Anesthesiology Research and Practice最新文献

{"title":"Study the Effect of Intraperitoneal Dexamethasone, Dexmedetomidine, and Their Combination on PONV After Laparoscopic Cholecystectomy: A Randomized Triple-Blind Trial.","authors":"Hany Bauiomy, Neveen A Kohaf, Mohammed Saad, Zaky Ftouh Rashed, Ahmed M Abosakaya","doi":"10.1155/anrp/4976637","DOIUrl":"10.1155/anrp/4976637","url":null,"abstract":"<p><p><b>Background:</b> Postoperative nausea and vomiting (PONV) are major adverse consequences following laparoscopic cholecystectomy. Several drugs have been used to combat its occurrence. <b>Objective:</b> This study aimed to show the efficacy of the intraperitoneal route and compare different antiemetic effects of dexamethasone, dexmedetomidine, and their combination on PONV after laparoscopic cholecystectomy under general anesthesia in a tertiary care hospital. <b>Design:</b> Prospective randomized triple-blind study. <b>Setting:</b> The trial was conducted at Benha University Hospitals. The trial was done from August 2023 to April 2024. <b>Patients:</b> Two hundred and forty patients aged 20-50 years, Apfel Score 1, the American Society of Anesthesiologists (ASA) physical status Classification I or II who underwent laparoscopic cholecystectomy. Exclusion criteria were a history of psychotic illnesses, Parkinson's disease, motion disorder, and a history of chemotherapy. <b>Interventions:</b> Patients were randomized equally into four groups. Group I (control group) received 20 mL normal saline, Group II (dexamethasone group) received 8 mg dexamethasone, Group III (dexmedetomidine group) received dexmedetomidine 1mic/kg, and Group IV (combination group) received the combination of both dexamethasone (8 mg) + dexmedetomidine (1mic/kg). The medications were diluted in 20 mL normal saline. <b>Main Outcome Measures:</b> The incidence of PONV encountered by patients in the first 24 h following surgery was recorded. <b>Results:</b> Nausea was reported in 26 (43.33%), 10 (16.67%), 11 (18.33%), and 6 (10%) in Groups I, II, III, and IV, respectively. Vomiting was observed in 25 (41.67%), 11 (18.33%), 10 (16.67%), and five (8.33%) in Groups I, II, III, and IV, respectively. Antiemetic medication was required for 24 (40%), 11 (18.33%), 12 (20%), and eight (13.33%) in Groups I, II, III, and IV, respectively. Nausea, vomiting, and antiemetics requirements differed significantly among the four groups (<i>p</i> value < 0.05). <b>Conclusions:</b> Intraperitoneal administration of dexamethasone and dexmedetomidine either alone or in combination decreased the incidence of PONV among patients scheduled for laparoscopic cholecystectomy. <b>Trial Registration:</b> ClinicalTrials.gov identifier: NCT05988671.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":"2025 ","pages":"4976637"},"PeriodicalIF":1.6,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11876534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bispectral Index and Surgical Space Conditions in Day Surgery Benign Gynecological Laparoscopies: A Double-Blinded Randomized Clinical Trial.","authors":"Elena Crescioli, Peter Søndergaard Thyrrestrup, Thale Almås","doi":"10.1155/anrp/4558323","DOIUrl":"https://doi.org/10.1155/anrp/4558323","url":null,"abstract":"<p><p><b>Background:</b> Ambulatory surgery is increased in numbers, healthcare costs are reduced, and patient safety is high when patient characteristics and type of surgery are properly evaluated. To maintain efficiency and patient safety, anesthesia and surgery must be optimized. The bispectral index (BIS) is a widely used and simplified measure of the depth of anesthesia and may provide a more stable anesthesia and avoid insufficient levels of anesthesia. We investigated whether BIS-guided anesthesia could increase the frequency of excellent overview of the surgical field. <b>Methods:</b> This is a single-center double-blinded randomized clinical trial. We enrolled patients undergoing gynecologic laparoscopies on a benign indication from April 2019 to March 2021. Using closed envelopes, patients were randomized to receive either a BIS-assisted anesthesia, or to receive anesthesia without BIS monitoring (i.e., control group). Surgeons graded their surgical field overview using a four-grade numerical scale at three predefined time points. The primary outcome was the proportion of patients graded with an excellent surgical overview. <b>Results:</b> We included 160 women: 80 patients were randomized to the BIS group and 80 to the control group. There was no statistically significant difference between groups in excellent surgical overview at any time point. Among secondary outcomes, a lower remifentanil consumption in the control group was found in comparison with the BIS group. <b>Conclusions:</b> This trial found no clinically relevant differences regarding surgical overview quality during gynecological laparoscopic surgery when using BIS to titrate anesthesia. To our knowledge, this is the first study investigating this aspect. <b>Trial Registration</b>: ClinicalTrials.gov identifier: NCT03911544.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":"2025 ","pages":"4558323"},"PeriodicalIF":1.6,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11872287/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143539972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perfusion Index Predicts the Effectiveness of Supraclavicular Brachial Plexus Block in Children Under General Anesthesia: A Randomized Controlled Trial.","authors":"Tiantian Chu, Siqi Zhou, Ting Peng, Hong Tao, Han Chen, Xu Yan, Yueyang Xin, Zhang Tian, Jinxu Wang, Lingli Deng, Aijun Xu","doi":"10.1155/anrp/5583145","DOIUrl":"https://doi.org/10.1155/anrp/5583145","url":null,"abstract":"<p><p><b>Objectives:</b> This study aimed to assess the predictive value of perfusion index (PI) in determining the effectiveness of supraclavicular block (SCB) in children under sevoflurane or propofol general anesthesia. <b>Methods:</b> In this randomized controlled study, 104 children who underwent elective upper extremity surgery under sevoflurane or propofol anesthesia were scheduled to be enrolled. The primary outcome was the effects of PI in predicting the effectiveness of SCB under general anesthesia. The PI value was obtained through pulse oximetries. Secondary outcomes include hemodynamic data, supplementary opioid doses, agitation score, pain score, and postoperative complications. <b>Results:</b> A total of 103 pediatric patients were analyzed. PI increased rapidly after anesthesia induction, and there was no significant difference in PI in the blocked side between the propofol group (PRO group) and sevoflurane group (SEV group). At 10 min after the block, PI in the blocked side was higher than that in the unblocked side in both groups (<i>p</i> < 0.05). However, PI showed low sensitivity and specificity in predicting the effect of SCB at 10 min in both groups. At PACU, PI exhibited a high sensitivity (0.837 vs. 0.796) and specificity (0.721 vs. 0.898) for SCB at cutoff values of 5.91 and 6.67 in both PRO and SEV groups. The area under the receiver operating characteristic curve (AUROC) values were 0.834 (95% CI 0.750-0.918) and 0.895 (95% CI 0.832-0.959). <b>Conclusion:</b> PI demonstrates limited sensitivity and specificity in predicting the effect of SCB at 10 min after block under general anesthesia. However, PI may serve as a more appropriate indicator to guide the necessity for supplemental analgesia in PACU. <b>Trial Registration:</b> ClinicalTrials.gov identifier: NCT04216823.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":"2025 ","pages":"5583145"},"PeriodicalIF":1.6,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11871980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143539973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"On-Pump FIBTEM-A5 Accurately Predicts the A5 Values After Protamine Administration.","authors":"Stanislaw Vander Zwaag, Matus Tomko, Tomas Madej, Jens Fassl","doi":"10.1155/anrp/2924468","DOIUrl":"10.1155/anrp/2924468","url":null,"abstract":"<p><p><b>Introduction:</b> In the present study, we aimed to investigate whether the measurements of the fibrinogen-dependent clot firmness in FIBTEM-one of the rotational thromboelastometry (ROTEM) assays-during cardiopulmonary bypass (CPB) accurately predict the values after protamine administration. <b>Materials and Methods:</b> In this single-center retrospective observational study, we analyzed a database of patients undergoing on-pump surgeries between May 2022 and February 2024. We included patients in whom an intraoperative ROTEM examination during CPB and a follow-up examination directly after protamine infusion were performed. We excluded patients who received either fibrinogen concentrate or fresh frozen plasma between the two examinations. FIBTEM A5 values in both examinations were compared. The Wilcoxon signed rank test was used to compare non-normally distributed data. Linear regression analysis was used to investigate the relationship between the on-pump and postprotamine FIBTEM A5 values. <b>Results:</b> Seventy patients were included in the statistical analysis. There was a slight but statistically significant difference between FIBTEM A5 during CPB (median 16.0 mm, IQR 10.0-22.0) and after protamine administration (median 15.5 mm, IQR 8.7-22.3, <i>p</i> = 0.021). However, in linear regression analysis, FIBTEM A5 values during the last 30 min of the extracorporeal circulation were a significant predictor of FIBTEM A5 after protamine administration (<i>R</i> = 0.902, <i>R</i> ² = 0.813, adjusted <i>R</i> ² = 0.810, F(df regression, df residual) = 295.980, <i>p</i> < 0.001). The equation: <i>y = </i>0.911<i>x</i> <i>+</i> 1 describes the line of best fit. <b>Conclusions:</b> Within the normal range limits, there is a very strong correlation between on-pump FIBTEM A5 values and FIBTEM A5 values after protamine administration.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":"2025 ","pages":"2924468"},"PeriodicalIF":1.6,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11824858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of the Association Between Neuraxial Anesthesia and Back Pain After Delivery: A Systematic Review and Meta-Analysis.","authors":"Sara Timerga, Getaw Walle, Wondwosen Mebratu, Aynalem Befkadu","doi":"10.1155/anrp/2105413","DOIUrl":"10.1155/anrp/2105413","url":null,"abstract":"<p><p><b>Background:</b> Back pain after delivery both under cesarean section and spontaneous vaginal delivery is the most common pregnancy-related musculoskeletal problem. There are multiple studies that emphasize the effect of epidural anesthesia and spinal anesthesia on the incidence and severity of postdelivery back pain. There are others stating no association between the two. <b>Objective:</b> The aim of this study is to summarize the relationship between back pain after delivery and neuraxial anesthesia. <b>Methods:</b> Studies identified from database: Cochrane Library, The Virtual Health Library, National Library of Medicine PubMed, Google Scholar, and citation searching with both experimental and observational study design were included. Exposed and nonexposed incidence of back pain was extracted to analyze the pooled odds ratio assessing the association of postpartum back pain and neuraxial anesthesia. Heterogeneity was checked across studies using Cochrane <i>Q</i> test statistic and <i>I</i> ². Small study effect was assessed using a funnel plot graphically and nonparametric rank correlation (Begg) test. <b>Results:</b> Four RCT and 11 observational studies were identified for analysis. The studies included mothers delivering under cesarean section and vaginal delivery with epidural anesthesia, spinal anesthesia, and combined spinal epidural anesthesia. Based on the 15 studies included in this meta-analysis, the pooled odds ratio according to random effect restricted maximum-likelihood model was 1.2 (95% CI (0.77-1.86)) with <i>p</i> value = 0.43. There was a significant heterogeneity with <i>I</i> ² = 97.76%, <i>H</i> ² = 44.58, and Cochrane <i>Q</i> statistics <i>p</i> value = 0.001. <b>Conclusion:</b> Our result suggests neuraxial anesthesia may not be the cause or the risk factor for the overwhelmingly high incidence of back pain women experience after delivery.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":"2025 ","pages":"2105413"},"PeriodicalIF":1.6,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11824844/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Remimazolam on the Baseline TOF Ratio: A Prospective, Clinical Study.","authors":"Tomoko Yuruki, Masafumi Fujimoto, Naoyuki Hirata","doi":"10.1155/anrp/9990140","DOIUrl":"10.1155/anrp/9990140","url":null,"abstract":"<p><p><b>Background:</b> Remimazolam is a newly developed benzodiazepine. Early recovery from anesthesia because of its ultra-short acting effect and less hemodynamic side effects has been reported as the specific advantages of remimazolam. Therefore, the maintenance of anesthesia with propofol may be sometimes switched to remimazolam anesthesia maintenance during surgery because of the risk of delayed awakening and unstable hemodynamics. In the present study, to determine the influence of switching anesthesia from propofol to remimazolam on the baseline TOF ratio, the TOF ratio under remimazolam anesthesia maintenance without any neuromuscular blocking agents was compared to that calibrated after induction of general anesthesia with propofol. <b>Methods:</b> Twelve patients scheduled for elective surgery under general anesthesia in the supine position were investigated. After induction of general anesthesia with remifentanil and propofol, a supraglottic airway was inserted without neuromuscular blockade, and TOF stimulation every 15 s at the adductor pollicis muscle was started with acceleromyography. After stable baseline responses to TOF stimulation being obtained for at least 10 min under propofol anesthesia, the anesthetic agent was switched to remimazolam and TOF stimulation every 15 s was maintained for a further 60 min without any interruption. In each case, the averaged TOF ratio during the last 10 min of TOF monitoring was compared to that during the 10 min immediately before the beginning of remimazolam infusion using a paired <i>t</i>-test. <b>Results:</b> There were no significant differences in the TOF ratios before and after switching anesthesia to remimazolam (1.07 ± 0.03 vs. 1.07 ± 0.03, <i>p</i>=0.325). <b>Conclusion:</b> Switching anesthesia from propofol to remimazolam does not affect the baseline TOF ratio.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":"2024 ","pages":"9990140"},"PeriodicalIF":1.6,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11620802/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142783864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of High-Volume Low-Concentration Intraperitoneal Bupivacaine Irrigation for Postoperative Analgesia in Patients Undergoing Laparoscopic Cholecystectomy: Bupivacaine Irrigation for Analgesia.","authors":"Swati Panwar, Mona Arya, J S Dali, Kapil Chaudhary, Sushanto Neogi","doi":"10.1155/2024/4545400","DOIUrl":"https://doi.org/10.1155/2024/4545400","url":null,"abstract":"<p><p><b>Background:</b> Intraperitoneal irrigation with a low-volume, high-concentration local anaesthetic in laparoscopic cholecystectomy (LC) provides less pain relief. We investigated the impact of high-volume, low-concentration bupivacaine on postoperative pain and opioid requirement. <b>Methods:</b> Patients undergoing LC were randomised into Group B (20 mL of 0.5% bupivacaine in 480 mL normal saline) or Group S (500 mL of normal saline). Fifteen patients were included in both the groups but one patient was excluded from Group S because of bile duct injury. The primary outcome was Duration of Analgesia (DOA). The secondary outcomes were the Numeric Pain Rating Scale (NRS) at extubation, at 15 min, 30 min and 1, 2, 4, 8, 12 and 24 h. Cumulative rescue analgesics, incidence of postoperative nausea, vomiting and shoulder pain. <b>Results:</b> Mean (median/range) duration of analgesia was 6.45 ± 5.57 h (6/0.15-24) in Group B vs 3.18 ± 4.21 h (0.3/0.15-12) in Group S. Cumulative requirement of rescue analgesic was higher in saline group being 56.25 ± 33.92 mg for diclofenac and 83.57 ± 66.75 mg for tramadol vis-à-vis 40.9 ± 39.17 mg and 30.00 ± 52.78 mg, respectively, in bupivacaine group. <b>Conclusion:</b> Irrigation of the peritoneal cavity with high-volume low-concentration bupivacaine in LC increases the duration of analgesia and decreases the analgesic requirement in the postoperative period. <b>Trial Registration:</b> ClinicalTrials.gov identifier: CTRI/2019/02/017802 dated 25/02/2019.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":"2024 ","pages":"4545400"},"PeriodicalIF":1.6,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11540860/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142602968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between MRI Findings of Facet Arthropathy and Synovitis With Health-Related Outcome and Pain Scores Following Therapeutic Lumbar Facet Injections.","authors":"Michael S Green, Michele Van Hal, Matthew Onimus, Christopher R Hoffman, Dhruv K C Goyal, Valeria Potigailo, Khuram S Kazmi","doi":"10.1155/2024/7889539","DOIUrl":"10.1155/2024/7889539","url":null,"abstract":"<p><p>Low back pain is a common complaint among adults. The facet joint is a major source of lumbar pain, and therapeutic facet injections have gained popularity as a minimally invasive treatment option. In addition, magnetic resonance imaging (MRI) utilization for diagnosing low back pain has increased significantly over the past few decades. Facet synovitis is an entity characterized by edema and inflammatory changes affecting the facet joints, adjacent bone marrow, and surrounding soft tissues. Although its underlying etiology remains poorly understood, recent reports suggest a high incidence in patients with arthropathy and arthritis. It is essential to explore potential correlations between specific MRI findings and outcomes after lumbar facet injections. This investigation is particularly relevant for facet synovitis, given its inflammatory nature and the common use of anti-inflammatory agents in facet injections. We investigated associations between MRI evidence of facet arthropathy and/or synovitis and the degree of improvement in health-related outcome and pain scores after therapeutic facet injections. The review was conducted on patients who received bilateral therapeutic facet injections, excluding those with prior lumbar spinal surgery or transitional segments. Facet arthropathy and synovitis were assessed on MRI by two neuroradiologists, and postprocedure outcomes such as pain and function were compared using univariate and multivariate analyses based on MRI findings. Our retrospective review indicates that patients receiving facet injections experience greater mean reduction in daily activity and workability burden scores from back pain when facet synovitis is a known portion of their pathology. The authors pose that further study could help identify patient populations that are the best candidates for therapeutic intervention. This may ultimately improve delivery of care, cost efficacy, and patient satisfaction.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":"2024 ","pages":"7889539"},"PeriodicalIF":1.6,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11511585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142493141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of a Nasal Cannula as a Preoxygenation Adjunct: A Randomized Crossover Study.","authors":"Murphy Joel, Suvajit Podder, Savan Kumar Nagesh, Ramyatha Aithal, Aditya R Devalla, Shaji Mathew","doi":"10.1155/2024/7873142","DOIUrl":"https://doi.org/10.1155/2024/7873142","url":null,"abstract":"<p><strong>Background: </strong>Preoxygenation prior to induction of general anesthesia is intended to increase the oxygen reserve in the lungs. This technique delays the onset of hypoxemia during the placement of the tracheal tube.</p><p><strong>Objective: </strong>To observe the benefits of oxygen through nasal cannula when used as an adjunct during preoxygenation.</p><p><strong>Methods: </strong>We enrolled 30 healthy volunteers and conducted a sequence of six preoxygenation tests. These included 3-minute tidal volume breathing and 8 vital capacity breaths, with and without oxygen flowing through the nasal cannula as an adjunct. Subjects were kept at a supine position with a face mask on their faces. Their baseline vitals were measured and end-tidal O₂ (ETO₂) was recorded at the end of each test. The comfort of each technique was also assessed.</p><p><strong>Results: </strong>When comparing the efficacy of the two preoxygenation methods, we found that the addition of oxygen through the nasal cannula improved the efficacy of preoxygenation with both the 3-minute tidal volume breathing method and the 8 vital capacity method (<i>p</i> < 0.001). The three-minute tidal volume breathing technique had higher end-tidal oxygen when compared to the eight vital capacity breaths.</p><p><strong>Conclusions: </strong>The administration of oxygen through a nasal cannula during preoxygenation improves the efficacy of preoxygenation in healthy volunteers. Tidal volume breathing for three minutes achieves a higher end-tidal oxygen concentration compared to eight vital capacity breaths over one minute.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":"2024 ","pages":"7873142"},"PeriodicalIF":1.6,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11392575/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Weight-Based Standardized Sugammadex Dosing in Pediatrics: A Quality Improvement Initiative to Improve Compliance with Dosing Guidelines and Reduce Waste and Cost.","authors":"Sydney E S Brown, Michael Meyer, Andrea Meyer, Ruth Cassidy, Xinyi Zhao, Deborah Wagner, Laura Wetzel, Douglas A Colquhoun","doi":"10.1155/2024/6049114","DOIUrl":"10.1155/2024/6049114","url":null,"abstract":"<p><strong>Methods: </strong>Sugammadex vials were fractionated into 25, 50, or 100 mg aliquots, which would be distributed to anesthesia staff by pharmacy staff in approximate 2 mg/kg of actual body weight doses (±10%). We analyzed changes in sugammadex waste and dosing practices 1/1/2019 to 3/15/2023 pre/postintervention (4/1/2021). We gauged dose appropriateness using last train of four (TOF) prior to sugammadex administration.</p><p><strong>Results: </strong>7,889 patients 2-17 years (4,771 with documented TOF), ASA 1-4 receiving general anesthesia with a steroidal NMB medication and sugammadex reversal. Pre- and postintervention mean doses were 2.5 mg/kg (SD: 1.2) and 2.4 mg/kg (SD: 0.96), respectively. A smaller proportion of cases received standard 2 or 4 mg/kg doses (pre: 77.6 vs. post: 66.7%). Mean waste per case declined from 4.2 mg/kg (SD: 4.1) to 0.22 mg/kg (SD: 0.38). Among cases with 0 or 1 measured twitches on TOF that should receive at least 4 mg/kg, fewer received at least 3.6 mg/kg (post: 56.7% vs. pre: 66.8%), and a greater proportion received less than 2.2 mg/kg (post: 27.4% vs. pre: 20.7%). Among cases that should have received at least 2 mg/kg by TOF, the proportion of patients receiving more than 3.6 mg/kg declined from 9.5% to 5.2%. <i>Discussion</i>. Fractionating sugammadex vials was associated with decreases in waste, but not dose, and significant underdosing was more likely to occur. While vial fractionation could enable increased access to sugammadex and other costly medications, it may introduce unintended consequences.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":"2024 ","pages":"6049114"},"PeriodicalIF":1.6,"publicationDate":"2024-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11366054/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}