Anesthesiology Research and Practice最新文献

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Perfusion Index Predicts the Effectiveness of Supraclavicular Brachial Plexus Block in Children Under General Anesthesia: A Randomized Controlled Trial. 灌注指数预测儿童全身麻醉下锁骨上臂丛阻滞的有效性:一项随机对照试验。
IF 1.6
Anesthesiology Research and Practice Pub Date : 2025-02-22 eCollection Date: 2025-01-01 DOI: 10.1155/anrp/5583145
Tiantian Chu, Siqi Zhou, Ting Peng, Hong Tao, Han Chen, Xu Yan, Yueyang Xin, Zhang Tian, Jinxu Wang, Lingli Deng, Aijun Xu
{"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}
引用次数: 0
On-Pump FIBTEM-A5 Accurately Predicts the A5 Values After Protamine Administration. 泵上fitem -A5准确预测鱼精蛋白给药后A5值。
IF 1.6
Anesthesiology Research and Practice Pub Date : 2025-01-29 eCollection Date: 2025-01-01 DOI: 10.1155/anrp/2924468
Stanislaw Vander Zwaag, Matus Tomko, Tomas Madej, Jens Fassl
{"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> <sup>2</sup> = 0.813, adjusted <i>R</i> <sup>2</sup> = 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}
引用次数: 0
Assessment of the Association Between Neuraxial Anesthesia and Back Pain After Delivery: A Systematic Review and Meta-Analysis. 评估轴向麻醉与产后背痛之间的关系:一项系统回顾和荟萃分析。
IF 1.6
Anesthesiology Research and Practice Pub Date : 2025-01-29 eCollection Date: 2025-01-01 DOI: 10.1155/anrp/2105413
Sara Timerga, Getaw Walle, Wondwosen Mebratu, Aynalem Befkadu
{"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> <sup>2</sup>. 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> <sup>2</sup> = 97.76%, <i>H</i> <sup>2</sup> = 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}
引用次数: 0
The Effect of Remimazolam on the Baseline TOF Ratio: A Prospective, Clinical Study. 雷马唑仑对基线TOF比率的影响:一项前瞻性临床研究。
IF 1.6
Anesthesiology Research and Practice Pub Date : 2024-11-28 eCollection Date: 2024-01-01 DOI: 10.1155/anrp/9990140
Tomoko Yuruki, Masafumi Fujimoto, Naoyuki Hirata
{"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}
引用次数: 0
Efficacy of High-Volume Low-Concentration Intraperitoneal Bupivacaine Irrigation for Postoperative Analgesia in Patients Undergoing Laparoscopic Cholecystectomy: Bupivacaine Irrigation for Analgesia. 腹腔镜胆囊切除术患者术后高容量低浓度布比卡因灌洗镇痛的疗效:布比卡因灌洗镇痛。
IF 1.6
Anesthesiology Research and Practice Pub Date : 2024-10-30 eCollection Date: 2024-01-01 DOI: 10.1155/2024/4545400
Swati Panwar, Mona Arya, J S Dali, Kapil Chaudhary, Sushanto Neogi
{"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}
引用次数: 0
Association Between MRI Findings of Facet Arthropathy and Synovitis With Health-Related Outcome and Pain Scores Following Therapeutic Lumbar Facet Injections. 腰椎面骨注射治疗后,面骨关节病和滑膜炎的核磁共振成像结果与健康相关结果和疼痛评分之间的关系
IF 1.6
Anesthesiology Research and Practice Pub Date : 2024-10-18 eCollection Date: 2024-01-01 DOI: 10.1155/2024/7889539
Michael S Green, Michele Van Hal, Matthew Onimus, Christopher R Hoffman, Dhruv K C Goyal, Valeria Potigailo, Khuram S Kazmi
{"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}
引用次数: 0
Use of a Nasal Cannula as a Preoxygenation Adjunct: A Randomized Crossover Study. 使用鼻导管作为预吸氧辅助工具:一项随机交叉研究。
IF 1.6
Anesthesiology Research and Practice Pub Date : 2024-09-05 eCollection Date: 2024-01-01 DOI: 10.1155/2024/7873142
Murphy Joel, Suvajit Podder, Savan Kumar Nagesh, Ramyatha Aithal, Aditya R Devalla, Shaji Mathew
{"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 O<sub>2</sub> (ETO<sub>2</sub>) 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}
引用次数: 0
Weight-Based Standardized Sugammadex Dosing in Pediatrics: A Quality Improvement Initiative to Improve Compliance with Dosing Guidelines and Reduce Waste and Cost. 基于体重的儿科舒格迈司标准化剂量:一项旨在提高用药指南合规性并减少浪费和成本的质量改进计划》(A Quality Improvement Initiative to Improve Compliance with Dosing Guidelines and Reduce Waste and Cost.
IF 1.6
Anesthesiology Research and Practice Pub Date : 2024-08-24 eCollection Date: 2024-01-01 DOI: 10.1155/2024/6049114
Sydney E S Brown, Michael Meyer, Andrea Meyer, Ruth Cassidy, Xinyi Zhao, Deborah Wagner, Laura Wetzel, Douglas A Colquhoun
{"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}
引用次数: 0
The Effect of Preoperative Anxiety on Motor and Sensory Block Duration and Effectiveness in Spinal Anesthesia. 术前焦虑对脊髓麻醉中运动和感觉阻滞时间及效果的影响。
IF 1.6
Anesthesiology Research and Practice Pub Date : 2024-08-19 eCollection Date: 2024-01-01 DOI: 10.1155/2024/8827780
Yadigar Yılmaz, Esra Durmayuksel, Tuna Erturk, Ferda Yılmaz Inal, Dilek Metin Yamac, Aysin Ersoy
{"title":"The Effect of Preoperative Anxiety on Motor and Sensory Block Duration and Effectiveness in Spinal Anesthesia.","authors":"Yadigar Yılmaz, Esra Durmayuksel, Tuna Erturk, Ferda Yılmaz Inal, Dilek Metin Yamac, Aysin Ersoy","doi":"10.1155/2024/8827780","DOIUrl":"10.1155/2024/8827780","url":null,"abstract":"<p><strong>Introduction: </strong>The aim was to evaluate the effect of preoperative anxiety on the sympathetic block that developed after spinal anesthesia and therefore the duration of motor and sensory blockade.</p><p><strong>Materials and methods: </strong>After the approval of the ethics committee, 90 patients between the ages of 18 and 55 years who were to be operated under spinal anesthesia were included in the study. Preoperative anxiety of the patients was evaluated with the Spielberger trait and State Anxiety Scale and Visual Analog Scale (VAS). The Bromage scores of the patients were followed up intermittently. Onset time of sensory block, onset time of motor block, and motor block recovery time were recorded. Cases with bradycardia and hypotension were noted.</p><p><strong>Results: </strong>No statistically significant correlation was found between the duration of motor block onset (5.81 ± 4 min), the sensory block onset time (0.89 ± 0.4 min), and the motor block recovery time (92.06 ± 36.9 min) with other variables. VAS (5.81 ± 2.5), STAI-1 (40.4 ± 9.8), and STAI-2 (41.69 ± 8.2) values had a statistically significant effect on the occurrence of bradycardia (14.4%). The variables of VAS, STAI-1, STAI-2, sensory block onset, motor block onset, and motor block recovery time were statistically significantly higher in women (mean 5.24 ± 2.4, 38.97 ± 9.9, 41.43 ± 8.7, 0.89 ± 0.42, 5.64 ± 3.82, and 88.77 ± 38.74 in males and mean 7.15 ± 2.1, 43.74 ± 8.9, 42.30 ± 7.0, 0.88 ± 0.27, 6.20 ± 4.35, and 99.70 ± 31.70 in females, respectively).</p><p><strong>Conclusion: </strong>It was observed that preoperative anxiety had no effect on motor and sensory block onset and duration.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":"2024 ","pages":"8827780"},"PeriodicalIF":1.6,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11347032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142071782","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}
引用次数: 0
Operating Room Noise Environment and Behavior in Children Undergoing General Anesthesia: A Randomized Controlled Trial. 手术室噪音环境与接受全身麻醉儿童的行为:随机对照试验
IF 1.6
Anesthesiology Research and Practice Pub Date : 2024-08-16 eCollection Date: 2024-01-01 DOI: 10.1155/2024/4838649
Marc Bozych, Nguyen K Tram, Julie Rice-Weimer, Richard S Cartabuke, Joseph D Tobias, Jamie Huffman, Christian Mpody, Joshua C Uffman
{"title":"Operating Room Noise Environment and Behavior in Children Undergoing General Anesthesia: A Randomized Controlled Trial.","authors":"Marc Bozych, Nguyen K Tram, Julie Rice-Weimer, Richard S Cartabuke, Joseph D Tobias, Jamie Huffman, Christian Mpody, Joshua C Uffman","doi":"10.1155/2024/4838649","DOIUrl":"10.1155/2024/4838649","url":null,"abstract":"<p><strong>Background: </strong>Excessive operating room noise impairs communication, distracts from monitoring equipment, and may increase patient and provider stress.</p><p><strong>Aim: </strong>This study investigates the effects of reduced noise on perioperative behavior in children undergoing general anesthesia and on anesthesia provider response time.</p><p><strong>Methods: </strong>Healthy children (the American Society of Anesthesiologists class I-II), 2-8 years of age, and their anesthesia providers were randomized into a control or treatment group exposed to reduced stimulation during induction and emergence. Primary outcomes were patient behavior and provider response time. Secondary outcomes were postoperative pain scores, provider responses exceeding 30 seconds, and median and maximum noise exposure.</p><p><strong>Results: </strong>64 children (27 females and 37 males) were randomized into a control or treatment group, of whom 32 (50%) underwent tonsillectomy/adenoidectomy and 32 (50%) underwent dental procedures. The average age was 4.6 (SD 1.43) years. Children exposed to reduced noise were less likely to be \"fussy about eating\" (<i>p</i>=0.042), more \"interested in what goes on around them\" (<i>p</i>=0.008), and had fewer temper tantrums (<i>p</i>=0.004) on postoperative day one or two and on postoperative day five, six, or seven. No other differences were found between groups in behavioral assessment scores or provider response times.</p><p><strong>Conclusions: </strong>Our study is the first to show that a low-stimulus environment improves postdischarge behavior. Provider response time was unaffected by reduced noise, and the average and peak noise exposure levels did not exceed national safety guidelines. This trial is registered with NCT03507855 and NCT03504553.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":"2024 ","pages":"4838649"},"PeriodicalIF":1.6,"publicationDate":"2024-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11343623/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142054632","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}
引用次数: 0
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