Asian journal of anesthesiology最新文献_第2页

The Effects of Intraoperative Goal-Directed Fluid Therapy in the Elderly: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. 术中定向液体疗法对老年人的影响：随机对照试验的系统回顾和荟萃分析。

Asian journal of anesthesiology Pub Date : 2024-09-24 DOI: 10.6859/aja.202409_62(3).0001

Joshua Eldad Frederich Lasanudin, Alesia Prillya Mauna

{"title":"The Effects of Intraoperative Goal-Directed Fluid Therapy in the Elderly: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Joshua Eldad Frederich Lasanudin, Alesia Prillya Mauna","doi":"10.6859/aja.202409_62(3).0001","DOIUrl":"10.6859/aja.202409_62(3).0001","url":null,"abstract":"Goal-directed fluid therapy (GDFT) has been proposed to optimize fluid management and reduce perioperative complications in the elderly. This meta-analysis evaluates the effects of intraoperative GDFT compared to conventional fluid therapy (CFT) on postoperative outcomes in elderly surgical patients. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline, randomized controlled trials (RCTs) were identified from six databases. Outcomes assessed included overall postoperative complications, 30-day mortality, hospital length of stay (LOS), and total fluid administered. Ten RCTs met the inclusion criteria, of which nine (n = 1,001) were included in the quantitative synthesis after excluding studies employing outdated protocols. GDFT significantly reduced overall complication rates (risk ratios [RR] = 0.80 [95% confidence interval (CI): 0.69-0.92]; P = 0.002), LOS (mean difference [MD] = -1.31 days [95% CI: -2.55 to -0.07]; P = 0.04), and intraoperative fluid volume (MD = -258.74 mL [95% CI: -450.86 to -66.68]; P = 0.008) compared to CFT. GDFT was also associated with lower 30-day mortality (RR = 0.42 [95% CI: 0.17-1.04]), though not statistically significant (P = 0.06). Substantial heterogeneity was noted for LOS and fluid volume. Subgroup analysis had no impact on LOS but decreased heterogeneity in intraoperative volume, with significant fluid-sparing effects only in the gastrointestinal surgery subgroup. Sensitivity analyses further revealed that the exclusion of specific studies influenced the results for mortality and LOS. In conclusion, when compared with CFT, intraoperative GDFT offers benefits in reducing postoperative complications, hospital stay, and fluid use in elderly patients. Further research is necessary to optimize protocols and address the observed heterogeneity.","PeriodicalId":8482,"journal":{"name":"Asian journal of anesthesiology","volume":"62 3","pages":"105-123"},"PeriodicalIF":0.0,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136351","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}

引用次数: 0

The Effect of Single Intraoperative Dose of Dexamethasone on the Blood Glucose Concentration in Diabetic and Non-Diabetic Patients: A Double Blinded Randomized Control Study. 术中单剂量地塞米松对糖尿病和非糖尿病患者血糖浓度的影响：一项双盲随机对照研究。

Asian journal of anesthesiology Pub Date : 2024-09-24 DOI: 10.6859/aja.202409_62(3).0005

Nadia Rose, S M Gajanan Babu, N K Navaneethan, K S Shruthi

{"title":"The Effect of Single Intraoperative Dose of Dexamethasone on the Blood Glucose Concentration in Diabetic and Non-Diabetic Patients: A Double Blinded Randomized Control Study.","authors":"Nadia Rose, S M Gajanan Babu, N K Navaneethan, K S Shruthi","doi":"10.6859/aja.202409_62(3).0005","DOIUrl":"10.6859/aja.202409_62(3).0005","url":null,"abstract":"Background: Dexamethasone is widely used in anesthesia practise as prophylaxis for postoperative nausea and vomiting (PONV). Our aims were to evaluate the postoperative glycemic profile after a single dose of intraoperative dexamethasone in non-diabetic and diabetic patients and to evaluate the PONV.Methods: This double-blinded, randomized, controlled study was done for 6 months from June to December 2024 in a tertiary care hospital after obtaining ethical committee clearance and CTRI registration. Patients were allocated to one of four groups: nondiabetics receiving saline, nondiabetics receiving dexamethasone, diabetics receiving saline, and diabetics receiving dexamethasone. The study drug or saline control was administered at the induction of anesthesia. Blood sugar values, two hours after dexamethasone/placebo administration as well as fasting blood sugar and postprandial blood sugar on postoperative day 1, 2 were taken as primary endpoints. PONV was assessed in the first 24 hours after surgery.Results: The rise in blood glucose levels was higher in the group receiving dexamethasone compared to saline in both diabetics and nondiabetics (P < 0.05). None of the patients had blood glucose values more than 180 mg/dL after 2 hours and 8 hours of dexamethasone administration.Conclusions: Dexamethasone can be considered as prophylaxis for PONV in well controlled diabetics and nondiabetics despite the increase in blood glucose levels as a hyperglycemic response (blood glucose value 180 mg/dL) to a single dose was not observed in our study.","PeriodicalId":8482,"journal":{"name":"Asian journal of anesthesiology","volume":"62 3","pages":"153-161"},"PeriodicalIF":0.0,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136378","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}

引用次数: 0

Nociception Along With Interventional Bronchoscopy: Analyzed With Analgesia Nociception Index. 介入支气管镜检查伴痛觉：用镇痛痛觉指数分析。

Asian journal of anesthesiology Pub Date : 2024-09-24 DOI: 10.6859/aja.202409_62(3).0003

Kuang-Cheng Chan, Chih-Jun Lai, Ching-Kai Lin, Ya-Jung Cheng

{"title":"Nociception Along With Interventional Bronchoscopy: Analyzed With Analgesia Nociception Index.","authors":"Kuang-Cheng Chan, Chih-Jun Lai, Ching-Kai Lin, Ya-Jung Cheng","doi":"10.6859/aja.202409_62(3).0003","DOIUrl":"10.6859/aja.202409_62(3).0003","url":null,"abstract":"Background: Anesthesia for interventional bronchoscopy (IB) presents significant challenges, primarily due to unpredictable responses such as coughing, airway spasms, and desaturation, even with monitored anesthetic care. However, the nociception inducing such responses and the impact of adding topical anesthesia (TA) have rarely been investigated. This study aims to map the timing and intensity of nociception, determine TA onset, and clarify TA's role in blocking nociception with subsequent IB procedures.Methods: Analgesia nociception index (ANI) and mean arterial blood pressure (MBP) were collected in patients undergoing IB procedures with bispectral index (BIS)-controlled intravenous anesthesia. Data were compared and analyzed along with various stages: anesthetic induction with iGel insertion, fibro-optic bronchoscopy (FOB) insertion, and applying TA with the spray-as-you-go (SAYGO) method using xylocaine, up to 30 minutes with subsequent IB procedures.Results: Data from 82 patients were analyzed. Under BIS-controlled anesthesia, iGel insertion decreased ANI significantly (P < 0.001). Following stabilization, ANI decreased significantly with SAYGO (P < 0.001), returned toward baseline within 5 minutes, and remained stably higher than baseline for up to 30 minutes. The changes on MBP were similar to those of ANI. No significant correlations were observed between BIS levels and ANI.Conclusions: ANI offers a valuable perspective on nociception, serves as a helpful reference for precise anesthetic management for IB. The key action, such as an ultrashort-acting anesthetic just before FOB insertion to block nociception from the establishment of TA without prolonged effect, is suggested for smooth, subsequent IB procedures.","PeriodicalId":8482,"journal":{"name":"Asian journal of anesthesiology","volume":"62 3","pages":"131-139"},"PeriodicalIF":0.0,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136327","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}

引用次数: 0

Additional Analysis Supports Shorter Intubation Time With VivaSight Double-Lumen Tubes for One-Lung Ventilation. 额外的分析支持VivaSight双腔管用于单肺通气缩短插管时间。

Asian journal of anesthesiology Pub Date : 2024-06-01 Epub Date: 2025-04-25 DOI: 10.6859/aja.202406_62(2).0005

I-Wen Chen, Kuo-Chuan Hung

引用次数: 0

Four Approaches of Styletubation for Handling the Orotracheal Intubation: A Technical Tip. 处理气管插管的四种方法：技术提示。

Asian journal of anesthesiology Pub Date : 2024-06-01 Epub Date: 2025-02-26 DOI: 10.6859/aja.202406_62(2).0006

Meng-Wai Cheong, Hsiang-Ning Luk, Jason Zhensheng Qu, Alan Shikani

引用次数: 0

Risk of Dementia After Uterus or Prostate Resection: 17-Year Follow-Up of a Population-Based Retrospective Cohort Study. 子宫或前列腺切除术后痴呆的风险：一项基于人群的回顾性队列研究的17年随访

Asian journal of anesthesiology Pub Date : 2024-06-01 Epub Date: 2025-01-20 DOI: 10.6859/aja.202406_62(2).0001

Chiu-Yin Lee, Yi-Chun Chen, Yen-Jen Oyang, Wei-Zen Sun

{"title":"Risk of Dementia After Uterus or Prostate Resection: 17-Year Follow-Up of a Population-Based Retrospective Cohort Study.","authors":"Chiu-Yin Lee, Yi-Chun Chen, Yen-Jen Oyang, Wei-Zen Sun","doi":"10.6859/aja.202406_62(2).0001","DOIUrl":"10.6859/aja.202406_62(2).0001","url":null,"abstract":"Background: The purpose of this retrospective study was to determine the effect of surgical operation, age at surgery, sex hormones, and anesthesia modality on the risk of dementia in both sexes.Methods: Data of females aged between 30 and 70 years old who were diagnosed with dysmenorrhea and underwent hysterectomy/myomectomy or without surgery, and males with benign prostate hyperplasia (BPH) with or without transurethral resection of the prostate (TURP) were identified from the National Health Insurance Research Database 2000-2016. The effect of age at surgery, surgery type, and anesthesia modality on dementia risk was assessed using Cox regression analyses.Results: Among the 855,893 subjects, 10,242 developed dementia. Surgery at older age increased dementia risk in both sexes. Among females, hysterectomy/myomectomy was not significantly associated with dementia risk, although myomectomy was associated with a lower risk for dementia than hysterectomy. In males, TURP significantly increased the risk of dementia.Conclusion: Men with BPH and women with dysmenorrhea who were older at surgery have a higher risk of dementia. Regardless of the anesthetic method, surgery increased the risk of dementia in men. Among the data of women, although the surgery factor was not significantly associated with dementia risk, women with myomectomy had a lower risk of dementia than the ones with hysterectomy. These findings together contributed to risk stratification for each sex in such surgical settings.","PeriodicalId":8482,"journal":{"name":"Asian journal of anesthesiology","volume":" ","pages":"67-75"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143027917","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}

引用次数: 0

Comparison of Inter-Incisor Distance as a Predictor of Difficult Intubation in Men and Women-A Prospective Observational Study. 门牙间距离作为男性和女性插管困难预测因素的比较——一项前瞻性观察研究。

Asian journal of anesthesiology Pub Date : 2024-06-01 Epub Date: 2025-01-16 DOI: 10.6859/aja.202406_62(2).0002

A Kireeti, Nirmala Jonnavithula, Tappa Rabbani

{"title":"Comparison of Inter-Incisor Distance as a Predictor of Difficult Intubation in Men and Women-A Prospective Observational Study.","authors":"A Kireeti, Nirmala Jonnavithula, Tappa Rabbani","doi":"10.6859/aja.202406_62(2).0002","DOIUrl":"10.6859/aja.202406_62(2).0002","url":null,"abstract":"Background: Most of the studies on difficult intubation and laryngoscopy focused on American and European populations. However, Indians have distinct anthropometric characteristics compared to these populations. This study aims to determine the gender difference in inter-incisor distance (IID) cut-off marks to assess the ease of intubation in the Indian population.Methods: A prospective observational study was conducted on 516 patients scheduled for elective surgery under general anesthesia with endotracheal intubation. Preoperative assessments included IID, thyromental distance, neck circumference, sternomental distance (SMD), thyrohyoid distance, mentohyoid distance, and modified mallampatti grading. Intubation difficulty scores (IDSs) were assessed during intubation. The optimal cut-off values of inter incisor gap and difficult intubation were analyzed by receiver operating characteristic curve analysis.Results: The total cohort was grouped into males (Group 1 [n = 258]) and females (Group 2 [n = 258]). Males had a significantly higher mean age (P = 0.04) and weight (P = 0.00) than females. Difficult intubation incidence was 16.3% of males and 6.2% of females. Increased IID (P = 0.039), decreased SMD (P = 0.046), and males (P = 0.002) are identified as predictors of difficult intubation.IID and IDS showed greater specificity than sensitivity, with significant cut-off values of 4.25 and 1.50, respectively.Conclusion: The cut-off value of IID did not show a significant difference in gender variation. Despite the low IID in females, intubation difficulties were not observed compared to males.","PeriodicalId":8482,"journal":{"name":"Asian journal of anesthesiology","volume":" ","pages":"76-84"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999160","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}

引用次数: 0

Deteriorating Hypotension and Trepopnea During Left Lateral Decubitus Position Before Spinal Anesthesia. 脊髓麻醉前左侧卧位时低血压和呼吸暂停恶化。

Asian journal of anesthesiology Pub Date : 2024-06-01 Epub Date: 2025-01-16 DOI: 10.6859/aja.202406_62(2).0004

Chi-Wei Feng, Yin-Tzu Liu, Tso-Chou Lin

引用次数: 0

Phenylephrine Infusion for the Prevention of Hypotension in Obese Patients During Cesarean Delivery Under Spinal Anesthesia: A Randomized, Placebo-Controlled, Double-Blind Study. 输注苯肾上腺素预防腰麻下剖宫产肥胖患者低血压：一项随机、安慰剂对照、双盲研究

Asian journal of anesthesiology Pub Date : 2024-06-01 Epub Date: 2025-04-25 DOI: 10.6859/aja.202406_62(2).0003

Márcio Luiz Benevides, José Márcio Costa Marques Júnior, Luis Fernando C de S A Martins, Lucas G Carrijo, Cristhiano C Prados, Samir C El Husny Filho, Ewerton M Coimbra, Marco A Marquioreto Benevides

{"title":"Phenylephrine Infusion for the Prevention of Hypotension in Obese Patients During Cesarean Delivery Under Spinal Anesthesia: A Randomized, Placebo-Controlled, Double-Blind Study.","authors":"Márcio Luiz Benevides, José Márcio Costa Marques Júnior, Luis Fernando C de S A Martins, Lucas G Carrijo, Cristhiano C Prados, Samir C El Husny Filho, Ewerton M Coimbra, Marco A Marquioreto Benevides","doi":"10.6859/aja.202406_62(2).0003","DOIUrl":"10.6859/aja.202406_62(2).0003","url":null,"abstract":"Background: Spinal anesthesia-induced hypotension can lead to adverse consequences for the mother-fetus binomial. We compared two prophylactic phenylephrine infusions with placebo in obese patients during cesarean delivery (CD) under spinal anesthesia.Methods: In this randomized, placebo-controlled, double-blind study, 121 patients were randomly allocated to receive 0.9% saline in Group C, prophylactic phenylephrine infusion 50 μg/min in Group P50, or prophylactic phenylephrine infusion 100 μg/min in Group P100, starting immediately after anesthesia induction until delivery. The primary outcome was the number of episodes of hypotension.Results: The median (interquartile range) of the number of episodes of hypotension in Group P100 [0.0 (0.0-0.0)] and Group P50 [0.0 (0.0-1.5)] were lower in Group C [3.0 (2.0-5.0)], P < 0.001. There was also a smaller number of episodes of hypotension in Group P100 than in Group P50, P = 0.016. The phenylephrine infusion groups had a significantly lower incidence of hypotension, increased time until the first episode of hypotension, and fewer physician interventions but a higher incidence of reactive hypertension in Group P100 than in Group C. Nausea and vomiting, bradycardia, and neonatal outcomes were not different among the groups.Conclusion: Prophylactic phenylephrine infusion of 100 or 50 μg/min in obese women during CD under spinal anesthesia reduced the number of episodes of hypotension, the incidence of hypotension, the number of physician interventions, and the number of rescue phenylephrine boluses, and increased the time until the first hypotension episode. However, 100 μg/min could lead to more reactive hypertension.","PeriodicalId":8482,"journal":{"name":"Asian journal of anesthesiology","volume":" ","pages":"85-94"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143975296","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}

引用次数: 0

An Occult Cardiac Tamponade: Echocardiographic Diagnosis of Aortic Root Rupture in Infective Endocarditis. 隐匿性心脏填塞：感染性心内膜炎主动脉根破裂的超声心动图诊断。

Asian journal of anesthesiology Pub Date : 2023-12-01 DOI: 10.6859/aja.202312_61(4).0006

Kenneth Y Lin, Ming-Chon Hsiung, Ting-Chao Lin, Wein-Shung Kuo

引用次数: 0