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Intrathecal Drug Delivery System in Prepontine Cistern for Patients with Intractable Craniofacial Cancer Pain: A Multicenter Retrospective Study. 针对顽固性颅面癌疼痛患者的鞘内给药系统:一项多中心回顾性研究
Anesthesia & Analgesia Pub Date : 2024-09-11 DOI: 10.1213/ane.0000000000007262
Dongju Long,Xinning Li,Yu Zhang,Jia Luo,Bojing Liu,Bo Hong,Fan Yang,Cong Zou,Feng Ge,Aimin Zhang,Huacheng Zhou,Yanying Xiao,Yaping Wang
{"title":"Intrathecal Drug Delivery System in Prepontine Cistern for Patients with Intractable Craniofacial Cancer Pain: A Multicenter Retrospective Study.","authors":"Dongju Long,Xinning Li,Yu Zhang,Jia Luo,Bojing Liu,Bo Hong,Fan Yang,Cong Zou,Feng Ge,Aimin Zhang,Huacheng Zhou,Yanying Xiao,Yaping Wang","doi":"10.1213/ane.0000000000007262","DOIUrl":"https://doi.org/10.1213/ane.0000000000007262","url":null,"abstract":"BACKGROUNDPatients with craniofacial cancer frequently suffer from severe pain. The traditional intrathecal, oral, or intravenous analgesics could only provide insufficient pain relief with many side effects. Thus, a more effective analgesia approach is required. This study aimed to investigate the safety and efficacy of placing the catheter of an intrathecal morphine pump in the prepontine cistern for the treatment of craniofacial cancer pain.METHODSWe performed a retrospective study of patients with primary or metastatic craniofacial cancer pain who received the catheter placement of an intrathecal morphine pump into the prepontine cistern in eleven medical centers from September 2019 to December 2023. Friedman test and pairwise signed-rank test were used to evaluate the difference in numeric rating scale (NRS) scores, the number of breakthrough pain episodes, dose of intrathecal morphine, and dose of systemic morphine equivalents (oral, patch, intravenous) from preoperative period to postoperative days 1, 7, and 30. P values were corrected for multiple comparisons using Bonferroni test.RESULTSThe study included 33 patients. The median (interquartile range [IQR]) of NRS scores at days 1, 7, and 30 postimplant were 2.0 (1.0-3.5), 2.0 (1.0-2.0), and 1.0 (1.0-2.0), respectively, which was significantly lower than that before surgery (median, 8.0; IQR, 7.0-10.0; all P < .001). Compared to baseline number/d of breakthrough pain episodes (median, 6.0; IQR, 4.5-10.0), there was a progressive decrease in the number/d of breakthrough pain episodes at day 1, day 7, and day 30 postimplant, and the median (IQR) were 1.0 (0.0-3.0), 2.0 (0.0-3.0), and 0.0 (0.0-1.2), respectively (all P < .001). Approximately 78.8% and 96.7% of patients reported pain relief >50% at days 1 and 30 postimplant, respectively. Compared with that at day 1 postimplant, the proportion of patients with a pain relief rate >75% at day 30 postimplant also increased with continued intrathecal treatment. Compared to the dose of baseline systemic morphine equivalents (median, 228 mg.d-1; IQR, 120-408 mg.d-1), the dose of systemic morphine equivalents reduced significantly from 0(0-120) mg.d-1 at day 1 postimplant (P = .001), to 0 (0-0) mg.d-1 at days 7 and 30 postimplant (both P < .001). Few patients reported perioperative adverse events, including nausea, constipation, hypotension, urinary retention, dry mouth, headache, and sedation. No severe adverse events occurred.CONCLUSIONSPlacing the catheter tip of an intrathecal morphine pump into the prepontine cistern could effectively relieve refractory craniofacial cancer pain with an extremely low total morphine dose requirement and few adverse events. This procedure could be considered in patients with severe refractory craniofacial cancer pain.","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"42 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142174726","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
Pro-Con Debate: Anesthesiologists Should Be Responsible for Treating Preoperative Anemia. 正反方辩论:麻醉师应负责治疗术前贫血。
Anesthesia & Analgesia Pub Date : 2024-09-09 DOI: 10.1213/ane.0000000000006854
Nadia B Hensley,Steven M Frank,Edward C Nemergut,Grant A Neely
{"title":"Pro-Con Debate: Anesthesiologists Should Be Responsible for Treating Preoperative Anemia.","authors":"Nadia B Hensley,Steven M Frank,Edward C Nemergut,Grant A Neely","doi":"10.1213/ane.0000000000006854","DOIUrl":"https://doi.org/10.1213/ane.0000000000006854","url":null,"abstract":"In this Pro-Con commentary article, we discuss whether anesthesiologists should be responsible for treating preoperative anemia. This debate was proposed based on the article published in this issue of Anesthesia & Analgesia by Warner et al, which is an advisory on managing preoperative anemia endorsed by both the Society of Cardiovascular Anesthesiologists and the Society for Advancement of Patient Blood Management. All evidence suggests that anemia is not just an innocent \"bystander\" which can be solved by transfusion. In fact, both anemia and transfusion are independently associated with adverse outcomes, so why not avoid both? It just makes sense that patients show up for surgery with enough red blood cells to avoid needing transfusion with someone else's. Even if we agree that preoperative anemia is worth treating before surgery, the question remains who should be responsible for doing so, and therein lies the reason for this Pro-Con debate. Should it be the responsibility of the anesthesiologist, or not? Let the readers decide.","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142170685","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
A Randomized Trial of Shortened Air-Q Self-Pressurizing Intubating Laryngeal Airway Versus Williams Intubating Airway for Flexible Bronchoscopic Intubation. 用于灵活支气管镜插管的缩短型 Air-Q 自加压喉插管气道与威廉姆斯插管气道的随机试验。
Anesthesia & Analgesia Pub Date : 2024-09-06 DOI: 10.1213/ane.0000000000006945
Claire X Sun,Kristopher M Schroeder,Richard E Galgon
{"title":"A Randomized Trial of Shortened Air-Q Self-Pressurizing Intubating Laryngeal Airway Versus Williams Intubating Airway for Flexible Bronchoscopic Intubation.","authors":"Claire X Sun,Kristopher M Schroeder,Richard E Galgon","doi":"10.1213/ane.0000000000006945","DOIUrl":"https://doi.org/10.1213/ane.0000000000006945","url":null,"abstract":"","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142170681","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
The Use of Ultrasound in Airway Management: Video in Clinical Anesthesia 超声波在气道管理中的应用:临床麻醉视频
Anesthesia & Analgesia Pub Date : 2024-09-04 DOI: 10.1213/ane.0000000000007046
Sara Hora Gomes, Robert Canelli, Francesco Corradi, José Miguel Pêgo, Maxwell B. Baker, Federico Bilotta
{"title":"The Use of Ultrasound in Airway Management: Video in Clinical Anesthesia","authors":"Sara Hora Gomes, Robert Canelli, Francesco Corradi, José Miguel Pêgo, Maxwell B. Baker, Federico Bilotta","doi":"10.1213/ane.0000000000007046","DOIUrl":"https://doi.org/10.1213/ane.0000000000007046","url":null,"abstract":"An abstract is unavailable.","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"214 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142259383","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
In Response 回应
Anesthesia & Analgesia Pub Date : 2024-09-04 DOI: 10.1213/ane.0000000000007154
Stephen Jackson, James M. Hunter, Gail A. Van Norman
{"title":"In Response","authors":"Stephen Jackson, James M. Hunter, Gail A. Van Norman","doi":"10.1213/ane.0000000000007154","DOIUrl":"https://doi.org/10.1213/ane.0000000000007154","url":null,"abstract":"An abstract is unavailable.","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142235268","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
A Process-Based Standardization of an Intraoperative Escalation Protocol in Anesthesiology 麻醉学术中升级规程的流程标准化
Anesthesia & Analgesia Pub Date : 2024-09-04 DOI: 10.1213/ane.0000000000006782
Shilen P. Thakrar, Christin Kim, Olga Suarez-Winowiski, Sergio B. Navarrete, Kenneth F. Potter, Praveen Prasanna, Jamie P. Graham, Mofya S. Diallo, Laura Lahaye, Alice A. Tolbert Coombs
{"title":"A Process-Based Standardization of an Intraoperative Escalation Protocol in Anesthesiology","authors":"Shilen P. Thakrar, Christin Kim, Olga Suarez-Winowiski, Sergio B. Navarrete, Kenneth F. Potter, Praveen Prasanna, Jamie P. Graham, Mofya S. Diallo, Laura Lahaye, Alice A. Tolbert Coombs","doi":"10.1213/ane.0000000000006782","DOIUrl":"https://doi.org/10.1213/ane.0000000000006782","url":null,"abstract":"ads to “near-misses,” adverse outcomes, and serious safety events (SSEs). The principles of an escalation culture have been used successfully in other highly reliable industries such as aviation, military, and manufacturing. We discuss here the introduction of a unique and compelling thought-process for developing an intraoperative escalation protocol that is specifically tailored for our institution. Inspired by a critical intraoperative event, this departmental protocol was developed based on an analysis of multispecialty literature and expert opinion to decrease the incidence of SSEs. It includes a stepwise approach and incorporates patient-specific information to guide team members who encounter dynamic clinical situations. The implementation of the protocol has facilitated continuous quality improvement through iterative education, improving communication, and enhancing decision-making. Concurrently, we have plans to incorporate technology and electronic decision support tools to enhance real-time communication, monitor performance, and foster a culture of safety....","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"38 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142259385","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
Persistent Opioid Use in New Zealand: Insight From a Universal Health System 新西兰持续使用阿片类药物的情况:全民医疗系统的启示
Anesthesia & Analgesia Pub Date : 2024-09-04 DOI: 10.1213/ane.0000000000007189
Naveen Nathan
{"title":"Persistent Opioid Use in New Zealand: Insight From a Universal Health System","authors":"Naveen Nathan","doi":"10.1213/ane.0000000000007189","DOIUrl":"https://doi.org/10.1213/ane.0000000000007189","url":null,"abstract":"An abstract is unavailable.","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142259387","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
Remote Monitoring and Artificial Intelligence: Novel Technologies and New Threats 远程监控与人工智能:新技术与新威胁
Anesthesia & Analgesia Pub Date : 2024-09-04 DOI: 10.1213/ane.0000000000007176
Fredrik Granholm, Derrick Tin, Richard Staynings, Gregory R. Ciottone
{"title":"Remote Monitoring and Artificial Intelligence: Novel Technologies and New Threats","authors":"Fredrik Granholm, Derrick Tin, Richard Staynings, Gregory R. Ciottone","doi":"10.1213/ane.0000000000007176","DOIUrl":"https://doi.org/10.1213/ane.0000000000007176","url":null,"abstract":"An abstract is unavailable.","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"44 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142235262","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
In Response 回应
Anesthesia & Analgesia Pub Date : 2024-09-04 DOI: 10.1213/ane.0000000000007177
Max Feinstein, Daniel Katz, Samuel Demaria, Ira S. Hofer
{"title":"In Response","authors":"Max Feinstein, Daniel Katz, Samuel Demaria, Ira S. Hofer","doi":"10.1213/ane.0000000000007177","DOIUrl":"https://doi.org/10.1213/ane.0000000000007177","url":null,"abstract":"An abstract is unavailable.","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"94 7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142235263","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
In Response 回应
Anesthesia & Analgesia Pub Date : 2024-09-04 DOI: 10.1213/ane.0000000000007148
Sherry Y. Jin, Allana Munro, Dolores M. McKeen, Vishal Uppal
{"title":"In Response","authors":"Sherry Y. Jin, Allana Munro, Dolores M. McKeen, Vishal Uppal","doi":"10.1213/ane.0000000000007148","DOIUrl":"https://doi.org/10.1213/ane.0000000000007148","url":null,"abstract":"An abstract is unavailable.","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"21 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142235269","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
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