Anesthesia and analgesia最新文献

{"title":"An Updated Systematic Review and Meta-Analysis of Unimodal Prehabilitation with Exercise Intervention to Enhance Postoperative Outcomes in Cancer Surgery.","authors":"Daniel Steffens, Mark Hancock, Wilson Jiang, Michael Solomon, Cherry Koh, Nicholas Hirst, Bernhard Riedel","doi":"10.1213/ANE.0000000000007226","DOIUrl":"10.1213/ANE.0000000000007226","url":null,"abstract":"<p><strong>Background: </strong>The objective of this systematic review and meta-analysis was to update the body of evidence on the efficacy of prehabilitation with exercise interventions, in reducing postoperative complications and length of hospital stay after cancer surgery.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted on MEDLINE, Embase, The Cochrane Library, CINAHL, AMED, and PsycINFO to identify randomized controlled trials investigating the impact of prehabilitation with exercise interventions for patients undergoing cancer surgery. Primary and secondary outcomes assessed were postoperative complications and length of hospital stay, respectively. Risk of bias was evaluated using the Cochrane risk of bias tool, and Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) methodology was used to determine the strength of evidence. Relative risk and mean difference were calculated using random-effects meta-analysis.</p><p><strong>Results: </strong>In this updated review, 32 trials (n = 2304 participants) were identified, with 5 trials focused on patients undergoing surgery for genitourinary cancer (n = 422 participants), 9 for lower gastrointestinal cancer (n = 639 participants), 6 for upper gastrointestinal cancer (n = 526), and 11 for lung cancer (n = 717 participants). The majority of included trials exhibited some risk of bias. Evidence of low-to-moderate quality indicated that prehabilitation with preoperative exercise significantly reduced postoperative complication rates by approximately 50% and decreased the length of hospital stay by 2.5 days in patients undergoing lung resection. Preoperative exercise did not demonstrate effectiveness in reducing postoperative complications or length of hospital stay for other cancer populations.</p><p><strong>Conclusions: </strong>Evidence supports the efficacy of prehabilitation with exercise in reducing postoperative complications and length of hospital stay in patients undergoing lung cancer surgery. Further research is warranted to establish the efficacy of unimodal prehabilitation with exercise in genitourinary, lower gastrointestinal, and upper gastrointestinal cancer populations having cancer surgery.</p>","PeriodicalId":7784,"journal":{"name":"Anesthesia and analgesia","volume":" ","pages":"811-820"},"PeriodicalIF":4.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142387374","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":"Should Cancer Diagnosis Influence American Society of Anesthesiologists Physical Status in Patients?","authors":"Nishkarsh Gupta, Muralidhara P, Anju Gupta","doi":"10.1213/ANE.0000000000007431","DOIUrl":"10.1213/ANE.0000000000007431","url":null,"abstract":"","PeriodicalId":7784,"journal":{"name":"Anesthesia and analgesia","volume":" ","pages":"e49-e50"},"PeriodicalIF":4.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143466827","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":"Cancer Biology and the Perioperative Period: Opportunities for Disease Evolution and Challenges for Perioperative Care.","authors":"Nicholas J S Perry, Shaman Jhanji, George Poulogiannis","doi":"10.1213/ANE.0000000000007328","DOIUrl":"10.1213/ANE.0000000000007328","url":null,"abstract":"<p><p>Efforts to deconvolve the complex interactions of cancer cells with other components of the tumor micro- and macro-environment have exposed a common tendency for cancers to subvert systems physiology and exploit endogenous programs involved in homeostatic control of metabolism, immunity, regeneration, and repair. Many such programs are engaged in the healing response to surgery which, together with other abrupt biochemical changes in the perioperative period, provide an opportunity for the macroevolution of residual disease. This review relates contemporary perspectives of cancer as a systemic disease with the overlapping biology of host responses to surgery and events within the perioperative period. With a particular focus on examples of cancer cell plasticity and changes within the host, we explore how perioperative inflammation and acute metabolic, neuroendocrine, and immune dyshomeostasis might contribute to cancer evolution within this contextually short, yet crucially influential timeframe, and highlight potential therapeutic opportunities within to further optimize surgical cancer care and its long-term oncological outcomes.</p>","PeriodicalId":7784,"journal":{"name":"Anesthesia and analgesia","volume":" ","pages":"846-859"},"PeriodicalIF":4.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142845633","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":"Single-Injection Intrathecal Hydrophilic Opioids in Abdominal Surgery: Ready to Roll Out?","authors":"Choy Lewis, Ravindra Alok Gupta, Ariana Nelson, Mark Koning","doi":"10.1213/ANE.0000000000006857","DOIUrl":"10.1213/ANE.0000000000006857","url":null,"abstract":"","PeriodicalId":7784,"journal":{"name":"Anesthesia and analgesia","volume":" ","pages":"888-890"},"PeriodicalIF":4.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143070820","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":"Once in a Lifetime.","authors":"Elizabeth Silva","doi":"10.1213/ANE.0000000000007186","DOIUrl":"10.1213/ANE.0000000000007186","url":null,"abstract":"","PeriodicalId":7784,"journal":{"name":"Anesthesia and analgesia","volume":" ","pages":"999-1000"},"PeriodicalIF":4.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142942787","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":"Machine Learning Modeling for American Society of Anesthesiologists Physical Status Classification Assignment in Children.","authors":"Hannah Lonsdale, Susan S Eagle, Robert E Freundlich","doi":"10.1213/ANE.0000000000007429","DOIUrl":"10.1213/ANE.0000000000007429","url":null,"abstract":"","PeriodicalId":7784,"journal":{"name":"Anesthesia and analgesia","volume":" ","pages":"e48-e49"},"PeriodicalIF":4.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12043420/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143063202","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":"In Response.","authors":"Andrea Girnius, John Crowe, Sean A Josephs","doi":"10.1213/ANE.0000000000007367","DOIUrl":"10.1213/ANE.0000000000007367","url":null,"abstract":"","PeriodicalId":7784,"journal":{"name":"Anesthesia and analgesia","volume":" ","pages":"e33-e34"},"PeriodicalIF":4.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143051332","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":"Anatomical Variation of the Interscalene Brachial Plexus Block: Clinical Importance and Alternative Approach.","authors":"Yavuz Gurkan, Ergun Mendes, Adem Halis, Rafet O Görgülü","doi":"10.1213/ANE.0000000000007393","DOIUrl":"10.1213/ANE.0000000000007393","url":null,"abstract":"","PeriodicalId":7784,"journal":{"name":"Anesthesia and analgesia","volume":" ","pages":"e41-e42"},"PeriodicalIF":4.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143050990","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":"Current Cancer Therapy: Perioperative Implications.","authors":"","doi":"10.1213/ANE.0000000000007470","DOIUrl":"https://doi.org/10.1213/ANE.0000000000007470","url":null,"abstract":"","PeriodicalId":7784,"journal":{"name":"Anesthesia and analgesia","volume":"140 4","pages":"752"},"PeriodicalIF":4.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143960796","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":"Dexamethasone: The Alan Turing of Surgical Site Infection in Noncardiac Surgery.","authors":"Fabricio Andres Lasso Andrade","doi":"10.1213/ANE.0000000000007386","DOIUrl":"10.1213/ANE.0000000000007386","url":null,"abstract":"","PeriodicalId":7784,"journal":{"name":"Anesthesia and analgesia","volume":" ","pages":"e38-e39"},"PeriodicalIF":4.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143051330","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}