia","volume":" ","pages":"e22-e23"},"PeriodicalIF":4.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143051369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Capillary Refill Time After Induction of General Anesthesia: A Pilot Study.","authors":"Zbigniew Putowski, Szymon Czajka, Anna Szczepańska, Wojciech Szczeklik, Eduardo Kattan, Glenn Hernández","doi":"10.1213/ANE.0000000000007257","DOIUrl":"10.1213/ANE.0000000000007257","url":null,"abstract":"","PeriodicalId":7784,"journal":{"name":"Anesthesia and analgesia","volume":" ","pages":"743-745"},"PeriodicalIF":4.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11805477/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142520754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Donation After Circulatory Death Liver Transplantation: Impact of Normothermic Machine Perfusion on Key Variables.","authors":"Alexander D Stoker, Andrew W Gorlin, David M Rosenfeld, Michelle C Nguyen, Amit K Mathur, Skye A Buckner-Petty, Blanca C Lizaola-Mayo, Peter E Frasco","doi":"10.1213/ANE.0000000000007093","DOIUrl":"10.1213/ANE.0000000000007093","url":null,"abstract":"<p><strong>Background: </strong>During orthotopic liver transplantation, allograft reperfusion is a dynamic point in the operation and often requires vasoactive medications and blood transfusions. Normothermic machine perfusion (NMP) of liver allografts has emerged to increase the number of transplantable organs and may have utility during donation after circulatory death (DCD) liver transplantation in reducing transfusion burden and vasoactive medication requirements.</p><p><strong>Methods: </strong>This is a single-center retrospective study involving 226 DCD liver transplant recipients who received an allograft transported with NMP (DCD-NMP group) or with static cold storage (DCD-SCS group). Veno-venous bypass was not used in any patients. Infusion doses of norepinephrine, epinephrine, and vasopressin as well as bolus doses of vasoactive medications during reperfusion were recorded. Blood component therapy was recorded according to phase of liver transplantation and during the first 24 hours postprocedure.</p><p><strong>Results: </strong>A total of 103 recipients in the DCD-NMP group and 123 patients in the DCD-SCS group were included. Post-reperfusion syndrome (PRS) incidence was reduced in the DCD-NMP group compared to the DCD-SCS group (10.7% [95% confidence interval, CI, 5.5%-18.3%] vs 42.3% [95% CI, 33.4%-51.5%]; P < .001). During the reperfusion period, patients in the DCD-SCS group required increased bolus doses of epinephrine and vasopressin compared to the DCD-NMP group (24.6 vs 7.5 µg; P < .001) and (5.4 vs 2.4 units; P < .001), respectively. The DCD-SCS group received a higher infusion dose of epinephrine during anhepatic phase, at reperfusion, and up to 90 minutes after reperfusion. In the postreperfusion period, there were significant increases in the transfusion of red blood cells (RBCs; 5.3 vs 3.7 units; P = .006), fresh frozen plasma (FFP; 3.4 vs 1.9 units; P < .001), cryoprecipitate (2.7 vs 1.8 pooled units; P = .015) and platelets (0.9 vs 0.4 units; P = .008) in the DCD-SCS group compared to the DCD-NMP group. During the first 24 hours postprocedure, transfusion of RBCs, FFP, and cryoprecipitate in the DCD-SCS group was increased compared to the DCD-NMP group ([2.6 vs 1.7 units; P = .028], [1.6 vs 0.8 units; P < .001], [1.5 vs 0.9 pooled units; P = .031]) respectively. Administration of tranexamic acid was more frequent in the DCD-SCS group during the post-reperfusion period compared to the DCD-NMP group (13% [95% CI, 5.7%-17.4%] vs 3.9% [95% CI, 1.1%-9.6% 95%]; P = .018).</p><p><strong>Conclusions: </strong>In DCD liver transplantation, use of NMP was associated with reduced incidence of PRS and decreased vasopressor and inotrope requirements at the time of allograft reperfusion compared to using SCS. Additionally, NMP was associated with reduced transfusion of all blood product components as well as antifibrinolytic agent administration in the post-reperfusion period. Reduced transfusion burden in the DCD-NMP group also occ","PeriodicalId":7784,"journal":{"name":"Anesthesia and analgesia","volume":" ","pages":"687-696"},"PeriodicalIF":4.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11805485/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142982508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anesthetic Sevoflurane Induces Enlargement of Dendritic Spine Heads in Mouse Neurons via Tau-Dependent Mechanisms.","authors":"Jia Yan, Hoai Ton, Jing Yan, Yuanlin Dong, Zhongcong Xie, Hong Jiang","doi":"10.1213/ANE.0000000000006941","DOIUrl":"10.1213/ANE.0000000000006941","url":null,"abstract":"<p><strong>Background: </strong>Sevoflurane induces neuronal dysfunction and cognitive impairment. However, the underlying mechanism remains largely to be determined. Tau, cyclophilin D, and dendritic spine contribute to cognitive function. But whether changes in dendritic spines are involved in the effects of sevoflurane and the potential association with tau and cyclophilin D is not clear.</p><p><strong>Methods: </strong>We harvested hippocampal neurons from wild-type mice, tau knockout mice, and cyclophilin D knockout mice. We treated these neurons with sevoflurane at day in vitro 7 and measured the diameter of dendritic spine head and the number of dendritic spines. Moreover, we determined the effects of sevoflurane on the expression of excitatory amino acid transporter 3 (EAAT3), extracellular glutamate levels, and miniature excitatory postsynaptic currents (mEPSCs). Finally, we used lithium, cyclosporine A, and overexpression of EAAT3 in the interaction studies.</p><p><strong>Results: </strong>Sevoflurane-induced tau phosphgorylation increased the diameter of dendritic spine head and decreased the number of dendritic spines in neurons harvested from wild-type and cyclophilin D knockout mice, but not tau knockout mice. Sevoflurane decreased the expression of EAAT3, increased extracellular glutamate levels, and decreased the frequency of mEPSCs in the neurons. Overexpression of EAAT3 mitigated the effects of sevoflurane on dendritic spines. Lithium, but not cyclosporine A, attenuated the effects of sevoflurane on dendritic spines. Lithium also inhibited the effects of sevoflurane on EAAT3 expression and mEPSCs.</p><p><strong>Conclusions: </strong>These data suggest that sevoflurane induces a tau phosphorylation-dependent demtrimental effect on dendritic spine via decreasing EAAT3 expression and increasing extracellular glutamate levels, leading to neuronal dysfunction.</p>","PeriodicalId":7784,"journal":{"name":"Anesthesia and analgesia","volume":" ","pages":"697-709"},"PeriodicalIF":4.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140179098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Substance-Use Disorders in Critically Ill Patients: A Narrative Review.","authors":"Rebecca Piland, Russell Jack Jenkins, Dana Darwish, Bridgette Kram, Kunal Karamchandani","doi":"10.1213/ANE.0000000000007078","DOIUrl":"10.1213/ANE.0000000000007078","url":null,"abstract":"<p><p>Substance-use disorders (SUDs) represent a major public health concern. The increased prevalence of SUDs within the general population has led to more patients with SUD being admitted to intensive care units (ICUs) for an SUD-related condition or with SUD as a relevant comorbidity. Multiprofessional providers of critical care should be familiar with these disorders and their impact on critical illness. Management of critically ill patients with SUDs is complicated by both acute exposures leading to intoxication, the associated withdrawal syndrome(s), and the physiologic changes associated with chronic use that can cause, predispose patients to, and worsen the severity of other medical conditions. This article reviews the epidemiology of substance use in critically ill patients, discusses the identification and treatment of common intoxication and withdrawal syndromes, and provides evidence-based recommendations for the management of patients exposed to chronic use.</p>","PeriodicalId":7784,"journal":{"name":"Anesthesia and analgesia","volume":" ","pages":"604-615"},"PeriodicalIF":4.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141905619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association of Social Determinants of Health With Reported Daily Pain Scores Among Patients With a History of Chronic Pain Using the \"All of Us\" Research Program.","authors":"Brian H Park, Alvaro A Macias, Kathleen M Fisch, Sierra Simpson, Jeffrey Chen, Rodney A Gabriel","doi":"10.1213/ANE.0000000000007211","DOIUrl":"10.1213/ANE.0000000000007211","url":null,"abstract":"","PeriodicalId":7784,"journal":{"name":"Anesthesia and analgesia","volume":" ","pages":"732-735"},"PeriodicalIF":4.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11805467/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142811933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leadership Excellence: A Cornerstone for Advancing Academic Anesthesiology.","authors":"Olubukola O Nafiu, Alice T Coombs, Matthias Eikermann, Jaideep J Pandit","doi":"10.1213/ANE.0000000000007120","DOIUrl":"10.1213/ANE.0000000000007120","url":null,"abstract":"","PeriodicalId":7784,"journal":{"name":"Anesthesia and analgesia","volume":" ","pages":"585-589"},"PeriodicalIF":4.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142520659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Links Between Cellular Energy Metabolism and Pain Sensation.","authors":"Xiongjuan Li, Zhao Zhao, Yuwen Ke, Yonghan Jiang, Yuqiang Liu, Zhiheng Liu","doi":"10.1213/ANE.0000000000007096","DOIUrl":"10.1213/ANE.0000000000007096","url":null,"abstract":"<p><p>One of the functions of organism cells is to maintain energy homeostasis to promote metabolism and adapt to the environment. The 3 major pathways of cellular energy metabolism are glycolysis, the tricarboxylic acid (TCA) cycle, and oxidative phosphorylation (OXPHOS). Neurons, astrocytes, and microglia are crucial in allodynia, hyperalgesia, and sensitization in nociceptive pathways. This review focused on these 3 major cellular energy metabolism pathways, aiming to elucidate the relationship between neurocyte and pain sensation and present the reprogramming of energy metabolism on pain, as well as the cellular and molecular mechanism underlying various forms of pain. The clinical and preclinical drugs involved in pain treatment and molecular mechanisms via cellular energy metabolism were also discussed.</p>","PeriodicalId":7784,"journal":{"name":"Anesthesia and analgesia","volume":" ","pages":"616-627"},"PeriodicalIF":4.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11805490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141900735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}