Anesthesiology Research and Practice最新文献

{"title":"Effect of Preoperative 2-Hour Carbohydrate Load on Pediatric Patients Undergoing Elective Surgery: A Randomized Controlled Study.","authors":"Wafaa Madhy Atia Abdelwahed, Wafaa Mohamed Abdelelsalam, Ola Ahmed Taha, Shaimaa Abdelbadie, Amany Mohamed Abo Taleb","doi":"10.1155/anrp/5580879","DOIUrl":"10.1155/anrp/5580879","url":null,"abstract":"<p><strong>Background: </strong>Preoperative prolonged fasting can lead to metabolic disturbances and discomfort in pediatrics. This work aimed to assess the systemic effect of different preoperative carbohydrate (CHO) loads in pediatrics undergoing elective surgery.</p><p><strong>Methods: </strong>This randomized single-blinded controlled trial was performed on 90 children, aged 5-10 years old, who were scheduled for elective surgery. Three equal groups were randomly assigned to patients. 2 h before surgery, patients received 10 mL/kg apple juice in Group 1, 1.75 mg/kg anhydrous glucose in Group 2, or water in Group 3. All patients followed standard fasting guidelines.</p><p><strong>Results: </strong>Inflammatory markers were notably elevated in Group 3 than in Groups 1 and 2 at the induction of anesthesia and 4 h after operation (<i>p</i> < 0.001). Insulin resistance (IR) markers significantly decreased in Group 3 at the induction of anesthesia but were significantly higher at 4 h after operation than in Groups 1 and 2 (<i>p</i> < 0.05). Random blood sugar was notably lower in Group 3 than in Groups 1 and 2 at induction of anesthesia and intraoperative but was significantly higher at 4 h after operation (<i>p</i> < 0.05). The patients' parents were significantly more satisfied in Groups 1 and 2 in comparison to Group 3 (<i>p</i> = 0.003).</p><p><strong>Conclusions: </strong>In pediatrics undergoing elective surgeries, preoperative CHO loading is a safe alternative to standard fasting as it results in better preservation of IR markers, inflammatory response, and parents' satisfaction levels.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier: NCT06833671.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":"2025 ","pages":"5580879"},"PeriodicalIF":1.3,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12675301/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145699363","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 Efficacy of Combinational Continuous Suprainguinal Fascia Iliaca Block and Pericapsular Nerve Group Block: A Retrospective Observational Study.","authors":"Kazuki Doi, Shunsuke Saima, Takashi Asai, Yasuhisa Okuda","doi":"10.1155/anrp/9975787","DOIUrl":"10.1155/anrp/9975787","url":null,"abstract":"<p><strong>Purpose: </strong>We conducted a retrospective observational study to assess if the combinational continuous suprainguinal fascia iliaca block and pericapsular nerve group block would be effective in inhibiting postoperative pain in patients undergoing total hip arthroplasty.</p><p><strong>Methods: </strong>In 40 patients who underwent elective total hip arthroplasty via anterior approach (April, 2023-April, 2024), suprainguinal fascia iliaca block and PENG block were performed with 25 mL of 0.2% levobupivacaine before induction of general anesthesia. Postoperatively, 0.125% levobupivacaine was continuously infused (at 4 mL h^-1) for suprainguinal fascia iliaca block. Postoperatively, the numerical rating scale (NRS) of pain at rest was recorded immediately after surgery and at 2, 6, 12, 24, and 48 h after surgery. Primary outcome measure was the incidence of rebound pain, and secondary outcome measure was the incidence of postoperative acute pain.</p><p><strong>Results: </strong>Postoperative acute pain was observed in 22 of 39 patients (56% [95% confidence interval: 40%-72%]). In the remaining 17 patients, rebound pain was observed in 2 (12% [95% confidence interval: 0%-27%]).</p><p><strong>Conclusions: </strong>We conclude that in the patients who underwent total hip arthroplasty via anterior approach, combinational use of continuous suprainguinal fascia iliaca block and PENG block may frequently be insufficient to prevent postoperative acute pain but may be effective in reducing the incidence of rebound pain.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":"2025 ","pages":"9975787"},"PeriodicalIF":1.3,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12661899/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145647018","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":"MIF-Mediated NLRP3 Inflammasome-Dependent Pyroptosis in Spinal Neurons and Microglial Polarization Facilitate Neuropathic Pain Progression.","authors":"Feng Zhou, Yue Tian, Wei Liao, Qingling Ma, Han Bao, Fanqing Meng, Jingjing Jiang","doi":"10.1155/anrp/6624776","DOIUrl":"10.1155/anrp/6624776","url":null,"abstract":"<p><p>Despite considerable advancements in therapeutic approaches, neuropathic pain remains a globally prevalent and challenging source of chronic suffering, underscoring the urgent demand for innovative treatment strategies. Here, we investigated the role of macrophage migration inhibitory factor (MIF) in neuropathic pain using a rodent model of chronic constriction injury (CCI) to the sciatic nerve, approved by the Ethical Committee of Animal Use and Care. Mechanical thresholds (von Frey hairs) and thermal latencies (hot plate) were measured, alongside spinal MIF expression, pyroptosis markers (e.g., GSDMD-N), and inflammatory cytokines (IL-1β, IL-6, and TNF-α). Our results showed that spinal MIF levels surged post-CCI, peaking on day 14 (<i>p</i> < 0.001), and drove microglial M1 polarization and inflammatory cytokine release (all <i>p</i> < 0.01). Notably, MIF activated the NLRP3 inflammasome, exacerbating neuronal pyroptosis (<i>p</i> < 0.01). These effects were mitigated by MIF inhibitor ISO-1 or NF-κB inhibitor PDTC, which reduced neuroinflammation and pain hypersensitivity. Collectively, this study reveals that MIF promotes NLRP3 inflammasome-mediated neuronal pyroptosis and microglial polarization via the NF-κB pathway, providing novel mechanistic insights into neuropathic pain alleviation through MIF inhibition.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":"2025 ","pages":"6624776"},"PeriodicalIF":1.3,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12659770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145647116","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":"Advantages of Blunt Radiofrequency Needles in CT-Guided Dorsal Root Ganglion Pulsed Radiofrequency for the Treatment of Zoster-Associated Pain.","authors":"Guanghui Zhang, Jing Yang, Xin Yao, Kai Luo, Zhiji Chen, Shuxiu Feng, Chunfang Wang, Xiaolan Gao, Zelin Weng","doi":"10.1155/anrp/8776779","DOIUrl":"10.1155/anrp/8776779","url":null,"abstract":"<p><strong>Objective: </strong>Compare the clinical efficacy of CT-guided blunt versus sharp needles for dorsal root ganglion-pulsed radiofrequency (DRG-PRF) in treating zoster-associated pain (ZAP).</p><p><strong>Method: </strong>This retrospective study analyzed 70 ZAP patients receiving CT-guided DRG-PRF between January 2021 and December 2024. Participants were divided into the blunt needle group (BNG, <i>n</i> = 30) and the sharp needle group (SNG, <i>n</i> = 40). Evaluated endpoints encompassed SF-MPQ scores, postoperative analgesia use, intraprocedural trajectory pain (NRS), operative time, number of CT scan slices, and incidence of complications.</p><p><strong>Result: </strong>The BN group showed lower puncture NRS scores, shorter operative time, and fewer CT scan layers than the SN group (<i>p</i> < 0.05). SF-MPQ scores (PRI, VAS, and PPI) decreased in both groups postoperatively (<i>p</i> < 0.05), with lower PRI and PPI in the BN group at Day 1, Week 1, and Months 1 and 3 (<i>p</i> < 0.05). Pregabalin use was lower in the BN group at Months 3 and 6, and tramadol use was lower at Week 1 and Month 1 (<i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>CT-guided DRG-PRF demonstrates good analgesic efficacy in the treatment of ZAP. Compared with sharp needles, blunt needles show superior performance in terms of intraoperative puncture pain, procedure duration, radiation exposure, and postoperative medication use. As an optimized puncture instrument for DRG-PRF, the blunt needle holds promise for broader clinical application and warrants further promotion.</p><p><strong>Trial registration: </strong>Chinese Clinical Trial Registry: ChiCTR2500102560.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":"2025 ","pages":"8776779"},"PeriodicalIF":1.3,"publicationDate":"2025-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12597763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145494285","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 Anesthetic and Surgical Outcomes Between General Anesthesia and Dexmedetomidine-Based Sedoanalgesia in Dacryocystorhinostomy Surgery With Bispectral Index Monitoring.","authors":"Utku Sağlam, Sertaç Argun Kıvanç, Nermin Kelebek Girgin","doi":"10.1155/anrp/6650312","DOIUrl":"10.1155/anrp/6650312","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to compare general anesthesia (GA) and sedoanalgesia (SA) with dexmedetomidine in terms of anesthetic and surgical outcomes in dacryocystorhinostomy (DCR) under bispectral index (BIS) monitoring.</p><p><strong>Methods: </strong>In this prospective randomized controlled study, 44 adult patients (≥ 18 y) were divided into two groups. Standard GA was induced in the GA group (<i>n</i> = 22), and dexmedetomidine-based SA in the SA group (<i>n</i> = 22). BIS monitoring was performed in all patients. Hemodynamic parameters, amount of intraoperative bleeding, duration of anesthesia and surgery, postoperative pain scores, complications, and patient and surgeon satisfaction were recorded.</p><p><strong>Results: </strong>The hemodynamic parameters, amount of intraoperative bleeding, duration of anesthesia and surgery, postoperative pain score, complications, and patient and surgeon satisfaction were similar between the two groups. Patient satisfaction was significantly higher in the SA group (<i>p</i> = 0.033).</p><p><strong>Conclusions: </strong>This study suggests that SA with dexmedetomidine accompanied by BIS monitoring can be an alternative to GA in selected patients undergoing external DCR surgery, because the anesthetic and surgical processes are similar to those of GA, and patient satisfaction is higher than that with GA.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier: NCT05397301.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":"2025 ","pages":"6650312"},"PeriodicalIF":1.3,"publicationDate":"2025-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12586881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145457558","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":"Effect of Goal-Directed Fluid Therapy on Hypotension From Spinal Anesthesia in Older Parturients Having Cesarean Section: A Randomized Controlled Trial.","authors":"Jun Ni, Huiying Zhang, Chenyang Xu, Xiali Qian, Huiling Yu, Zijun Tian, Mao Mao, Shanwu Feng","doi":"10.1155/anrp/2753707","DOIUrl":"10.1155/anrp/2753707","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The proportion of advanced maternal age (AMA) parturients in China has gradually increased. AMA is considered a risk factor for adverse maternal and fetal outcomes. Goal-directed fluid therapy (GDFT) was used to guide perioperative volume management in order to reduce spinal anesthesia-induced hypotension and optimize maternal and infant outcomes for AMA parturients undergoing cesarean section. The primary endpoint of this study was the incidence of hypotension induced by spinal anesthesia in AMA parturients undergoing cesarean section. Secondary outcomes included intraoperative infusion volume, time to first postoperative flatus, postoperative blood loss within 24 h, neonatal 1-min and 5-min Apgar scores, umbilical artery blood gas analysis, and NICU transfer rate.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A total of 69 AMA parturients with BMI ≤ 35 kg/m&lt;sup&gt;2&lt;/sup&gt; who underwent elective cesarean section with spinal anesthesia were randomly divided into the control group (Group C, &lt;i&gt;n&lt;/i&gt; = 35) and the GDFT group (Group G, &lt;i&gt;n&lt;/i&gt; = 34). Group C parturients received compound sodium lactate infusion of 20 mL·kg&lt;sup&gt;-1&lt;/sup&gt;·h&lt;sup&gt;-1&lt;/sup&gt; before delivery, which was reduced to 5 mL·kg&lt;sup&gt;-1&lt;/sup&gt;·h&lt;sup&gt;-1&lt;/sup&gt; after delivery. Group G parturients were first given compound sodium lactate 3 mL/kg within 3 min after entering the operating room. Thereafter, under the guidance of transthoracic echocardiography (TTE), when the Δ stroke volume (ΔSV) was ≤ 10%, compound sodium lactate was infused at 5 mL·kg&lt;sup&gt;-1&lt;/sup&gt;·h&lt;sup&gt;-1&lt;/sup&gt;; when the ΔSV was &gt; 10%, the liquid was continued given at 3 mL·kg&lt;sup&gt;-1&lt;/sup&gt;·3 min&lt;sup&gt;-1&lt;/sup&gt; until ΔSV ≤ 10%, followed by infusion rate of 5 mL·kg&lt;sup&gt;-1&lt;/sup&gt;·h&lt;sup&gt;-1&lt;/sup&gt;. The primary endpoint was defined as the incidence of hypotension induced by spinal anesthesia in AMA parturients undergoing cesarean section before anesthesia (T0), after completion of subarachnoid block (T1), at fetal delivery (T2), and at the end of surgery (T3), with hypotension defined as systolic blood pressure (SBP) ≤ 80% of baseline value or mean arterial pressure (MAP) ≤ 65 mmHg. Secondary endpoints included intraoperative infusion volume, time to first postoperative flatus, postoperative blood loss within 24 h, neonatal 1-min and 5-min Apgar scores, umbilical artery blood gas analysis, and NICU transfer rate.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Result: &lt;/strong&gt;Compared with Group C, the amount of predelivery fluid and intraoperative infusion in Group G was significantly reduced (&lt;i&gt;p&lt;/i&gt; &lt; 0.001), and the incidence of intraoperative hypotension in Group G was significantly decreased (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). Compared with T0, SBP was significantly decreased at T1-T3 in both groups (&lt;i&gt;p&lt;/i&gt; &lt; 0.05), SV was significantly decreased at T1 in both groups. Compared with Group C, CO was significantly decreased at T1 in Group G (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). The first postoperative flatus time was 36.71 ± 10.65 h vs. 31.62 ± 9.19 h, the first ambulation time","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":"2025 ","pages":"2753707"},"PeriodicalIF":1.3,"publicationDate":"2025-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12568773/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145407829","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 Emergence Delirium in Patients Undergoing Laparoscopic Cholecystectomy With High or Low Fresh Gas Flow During Anesthesia: A Prospective Randomized Double-Blind Study.","authors":"Sunil Bhatta, Subrata Podder, Shyam Charan Meena","doi":"10.1155/anrp/5927191","DOIUrl":"10.1155/anrp/5927191","url":null,"abstract":"<p><strong>Context: </strong>Cause of \"emergence delirium\" (ED) after general anesthesia with volatile anesthetics in adults remains unclear. While low \"fresh gas flow\" (FGF) is integral to current anesthesia practice, there is limited literature about FGF's role in ED.</p><p><strong>Aims: </strong>To compare ED in patients receiving high or low FGF during anesthesia with sevoflurane while undergoing laparoscopic cholecystectomy for gallstone disease.</p><p><strong>Settings and design: </strong>Prospective randomized double-blind study.</p><p><strong>Methods and materials: </strong>One hundred American Society of Anesthesiologists (ASA) I and II patients, aged 18-50 years, were randomized to a low FGF or high FGF group of 50 patients each. After preoxygenation with 100% oxygen for 3 min, patients were induced. The low FGF group received 4 L for 5 min, followed by 1 L till the end, while the high FGF group received 4 L throughout. Sevoflurane, nitrous oxide, and oxygen (N₂O : O₂ = 1 : 1) were used to maintain minimum alveolar concentration (MAC) value of ≥ 1.2. A blind independent observer assessed ED by Richmond agitation-sedation scale (RASS).</p><p><strong>Statistical analysis used: </strong>Student's <i>T</i>-test, chi-square test, and Mann-Whitney <i>U</i> test.</p><p><strong>Results: </strong>Postoperative lactate was significantly higher in the low FGF group compared with the high FGF group (1.49 ± 0.69 vs. 1.05 ± 0.54 mmol/L, <i>p</i> ≤ 0.001). RASS scores were also higher with low FGF both immediately after PACU admission (median 1 [IQR 1-1] vs. -1 [IQR -2-0], <i>p</i> < 0.001) and at 10 min (median 0 [IQR 0-1] vs. 0 [IQR -1-0], <i>p</i> < 0.001), while scores at 20 and 30 min were comparable.</p><p><strong>Conclusions: </strong>ED and lactate levels were significantly higher in patients receiving low FGF compared to high FGF during anesthesia.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":"2025 ","pages":"5927191"},"PeriodicalIF":1.3,"publicationDate":"2025-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12558388/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145385955","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":"Low vs. High Inspiratory Oxygen Fraction During Mechanical Ventilation in Obese Patients: Impact on Postoperative Pulmonary Outcomes.","authors":"Xuelong Zhou, Jia Liu, Jingming Zhu, Xiuhong Jiang, Qi Zou","doi":"10.1155/anrp/5336172","DOIUrl":"10.1155/anrp/5336172","url":null,"abstract":"<p><strong>Background: </strong>Obese patients undergoing general anesthesia are at heightened risk for postoperative pulmonary complications (PPCs) due to impaired respiratory mechanics. While lung-protective ventilation strategies are widely adopted, the role of intraoperative inspiratory oxygen fraction (FiO₂) in this population remains controversial.</p><p><strong>Methods: </strong>We conducted a prospective, randomized controlled trial comparing low (FiO₂ 40%) versus high (FiO₂ 80%) intraoperative oxygen concentration in 113 obese patients undergoing elective laparoscopic bariatric surgery. All patients received standardized lung-protective ventilation. The primary outcome was the incidence and severity of PPCs within 5 postoperative days. Secondary outcomes included hospital length of stay, mortality, postoperative nausea and vomiting (PONV), and surgical site infection (SSI).</p><p><strong>Results: </strong>The incidence of PPCs was 70.7% in the high FiO₂ group and 55.5% in the low FiO₂ group (<i>p</i>=0.08). Grade ≥ 3 PPCs occurred only in the high FiO₂ group (3.4%). The average PPC severity score was lower in the low FiO₂ group (0.9 ± 0.9 vs. 1.2 ± 0.9, <i>p</i>=0.08). No differences were observed in hospital stay, mortality, or SSI. PONV was more frequent in the low FiO₂ group (43.6% vs. 27.6%, <i>p</i>=0.08).</p><p><strong>Conclusion: </strong>Although the difference was not statistically significant, the observed lower incidence of PPCs in the low FiO₂ group may indicate a potential clinical effect. Larger, multicenter trials are warranted to confirm these results and optimize oxygen management in obese surgical patients. <b>Trial Registration:</b> Chinese Clinical Trial Registry: ChiCTR2300076656.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":"2025 ","pages":"5336172"},"PeriodicalIF":1.3,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12517982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145290669","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 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":"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}