Anesthesia and analgesia最新文献

{"title":"New Approaches to Clinical Hemodynamics.","authors":"Avery Tung, Michael F O'Connor","doi":"10.1213/ANE.0000000000007532","DOIUrl":"10.1213/ANE.0000000000007532","url":null,"abstract":"","PeriodicalId":7784,"journal":{"name":"Anesthesia and analgesia","volume":" ","pages":"109-112"},"PeriodicalIF":4.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075543","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":"Norepinephrine for Spinal Hypotension.","authors":"","doi":"10.1213/ANE.0000000000007601","DOIUrl":"https://doi.org/10.1213/ANE.0000000000007601","url":null,"abstract":"","PeriodicalId":7784,"journal":{"name":"Anesthesia and analgesia","volume":"141 1","pages":"16"},"PeriodicalIF":4.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144309452","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":"In Response.","authors":"Shiyun Jin, Shufang He, Ye Zhang","doi":"10.1213/ANE.0000000000007624","DOIUrl":"https://doi.org/10.1213/ANE.0000000000007624","url":null,"abstract":"","PeriodicalId":7784,"journal":{"name":"Anesthesia and analgesia","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144493470","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":"Perioperative Handoffs: Striking the Balance Between Standardization and Customization Is Key to Implementation Success.","authors":"Cliodhna Ashe, Andrew Bochenek, Steven B Greenberg","doi":"10.1213/ANE.0000000000007603","DOIUrl":"https://doi.org/10.1213/ANE.0000000000007603","url":null,"abstract":"","PeriodicalId":7784,"journal":{"name":"Anesthesia and analgesia","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144282012","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":"Xylazine-a Bane in Need of an Antidote.","authors":"Peter A Goldstein","doi":"10.1213/ANE.0000000000007590","DOIUrl":"https://doi.org/10.1213/ANE.0000000000007590","url":null,"abstract":"","PeriodicalId":7784,"journal":{"name":"Anesthesia and analgesia","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144282016","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":"Right Ventricle-Pulmonary Artery Coupling and Major Morbidity and Operative Mortality After Cardiac Surgery.","authors":"Katherine W Sun, Yi-Ju Li, Hui Huang, Anne D Cherry, Daryl Kerr, Crosby M Culp, Fawaz Alenezi, Mihai V Podgoreanu, Brittany A Zwischenberger, Alina Nicoara","doi":"10.1213/ANE.0000000000007582","DOIUrl":"https://doi.org/10.1213/ANE.0000000000007582","url":null,"abstract":"<p><strong>Background: </strong>The right ventricle-pulmonary artery (RV-PA) coupling ratio provides an assessment of RV function indexed to PA afterload. A low preoperative RV-PA ratio has been associated with increased mortality after transcatheter procedures. In patients undergoing cardiac surgery, we hypothesized that a lower preoperative RV-PA ratio is independently associated with a higher risk of major morbidity and operative mortality (MMOM).</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of adult patients who underwent coronary artery bypass graft and/or valve surgery (aortic, mitral, and tricuspid). The RV-PA ratio was calculated using the ratio of tricuspid annular plane systolic excursion (TAPSE) to PA systolic pressure (PASP). The primary outcome was MMOM as defined by the Society of Thoracic Surgeons (STS). The Youden index was used to determine the optimal cutoff to classify into low versus high TAPSE/PASP ratio groups. Multivariable analysis was performed to test the association of TAPSE/PASP ratio with MMOM and other clinical outcomes with P- value <0.05 used for statistical significance.</p><p><strong>Results: </strong>One hundred and twenty-four (14.3%) of the 868 patients who met inclusion criteria had the primary outcome of MMOM. Patients in the low TAPSE/PASP group were more likely to have MMOM (90 (22.0%) vs 34 (7.4%); P < .001) as well as longer intensive care unit length of stay (ICU-LOS), hospital LOS (H-LOS), and mechanical ventilation time (MVT). By multivariable analysis, TAPSE/PASP ratio <0.52 mm/mm Hg was associated with a significant increase in the risk of MMOM (odds ratio [OR] 1.77, 95% confidence interval [CI], 1.10-2.83, P = .018). In the analyses of secondary outcomes, for every 0.1 mm/mm Hg increase in TAPSE/PASP ratio, there was a 4% reduction in ICU-LOS and MVT, and a 3% reduction in H-LOS.</p><p><strong>Conclusions: </strong>TAPSE/PASP ratio <0.52 mm/mm Hg was associated with a significant increase in the risk of MMOM. Low preoperative TAPSE/PASP ratio was also associated with longer ICU-LOS, H-LOS, and MVT, even when adjusting for STS risk score for MMOM and cardiopulmonary bypass time.</p>","PeriodicalId":7784,"journal":{"name":"Anesthesia and analgesia","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144282015","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":"Processed Electroencephalogram Monitoring During Trauma Surgery.","authors":"Marissa Tuler, Robert Canelli, Wissam Mustafa, Donald Lambert","doi":"10.1213/ANE.0000000000007605","DOIUrl":"https://doi.org/10.1213/ANE.0000000000007605","url":null,"abstract":"","PeriodicalId":7784,"journal":{"name":"Anesthesia and analgesia","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144282014","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":"Balancing Reimbursement and Safety: The Anthem Blue Cross Blue Shield Policy Shift and Its Impact on Anesthesia Care.","authors":"Jeanie Marchbanks, Adam Khan, Caleb Smith, Matt Vassar","doi":"10.1213/ANE.0000000000007559","DOIUrl":"https://doi.org/10.1213/ANE.0000000000007559","url":null,"abstract":"","PeriodicalId":7784,"journal":{"name":"Anesthesia and analgesia","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144282010","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":"Intrathecal Morphine and Its Impact on Length of Stay in Joint Arthroplasty Surgery: A Double-Blind Randomized Clinical Trial.","authors":"Sierra Cheng, Yehoshua Gleicher, Muhammad I Khan, Hermann Dos Santos Fernandes, Shiva Khandadashpoor, Xiang Y Ye, Naveed Siddiqui","doi":"10.1213/ANE.0000000000007598","DOIUrl":"https://doi.org/10.1213/ANE.0000000000007598","url":null,"abstract":"","PeriodicalId":7784,"journal":{"name":"Anesthesia and analgesia","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144282011","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":"Pharmacologic Reversal of Xylazine-Induced Unconsciousness in Rats.","authors":"Gwi H Park, Eric M Smith, David P Obert, Kathleen F Vincent, Ken Solt","doi":"10.1213/ANE.0000000000007589","DOIUrl":"https://doi.org/10.1213/ANE.0000000000007589","url":null,"abstract":"<p><strong>Background: </strong>Xylazine is an alpha-2 adrenergic agonist approved for veterinary use as a sedative and analgesic for animals. Unfortunately, xylazine has recently become a common adulterant of street drugs in the United States with xylazine-related overdoses and deaths increasing each year. Although the alpha-2 adrenergic antagonist, atipamezole, is an efficacious reversal agent for xylazine that is approved for use in animals, it is not approved for humans. In this study, we aimed to test alternative reversal agents for xylazine, and compare them with atipamezole in a rat model of xylazine-induced unconsciousness.</p><p><strong>Methods: </strong>In adult Sprague-Dawley rats, we induced loss of righting reflex (LORR, a surrogate end point for loss of consciousness) with xylazine (5 mg/kg, intravenous [IV]) and attempted to restore consciousness by administering agents with distinct molecular mechanisms of action: atipamezole (alpha-2 adrenergic antagonist, 200 µg/kg IV); d-amphetamine (norepinephrine and dopamine reuptake inhibitor and releasing agent, 1 mg/kg); chloro-APB (dopamine D1 receptor agonist, 3 mg/kg IV); and atomoxetine (norepinephrine reuptake inhibitor, 3 mg/kg IV). Pulse oximetry and heart rate were monitored continuously. After administration of the reversal agents, time to return of righting reflex (RORR) was recorded (n = 12) and animals were assessed with a novel object recognition test (n = 17). One subset of animals underwent surgery to have electroencephalogram (EEG) leads implanted (n = 4). EEG data were recorded after xylazine injection and ensuing administration of a reversal agent and spectral analysis was performed.</p><p><strong>Results: </strong>After xylazine-induced unconsciousness, the median time to RORR in atipamezole-, d-amphetamine-, and chloro-APB-treated rats was 1.5 minutes (Interquartile Range [1.0-2.0]), 2 minutes (interquartile range [IQR] [1.0-3.0]), and 2 minutes (IQR [1.0-2.0]) post drug injection, respectively, compared to 56 minutes (IQR [39.5-70.5]) after saline control (F[4,40] = 41.62, P < .0001). Atomoxetine did not significantly accelerate time to RORR. During the novel object recognition test, all animals spent the same amount of time with the familiar and novel object (range 0-143.5 sec), indicating that no reversal agents restored recognition memory. Xylazine induced an EEG pattern dominated by slow-delta oscillations. Atipamezole, d-amphetamine, and chloro-APB restored EEG oscillations similar to the awake state.</p><p><strong>Conclusions: </strong>Atipamezole, d-amphetamine, and chloro-APB accelerate emergence from xylazine-induced unconsciousness and restore EEG oscillation patterns consistent with wakefulness. However, none of these reversal agents restore recognition memory.</p>","PeriodicalId":7784,"journal":{"name":"Anesthesia and analgesia","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144282013","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}