Anesthesia & Analgesia最新文献_第3页

Postoperative Nausea and Vomiting Prevention After Intrathecal Morphine-Pondering the Permutations. 鞘内吗啡术后恶心呕吐的预防——对其排列的思考。

Anesthesia & Analgesia Pub Date : 2025-05-09 DOI: 10.1213/ane.0000000000007574

Anisha Pauline Paul,Aruna Parameswari

引用次数: 0

Efficacy of Remimazolam in Anesthetic Induction: Population Characteristic Concerns. 雷马唑仑在麻醉诱导中的疗效：人群特征关注。

Anesthesia & Analgesia Pub Date : 2025-05-09 DOI: 10.1213/ane.0000000000007543

Dengfeng Liu,Chunwei Lian,Li Pan

引用次数: 0

Office-Based Anesthesia: The Focus on Communication, Competency, Connectivity, and Collaboration. 基于办公室的麻醉：关注沟通、能力、连接和协作。

Anesthesia & Analgesia Pub Date : 2025-05-08 DOI: 10.1213/ane.0000000000007576

Steven B Greenberg

引用次数: 0

The Effects of Dexamethasone in Cardiac Surgery: A Registry-Based, Real-World Data Analysis of Clinical Outcomes From the Netherlands Heart Registration. 地塞米松在心脏手术中的作用：一项基于登记的、来自荷兰心脏登记临床结果的真实世界数据分析。

Anesthesia & Analgesia Pub Date : 2025-05-08 DOI: 10.1213/ane.0000000000007541

Gijs J van Steenbergen,Ted Reniers,Ashley De Bie Dekker,Irene S Lensen,Peter G Noordzij,Thijs C D Rettig,Thomas van Brakel,Arthur Bouwman,Jules R Olsthoorn,

{"title":"The Effects of Dexamethasone in Cardiac Surgery: A Registry-Based, Real-World Data Analysis of Clinical Outcomes From the Netherlands Heart Registration.","authors":"Gijs J van Steenbergen,Ted Reniers,Ashley De Bie Dekker,Irene S Lensen,Peter G Noordzij,Thijs C D Rettig,Thomas van Brakel,Arthur Bouwman,Jules R Olsthoorn,","doi":"10.1213/ane.0000000000007541","DOIUrl":"https://doi.org/10.1213/ane.0000000000007541","url":null,"abstract":"BACKGROUNDIn cardiac surgery, modulating the inflammatory response with prophylactic steroids may reduce morbidity and mortality. We aimed to evaluate the association of dexamethasone use with clinical outcomes and its variation in clinical practice in a real-world setting.METHODSThis retrospective, population-based study evaluated data of elective and urgent to on-pump cardiac surgery patients from the Netherlands Heart Registration between 2013 and 2021. Patients who received perioperative dexamethasone were compared to those who did not. The primary outcomes were 30-day mortality and a composite of 30-day mortality, in-hospital stroke, and 30-day renal or respiratory failure. Secondary outcomes included the individual components of the composite outcome, a composite of infection-related outcomes, arrhythmias, and length of hospital stay. Propensity score matching was applied to adjust for confounders. Clinical practice variation was assessed through a national survey of Dutch cardiac anesthesiologists.RESULTSIn the study, 54,694 patients were included, with 40,891 patients (74.8%) receiving dexamethasone. After propensity score matching, dexamethasone use was associated with a lower risk of the composite clinical outcome (odds ratio [OR] 0.82, 95% confidence interval [CI], 0.72-0.92, P < .001), with a significant reduction in renal failure (OR 0.57, 95% CI, 0.47-0.70, P < .001). The length of hospital stay was significantly shorter (B -0.17, 95% CI, -0.32 to -0.02, P = .025). Other individual components of the composite outcome and secondary outcomes did not show a significant association with dexamethasone use. However, in patients >80 years, dexamethasone use was associated with increased 30-day mortality (OR 1.52, 95% CI, 1.01-2.28, P = .044). The observed benefits were consistent across other demographic and clinical subgroups. The survey indicated substantial variability in dexamethasone use across centers and anesthesiologists.CONCLUSIONSProphylactic dexamethasone during adult cardiac surgery was associated with reduced composite clinical outcomes, renal failure, and shorter hospital stays, and seemed associated with 30-day mortality in patients >80 years old.","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"120 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143926476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Effects of Dexmedetomidine Combined With Lidocaine Topical Administration on Cough Reflex During Extubation in Thyroidectomy Patients: A Randomized Clinical Trial. 右美托咪定联合利多卡因局部给药对甲状腺切除术患者拔管时咳嗽反射的影响：一项随机临床试验。

Anesthesia & Analgesia Pub Date : 2025-05-08 DOI: 10.1213/ane.0000000000007560

Keyan Wang,Bowen Wei,Xuanxuan Wang,Yang Gao,Yuanyuan Cao,Lei Zhang,Meng Ning,Lijian Chen

{"title":"Effects of Dexmedetomidine Combined With Lidocaine Topical Administration on Cough Reflex During Extubation in Thyroidectomy Patients: A Randomized Clinical Trial.","authors":"Keyan Wang,Bowen Wei,Xuanxuan Wang,Yang Gao,Yuanyuan Cao,Lei Zhang,Meng Ning,Lijian Chen","doi":"10.1213/ane.0000000000007560","DOIUrl":"https://doi.org/10.1213/ane.0000000000007560","url":null,"abstract":"BACKGROUNDCough reflex during extubation can lead to complications such as increased bleeding and hemodynamic instability, especially in thyroidectomy, therefore, effective suppression of cough reflex is clinically important. The aim of the study was to investigate the inhibitory effect of dexmedetomidine combined with lidocaine on the cough reflex during extubation in thyroidectomy.METHODSA total of 180 female patients, aged 18 to 65 years, undergoing elective thyroidectomy under general anesthesia, were randomized into 3 groups: dexmedetomidine combined with lidocaine (Dex-Lido group, n = 60), lidocaine alone (Lido group, n = 60), or normal saline (Control group, n = 60). Before tracheal intubation, patients in the Dex-Lido group received dexmedetomidine combined with 2% lidocaine spray, those in the Lido group received 2% lidocaine spray, and those in the Control group received 0.9% normal saline spray, applied to the supraglottic, glottic, and subglottic areas. The primary outcome was the incidence of cough reflex at extubation. Secondary outcomes included cough severity, postoperative sore throat, hoarseness, nausea, and vomiting, as well as the need for analgesics and antiemetics, pain levels, sedation scores, and length of hospital stay.RESULTSThe incidence of cough reflex during extubation was significantly lower in both the Dex-Lido and Lido groups compared to the Control group (23% vs 70%; odds ratio [OR], 0.13; 95% confidence interval [CI], 0.06-0.29; P < .001 for Dex-Lido; 47% vs 70%; OR, 0.38; 95% CI, 0.18-0.79]; P = .010 for Lido), with a statistically significant difference between the Dex-Lido and Lido groups (23% vs 47%; OR, 0.35; 95% CI, 0.16-0.76; P = .007). Additionally, the severity of the cough reflex was markedly lower in the Dex-Lido group compared to the Control group (8/60 vs 26/60; OR, 0.20; 95% CI, 0.08-0.50; P < .001).CONCLUSIONSThe combination of dexmedetomidine and lidocaine laryngopharynx spray effectively suppresses the cough reflex during extubation, reduces postoperative sore throat, and stabilizes hemodynamics in female patients undergoing thyroid surgery.","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"53 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143926477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

To Achieve Cultural Change in Health Care Focus on Power and Agency, Process, and Relationships. 实现卫生保健文化变革的重点是权力和代理、过程和关系。

Anesthesia & Analgesia Pub Date : 2025-05-08 DOI: 10.1213/ane.0000000000007526

Tanisha Jowsey,Craig S Webster,Thomas Swinburn,Jennifer M Weller

引用次数: 0

Unplanned Intensive Care Unit Admissions: Demography of a "Not Never" Event. 计划外重症监护病房入院：人口统计的“不是永远不会”事件。

Anesthesia & Analgesia Pub Date : 2025-05-07 DOI: 10.1213/ane.0000000000007529

Richard P Dutton,Richard D Urman,Avery Tung

引用次数: 0

The "5-Ps" Mnemonic for Antibiotic Prophylaxis Before Surgery. 术前抗生素预防的“5-Ps”记忆法。

Anesthesia & Analgesia Pub Date : 2025-05-07 DOI: 10.1213/ane.0000000000007596

Ahmed Hasanin,Maha Mostafa

引用次数: 0

US Food and Drug Administration Approval of Suzetrigine: A Breakthrough in Nonopioid Pain Management. 美国食品和药物管理局批准suzetriine：非阿片类药物疼痛管理的突破。

Anesthesia & Analgesia Pub Date : 2025-05-07 DOI: 10.1213/ane.0000000000007550

Muhammad Areeb Ul Haq,Sabrina Najeeb,Wasi Junaid,Rafia Chaudhry

引用次数: 0

Emerging Technology and the Future of Perioperative Care: Perspectives and Recommendations From the 2023 Stoelting Conference of the Anesthesia Patient Safety Foundation. 新兴技术和围手术期护理的未来：来自麻醉患者安全基金会2023年偷盗会议的观点和建议。

Anesthesia & Analgesia Pub Date : 2025-05-07 DOI: 10.1213/ane.0000000000007540

Jonathan M Tan,Maxime Cannesson,Jeffrey M Feldman,Allan F Simpao,Susan P McGrath,Ashish K Khanna,John W Beard,Patricia McGaffigan,Daniel J Cole

{"title":"Emerging Technology and the Future of Perioperative Care: Perspectives and Recommendations From the 2023 Stoelting Conference of the Anesthesia Patient Safety Foundation.","authors":"Jonathan M Tan,Maxime Cannesson,Jeffrey M Feldman,Allan F Simpao,Susan P McGrath,Ashish K Khanna,John W Beard,Patricia McGaffigan,Daniel J Cole","doi":"10.1213/ane.0000000000007540","DOIUrl":"https://doi.org/10.1213/ane.0000000000007540","url":null,"abstract":"Anesthesiology has a longstanding commitment to patient safety, characterized by innovative research, quality improvement, multidisciplinary collaboration, and engineering-based approaches to care systems. The field has been instrumental in advancing technological developments across the perioperative continuum, contributing to the ongoing mission of harm reduction and risk mitigation. However, modern challenges in health care, including increasingly complex patient conditions, workforce shortages, burnout, and the overwhelming volume of health data generated, have created a more urgent and multifaceted landscape for patient safety efforts. Furthermore, with the expanding perioperative continuum, from prehabilitation to postoperative acute care at home, anesthesiology teams must now adapt to a broader role in patient care. To continue enhancing patient safety, anesthesiology must integrate emerging technologies into clinical workflows, scaling their presence and effectiveness. The 2023 Anesthesia Patient Safety Foundation Stoelting Conference highlighted the necessity for anesthesiology to embrace these innovations while recognizing the challenges they pose. Three key technological domains were emphasized: wearables and the Internet of Medical Things; big data and artificial intelligence; and clinical decision support systems coupled with advanced alarm systems. These technologies offer opportunities to improve patient safety but require careful integration into clinical practice. This report explores the potential of these technologies to reshape anesthesiology and perioperative care while focusing on their application across 4 key phases: the preanesthesia phase at home; the intraoperative phase within health systems; postanesthesia recovery; and recovery at home. By leveraging these technologies, anesthesiology can enhance decision-making, improve outcomes, and continue advancing the mission of patient safety in a rapidly evolving health care landscape.","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"37 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143920994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0