Asian journal of anesthesiology最新文献

{"title":"Evaluation of Dexmedetomidine as an Adjuvant to Ropivacaine in Transversus Abdominis Plane Block for Postoperative Analgesia in Unilateral Infraumbilical Surgeries-A Randomized Prospective Trial.","authors":"K. Gupta, Bhabesh Prasad Panda, Gurpreet Singh, Amanjot Singh","doi":"10.6859/aja.202202/PP.0002","DOIUrl":"https://doi.org/10.6859/aja.202202/PP.0002","url":null,"abstract":"BACKGROUND\u0000Transversus abdominis plane (TAP) block has been demonstrated to be an effective module of multimodal analgesic treatments for infra-umbilical surgeries with limited duration of action. Various adjuvants have been studied to increase the efficacy of this technique. Herein, we evaluated the analgesic efficacy of dexmedetomidine with ropivacaine in TAP block for unilateral infra-umbilical surgeries under spinal anesthesia.\u0000\u0000\u0000METHODS\u0000The study was conducted on 60 adult patients with the age of 18-65 years, who were planned for unilateral infra-umbilical surgeries under spinal anesthesia. These patients are randomly divided into 2 groups (30 each). In group A, 20 mL of 0.25% ropivacaine with 1 mL of normal saline, and in group B, 20 mL of 0.25% ropivacaine with 0.5 μg/kg (1 mL) dexmedetomidine was given in ultrasound-guided TAP block. Duration, quality of analgesia, and total analgesic consumption were noted. Statistical analysis was performed with SPSS software version 21.0 (IBM Corp., Armonk, NY, USA) by using Student's t-test and chi-square test.\u0000\u0000\u0000RESULTS\u0000The mean duration of analgesia was significantly longer in group B than group A (842.50 ± 38.74 min and 435.17 ± 25.75 min, respectively). Verbal numerical rating scale was persistently low in both groups, except at the 7th hour and 20th hour in group A and the 12th hour in group B. Total analgesic consumption and number of analgesics doses during 24 hours after surgery were also lower in group B.\u0000\u0000\u0000CONCLUSIONS\u0000The addition of dexmedetomidine as adjuvant to 0.25% ropivacaine for TAP block significantly increases the duration and quality of analgesia without any significant adverse effects.","PeriodicalId":8482,"journal":{"name":"Asian journal of anesthesiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45063366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Radiofrequency and Corticosteroid Injection for Treatment of Lumbar Facet Joint Pain: A Meta-Analysis.","authors":"A. Wardhana, R. Ikawaty, H. Sudono","doi":"10.6859/aja.202202/PP.0003","DOIUrl":"https://doi.org/10.6859/aja.202202/PP.0003","url":null,"abstract":"BACKGROUND\u0000Lumbar facet joint (LFJ) pain was reported to occur in 27%-40% of patients with chronic low back pain (LBP). Several therapeutic procedures such as corticosteroid injection (CI) and radiofrequency (RF) ablation have been used. However, there is no clear consensus that one is superior to the other. This study aimed to perform a meta-analysis to compare the effectiveness of CI and RF ablation for LFJ pain.\u0000\u0000\u0000METHODS\u0000This study was conducted by searching for all randomized controlled trials comparing the effect of CI and RF ablation on LFJ pain in Cochrane Central Register of Controlled Trials and PubMed database. We performed inverse-variance weighted meta-analysis of outcomes including pain intensity and functional disability at 3, 6, and 12-month measurement by using RevMan 5.3 (Cochrane, London, England).\u0000\u0000\u0000RESULTS\u0000CI was associated with a higher pain intensity score when compared to RF ablation at 3 months (3 trials; standardized mean difference [SMD], 1.09; 95% CI, 0.79 to 1.38; P ＜ 0.00001; I^2 = 96%), at 6 months (7 trials; SMD, 2.10; 95% CI, 0.98 to 3.22; P = 0.00002; I^2 = 96%), and at 12 months (3 trials; SMD, 2.15; 95% CI, -0.26 to 4.56; P = 0.08; I^2 = 98%). The estimated effect of CI on functional disability score at 6 months when CI was compared to RF ablation showed a significant increase (3 trials; MD, 18.78; 95% CI, 16.20 to 21.36; P ＜ 0.00001; I^2 = 98%).\u0000\u0000\u0000CONCLUSIONS\u0000Pooled analysis from limited trials showed a benefit of RF to the improvement of pain intensity and functional disability when we compared RF with CI for the treatment of LFJ pain.","PeriodicalId":8482,"journal":{"name":"Asian journal of anesthesiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42601736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Submental Intubation in Patients With Complex Facial Bone Fractures.","authors":"Yung-Lin Hsieh, Po-Chih Hsu, Cay-Huyen Chen, Ming-Chang Kao","doi":"10.6859/aja.202112_59(4).0007","DOIUrl":"https://doi.org/10.6859/aja.202112_59(4).0007","url":null,"abstract":"","PeriodicalId":8482,"journal":{"name":"Asian journal of anesthesiology","volume":"59 4","pages":"174-175"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39393032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Total Intravenous Anesthesia Versus Inhalation Anesthesia on Postoperative Analgesia and Nausea and Vomiting After Bariatric Surgery: A Systematic Review and Meta-Analysis.","authors":"Muhammad M Ahmed,&nbsp;Chenchen Tian,&nbsp;Justin Lu,&nbsp;Yung Lee","doi":"10.6859/aja.202112_59(4).0002","DOIUrl":"https://doi.org/10.6859/aja.202112_59(4).0002","url":null,"abstract":"<p><p>Anesthesia for patients with morbid obesity can be challenging because of increased risk of opioid-related adverse events, postoperative nausea and vomiting (PONV), and poor pain control. We conducted a systematic review and meta-analysis to compare the safety and efficacy of total intravenous anesthesia (TIVA) with inhalation anesthesia in patients undergoing bariatric surgery. We searched MEDLINE, EMBASE, CENTRAL, and the Clinical Trials Registry database from inception to July 22, 2020. Primary outcomes were postoperative pain and PONV scores. Secondary outcomes included opioid requirements, intraoperative time, complications, and time to recovery. Grading of Recommendations Assessment, Development, and Evaluation framework was used to rate the certainty of evidence. Among 722 studies identified in our search, 7 randomized studies involving a total of 682 patients met the inclusion criteria. Bariatric surgery with TIVA resulted in a lower incidence of nausea (relative risk [RR], 0.54; 95% CI, 0.31-0.94; P = 0.03; moderate certainty) and vomiting (RR, 0.31; 95% CI, 0.13-0.74; P = 0.008; moderate certainty). There was no difference in postoperative pain at 30 minutes, 1 hour, or 24 hours, or in postoperative opioid requirements. Patients undergoing bariatric surgery with TIVA had significantly lower incidence of PONV but no difference in postoperative pain when TIVA was compared to inhalation anesthesia techniques. These benefits should be considered in order to improve the quality of care and enhance recovery for the bariatric population, who are at an increased baseline risk of perioperative complications. Future adequately powered randomized controlled trials are needed to compare the efficacy of the anesthesia regimens in patients undergoing bariatric surgery.</p>","PeriodicalId":8482,"journal":{"name":"Asian journal of anesthesiology","volume":"59 4","pages":"135-151"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39798580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Randomized, Active-Controlled, Parallel-Group Clinical Study Assessing the Efficacy and Safety of FKScope® for Nasotracheal Intubation in Patients Scheduled for Oral and Maxillofacial Surgery Under General Anesthesia.","authors":"Yu-Chi Huang,&nbsp;Shu-Yu Ou,&nbsp;Yu-Ting Kuo,&nbsp;Yuan-Yi Chia","doi":"10.6859/aja.202112_59(4).0003","DOIUrl":"https://doi.org/10.6859/aja.202112_59(4).0003","url":null,"abstract":"<p><strong>Background: </strong>Most of the reports showed that videolaryngoscopy has better outcomes than direct laryngoscopy for nasotracheal intubation. The FKScope® comprises a semirigid and malleable stylet with a terminal camera and has been used to facilitate orotracheal intubation. However, its efficacy and safety for nasotracheal intubation remain unknown. This study compared FKScope® with Macintosh direct laryngoscopy for nasotracheal intubation.</p><p><strong>Methods: </strong>Sixty-four patients scheduled for oral and maxillofacial surgery requiring nasotracheal intubation were enrolled and randomly assigned to FKScope® (n = 32) or Macintosh group (n = 32). The primary outcome was time to successful intubation during the first attempt. Secondary outcomes included modified nasal intubation difficulty scale (MNIDS) scores; percentage of glottic opening (POGO); immediate postintubation side effects such as mucosal bleeding, dental injury, and lip lacerations; and postoperative side effects including nasal pain, sore throat, hoarseness, dysphagia, and dyspnea.</p><p><strong>Results: </strong>The rates of successful first-attempt intubation were 87.5% and 90.6% in the FKScope® and Macintosh group, respectively (P = 0.69). Mean (± standard deviation) total intubation time was 68.7 ± 34.8 s in the FKScope® group compared with 61.5 ± 21.9 s in the Macintosh group (P = 0.35), despite a higher POGO for the FKScope® group (77 ± 27 vs. 41 ± 31, P ＜ 0.01). The MNIDS scores of the FKScope® group were significantly lower (0.8 ± 1.0 vs. 2.8 ± 1.4, P ＜ 0.01). The groups did not differ significantly regarding most postoperative side effects, although the FKScope® group had fewer lip lacerations (P = 0.04).</p><p><strong>Conclusions: </strong>The use of FKScope® improves the view of the glottic opening and is safe for nasotracheal intubation with normal airways. However, secretions and blood can obstruct the camera, and therefore, to select the patient carefully is necessary.</p>","PeriodicalId":8482,"journal":{"name":"Asian journal of anesthesiology","volume":"59 4","pages":"152-160"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39870931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Combination Between Ketamine and Parecoxib as Multimodal Preemptive Analgesia With Ketamine Alone for Elective Laparotomy.","authors":"Rabiatul Aida Ramli,&nbsp;Wan Mohd Nazaruddin Wan Hassan,&nbsp;Saedah Ali,&nbsp;Abdul Karim Othman,&nbsp;Rhendra Hardy Mohamad Zaini,&nbsp;Mohamad Hasyizan Hassan","doi":"10.6859/aja.202112_59(4).0004","DOIUrl":"https://doi.org/10.6859/aja.202112_59(4).0004","url":null,"abstract":"<p><strong>Background: </strong>Preemptive analgesia is important for reducing postoperative analgesia requirement. Therefore, this study compared the efficacy of intravenous (IV) ketamine alone with the efficacy of a combination of low-dose IV ketamine and IV parecoxib as part of a multimodal preemptive analgesia regimen in patients undergoing elective laparotomy.</p><p><strong>Methods: </strong>In this prospective study, 48 patients scheduled for elective laparotomy were randomized to two groups of preemptive analgesia, namely, group K-P, in which anestheologists administered a combination of 0.3 mg/kg IV ketamine and 40.0 mg IV parecoxib, or group K, in which ones gave 0.3 mg/kg IV ketamine alone. Patients from both groups underwent surgery under general anesthesia, and total intraoperative opioid requirement was recorded. After surgery, morphine administered by automated patient-controlled analgesia (PCA) infusion device was initiated in all patients. Pain score was assessed using the visual analogue scale (VAS), and postoperative opioid requirement was recorded at 1 and 4 hours, and subsequently from 4-hour intervals up to 24 hours after surgery.</p><p><strong>Results: </strong>Compared to group K, group K-P required significantly lower rescue IV fentanyl in the recovery bay (0.10 ± 0.28 vs. 0.35 ± 0.46 μg/kg; P = 0.031), showing prolonged time-to-first analgesic request recorded by PCA device (70.8 ± 40.0 vs. 22.2 ± 15.8 mins; P ＜ 0.001), lower total morphine requirement delivered by PCA device (8.0 ± 4.6 vs. 16.8 ± 6.5 mg; P ＜ 0.001), and lower VAS values measured at all time points. There was no significant difference in intraoperative total opioid requirement between the groups.</p><p><strong>Conclusions: </strong>Among laparotomy patients, multimodal preemptive analgesia by the use of a combination of low-dose IV ketamine and IV parecoxib was more effective than IV ketamine alone in reducing pain scores and postoperative analgesia requirement (e.g., PCA-administered morphine).</p>","PeriodicalId":8482,"journal":{"name":"Asian journal of anesthesiology","volume":"59 4","pages":"161-168"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39870932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using ＂ROSE＂ Concept in Postoperative Fluid Management After Cadaveric Liver Transplantation.","authors":"Hsiang-Han Huang,&nbsp;Chueng-He Lu,&nbsp;Teng-Wei Chen,&nbsp;Wei-Hung Chan","doi":"10.6859/aja.202112_59(4).0005","DOIUrl":"https://doi.org/10.6859/aja.202112_59(4).0005","url":null,"abstract":"","PeriodicalId":8482,"journal":{"name":"Asian journal of anesthesiology","volume":"59 4","pages":"169-171"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39870933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efforts on Education by Using Social Media for Young Anesthesiologists in the COVID-19 Pandemic.","authors":"Saori Kase,&nbsp;Keisuke Yoshida,&nbsp;Takahiro Hakozaki","doi":"10.6859/aja.202112_59(4).0006","DOIUrl":"https://doi.org/10.6859/aja.202112_59(4).0006","url":null,"abstract":"","PeriodicalId":8482,"journal":{"name":"Asian journal of anesthesiology","volume":"59 4","pages":"172-173"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39870934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safe Practice of Total Intravenous Anesthesia With Target-Controlled Infusion in Taiwan: A Recommendation.","authors":"Hou-Chuan Lai,&nbsp;Yi-Hsuan Huang,&nbsp;Jen-Yin Chen,&nbsp;Chih-Shung Wong,&nbsp;Kuang-I Cheng,&nbsp;Ching-Hui Shen,&nbsp;Zhi-Fu Wu","doi":"10.6859/aja.202112_59(4).0001","DOIUrl":"https://doi.org/10.6859/aja.202112_59(4).0001","url":null,"abstract":"<p><p>There have been immense advances in the safety and variety of intravenous anesthetic delivery systems including drug cost reduction, development of more effective opioids, and improvement in depth of anesthesia monitoring in the last 20 years. Propofol-based total intravenous anesthesia (TIVA) with target-controlled infusion (TCI) is relatively easy to practice. While this technique promotes a higher overall anesthesia quality and patient survival, especially for cancer patients, there are deficiencies in training and education of the technique. Therefore, the Society for Intravenous Anesthesia and the Association of Anesthetists (United Kingdom) have laid out guidelines in an attempt to highlight multiple important TIVA-related safety issues to help clinicians feel more confident. In the present article, we discuss five recommendations and four special clinical situations. Preparation, equipment familiarity, and safe delivery techniques are extremely important for the proper employment of this method. Herein, we emphasize the importance of proper education, and the clinical practice experience of the TIVA technique. Additionally, we suggest a modified connection method to set up a safely administered line. We highlight the advantages of using processed electroencephalogram monitoring (such as bispectral index or Entropy) to prevent awareness during TIVA administration in difficult clinical situations. These situations may include triple low patients (e.g., low blood pressure, low maintained effect-site concentration of propofol, and low body weight ≤ 18), obese patients, and patients with difficult infusion site monitoring or use of neuromuscular blocking agents. Due to a limited consensus among Taiwanese medical professionals, this document is intended to act as a safe practice reference for the use of TIVA with TCI. Additionally, two pithy formula codes, 4321 for propofol with fentanyl/alfentanil and 42222111 for propofol with remifentanil, are provided for the general population and one pithy formula code, 4321 for propofol with fentanyl, is provided for pediatric patients.</p>","PeriodicalId":8482,"journal":{"name":"Asian journal of anesthesiology","volume":"59 4","pages":"123-134"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39798579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility and Safety of Using Supraglottic Airway Devices for Pediatric Patients Undergoing Magnetic Resonance Imaging: A Case Series of High-Risk Patients.","authors":"Jia-Jing Wu,&nbsp;Yueh-Hsun Chuang,&nbsp;Chun-Yu Wu","doi":"10.6859/aja.202109_59(3).0003","DOIUrl":"https://doi.org/10.6859/aja.202109_59(3).0003","url":null,"abstract":"<p><strong>Background: </strong>General anesthesia or sedation is commonly required for pediatric patients undergoing magnetic resonance imaging (MRI) scans, and airway management during the procedure is the highest concern for anesthesiologists owing to the limited access to the patient in the MRI unit. The use of supraglottic airway devices (SADs) has recently become more popular than endotracheal tubes; however, the feasibility of using SADs for children in MRI suites was reported only in a few studies that involved healthy patients.</p><p><strong>Methods: </strong>We present a successful case series of 30 pediatric patients, and the majority are high-risk patients, including patients with aromatic L-amino acid decarboxylase (AADC) deficiency, mitochondrial disease, and tuberous sclerosis, using either i-gel or laryngeal masks for airway maintenance during MRI examination.</p><p><strong>Results: </strong>A total of 38 MRI exams were conducted; the patients' median age was 4 (range 1.6-17.0 years), and the mean examination time was 50.87 minutes. No patient experienced oxygen desaturation, and only 1 patient with AADC deficiency had an episode of hypotension. The MRI scans were completed without interruption with an adequate image quality according to a specialized radiologist.</p><p><strong>Conclusion: </strong>From the clinical point of view, this case series demonstrated a broader application of SADs for airway maintenance during MRI scans for pediatric patients with a high risk during anesthesia rather than only for a healthy patient population.</p>","PeriodicalId":8482,"journal":{"name":"Asian journal of anesthesiology","volume":"59 3","pages":"96-101"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39187195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}