Anesthesia & Analgesia最新文献

{"title":"Movements During Intended General Anesthesia and Psychologically Traumatic Accidental Awareness: Explanatory Role of the \"Efference Copy Network\".","authors":"Jaideep J Pandit","doi":"10.1213/ane.0000000000007722","DOIUrl":"https://doi.org/10.1213/ane.0000000000007722","url":null,"abstract":"","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"122 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145003293","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}

{"title":"Multimodal Analgesia in Enhanced Recovery After Cardiac Surgery-Does it Work?","authors":"Abimbola O Faloye,Stephanie O Ibekwe","doi":"10.1213/ane.0000000000007755","DOIUrl":"https://doi.org/10.1213/ane.0000000000007755","url":null,"abstract":"","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145003298","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}

{"title":"When Imperfection Becomes Ideal: Rethinking Academic Culture Around Faculty Advancement.","authors":"James Harvey Jones","doi":"10.1213/ane.0000000000007738","DOIUrl":"https://doi.org/10.1213/ane.0000000000007738","url":null,"abstract":"","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145003203","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}

{"title":"Evolving Clinical Trial Structures: Raising the Bar for Anesthesiology Research and Creating New Challenges for Journals.","authors":"Valluvan Rangasamy,Balachundhar Subramaniam,Jaideep J Pandit","doi":"10.1213/ane.0000000000007731","DOIUrl":"https://doi.org/10.1213/ane.0000000000007731","url":null,"abstract":"","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"40 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145003296","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}

{"title":"Is Electroencephalographic Burst-Suppression Good, Bad, or Indifferent for Brain Health? Context Matters.","authors":"Anita M Jegarl,Maria C Walline,Peter A Goldstein,Seyed A Safavynia","doi":"10.1213/ane.0000000000007739","DOIUrl":"https://doi.org/10.1213/ane.0000000000007739","url":null,"abstract":"Intraoperative burst-suppression (BSP) has long been postulated to be associated with an increased risk of postoperative delirium (POD) based on data from human experimental studies and meta-analyses. However, the effects of BSP on POD are not consistently demonstrated in large-scale randomized controlled trials. At a minimum, this warrants an explanation of the discrepancies between these results, and at a maximum, prompts the questioning of the utility of intraoperative electroencephalographic (EEG) monitoring for POD altogether. Here, we provide a narrative review of the mechanisms of BSP generation in several clinical contexts, including those produced by general anesthetics and neuronal pathologies, the role and utility of BSP in cerebral protection strategies, and the significance of BSP with respect to long-term functional neurological outcomes. We offer a framework with which to understand BSP generation across clinical contexts and discuss its scientific and clinical implications.","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"72 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145003301","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}

{"title":"Retrospective Analysis of Factors Associated With Increased Anesthesia Ready Time in Patients With Odontogenic Infections.","authors":"Akshay Govind,Bryan Rogers,Zhenzhen Zhang,Caroline Salter,Sophie Feng,Michael F Aziz","doi":"10.1213/ane.0000000000007740","DOIUrl":"https://doi.org/10.1213/ane.0000000000007740","url":null,"abstract":"BACKGROUNDAirway management in patients with odontogenic infections presents a known challenge. The current study aims to identify factors associated with anesthesia ready time (ART) and first-attempt intubation failure (FAIF) in patients with odontogenic infections.METHODSIn a retrospective cohort study, subjects 14 years and older between January 1, 2012, and December 31, 2019, requiring incision and drainage for odontogenic infections under general anesthesia were included. Predictor variables included age, sex, race, body mass index (BMI), maximum incisal opening (MIO), Mallampati score, size and location of abscesses, airway deviation, intubation method, and route. The primary outcome variable, ART, was measured as the time elapsed between the patient entering the operating room and the anesthesiologist marking \"Anesthesia Ready.\" A secondary outcome variable was FAIF. T tests, analysis of variance (ANOVA), or nonparametric tests were used to compare ART values based on our predictor variables. Logistic regression was used to assess for FAIF. A significance level of P ≤ .05 was used.RESULTSThe sample was composed of 137 intubations in 129 subjects with a mean age of 38.6 (standard deviation [SD] 7.1) years, of which 59 (45.7%) were male. Mean ART was 19.2 (SD 10.4) [95% confidence interval [CI], 17.5-20.9] minutes. Abscess size was not associated with ART. Factors associated with increased ART were severe airway deviation (mean 23.0 [95% CI, 19.4-26.6] minutes, P = .02), involvement of the sublingual (mean 20.5 [95% CI, 18.1-22.8] minutes, P = .02), lateral pharyngeal (mean 21.7 [18.5-24.9] minutes, P = .02), and retropharyngeal (mean 24.7 [18.1-31.3] minutes, P = .02) spaces, total number of spaces involved (r = 0.18, P = .03), choice of flexible scope (FS) intubation (mean 26.8 [95% CI, 22.6-31.0] minutes, P < .01), and nasal route of intubation (mean 24.2 [95% CI, 21.3-27.2 minutes, P < .01)], the last 2 of which maintained significance after Bonferroni correction for multiple comparisons. FS intubation method remained significantly associated with increased ART, regardless of whether oral or nasal route was used (P < .01). FAIF was encountered 13.3% of the time.CONCLUSIONSFor patients with odontogenic infections, the strongest predictor of increased ART is the choice of FS technique. Other factors that may be associated with increased ART are severe airway deviation, number of spaces involved, involvement of the sublingual, lateral pharyngeal, or retropharyngeal spaces, although these other factors lose statistical significance after correction for multiple comparisons.","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145003294","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}

{"title":"The Influence of Vasopressor-Induced Arterial Blood Pressure Elevation on Muscle-Recorded Motor Evoked Potentials.","authors":"Sebastiaan E Dulfer,Rob J M Groen,Fiete Lange,Katalin Tamasi,Frits H Wapstra,Lilian M Mennink,Bianca M Dijkstra,Thouraya J Dil,Christopher Faber,Anthony R Absalom,Marko M Sahinovic,Gea Drost","doi":"10.1213/ane.0000000000007701","DOIUrl":"https://doi.org/10.1213/ane.0000000000007701","url":null,"abstract":"BACKGROUNDTranscranial electrical stimulation muscle-recorded motor evoked potentials (Tc-mMEPs) are used to monitor the spinal cord motor tracts during spinal surgery. There is considerable intra- and interindividual variability in the signals recorded, causing a high incidence of false positive warnings. Inadequate blood pressure is commonly blamed for false positive warnings and is usually managed with fluid and vasopressor therapy. The aim of the study was to systematically investigate the effects of norepinephrine and ephedrine-induced arterial blood pressure elevation on Tc-mMEPs.METHODSTwenty-five patients undergoing spinal surgery were included in this prospective observational study. After anesthetic induction and positioning, but before incision, a norepinephrine infusion was used to increase the mean arterial pressure (MAP) from approximately 60 to 100 mm Hg. Tc-mMEP amplitudes and area under the curves (AUC) were recorded from the abductor hallucis (AH), tibialis anterior (TA), and hand muscles every 2 minutes. Voltage thresholds of the AH, TA, and hand muscles were determined at MAP values of 60, 80, and 100 mm Hg. The primary objective was to determine the effects of increasing the MAP with a vasopressor infusion on Tc-mMEP amplitude, AUC, and threshold. For the secondary objective, the outcomes were adjusted for depth of anesthesia and propofol concentrations. Post hoc analyses included adjusting for confounders, noradrenaline infusion rate, and use of ephedrine, investigating the effects of cardiac index on Tc-mMEP characteristics, investigating the influence of increasing MAP on the excitability of the peripheral nervous system, and investigating the effects of MAP on BIS.RESULTSIn the AH, TA, and hand muscles, Tc-mMEP amplitudes and AUC were significantly associated with MAP (P < .02). A 10 mm Hg increase of the MAP was associated with a 11.0% to 17.7% increase in the amplitude and a 10.5% to 16.8% increase in the AUC. When adjusting for BIS, propofol concentrations, and use of ephedrine, MAP remained only significantly associated with the Tc-mMEP amplitude (P = .002) and AUC (P = .003) of the AH muscles. The influence of cardiac index on Tc-mMEP amplitude and AUC provided similar results when compared to the influence of MAP on Tc-mMEP amplitude and AUC. No influence of increasing MAP on the excitability of the peripheral nervous system was found. Increasing MAP significantly increased BIS values, even when corrected for propofol concentrations.CONCLUSIONSElevation of MAP is associated with significantly higher Tc-mMEP amplitudes, AUCs, and lower voltage threshold. When corrected for BIS, propofol concentration, and use of ephedrine, the associations between increasing MAP and Tc-mMEP characteristics were largely attenuated. BIS values significantly increased by increasing MAP, when corrected for propofol concentration. Thereby, our results imply that increasing MAP increases the cortical excitability.","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145003299","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}

{"title":"In Remembrance: Jack Lancelot \"Lance\" Lichtor, MD.","authors":"Roberta L Hines","doi":"10.1213/ane.0000000000007737","DOIUrl":"https://doi.org/10.1213/ane.0000000000007737","url":null,"abstract":"","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145003300","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}

{"title":"Handoff Mnemonics: Effective in the Perioperative Setting?","authors":"","doi":"10.1213/ane.0000000000007699","DOIUrl":"https://doi.org/10.1213/ane.0000000000007699","url":null,"abstract":"","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"27 1","pages":"467"},"PeriodicalIF":0.0,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144857700","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}

{"title":"Perioperative DNR Orders: Gaps in Understanding.","authors":"","doi":"10.1213/ane.0000000000007700","DOIUrl":"https://doi.org/10.1213/ane.0000000000007700","url":null,"abstract":"","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"29 1","pages":"484"},"PeriodicalIF":0.0,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144857699","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}