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Comments on "Association between intraoperative hypotension and postoperative ICU delirium: a retrospective observational study" by Ono et al. 对Ono等人“术中低血压与术后ICU谵妄的关系:一项回顾性观察研究”的评论。
IF 2.7 3区 医学 Q2 ANESTHESIOLOGY Pub Date : 2026-02-07 DOI: 10.1007/s00540-026-03678-z
Liyun Wang, Na Mi, Yueying Li
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引用次数: 0
In reply: thermoregulatory bias may invalidate the claim of metabolic equivalence between propofol and remimazolam. 作为答复:体温调节偏倚可能使异丙酚和雷马唑仑之间代谢等同的说法无效。
IF 2.7 3区 医学 Q2 ANESTHESIOLOGY Pub Date : 2026-02-07 DOI: 10.1007/s00540-026-03687-y
Kenya Yarimizu, Hiroaki Toyama
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引用次数: 0
Impact of residual kidney function on hemodynamic changes during induction of general anesthesia in hemodialysis patients: a retrospective observational study. 血透患者全身麻醉诱导过程中残余肾功能对血流动力学变化的影响:一项回顾性观察研究。
IF 2.7 3区 医学 Q2 ANESTHESIOLOGY Pub Date : 2026-02-07 DOI: 10.1007/s00540-026-03681-4
Jin Sato, Hideki Hino, Kotaro Hori, Shogo Tsujikawa, Ryota Watanabe, Tadashi Matsuura, Takashi Mori

Purpose: This study aimed to investigate whether residual kidney function (RKF) influences perioperative hemodynamic stability in hemodialysis patients. Although anesthesiologists have had the clinical impression that RKF contributes to more stable blood pressure during induction of general anesthesia, this association has not been demonstrated. We hypothesized that RKF was associated with less hypotension at induction.

Methods: We conducted a single-center retrospective study of hemodialysis patients undergoing elective surgery under general anesthesia. RKF was defined as urine output ≥ 100 mL/day. The primary outcome was the lowest systolic blood pressure (SBP) during induction. Propensity score matching was performed. Independent predictors of hypotension were identified using multivariable logistic regression.

Results: Of 1,086 patients screened, 882 were analyzed (RKF + 335; RKF- 527). After matching, 160 patients were included in each group. In the matched cohort, the lowest SBP was higher in the RKF + group (111 ± 32 vs. 105 ± 30 mmHg; p = 0.044). In the full cohort, both the lowest SBP (112 ± 30 vs. 103 ± 29 mmHg; p < 0.001) and the decrease (28 ± 33 vs. 37 ± 31 mmHg; p < 0.001) were more favorable in the RKF + group, with lower phenylephrine use (0.09 ± 0.19 vs. 0.16 ± 0.35 mg; p = 0.001). Logistic regression confirmed RKF, surgery type, and preoperative SBP as independent predictors.

Conclusions: RKF was associated with higher SBP at induction of general anesthesia, independent of anesthetic and vasopressor doses. Preoperative assessment of RKF may help identify dialysis patients at risk of induction-related hypotension.

目的:探讨残余肾功能(RKF)对血液透析患者围手术期血流动力学稳定性的影响。虽然麻醉医师在临床印象中认为RKF有助于全身麻醉诱导时血压更稳定,但这种关联尚未得到证实。我们假设RKF与诱导时低血压的减少有关。方法:对全身麻醉下择期手术的血液透析患者进行单中心回顾性研究。RKF定义为尿量≥100ml /天。主要终点是诱导时的最低收缩压(SBP)。进行倾向评分匹配。使用多变量逻辑回归确定低血压的独立预测因素。结果:在筛选的1,086例患者中,分析了882例(RKF + 335; RKF- 527)。配对后,每组160例。在匹配的队列中,RKF +组的最低收缩压更高(111±32比105±30 mmHg; p = 0.044)。在整个队列中,最低收缩压(112±30 vs 103±29 mmHg); p结论:RKF与全麻诱导下的较高收缩压相关,与麻醉剂和血管加压剂剂量无关。术前评估RKF可能有助于识别有诱导相关性低血压风险的透析患者。
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引用次数: 0
To the editor: reply to the letter to the editor regarding "Incidence and predictors of activities of daily living decline after transcatheter aortic valve implantation". 致编辑:回复关于“经导管主动脉瓣植入术后日常生活活动能力下降的发生率及预测因素”的致编辑信。
IF 2.7 3区 医学 Q2 ANESTHESIOLOGY Pub Date : 2026-02-07 DOI: 10.1007/s00540-026-03682-3
Yasutaka Yamada
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引用次数: 0
The transitional pain service: a narrative review on the approach to managing chronic post-surgical pain. 过渡性疼痛服务:对治疗慢性术后疼痛方法的叙述回顾。
IF 2.7 3区 医学 Q2 ANESTHESIOLOGY Pub Date : 2026-02-05 DOI: 10.1007/s00540-025-03649-w
Praveen K Ganty, Dorothy Wong, Hance A Clarke

We conducted a narrative review of the Transitional Pain Service (TPS) to (1) synthesize current evidence on its effectiveness and (2) identify key prerequisites for future TPS implementation. Chronic post-surgical pain (CPSP) is a significant and potentially preventable postoperative complication following major surgery. Established at Toronto General Hospital in 2014, the TPS represents a novel multidisciplinary model designed to mitigate CPSP risk and reduce opioid dependence. A comprehensive search of OVID Medline, supplemented by manual hand-searching, was performed using terms related to transitional pain, postoperative pain management, opioids, and chronic pain. Searches were restricted to English language human studies published from 2014 onward. Fourteen articles met inclusion criteria. Across the literature, TPS interventions consistently demonstrated reductions in postoperative pain and opioid consumption, along with improvements in functional and psychological outcomes. The TPS provides an essential multimodal approach to postoperative care, supporting long-term reductions in opioid use and chronic pain burden. Key prerequisites are proposed to guide successful implementation in future clinical settings.

我们对过渡性疼痛服务(TPS)进行了叙述性回顾,以:(1)综合目前关于其有效性的证据;(2)确定未来实施TPS的关键先决条件。慢性术后疼痛(CPSP)是大手术后重要且有可能预防的术后并发症。TPS于2014年在多伦多总医院成立,代表了一种新的多学科模型,旨在减轻CPSP风险并减少阿片类药物依赖。全面搜索OVID Medline,辅以人工搜索,使用与过渡性疼痛、术后疼痛管理、阿片类药物和慢性疼痛相关的术语进行搜索。检索仅限于2014年以后发表的英语人类研究。14篇文章符合纳入标准。在所有文献中,TPS干预一致证明了术后疼痛和阿片类药物消耗的减少,以及功能和心理结果的改善。TPS为术后护理提供了一种重要的多模式方法,支持长期减少阿片类药物使用和慢性疼痛负担。提出了指导未来临床环境成功实施的关键先决条件。
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引用次数: 0
Comments on "Incidence and predictors of activities of daily living decline after transcatheter aortic valve implantation" by Yamada et al. 对Yamada等人“经导管主动脉瓣植入术后日常生活能力下降的发生率及预测因素”的评论。
IF 2.7 3区 医学 Q2 ANESTHESIOLOGY Pub Date : 2026-02-04 DOI: 10.1007/s00540-026-03673-4
Wei-Na Lu, Wen-Yan Xie, Xu Shen
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引用次数: 0
Clarifying methodological foundations underlying our study on preoperative sleep and postpartum recovery. 阐明术前睡眠与产后恢复研究的方法学基础。
IF 2.7 3区 医学 Q2 ANESTHESIOLOGY Pub Date : 2026-02-03 DOI: 10.1007/s00540-026-03670-7
Sayaka Hirai, Mitsuru Ida, Masahiko Kawaguchi
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引用次数: 0
Success rate and efficacy of intentional ipsilateral epidural catheter placement for anterior cruciate ligament reconstruction surgery: a retrospective analysis of 307 consecutive patients. 前交叉韧带重建术中同侧硬膜外置管的成功率和疗效:回顾性分析307例患者。
IF 2.7 3区 医学 Q2 ANESTHESIOLOGY Pub Date : 2026-02-03 DOI: 10.1007/s00540-026-03680-5
Yuki Aoyama, Shinichi Sakura, Hiroshi Ishimura, Yasushi Takeda, Yuji Nishikawa, Kenji Sakai, Tetsuro Nikai

Purpose: Intentional placement of an epidural catheter toward the operative side can produce a predominantly ipsilateral effect, which may benefit patients undergoing unilateral knee surgery. In this study, we retrospectively evaluated the success rate and efficacy of intentional ipsilateral epidural catheter placement in patients undergoing anterior cruciate ligament reconstruction (ACLR).

Methods: With IRB approval, we retrospectively analyzed existing clinical data that had been routinely collected from patients who underwent ACLR and received intentional ipsilateral epidural catheter placement combined with spinal anesthesia between January 2021 and December 2023. All epidural catheters were advanced toward the operative side and used for continuous infusion for 3 days. Catheter tip position was evaluated by X-ray on postoperative day (POD) 1. Pain scores on the Numerical Rating Scale (NRS), analgesic requirements, distribution of sensory blockade, motor function, and complications through POD4 were evaluated.

Results: Of 307 patients undergoing ACLR, 297 patients were included in the analysis. Catheters were inserted between the T11/12 and L1/2 intervertebral spaces. X-rays revealed that the epidural catheter tip was located on the operated side in 274 patients (92.3%). An ipsilateral-dominant sensory block covering lumbar segments was observed in more than 90% of patients throughout 3 PODs. Median NRS scores during mobilization remained below 3 with epidural infusion, and 263 patients (88.6%) could perform active straight leg raise on the operative side on POD1.

Conclusion: Intentional ipsilateral epidural catheter placement demonstrated a high success rate, provided motor-sparing and satisfactory analgesia in patients undergoing ACLR.

目的:向手术侧放置硬膜外导管可以产生主要的同侧效果,这可能有利于单侧膝关节手术的患者。在这项研究中,我们回顾性评估了前交叉韧带重建(ACLR)患者的同侧硬膜外置管的成功率和疗效。方法:经IRB批准,我们回顾性分析了2021年1月至2023年12月期间接受ACLR并接受同侧硬膜外置管联合脊髓麻醉的患者常规收集的现有临床数据。所有硬膜外置管均向手术侧推进,连续输注3天。术后第1天(POD) x线评估导管尖端位置。评估两组患者的数值评定量表(NRS)疼痛评分、镇痛需求、感觉阻滞分布、运动功能及POD4并发症。结果:307例行ACLR的患者中,有297例纳入分析。在T11/12和L1/2椎间隙之间插入导管。x线显示硬膜外导管尖端位于手术侧274例(92.3%)。在3个pod中,超过90%的患者观察到覆盖腰椎节段的同侧主导型感觉阻滞。在硬膜外输液下,活动时的中位NRS评分保持在3分以下,263例(88.6%)患者在POD1上可以在手术侧进行主动直腿抬高。结论:同侧硬膜外置管具有较高的成功率,为ACLR患者提供了运动保留和满意的镇痛效果。
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引用次数: 0
Postoperative pulmonary complications of desflurane- versus sevoflurane-based general anesthesia in patients with chronic obstructive pulmonary disease or asthma undergoing gastrointestinal cancer surgery: a nationwide retrospective cohort study. 慢性阻塞性肺疾病或哮喘患者接受胃肠道肿瘤手术时地氟醚与七氟醚全麻的术后肺部并发症:一项全国回顾性队列研究
IF 2.7 3区 医学 Q2 ANESTHESIOLOGY Pub Date : 2026-02-01 Epub Date: 2025-07-16 DOI: 10.1007/s00540-025-03548-0
Kanako Makito, Yuichiro Matsuo, Hiroki Matsui, Kiyohide Fushimi, Hideo Yasunaga

Purpose: Desflurane and sevoflurane are widely used for general anesthesia; however, it remains uncertain if sevoflurane might be preferable for patients with chronic respiratory inflammatory diseases. This study compared postoperative outcomes of desflurane and sevoflurane following gastrointestinal cancer surgery in patients with chronic obstructive pulmonary disease (COPD) or asthma.

Methods: We conducted a retrospective cohort study using the Japanese Diagnosis Procedure Combination database (April 2011-March 2022), identifying patients with COPD or asthma who underwent gastrointestinal cancer surgery. The primary outcome was postoperative pulmonary complications, including pneumonia, respiratory failure, mechanical ventilation > 24 h, and unplanned reintubation within 7 days after surgery. Secondary outcomes were in-hospital mortality and postoperative stay. We conducted propensity score overlap weighting and instrumental variable analyses adjusted for confounders.

Results: We identified 24,243 COPD and 16,199 asthma patients. Propensity score overlap weighting showed no significant association between desflurane and increased postoperative pulmonary complications in COPD [adjusted risk difference (aRD) - 0.57%; 99% confidence interval (CI), - 1.8% to 0.60%] or asthma (aRD, - 0.62%; 99% CI, - 1.8% to 0.59%). In-hospital mortality did not differ significantly between groups in COPD (aRD, - 0.24%; 99% CI, - 0.76% to 0.29%) or asthma (aRD, 0.07%; 99% CI, - 0.45% to 0.59%). The postoperative stay also showed no significant association between the desflurane and sevoflurane groups.

Conclusions: Desflurane-based anesthesia was not associated with increased postoperative pulmonary complications and mortality compared to sevoflurane in patients with chronic respiratory diseases undergoing gastrointestinal cancer surgery. However, further studies using reliable diagnostic criteria to assess COPD or asthma are warranted.

目的:地氟醚、七氟醚广泛用于全身麻醉;然而,七氟醚是否更适合慢性呼吸道炎症性疾病患者仍不确定。本研究比较了慢性阻塞性肺疾病(COPD)或哮喘患者胃肠道肿瘤手术后地氟醚和七氟醚的术后结果。方法:我们使用日本诊断程序组合数据库(2011年4月- 2022年3月)进行了一项回顾性队列研究,确定了接受胃肠癌手术的COPD或哮喘患者。主要结局为术后肺部并发症,包括肺炎、呼吸衰竭、机械通气bbb24 h、术后7天内计划外再插管。次要结局是住院死亡率和术后住院时间。我们进行了倾向得分重叠加权和工具变量分析,调整了混杂因素。结果:我们确定了24243例COPD患者和16199例哮喘患者。倾向性评分重叠加权显示地氟醚与COPD术后肺部并发症增加无显著相关性[校正风险差(aRD) - 0.57%;99%置信区间(CI), - 1.8%至0.60%]或哮喘(aRD, - 0.62%;99% CI, - 1.8%至0.59%)。住院死亡率在COPD组间无显著差异(d, - 0.24%;99% CI, - 0.76%至0.29%)或哮喘(aRD, 0.07%;99% CI, - 0.45%至0.59%)。地氟醚组和七氟醚组的术后停留时间也没有明显的相关性。结论:与七氟醚相比,地氟醚麻醉与接受胃肠道肿瘤手术的慢性呼吸系统疾病患者术后肺部并发症和死亡率增加无关。然而,使用可靠的诊断标准评估COPD或哮喘的进一步研究是有必要的。
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引用次数: 0
Association between body mass index and pain outcomes in elderly patients with chronic pain: A retrospective cohort study. 老年慢性疼痛患者体重指数与疼痛结局的关系:一项回顾性队列研究。
IF 2.7 3区 医学 Q2 ANESTHESIOLOGY Pub Date : 2026-02-01 Epub Date: 2025-07-15 DOI: 10.1007/s00540-025-03546-2
Tamaki Aihara, Yusuke Nagamine, Masaki Kitahara, Takahisa Goto

Purpose: The purpose of this study was to investigate the association between body mass index (BMI) and changes in pain scores among elderly patients with chronic pain. The pain disability assessment scale (PDAS) and the pain catastrophizing scale (PCS) were employed as assessment tools.

Methods: A single-center, retrospective cohort study was conducted at a university hospital multidisciplinary pain center from 2017 to 2020, involving 180 patients aged ≥ 65 years with noncancer pain persisting for at least 3 months. Patients were classified into three groups according to BMI: low (BMI < 18.5), standard (18.5 ≤ BMI < 25), and high (BMI ≥ 25). Initial, 3-month, and 6-month PDAS and PCS scores were collected and analyzed using mixed-effects models.

Results: No significant differences were observed in PDAS scores across BMI groups. However, PCS scores were significantly higher in the low BMI group. Furthermore, no significant differences were detected in PDAS and PCS scores based on the interaction between BMI group and time point (month).

Conclusion: Among elderly patients with chronic pain, the low BMI group exhibited a significantly higher PCS score, while PDAS scores did not vary based on the BMI group. No differences were detected in treatment-related changes over time across BMI groups.

目的:本研究旨在探讨老年慢性疼痛患者体重指数(BMI)与疼痛评分变化的关系。采用疼痛失能量表(PDAS)和疼痛灾变量表(PCS)作为评估工具。方法:2017 - 2020年在某大学医院多学科疼痛中心进行单中心、回顾性队列研究,纳入180例年龄≥65岁且非癌性疼痛持续至少3个月的患者。根据BMI将患者分为三组:低(BMI)结果:BMI组间PDAS评分无显著差异。然而,低BMI组的PCS得分明显更高。此外,基于BMI组与时间点(月)的相互作用,PDAS和PCS评分无显著差异。结论:在老年慢性疼痛患者中,低BMI组的PCS评分显著高于BMI组,而不同BMI组的PDAS评分无显著差异。随着时间的推移,BMI组之间的治疗相关变化没有发现差异。
{"title":"Association between body mass index and pain outcomes in elderly patients with chronic pain: A retrospective cohort study.","authors":"Tamaki Aihara, Yusuke Nagamine, Masaki Kitahara, Takahisa Goto","doi":"10.1007/s00540-025-03546-2","DOIUrl":"10.1007/s00540-025-03546-2","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to investigate the association between body mass index (BMI) and changes in pain scores among elderly patients with chronic pain. The pain disability assessment scale (PDAS) and the pain catastrophizing scale (PCS) were employed as assessment tools.</p><p><strong>Methods: </strong>A single-center, retrospective cohort study was conducted at a university hospital multidisciplinary pain center from 2017 to 2020, involving 180 patients aged ≥ 65 years with noncancer pain persisting for at least 3 months. Patients were classified into three groups according to BMI: low (BMI < 18.5), standard (18.5 ≤ BMI < 25), and high (BMI ≥ 25). Initial, 3-month, and 6-month PDAS and PCS scores were collected and analyzed using mixed-effects models.</p><p><strong>Results: </strong>No significant differences were observed in PDAS scores across BMI groups. However, PCS scores were significantly higher in the low BMI group. Furthermore, no significant differences were detected in PDAS and PCS scores based on the interaction between BMI group and time point (month).</p><p><strong>Conclusion: </strong>Among elderly patients with chronic pain, the low BMI group exhibited a significantly higher PCS score, while PDAS scores did not vary based on the BMI group. No differences were detected in treatment-related changes over time across BMI groups.</p>","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":"39-47"},"PeriodicalIF":2.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12860826/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144642628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Journal of Anesthesia
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