Anesthesiology最新文献

{"title":"Intersections of Anesthesiology and Psychiatry: Comment.","authors":"Alexander Sartorius, Sebastian Karl, Christoph Janke, Grietje Beck","doi":"10.1097/ALN.0000000000005310","DOIUrl":"10.1097/ALN.0000000000005310","url":null,"abstract":"","PeriodicalId":7970,"journal":{"name":"Anesthesiology","volume":"142 3","pages":"577-578"},"PeriodicalIF":9.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143389803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing Perioperative Extracorporeal Cardiopulmonary Resuscitation Outcomes: Activate Early and Select Carefully.","authors":"Michael Mazzeffi, Akram Zaaqoq, Nicholas Teman","doi":"10.1097/ALN.0000000000005323","DOIUrl":"10.1097/ALN.0000000000005323","url":null,"abstract":"","PeriodicalId":7970,"journal":{"name":"Anesthesiology","volume":"142 3","pages":"440-442"},"PeriodicalIF":9.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143389808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Science, Medicine, and the Anesthesiologist.","authors":"","doi":"10.1097/ALN.0000000000005372","DOIUrl":"10.1097/ALN.0000000000005372","url":null,"abstract":"","PeriodicalId":7970,"journal":{"name":"Anesthesiology","volume":"142 3","pages":"A13-A15"},"PeriodicalIF":9.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143389810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Repeated High-dose Fentanyl Administration in Rats Reveals Minimal Tolerance to Unconsciousness, Bradycardia, Muscle Rigidity, and Respiratory Depression.","authors":"David P Obert, Gwi H Park, Kaitlyn Strong, David R Schreier, Elizabeth Korn, Carla Troyas, Kathleen F Vincent, Ken Solt","doi":"10.1097/ALN.0000000000005324","DOIUrl":"10.1097/ALN.0000000000005324","url":null,"abstract":"<p><strong>Background: </strong>Fentanyl is a synthetic opioid that is widely used in anesthesiology, but its illicit use is rapidly increasing. At high doses, fentanyl induces unconsciousness and muscle rigidity, the mechanisms of which are poorly understood. Since animal models are needed to study these effects, the aim of this study was to establish a rat model of fentanyl abuse and investigate the effects of repeated high-dose fentanyl injections on loss of righting reflex, heart rate, respiratory depression, muscle, and brain activity.</p><p><strong>Methods: </strong>Male and female Sprague-Dawley rats were studied (n = 40). A bolus of 100 µg/kg fentanyl was administered intravenously twice a week for 5 consecutive weeks. Time to return of righting reflex after fentanyl injection and changes in electromyography/electroencephalography activity as well as heart rate were analyzed. Additionally, arterial blood gas analysis for evaluation of ventilation was performed. Mixed-effect models with Dunnett test and effect sizes were used for statistical analysis.</p><p><strong>Results: </strong>Repeated injections resulted in a U-shaped change in time to return of righting reflex with the longest latency after the first exposure (median, 50 [first to third quartile, 36 to 56] min) and the shortest after the fifth exposure (16 [13 to 33] min). After fentanyl administration, heart rate dropped immediately by 225 beats/min (95% CI, 179 to 271; F = 3,952.16; P < 0.001), while electromyography activity increased by 291% (95% CI, 212 to 370; F = 27.51; P < 0.001) and partial pressure of arterial carbon dioxide increased by 49.4 mmHg (95% CI, 40.6 to 58.2; F = 75.97; P < 0.001) within 5 min after injection. Additionally, pH decreased by 0.48 (95% CI, 0.41 to 0.54; F = 142.00; P < 0.01), and partial pressure of arterial oxygen decreased by 50.4 mmHg (40.8 to 60.0; F = 57.90; P < 0.001). Repeated fentanyl exposures did not significantly affect the extent of these changes (EMG, F = 1.63, P = 0.237; partial pressure of arterial carbon dioxide, F = 1.23, P = 0.312; heart rate, F = 1.05, P = 0.400; pH, F = 3.05, P = 0.066; arterial partial pressure of oxygen, F = 3.35, P = 0.052). Electroencephalography analysis revealed that repeated fentanyl exposures elicited significantly higher absolute power in frequencies greater than 20 Hz as indicated by an area under the receiver operator characteristics curve greater than 0.7.</p><p><strong>Conclusions: </strong>The authors established a rodent model of repeated high-dose fentanyl administration. Overall, significant evidence of tolerance was not observed after 10 exposures of high-dose fentanyl for any of the analyzed parameters. These results suggest that tolerance does not develop for fentanyl-induced unconsciousness, muscle rigidity, or respiratory depression.</p>","PeriodicalId":7970,"journal":{"name":"Anesthesiology","volume":" ","pages":"465-475"},"PeriodicalIF":9.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11813677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142869297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How an Unusual Trade-off Could Save a Life in Gaza.","authors":"Stefano Di Bartolomeo","doi":"10.1097/ALN.0000000000005289","DOIUrl":"10.1097/ALN.0000000000005289","url":null,"abstract":"","PeriodicalId":7970,"journal":{"name":"Anesthesiology","volume":" ","pages":"569-570"},"PeriodicalIF":9.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Liposomal Bupivacaine for Nerve Blockade: Reply.","authors":"Peter Marhofer, Markus Zadrazil","doi":"10.1097/ALN.0000000000005307","DOIUrl":"10.1097/ALN.0000000000005307","url":null,"abstract":"","PeriodicalId":7970,"journal":{"name":"Anesthesiology","volume":"142 3","pages":"574-575"},"PeriodicalIF":9.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143389806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anesthesiology.","authors":"","doi":"10.1097/ALN.0000000000005383","DOIUrl":"10.1097/ALN.0000000000005383","url":null,"abstract":"","PeriodicalId":7970,"journal":{"name":"Anesthesiology","volume":"142 3","pages":"A7-A9"},"PeriodicalIF":9.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143389870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chewing Gum: A Viable Option as a Rescue Therapy for Postoperative Nausea and Vomiting?","authors":"Mi Wang, Tong J Gan","doi":"10.1097/ALN.0000000000005332","DOIUrl":"10.1097/ALN.0000000000005332","url":null,"abstract":"","PeriodicalId":7970,"journal":{"name":"Anesthesiology","volume":"142 3","pages":"434-437"},"PeriodicalIF":9.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143389875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perioperative Extracorporeal Cardiopulmonary Resuscitation in Adults: A Single-center Retrospective Review and Analysis.","authors":"Ashie Kapoor, Michael W Wolfe, Weiting Chen, Peyman Benharash, Vadim Gudzenko","doi":"10.1097/ALN.0000000000005312","DOIUrl":"10.1097/ALN.0000000000005312","url":null,"abstract":"<p><strong>Background: </strong>Extracorporeal cardiopulmonary resuscitation (CPR) for refractory in-hospital cardiac arrest has been associated with improved survival compared with conventional CPR. Perioperative patients represent a unique cohort of the inpatient population. This study aims to describe and analyze the characteristics and outcomes of patients who received extracorporeal CPR for perioperative cardiac arrest.</p><p><strong>Methods: </strong>A single-center retrospective review of perioperative extracorporeal CPR in adults from January 2015 to August 2022 was performed. Patient demographics, cardiac arrest variables, and outcome data were obtained and analyzed. The primary study outcome was survival with favorable neurologic outcome.</p><p><strong>Results: </strong>A total of 33 patients received extracorporeal CPR for perioperative cardiac arrest. Of the 33 patients, 24 (73%) had a cardiac arrest in the cardiac catheterization laboratory, while 9 (27%) had a cardiac arrest in the operating room or interventional radiology suite. Survival to discharge was 57.6%, of whom 17 (89.5%) had neurologically favorable outcomes with cerebral performance category scores of 1 or 2 at discharge. The mean total CPR time was significantly lower in the survivor group than in the nonsurvivor group (16.5 vs . 25.0 min; P < 0.05). Survivors had significantly lower lactate levels (73 mg/dl vs . 115 mg/dl; P = 0.005) and higher pH levels (7.17 vs. 7.03; P = 0.005) compared with nonsurvivors.</p><p><strong>Conclusions: </strong>The use of extracorporeal CPR for adults with perioperative cardiac arrest can be associated with excellent survival with neurologically favorable outcomes in carefully selected patients. Longer CPR time, higher lactate levels, and lower pH were associated with increased mortality. Given the small sample size, no other prognostic factors were identified, although certain trends were detected between survival groups.</p>","PeriodicalId":7970,"journal":{"name":"Anesthesiology","volume":" ","pages":"511-521"},"PeriodicalIF":9.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142715073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Poem for Henry.","authors":"Justin C Cordova","doi":"10.1097/ALN.0000000000005236","DOIUrl":"10.1097/ALN.0000000000005236","url":null,"abstract":"","PeriodicalId":7970,"journal":{"name":"Anesthesiology","volume":"142 3","pages":"567-568"},"PeriodicalIF":9.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143389863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}