Asian journal of anesthesiology最新文献

{"title":"A Narrative Review of Remimazolam in Procedural Sedation.","authors":"Geng-Ci Chen,&nbsp;Shih-Syuan Lin,&nbsp;Po-An Lin,&nbsp;Wei-Cheng Tseng,&nbsp;Chueng-He Lu","doi":"10.6859/aja.202306_61(2).0001","DOIUrl":"https://doi.org/10.6859/aja.202306_61(2).0001","url":null,"abstract":"<p><p>Remimazolam is a recently approved benzodiazepine for procedural sedation in Taiwan. It is a new type of short-acting γ-aminobutyric acid receptor agonist with the characteristics of non-organ-dependent metabolism, no injection pain, and inactive metabolites. Remimazolam has a mild cardiopulmonary suppressive effect, showing good effectiveness and safety in clinical applications, especially in the elderly, critically ill patients, or patients with hepatic and renal insufficiency. This review aims to provide an overview of the specific basic and clinical pharmacology of remimazolam and provide scientific support for the clinical application of this novel sedative drug in procedural sedation.</p>","PeriodicalId":8482,"journal":{"name":"Asian journal of anesthesiology","volume":"61 2","pages":"39-45"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10250315","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":"VivaSight Double-Lumen Tube Versus Conventional Double-Lumen Tube for One-Lung Ventilation: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Mahfouz Sharapi,&nbsp;Mohamed El-Samahy,&nbsp;Marwa Abdelazim Rizk,&nbsp;Ahmed Gadallah,&nbsp;Adel Mouffokes,&nbsp;Khaled Albakri","doi":"10.6859/aja.202306_61(2).0002","DOIUrl":"10.6859/aja.202306_61(2).0002","url":null,"abstract":"<p><p>The main objective of this systematic review and meta-analysis was to determine the safety and effectiveness of VivaSight double-lumen tubes (VS-DLTs) in one-lung ventilation (OLV) compared to conventional DLTs (c-DLTs). The study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement's guidelines. From the database's inception to December 2022, we searched seven different databases. We included 364 patients from six randomized controlled trials who were scheduled to undergo surgery requiring OLV. The Cochrane risk of bias assessment tool was utilized to determine the risk of bias. The odds ratio (OR) was estimated for categorical variables, while the mean difference was calculated for continuous variables. Patients were randomly assigned to the VS-DLT or c-DLT group. The results revealed that patients in the c-DLT group have longer intubation time than the VS-DLT patients (mean difference [MD] = -90.01; 95% confidence interval [CI], -161.33 to -18.69; P = 0.01). Significantly, more secretions were present in the VS-DLT group than in the c-DLT group (OR = 4.24; CI, 1.96 to 9.13; P = 0.0002). Also, the fiberoptic bronchoscope was used more frequently in the c-DLT group compared to the VS-DLT group (OR = 0.01 [0.00, 0.07]; P < 0.00001). We found that VS-DLT was safe as the pooled analysis showed no significant difference according to side effects such as hoarseness and sore throat. The other outcomes, such as dislodgement, the clearance of secretions, and the quality of lung deflation (excellent), were non-significant between the two groups.</p>","PeriodicalId":8482,"journal":{"name":"Asian journal of anesthesiology","volume":"61 2","pages":"46-60"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10209687","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 the Effectiveness of Nasal Cannula Versus Face Mask With Reservoir Bag in Postoperative Patients Undergoing General Anesthesia: A Prospective Randomized Controlled Trial.","authors":"Thitinuch Ruenhunsa,&nbsp;Panyaporn Chinsatit,&nbsp;Saranyoo Nonphiaraj,&nbsp;Siwalai Sucher,&nbsp;Sarinya Chanthawong,&nbsp;Wilawan Somdee,&nbsp;Peerapong Sangsungnern","doi":"10.6859/aja.202306_61(2).0005","DOIUrl":"https://doi.org/10.6859/aja.202306_61(2).0005","url":null,"abstract":"<p><strong>Background: </strong>High-concentration oxygen delivery via a face mask (FM) with a reservoir bag is a common practice to prevent postoperative hypoxemia; however, it may also lead to atelectasis and other respiratory complications. Lower concentrations delivered via nasal cannula (NC) may be equally effective in preventing postoperative hypoxemia. The present study aimed to compare peripheral oxygen saturation (SpO_2) delivered via NC versus FM with a reservoir bag in patients who have undergone general anesthesia (GA).</p><p><strong>Methods: </strong>Eighty-four patients scheduled for GA were randomized to receive either oxygen via NC (NC group, n = 42) or FM with a reservoir bag (FM group, n = 42) for 30 minutes after GA at a postanesthesia care unit (PACU). All patients were assessed based on SpO_2 value, adverse events, and patient satisfaction (measured using a 100-mm visual analog scale).</p><p><strong>Results: </strong>The overall difference between groups in the change of SpO_2 over 30 minutes at the PACU was -0.004 (95% confidence interval, -0.015 to 0.008; P = 0.527). SpO_2 during the first five minutes was lower in NC group, but the difference was not statistically significant. No desaturation occurred in either group, and there was no observed difference between groups in terms of adverse events. Patient satisfaction scores were also similar (P = 0.612).</p><p><strong>Conclusions: </strong>Oxygen supplementation via NC and via FM with a reservoir bag were equally effective in preventing postoperative hypoxemia after GA.</p>","PeriodicalId":8482,"journal":{"name":"Asian journal of anesthesiology","volume":"61 2","pages":"81-88"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10314437","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":"Automated Closed-Loop Propofol Anesthesia Versus Desflurane Inhalation Anesthesia in Obese Patients Undergoing Bariatric Surgery: A Comparative Randomized Analysis of Recovery Profile.","authors":"Amitabh Dutta,&nbsp;Nitin Sethi,&nbsp;Goverdhan D Puri,&nbsp;Jayashree Sood,&nbsp;Prabhat Kumar Choudhary,&nbsp;Anil Kumar Jain,&nbsp;Bhuwan Chand Panday,&nbsp;Manish Gupta","doi":"10.6859/aja.202306_61(2).0003","DOIUrl":"https://doi.org/10.6859/aja.202306_61(2).0003","url":null,"abstract":"<p><strong>Introduction: </strong>Precision general anesthesia (GA) techniques that minimize the presence of residual anesthetic and facilitate recovery, are desirable in patients with morbid obesity. Automated administration of propofol total intravenous anesthesia (TIVA), which facilitates precision propofol delivery by factoring in continuous patient input variable (bispectral index) to establish a closed feedback loop system, may help mitigate concerns related to propofol's lipid solubility and adverse accumulation kinetics in patients with morbid obesity. This randomized study evaluated the recovery of patients with morbid obesity undergoing bariatric surgery under propofol TIVA automated by a closed-loop anesthesia delivery system (CLADS) versus desflurane GA.</p><p><strong>Methods: </strong>Forty patients, randomly allocated to receive propofol TIVA (CLADS group) or desflurane GA (desflurane group), were evaluated for postoperative recovery (early and intermediate) (primary objective); they were evaluated for intraoperative hemodynamics, anesthesia depth consistency, anesthesia delivery performance characteristics, patient satisfaction, and incidence of adverse events (sedation, pain, postoperative nausea, and vomiting) (secondary objective).</p><p><strong>Results: </strong>No difference was found for the time-to-eye-opening (CLADS group: 4.7 [3.0, 6.7] min vs. desflurane group: 5.6 [4.0, 6.9] min, P = 0.576), time-to-tracheal-extubation (CLADS group: 6.7 [4.7, 9.3] min vs. desflurane group: 7.0 [5.8, 9.2] min, P = 0.528), ability-to-shift score from operating room table to the transport bed (CLADS group: 3 [3.0, 3.5] vs. desflurane group: 3 [3.0, 4.0], P = 0.703), and time to achieve a modified Aldrete score 9/10 (CLADS group: 15 [15.0, 37.5] min vs. desflurane group: 15 [15.0, 43.7] min, P = 0.867).</p><p><strong>Conclusion: </strong>Automated propofol TIVA as administered by CLADS, which matched desflurane GA with respect to depth of anesthesia consistency and postanesthesia recovery profile, can be explored further as an alternative anesthesia technique in patients with morbid obesity.</p>","PeriodicalId":8482,"journal":{"name":"Asian journal of anesthesiology","volume":"61 2","pages":"61-70"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10257875","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 Caudal Dexmedetomidine and Midazolam as an Adjuvant to Ropivacaine for Postoperative Pain Relief in Children Undergoing Infra-Umbilical Surgeries: A Randomized Controlled Trial.","authors":"Arunima M Mohan, Ankur Sharma, Shilpa Goyal, Nikhil Kothari, Raksha Vyas, Akhil Dhanesh Goel, Priyanka Sethi, Kamlesh Kumari, Pradeep Bhatia","doi":"10.6859/aja.202306_61(2).0006","DOIUrl":"10.6859/aja.202306_61(2).0006","url":null,"abstract":"<p><strong>Background: </strong>We explored the analgesic efficacy of two non-opioid adjuvants (midazolam and dexmedetomidine) with ropivacaine in children undergoing infraumbilical surgeries.</p><p><strong>Methods: </strong>In this parallel group randomized controlled trial, 135 children aged between 2 and 8 years were recruited. Children were randomly allocated to one of three groups: RD received 1 mL/kg of ropivacaine (0.2%) with dexmedetomidine 1 μg/kg, RM received 1 mL/kg of ropivacaine (0.2%) with midazolam 30 µg/kg, and R received 1 mL/kg of ropivacaine (0.2%) with 1 mL normal saline. The primary outcome of the present study was to determine the duration of postoperative analgesia. Secondary outcomes were assessing postoperative face, leg, activity, cry, consolability (FLACC) pain score, rescue analgesics, hemodynamics, sedation scores, and adverse effects.</p><p><strong>Results: </strong>The analgesia duration was significantly prolonged in the RD and RM group (600.0 [480.0-720.0] minutes and 600.0 [480.0-720.0] minutes, respectively) compared to the R group 360.0 (300.0-480.0) minutes (P < 0.001). The FLACC score was comparatively higher in the R group compared to the RD and RM groups postoperatively. Time for the first rescue analgesia was more prolonged in RD and RM groups when compared with the R group. Postoperative sedation was higher in the RM group up to 120 minutes postoperatively compared to the RD and R groups.</p><p><strong>Conclusion: </strong>The combination of dexmedetomidine or midazolam with local anesthetics significantly increases the analgesia duration while minimizing adverse effects.</p>","PeriodicalId":8482,"journal":{"name":"Asian journal of anesthesiology","volume":"61 2","pages":"89-101"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10209689","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":"Effects of Intravenous Dexmedetomidine on Hemodynamic Responses to Pneumoperitoneum During Laparoscopic Cholecystectomy.","authors":"Rashna Shakya,&nbsp;Shyam Krishna Maharjan","doi":"10.6859/aja.202306_61(2).0004","DOIUrl":"https://doi.org/10.6859/aja.202306_61(2).0004","url":null,"abstract":"<p><strong>Background: </strong>Dexmedetomidine is a potent α_2 agonist which has been used for blunting the stress responses during critical events such as laryngoscopy, endotracheal intubation, pneumoperitoneum creation, and extubation. The purpose of this study was to see the efficacy of intravenously administered dexmedetomidine at a dose of 0.5 mcg/kg in attenuating the hemodynamic responses due to pneumoperitoneum during laparoscopic cholecystectomy under general anesthesia.</p><p><strong>Methods: </strong>Sixty patients, ASA-PS class I (American Society of Anesthesiologist physical status class I), aged between 18 and 60 years, of either sex with weight ranging from 50 to 80 kg, scheduled for laparoscopic cholecystectomy were randomized into two groups (groups A and B) in a double-blinded fashion. Both groups were pre-medicated with an injection glycopyrrolate. Group A received 100 mL normal saline (NS) over 10 minutes while group B received dexmedetomidine 0.5 mcg/kg diluted in 100 mL NS over 10 minutes before induction of general anesthesia. Heart rate, systolic, diastolic, and mean arterial pressures were noted.</p><p><strong>Results: </strong>Following pneumoperitoneum, there was no statistically significant difference in the hemodynamic parameters between the two groups (P > 0.05).</p><p><strong>Conclusion: </strong>Administration of dexmedetomidine at a dose of 0.5 mcg/kg before induction did not blunt the hemodynamic responses to pneumoperitoneum during laparoscopic cholecystectomy.</p>","PeriodicalId":8482,"journal":{"name":"Asian journal of anesthesiology","volume":"61 2","pages":"71-80"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10607245","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":"Styletubation: The Paradigmatic Role of Video-Assisted Intubating Stylet Technique for Routine Tracheal Intubation.","authors":"Hsiang-Ning Luk,&nbsp;Jason Zhensheng Qu,&nbsp;Alan Shikani","doi":"10.6859/aja.202306_61(2).0007","DOIUrl":"https://doi.org/10.6859/aja.202306_61(2).0007","url":null,"abstract":"","PeriodicalId":8482,"journal":{"name":"Asian journal of anesthesiology","volume":"61 2","pages":"102-106"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10286638","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":"Truncal Blocks for Emergency Laparotomy in a High-Risk Patient: A Case Report and Literature Review.","authors":"Y. Koyama, Kei Morita, Yoriko Murase, Haruko Nishikawa, K. Tsuzaki","doi":"10.6859/aja.202305/PP.0002","DOIUrl":"https://doi.org/10.6859/aja.202305/PP.0002","url":null,"abstract":"In critically ill patients undergoing laparotomy, both general anesthesia (GA) and central neuraxial block (CNB) may pose significant risks. Peripheral truncal blocks have been reported to provide effective postoperative analgesia following laparotomy. However, there are a limited number of reports describing this technique as surgical anesthesia for laparotomy. An 86-year-old man with non-specific interstitial pneumonia under home oxygen therapy and aortic valve stenosis was diagnosed with an incarcerated inguinal hernia. Because of these comorbidities, both GA and CNB were considered relatively contraindicated. Thus, we chose an ultrasound-guided transverse abdominis plane block and ilioinguinal/iliohypogastric block supplemented with neuroleptanesthesia as surgical anesthesia for emergency laparotomy. The surgery was uneventful using this technique. Truncal blocks supplemented with titrated intravenous sedatives/analgesics could be an alternative in high-risk patients undergoing laparotomy in whom both GA and CNB are considered relatively contraindicated.","PeriodicalId":8482,"journal":{"name":"Asian journal of anesthesiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45818888","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":"Injection Site Reactions Before and After Intramuscular Injection Technique Revision: A Postmarketing Analysis of NALDEBAIN® From 2017 to 2022.","authors":"K. Man, Sing-Ong Lee, Chueng-He Lu, Chih-Shung Wong, Wei-Zen Sun","doi":"10.6859/aja.202305/PP.0001","DOIUrl":"https://doi.org/10.6859/aja.202305/PP.0001","url":null,"abstract":"BACKGROUND\u0000The NALDEBAIN® has been available since 2017, and high incidence of injection reactions in the phase 3 study has been reported. Since the first year in the market, the injection site reactions were still the majority of adverse drug reactions (ADRs) in pharmacovigilance reports. The new intramuscular (IM) instruction and package was introduced in the middle of 2018. In this retrospective study, we analyzed the pharmacovigilance data and published postmarketing studies to investigate the impact of IM injection-related reactions in Taiwan between the period of 2017-2022.\u0000\u0000\u0000METHODS\u0000Individual case safety reports (ICSRs) and ADRs were classified by system organ class and preferred term. The reporting rate of ICSRs was used to evaluate the impact of the new IM instruction and package.\u0000\u0000\u0000RESULTS\u0000A total of 37 ICSRs were identified from pharmacovigilance reports. Among them, 51% of IM injection-related reactions were reported after one single dose of NALDEBAIN administration. The reporting rate of IM injection-related reactions in pharmacovigilance data dropped from 125.00 to 3.56 per ten thousand exposures after IM instruction and package revision in 2018. In addition, the percentage of IM injection-related reactions also reduced in postmarketing studies from 27.5% to 4.5%. There were no serious IM injection-related reactions found in the pharmacovigilance and postmarketing dataset.\u0000\u0000\u0000CONCLUSION\u0000Injection site reactions were common after intramuscularly administered oil-based agents during the first year which is later markedly reduced by changing the length of the needle and injection education.","PeriodicalId":8482,"journal":{"name":"Asian journal of anesthesiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42810094","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":"Styletubation: The Paradigmatic Role of Video-Assisted Intubating Stylet Technique for Routine Tracheal Intubation.","authors":"H. Luk, J. Qu, A. Shikani","doi":"10.6859/aja.202304/PP.0001","DOIUrl":"https://doi.org/10.6859/aja.202304/PP.0001","url":null,"abstract":"","PeriodicalId":8482,"journal":{"name":"Asian journal of anesthesiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47469310","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}