Anesthesiology Research and Practice最新文献

{"title":"The Efficacy of Continuous Adductor Canal Block Oblique Approach to Postoperative Analgesia After Total Knee Arthroplasty: A Randomized, Double-Blinded, Controlled Clinical Trial.","authors":"Zhen Wan, Haiming Liao, Jinhuo Qin, Simin Tang, Jingjing Su, Jun Zhou","doi":"10.1155/anrp/3267589","DOIUrl":"https://doi.org/10.1155/anrp/3267589","url":null,"abstract":"<p><strong>Background: </strong>Continuous adductor canal block (CACB) is a highly effective analgesic technique in total knee arthroplasty. The brachy axis approach (BA) is currently the common method used for CACB. Although CACB for BA offers advantages such as easy localization and operation due to clear anatomy, it has limitations such as short catheter placement and a high dislocation rate. These limitations can result in insufficient postoperative analgesia and impact patient rehabilitation. The perineural catheters placed parallel for CACB increases the difficulty of operation and the risk of puncture injury. In this study, the authors first applied the oblique approach (OA) to CACB and systematically compared the postoperative analgesic effects and adverse reactions of these two CACB methods with different puncture angles.</p><p><strong>Methods: </strong>Ninety subjects who underwent TKA were randomly assigned to receive ultrasound-guided CACB using either the OA or BA. The main outcome measured was the exercise maximum visual analog scale (VAS) score at 72 h after surgery. The main safety indicator was the rate of catheter dislocation. The data were recorded and analyzed using analysis of variance, with adjustments made for baseline characteristics.</p><p><strong>Results: </strong>There was no statistical difference in catheter placement time or postoperative resting VAS between the two groups. However, the postoperative exercise VAS and the incidence of postoperative adverse effects were lower in the OA group compared to the BA group.</p><p><strong>Conclusions: </strong>The OA of CACB applied after TKA improved the analgesic effect during the postoperative motor state compared to the BA and reduced the incidence of adverse reactions, without increasing the catheterization procedure time.</p><p><strong>Trial registration: </strong>Chinese Clinical Trial Registry: ChiCTR2200059889.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":"2025 ","pages":"3267589"},"PeriodicalIF":1.3,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12503995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145249361","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":"Comparison of the Effects of Intravenous Dexmedetomidine and Remifentanil in Attenuating the Cardiovascular Response to Extubation in Patients Under General Anesthesia: A Randomized Clinical Trial.","authors":"Hamidreza Shetabi, Mehrdad Masoudifar, Hossein Mahjobipoor, Faezeh Poorsajad","doi":"10.1155/anrp/9949776","DOIUrl":"10.1155/anrp/9949776","url":null,"abstract":"<p><p><b>Background:</b> Considering the importance of hemodynamic stability during tracheal tube removal in patients undergoing surgery with general anesthesia. This study was designed to evaluate and compare the impacts of intravenous dexmedetomidine and remifentanil on mitigating the cardiovascular responses associated with extubation in individuals receiving general anesthesia. <b>Methods:</b> In this clinical study, a cohort of 90 patients scheduled for surgical procedures under general anesthesia was evenly divided into three groups of 30, receiving dexmedetomidine (0.7 μg/kg), remifentanil (0.3 μg/kg), or a placebo of normal saline. Hemodynamic metrics, such as heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP), were assessed at baseline, prior to extubation, and at intervals of 1, 3, 5, and 10 min following extubation. <b>Results:</b> At 1-10 min postextubation, the control group (C) had a higher HR than the dexmedetomidine (D) and remifentanil (R) groups (<i>p</i> < 0.001), there was no difference in HR between the D and R groups (<i>p</i>=0.57). There was a significant difference in SBP between D and C groups (<i>p</i>=0.09) and between D and C groups (<i>p</i>=0.047). No significant differences in DBP were found among the groups (<i>p</i> > 0.0.5). There was a notable difference in MAP changes between Groups D and C (<i>p</i>=0.010), but there were no differences between Groups D and R (<i>p</i>=0.14) and R and C (<i>p</i>=0.84). In addition, the incidence of tachycardia in Group C was significantly higher than that in other groups (<i>p</i> < 0.001). In addition, the incidence of tachycardia in Group C was significantly higher than that in other groups (<i>p</i> < 0.001). <b>Conclusion:</b> Administering dexmedetomidine at a dosage of 0.7 μg/kg enhances hemodynamic stability during extubation and decreases the occurrence of hemodynamic disturbances and coughing when compared to remifentanil at 0.3 μg/kg and the control group. Therefore, it is regarded as the optimal option for alleviating cardiovascular responses during extubation. <b>Trial Registration:</b> Iranian Clinical Trials Registry: IRCT20200825048515N74.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":"2025 ","pages":"9949776"},"PeriodicalIF":1.3,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12490926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231361","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":"A Comparison of Single Dose Remimazolam With Dexmedetomidine for the Prevention of Emergence Delirium in Children Undergoing Tonsillectomy and Adenoidectomy Surgery Under Sevoflurane Anesthesia: A Randomized Clinical Trial.","authors":"Ting Liu, Jing Zhou, Xi-Xi Wang, Si-Fei Gan, Jie-Qiong Liu, Peng-Fei Zhu, Mei-Hong Li, Fang Luo","doi":"10.1155/anrp/7780635","DOIUrl":"10.1155/anrp/7780635","url":null,"abstract":"<p><p><b>Introduction:</b> Emergence delirium, characterized by early postoperative behavioral changes in pediatric patients, poses potential risks to patient safety, resulting in extended hospital stays and increased medical costs. Remimazolam has a rapid onset, moderate half-life, and lower compression on respiratory and circulatory function. This double-blind randomized study aims to compare the incidence of emergence delirium in pediatric patients who received a single dose of remimazolam or dexmedetomidine before the end of sevoflurane anesthesia. <b>Methods:</b> A total of 110 pediatric patients aged 2-12 years, American Society of Anesthesiologists (ASA) Class I or II, undergoing elective tonsillectomy and adenoidectomy were included in this study and randomized into the dexmedetomidine group and remimazolam group (R group) (<i>n</i> = 55). Inhalation of sevoflurane was stopped 15 min before surgery after asking the surgeon's opinion, and either 0.2 mg/kg of remimazolam or 0.2 μg/kg of dexmedetomidine was administered. The main and secondary results of the research were both analyzed with the intention-to-treat analysis. The main outcome observed in this study was the incidence of emergence delirium in both groups. Secondary outcomes were vital signs at various time points after administration, Pediatric Anesthesia Emergence Delirium (PAED) scale score for delirium, extubation time, the length of time in the postanesthesia care unit (PACU), postoperative adverse events, and parental satisfaction. <b>Results:</b> The intention-to-treat analysis indicated that the mean age of patients was 5.7 ± 0.4 years, with 62 (56.4%) of them being male. The incidence of emergence delirium was 25.5% overall, with no significant difference seen between the two groups. Compared to the R group, dexmedetomidine decreased the heart rate significantly (<i>p</i> < 0.001). There were no differences in extubation time, PACU stay, postoperative adverse events, and parental satisfaction between the two groups. In addition, age is an independent risk factor contributing to the emergence delirium. <b>Conclusions:</b> Discontinuing the inhalation of sevoflurane 15 min before the end of the procedure and administering 0.2 mg/kg of remimazolam intravenously did not show superiority over 0.2 μg/kg of dexmedetomidine in preventing emergence delirium. <b>Trial Registration:</b> Chinese Registry of Clinical Trials: ChiCTR2300072526.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":"2025 ","pages":"7780635"},"PeriodicalIF":1.3,"publicationDate":"2025-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12450552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145124126","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":"Bridging the Gap: The Impact of Preoperative Nutritional Status and Inflammation in Postoperative Pain in Elderly Patients.","authors":"Rafail Ioannidis, Despoina Sarridou, Christina Tsigalou, Adamantios Bampoulas, Pelagia Chloropoulou","doi":"10.1155/anrp/6832202","DOIUrl":"10.1155/anrp/6832202","url":null,"abstract":"<p><p>Nutritional screening is gaining recognition in perioperative medicine, as anesthesiologists need to assess patients' nutritional status to identify malnutrition risks. Poor nutritional status is associated with increased perioperative complications, including postoperative pain. Effective pain management is crucial to prevent acute pain from developing into chronic pain. However, the link between malnutrition and pain is not well established, prompting interest in whether nutritional assessment tools correlate with pain severity. The Mini Nutritional Assessment Short-Form (MNA-SF) is a validated screening tool for geriatric patients, recommended by European Society for Clinical Nutrition and Metabolism (ESPEN) for routine use. The modified Nutrition Risk in Critically Ill (mNUTRIC) score evaluates critically ill patients' nutritional risk, guiding interventions to improve outcomes. This study aimed to explore the relationship between nutritional status, inflammatory markers, and postoperative pain in elderly surgical patients to optimize care. A prospective study involving 108 elderly patients (≥ 70 years) assessed the preoperative nutritional status using MNA-SF, mNUTRIC, Acute Physiology and Chronic Health Evaluation (APACHE), Sequential Organ Failure Assessment (SOFA), and inflammatory biomarkers (C-reactive protein (CRP) and albumin (Alb)). Postoperative pain was measured at surgery, 30 days, and 6 months. Statistical analysis found significant links between the nutritional status and pain outcomes. Higher mNUTRIC and APACHE scores correlated with increased pain, while higher Alb and MNA-SF scores were associated with lower pain levels. Chronic pain at 6 months was strongly linked to poor preoperative nutritional and inflammatory status. Findings suggest that nutritional deficiencies and inflammation are associated with postoperative pain and recovery. Integrating nutritional screening into preoperative assessments could improve outcomes by guiding interventions. Future research should refine predictive models to better understand the complex interplay between nutrition, inflammation, and pain in perioperative care. <b>Trial Registration:</b> ClinicalTrials.gov identifier: NCT06802575.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":"2025 ","pages":"6832202"},"PeriodicalIF":1.3,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12411042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145013699","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":"Corrigendum to \"Maternal Satisfaction and Associated Factors with Postcesarean Section Pain Management: A Cross-Sectional Study\".","authors":"","doi":"10.1155/anrp/9838065","DOIUrl":"10.1155/anrp/9838065","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1155/2024/4885678.].</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":"2025 ","pages":"9838065"},"PeriodicalIF":1.3,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12393921/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939027","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":"Anesthetic Personnel's Experiences and Perspectives With a National Standard for Safeguarding Anesthesia Practice: A Cross-Sectional Study in Norway.","authors":"Ann-Chatrin Linqvist Leonardsen, Arvid Steinar Haugen, Johan Ræder, Therese Jenssen Finjarn, Erik Isern, Elin Kismul Aakre, Anne Marie Gran Bruun, Kristoffer Hennum, Jan Petter Ramstad, Tina Sand, Cathrine Saltnes, Svein Arne Monsen","doi":"10.1155/anrp/6302974","DOIUrl":"10.1155/anrp/6302974","url":null,"abstract":"<p><p><b>Background:</b> Globally, anesthesiologists and nurse anesthetists collaborate closely during anesthesia administration. However, there is a scarcity of guidelines detailing the division of tasks and responsibilities between these two professions. The Norwegian Standard for the Safe Practice of Anesthesia (NSA) was developed jointly by the Norwegian Association of Anesthesiologists and the Norwegian Association of Nurse Anesthetists as a consensus guideline to safeguard satisfactory anesthetic practice. This study aimed to explore the experiences and perspectives of anesthesiologists and nurse anesthetists regarding the NSA. <b>Methods:</b> The study employed a cross-sectional, observational design, utilizing a questionnaire. A purposive sampling strategy was employed, inviting all members of the two associations (<i>N</i> = 3300) to participate in a web-based survey. Data were analyzed using the Statistical Package for the Social Sciences, Version 28. Descriptive statistics and independent samples <i>t</i>-tests were utilized to analyze the data. A two-sided <i>p</i> value of ≤ 0.05 was considered statistically significant. <b>Results:</b> In total, 823 respondents (24.9%) completed the questionnaire in September 2024. The results indicate several areas for improvement to achieve the recommended standards of anesthetic practice as outlined by the NSA. Statistically significant differences were observed between responses from anesthesiologists and nurse anesthetists. Approximately two-thirds of respondents reported the NSA as relevant to their daily work, and between 13 and 30 percent had experienced or were aware of situations where the standard was utilized in root cause analyses of adverse anesthetic events. <b>Conclusion:</b> The findings suggest that the NSA is employed in clinical practice. However, assuming the NSA ensures satisfactory anesthetic practice, there are several areas requiring improvement. Given the overlapping roles and responsibilities of anesthesiologists and nurse anesthetists, the NSA may serve as a model for similar guidelines in other countries.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":"2025 ","pages":"6302974"},"PeriodicalIF":1.3,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12289357/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706054","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":"Analgesic and Sedative Effect of Fentanyl Versus Dexmedetomidine Infusion in Postoperative Mechanically Ventilated Children After Open Abdominal Surgeries: Randomized Controlled Trial.","authors":"Amany Mohamed Abotaleb, Mai Rabie Elsheikh, Khalid Mohamed Elshimy, Mohamed Elsaid AbdelFattah","doi":"10.1155/anrp/9699738","DOIUrl":"10.1155/anrp/9699738","url":null,"abstract":"<p><p><b>Background:</b> Optimal sedation and analgesia management in mechanically ventilated (MV) children post-abdominal surgery remain controversial. This study compared the efficacy and safety of fentanyl versus dexmedetomidine infusion in this population. <b>Methods:</b> A randomized, double-blinded study enrolled 54 MV children aged 4-11 years post-open abdominal surgeries. Patients received either fentanyl (1 μg/kg bolus, 1-5 μg/kg/h infusion) in Group F or dexmedetomidine (1 μg/kg bolus, 0.2-0.7 μg/kg/h infusion) in Group D. Hemodynamic parameters, sedation (COMFORT-B scale), pain (FLACC scale), and weaning times were assessed. <b>Results:</b> Group D showed significantly lower mean arterial pressure and heart rates from 6 to 24 h post-intervention (<i>p</i> < 0.05). Oxygen saturation remained similar between groups. Dexmedetomidine provided superior sedation (COMFORT-B: 7 [6-8] vs. 8 [7-8], <i>p</i>=0.022) and analgesia (FLACC: 1 [1-2.5] vs. 2 [2-3], <i>p</i>=0.005). However, dexmedetomidine achieved faster weaning (25.89 ± 2.01 vs. 29.19 ± 1.44 h, <i>p</i> < 0.001) and higher extubation times (51.93 ± 4.84 vs. 43.78 ± 5.32 min, <i>p</i> < 0.001). <b>Conclusions:</b> While dexmedetomidine offered better sedation and pain control, fentanyl facilitated quicker weaning and extubation from MV and better hemodynamics in postoperative MV children after open abdominal surgeries. <b>Trial Registration:</b> ClinicalTrials.gov identifier: NCT06994273.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":"2025 ","pages":"9699738"},"PeriodicalIF":1.6,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12245487/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144607200","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":"Comparison of Nasal and Oropharyngeal Bleeding in Video Laryngoscopy Versus Direct Laryngoscopy for Nasotracheal Intubation in Maxillofacial Trauma: A Randomized Controlled Trial.","authors":"Ayman Mohamady Eldemrdash, Mohamed A Alazhary, Zaher Zaki Zaher, Tarek S Hemaida, Mohammed Essam Yahia, Soudy S Hammad","doi":"10.1155/anrp/7797828","DOIUrl":"10.1155/anrp/7797828","url":null,"abstract":"<p><p><b>Background:</b> Nasotracheal intubation (NTI) is commonly used in maxillofacial trauma but carries a high risk of bleeding and airway complications, particularly with direct laryngoscopy (DL). Video laryngoscopy (VL) provides better glottic visualization and may reduce airway trauma. This study compares VL and DL for NTI in maxillofacial trauma patients, focusing on bleeding severity, intubation efficiency, and complications. <b>Methods:</b> This randomized controlled trial included 64 patients undergoing NTI for maxillofacial trauma, randomly assigned to VL or DL. The primary outcome was nasal and oropharyngeal bleeding severity, assessed using Fromme's scale. Secondary outcomes included first-pass success rate, intubation time, need for adjunctive maneuvers (Magill forceps and cervical spine extension), and intubation-related complications. All intubations were performed under general anesthesia following standardized airway preparation. <b>Results:</b> VL resulted in significantly lower nasal and oropharyngeal bleeding severity, with no bleeding (score 0) observed in 43.8% of the VL patients versus 12.5% of the DL group (<i>p</i>=0.005). VL also resulted in shorter intubation times (51.9 ± 7.9 s vs. 58.1 ± 8.7 s; <i>p</i>=0.003). The need for adjunctive maneuvers was significantly lower in the VL group (<i>p</i> < 0.001), and severe complications such as fractured teeth or deep lip injuries occurred more frequently in the DL group (<i>p</i>=0.02). The first-pass success rate was higher in the VL group (96.9%) than in the DL group (78.1%) though the difference was not statistically significant (<i>p</i>=0.058). <b>Conclusion:</b> VL demonstrated superior intubation efficiency and reduced bleeding severity compared with DL in maxillofacial trauma patients. Given its safety advantages and reduced need for adjuncts, VL appears to be a preferable technique for NTI in maxillofacial trauma though further multicenter studies are ensured. <b>Trial Registration:</b> ClinicalTrials.gov identifier: NCT06386757.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":"2025 ","pages":"7797828"},"PeriodicalIF":1.6,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12245500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144607201","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":"Dexamethasone, Dexmedetomidine, and Combination of Dexamethasone-Dexmedetomidine as Adjuvants to Bupivacaine for Costoclavicular Block: A Randomized Controlled Study.","authors":"Keerthana Kalaimani, Anisha Pauline Paul, Aruna Parameswari, Mahesh Vakamudi, Varun Karuppiah Thiagarajan, Kishore Manivannan","doi":"10.1155/anrp/5683873","DOIUrl":"10.1155/anrp/5683873","url":null,"abstract":"<p><p><b>Background:</b> The costoclavicular block is an upcoming approach in blocking the brachial plexus for upper limb surgeries. The addition of dexamethasone and dexmedetomidine to the local anesthetic mixture can prolong the duration of analgesia of brachial plexus block. We compared the addition of three different adjuvants-dexamethasone, dexmedetomidine, and dexamethasone-dexmedetomidine combination with bupivacaine in costoclavicular block. <b>Methods:</b> We randomized 105 patients undergoing elective hand and forearm surgery under ultrasound guided costoclavicular block. Along with the local anesthetics, Group D patients received 4 mg dexamethasone, Group X patients received 1 µg/kg dexmedetomidine, and Group D-X patients received 4 mg dexamethasone and 1 µg/kg dexmedetomidine. The primary outcome analyzed was the analgesic duration. The secondary outcomes studied were the duration of sensory and motor block, time to onset of sensory and motor block, sedation scores, and adverse effects. <b>Results:</b> The duration of analgesia was significantly prolonged in Group D-X when compared to that in Group X and Group D [(19 h; IQR, 18.5-19.0 h) versus (16 h; IQR, 15.5-16.5 h) versus (13 h, IQR, 12-14 h) <i>p</i> value < 0.001]. The duration of sensory block was significantly prolonged in Group D-X compared to that in Group X and Group D [(15 h, IQR, 15-16 h) versus (13 h, IQR, 12-14 h) versus (10 h, IQR, 10-11 h) <i>p</i> value < 0.001]. Similarly, the duration of motor block was prolonged in Group D-X compared to that in Group X and Group D [(16 h; IQR: 16-17.5 h) versus (14 h; IQR; 13-15 h) versus (11 h; IQR: 11-12 h) with significant <i>p</i> value < 0.001. Also, the time to onset of sensory and motor block was earlier in Group D-X. The sedation scores were not significant, and no adverse events were observed. <b>Conclusion:</b> Addition of dexamethasone and dexmedetomidine together to a local anesthetic in ultrasound guided costoclavicular block resulted in faster onset with longer analgesic and sensorimotor block duration. <b>Trial Registration:</b> Clinical Trials Registry-India: CTRI/2024/01/061072.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":"2025 ","pages":"5683873"},"PeriodicalIF":1.6,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144625292","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 Epidemiology and Outcomes of Acute Kidney Injury in Patients With Chronic Kidney Disease: A Single-Center Retrospective Cohort Study.","authors":"Shunsuke Oura, Marie Okada, Ryo Miyashita, Shuji Yamamoto","doi":"10.1155/anrp/6657933","DOIUrl":"10.1155/anrp/6657933","url":null,"abstract":"<p><p><b>Background:</b> Previous studies have highlighted the association between chronic kidney disease (CKD) and the increased incidence of postoperative acute kidney injury (AKI). However, the risk factor and incidence of postoperative AKI in patients with CKD undergoing elective surgery remained unclear. This retrospective study aimed to evaluate the perioperative predictors of postoperative AKI in patients with CKD. <b>Methods:</b> Data from 137 patients with CKD, defined by an estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m², who underwent elective surgery under general or regional anesthesia between November 2018 and October 2023, were retrospectively reviewed. Patients were placed on a peripheral arterial catheter, and dual arterial blood gas analysis was performed within 30 min before and after surgery. Patients undergoing cardiac surgery, emergency surgery, preoperative renal replacement therapy, as well as those with missing data, were excluded from the study. Both general and local anesthesia modalities were included in the analysis. <b>Results:</b> The incidence of postoperative AKI was 24%. All cases of AKI were classified as Stage 1. Preoperative ischemic heart disease (odds ratio: 2.660, 95% CI: 1.16-6.10, <i>p</i>=0.00207) and lower eGFR (odds ratio: 0.947, 95% CI: 0.915-0.980, <i>p</i>=0.00181) were associated with increased risk of postoperative AKI. More patients who developed postoperative AKI converted to maintained dialysis compared to patients who did not develop AKI (15% vs. 2.1%, <i>p</i>=0.0021). <b>Conclusions:</b> History of ischemic heart disease and preoperative lower eGFR and may serve as risk factors for postoperative AKI in CKD patients.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":"2025 ","pages":"6657933"},"PeriodicalIF":1.6,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12133357/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144214640","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}