Journal of Clinical Anesthesia最新文献

{"title":"PPI and postinduction hypotension: Null association or methodological artifact?","authors":"Yanru Xiang , Mingyue Xia , Xingping Dai","doi":"10.1016/j.jclinane.2025.112108","DOIUrl":"10.1016/j.jclinane.2025.112108","url":null,"abstract":"","PeriodicalId":15506,"journal":{"name":"Journal of Clinical Anesthesia","volume":"110 ","pages":"Article 112108"},"PeriodicalIF":5.1,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145980111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative sleep disturbances: Therapeutic target or epiphenomenon of brain vulnerability?","authors":"Mattia Madeo , Stefano Fresilli , Andrea Bruni","doi":"10.1016/j.jclinane.2026.112132","DOIUrl":"10.1016/j.jclinane.2026.112132","url":null,"abstract":"","PeriodicalId":15506,"journal":{"name":"Journal of Clinical Anesthesia","volume":"110 ","pages":"Article 112132"},"PeriodicalIF":5.1,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145923705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"On the Cover - King et al","authors":"","doi":"10.1016/S0952-8180(26)00002-4","DOIUrl":"10.1016/S0952-8180(26)00002-4","url":null,"abstract":"","PeriodicalId":15506,"journal":{"name":"Journal of Clinical Anesthesia","volume":"109 ","pages":"Article 112124"},"PeriodicalIF":5.1,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145938767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial Board w/barcode","authors":"","doi":"10.1016/S0952-8180(26)00004-8","DOIUrl":"10.1016/S0952-8180(26)00004-8","url":null,"abstract":"","PeriodicalId":15506,"journal":{"name":"Journal of Clinical Anesthesia","volume":"109 ","pages":"Article 112126"},"PeriodicalIF":5.1,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145938763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of preoperative sleep disturbance on perioperative neurocognitive disorders in older adults undergoing major non-cardiac surgery: A multicenter prospective cohort study","authors":"Chao Chen ,&nbsp;Shengfeng Yang ,&nbsp;Yewei Shi ,&nbsp;Zhenyan Zhu ,&nbsp;Xinglong Xiong ,&nbsp;Ling Huang ,&nbsp;Jun Lu ,&nbsp;Guangling Tang ,&nbsp;Xianzhou Gu ,&nbsp;Guangdi Zhang ,&nbsp;Yu Wan ,&nbsp;Ruixue Zhai ,&nbsp;Sijie Tang ,&nbsp;Yuanyu Feng ,&nbsp;Yusu Wang ,&nbsp;Jielei Pan ,&nbsp;Jing Shi","doi":"10.1016/j.jclinane.2026.112123","DOIUrl":"10.1016/j.jclinane.2026.112123","url":null,"abstract":"<div><h3>Background</h3><div>Perioperative neurocognitive disorders (PND) significantly affect recovery in older adult surgical patients. However, whether untreated preoperative sleep disturbance (SD) independently contributes to postoperative cognitive dysfunction (POCD) remains unclear.</div></div><div><h3>Methods</h3><div>This multicenter prospective cohort study involving 535 patients aged ≥60 years undergoing major non-cardiac surgery (≥2 h) was conducted between June 30, 2024 and May 31, 2025. Patients were stratified by Pittsburgh Sleep Quality Index (PSQI): SD (PSQI&gt;7, <em>n</em> = 288) or non-SD (PSQI≤7, <em>n</em> = 247). The primary outcome was POCD assessed on postoperative days 7, 30, 90, and 180. Secondary outcomes included postoperative delirium (days 1–3), 15-item quality of recovery (QoR-15) scores, and insomnia severity (days 30, 90, and 180). Generalized estimating equations identified independent predictors of POCD.</div></div><div><h3>Results</h3><div>Compared with non-SD patients, SD patients showed significantly increased POCD risk on postoperative day 7 (41.7 % vs. 27.1 %; RR = 1.44, 95 %CI 1.16–1.79; <em>P</em> &lt; 0.001), day 30 (36.1 % vs. 18.2 %; RR = 1.73, 95 %CI 1.33–2.25; <em>P</em> &lt; 0.001), day 90 (25.7 % vs. 13.0 %; RR = 1.66, 95 %CI 1.22–2.25; <em>P</em> &lt; 0.001), and day 180 (19.4 % vs. 8.9 %; RR = 1.75, 95 %CI 1.21–2.52; <em>P</em> &lt; 0.001). Preoperative SD was associated with increased delirium risk (29.9 % vs. 18.6 %; RR = 1.43, <em>P</em> = 0.006), poorer QoR-15 scores (difference = 8, <em>P</em> &lt; 0.001), and persistent insomnia (34.7 % vs. 13.8 % at day 180, <em>P</em> &lt; 0.001). PSQI≥10 optimally predicted POCD risk (sensitivity 71.8 %, specificity 69.4 %).</div></div><div><h3>Conclusions</h3><div>Untreated preoperative SD independently predicts both early delirium and POCD after major non-cardiac surgery. A PSQI≥10 effectively identifies high-risk older adult patients, emphasizing preoperative sleep optimization as a potential strategy to mitigate postoperative cognitive impairment.</div></div>","PeriodicalId":15506,"journal":{"name":"Journal of Clinical Anesthesia","volume":"110 ","pages":"Article 112123"},"PeriodicalIF":5.1,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145903816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intravenous ferric derisomaltose for preoperative anemia in abdominal surgery","authors":"Eduardo Mendez-Pino ,&nbsp;Laura Ibanez-Pintor ,&nbsp;Laura Mendez-Pino ,&nbsp;Andres Zorrilla-Vaca ,&nbsp;David L. Hepner","doi":"10.1016/j.jclinane.2025.112107","DOIUrl":"10.1016/j.jclinane.2025.112107","url":null,"abstract":"<div><h3>Background</h3><div>There is increasing evidence supporting the use of intravenous (IV) iron in the perioperative setting, which has been shown to improve hemoglobin levels and reduce the need for transfusion. This study aimed to evaluate the efficacy of a single preoperative IV infusion of ferric derisomaltose administered 3 to 4 weeks prior to abdominal surgery in increasing hemoglobin (Hb) levels.</div></div><div><h3>Methods</h3><div>This single arm prospective trial with pos-hoc matched controls included adult patients with preoperative iron deficiency anemia (Hb ≤ 12 g/dL, and ferritin&lt;30 ng/mL or transferrin saturation &lt; 20 %) scheduled for abdominal surgery and treated with 1000 mg of IV ferric derisomaltose 3–4 weeks prior to surgery. The primary outcome was the change in Hb from baseline to the day of surgery. Between-group comparisons were performed using the paired <em>t-</em>test. A random control cohort who met our inclusion criteria but did not receive the treatment was included in a <em>post-hoc</em> analysis to evaluate associations with in-hospital blood transfusion.</div></div><div><h3>Results</h3><div>Among 36 patients treated with IV ferric derisomaltose, there was a significant improvement in hemoglobin levels after 3–4 weeks of drug administration (mean difference [MD] 1.88 g/dL, 95 % confidence interval [CI] 1.40 to 2.36) and after surgery (MD 0.67 g/dL, 95 %CI 0.16 to 1.17). Patients with moderate-to-severe pre-infusion anemia (Hb ≤ 10 g/dL) had a significantly superior improvement in Hb levels compared to patients with mild anemia (<em>P</em> = 0.03). In <em>post-hoc</em> analysis including a control group, transfusion rate was similar between the treated and control group (odds ratio 1.00, 95 %CI 0.29–3.48).</div></div><div><h3>Conclusion</h3><div>In this preliminary report with limited sample size, our findings suggest that a single preoperative dose of 1000 mg of IV ferric derisomaltose improves hemoglobin levels. Its ability to provide timely optimization before surgery warrants further investigation in large-scale trials to better define its role in perioperative care.</div></div>","PeriodicalId":15506,"journal":{"name":"Journal of Clinical Anesthesia","volume":"109 ","pages":"Article 112107"},"PeriodicalIF":5.1,"publicationDate":"2026-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145880369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of prehabilitation interventions on exercise capacity of patients undergoing major abdominal and cardiothoracic surgery: A systematic review and network meta-analysis of randomized controlled trials","authors":"Susana Priego-Jiménez PhD ,&nbsp;Pablo Priego Jiménez PhD ,&nbsp;María López-González MsC ,&nbsp;Patricia Lorenzo-García PhD ,&nbsp;Miguel Contreras-Molina MsC ,&nbsp;Celia Álvarez-Bueno PhD","doi":"10.1016/j.jclinane.2025.112112","DOIUrl":"10.1016/j.jclinane.2025.112112","url":null,"abstract":"<div><h3>Background</h3><div>Prehabilitation has reported improvements in exercise capacity, as measured by the six-minute walking test (6MWT), in people undergoing major abdominal and cardiothoracic surgery, although there is no evidence about which component of prehabilitation is most effective for improving exercise capacity.</div></div><div><h3>Methods</h3><div>A network meta-analysis (NMA) was performed to determine the effects of different components of prehabilitation on exercise capacity in people undergoing major abdominal or cardiothoracic surgery. A literature search was performed from baseline to September 2025. Randomized controlled trials on the effectiveness of prehabilitation programs on exercise capacity presurgery and recovery postsurgery were included. We assessed the risk of bias via the Cochrane risk of bias (RoB 2.0) tool and the quality of the evidence via the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) tool. Pairwise meta-analyses and NMAs were performed for direct and indirect evidence.</div></div><div><h3>Results</h3><div>Thirty-eight studies were included in this NMA. The effects associated with improvements in exercise capacity presurgery scores were greatest for the moderate-intensity exercise group versus control group (Effect size [ES]: 0.93 95 % CI: 0.46, 1.40), followed by the multimodal group (exercise+ nutrition + psychological intervention) versus the control group (ES: 0.50, 95 % CI: 0.15, 0.86). The effects associated with 6MWT recovery postsurgery score were greatest for the exercise+ nutrition group versus the control group (ES: 1.08, 95 % CI: 0.00, 2.16), followed by the moderate-intensity exercise group versus the control group (ES: 0.55, 95 % CI: 0.08, 1.01), and the multimodal group versus the control group (ES: 0.35, 95 % CI: 0.03, 0.68).</div></div><div><h3>Conclusions</h3><div>Moderate-intensity exercise, followed by multimodal exercise, should be considered the most effective strategy for improving exercise capacity in people undergoing major abdominal and cardiothoracic surgery. Exercise plus nutrition is the most effective intervention to improve 6MWT recovery postsurgery, followed by moderate-intensity exercise and multimodal interventions. Owing to the importance of this outcome, as a predictor of both postsurgical complications and recovery capacity after surgery, it is essential to know the most effective intervention to improve it.</div></div>","PeriodicalId":15506,"journal":{"name":"Journal of Clinical Anesthesia","volume":"109 ","pages":"Article 112112"},"PeriodicalIF":5.1,"publicationDate":"2026-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145880472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transnasal humidified rapid-insufflation ventilatory exchange (THRIVE) use in a pediatric population: A prospective, randomized controlled trial","authors":"Ellen Y. Wang MD ,&nbsp;Andrew J. Renuart MD ,&nbsp;Stephen G. Flynn MD ,&nbsp;Hanna Van Pelt BS ,&nbsp;Prabhakar Devavaram MBBS ,&nbsp;Linda A. Bulich MD ,&nbsp;Mary Lyn Stein MD ,&nbsp;Niroop R. Ravula MD, FRCA ,&nbsp;Rajvinder S. Dhamrait MD, MBA, FCARCSI, FRCA ,&nbsp;Kristin M. Kennedy MD ,&nbsp;Man Yee Suen MMedSc ,&nbsp;Christian Jackson MS ,&nbsp;Kush Gupta MD ,&nbsp;Alex Swanger MD ,&nbsp;Romy Yun MD ,&nbsp;Michael A. Evans MD, FAAP, FASA ,&nbsp;Vanessa A. Olbrecht MD ,&nbsp;Thomas J. Caruso MD, PhD","doi":"10.1016/j.jclinane.2025.112117","DOIUrl":"10.1016/j.jclinane.2025.112117","url":null,"abstract":"<div><h3>Background</h3><div>Maintenance of oxygenation during microdirect laryngoscopy and bronchoscopy (MDLB) is an anesthetic challenge for pediatric anesthesia providers. High flow nasal cannula (HFNC) as transnasal humidified rapid insufflation ventilatory exchange (THRIVE) is a safe method to deliver humidified oxygen to pediatric patients; however, its role in pediatrics for preventing apneic desaturation while under anesthesia is unclear. This study evaluated THRIVE for pediatric patients undergoing airway procedures. The primary aim was to assess the frequency of patients who had at least one “relative desaturation” event, assessed as a 4 % drop from a patient's average baseline saturation using the measure of oxygen desaturation index (ODI). The secondary aims assessed frequencies of total relative desaturation events, absolute desaturations below 90 % and surgical interruptions due to airway conditions.</div></div><div><h3>Methods</h3><div>This was a prospective, randomized controlled trial conducted across three pediatric sites (Lucile Packard Children's Hospital [Stanford University, Palo Alto, CA], UC Davis Children's Hospital [University of California, Davis, CA], and Boston Children's Hospital [Harvard University, Boston, MA]). Participants between the ages of 2 months to 18 years underwent airway examinations or airway procedures under general anesthesia. Participants were randomized in a 1:1 ratio to THRIVE or standard of care (SOC).</div></div><div><h3>Results</h3><div>A total of 144 participants were included. ODI measurements of relative desaturation in the THRIVE group and SOC group showed no differences in number of the participants who ever desaturated (<em>p</em> = 0.18). There was a difference in total number of relative desaturation events, accounting for multiple events per participant (<em>p</em> = 0.04). There were no differences in surgical interruptions due to airway conditions.</div></div><div><h3>Conclusion</h3><div>THRIVE was not superior to SOC for reducing the number of patients who experienced desaturations or surgical interruptions, though it may have some benefit for reducing the total number of desaturation events in those who desaturate.</div></div>","PeriodicalId":15506,"journal":{"name":"Journal of Clinical Anesthesia","volume":"109 ","pages":"Article 112117"},"PeriodicalIF":5.1,"publicationDate":"2026-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145880475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The PAPE block: Ultrasound-guided pericapsular anterior and posterior elbow nerve group block for motor-sparing analgesia","authors":"Qingyu Teng MM,&nbsp;Zhiqiang Qian MM,&nbsp;Sijia Yao MM,&nbsp;Qi Li MM,&nbsp;Tao Xu Ph.D, M.D","doi":"10.1016/j.jclinane.2025.112121","DOIUrl":"10.1016/j.jclinane.2025.112121","url":null,"abstract":"","PeriodicalId":15506,"journal":{"name":"Journal of Clinical Anesthesia","volume":"109 ","pages":"Article 112121"},"PeriodicalIF":5.1,"publicationDate":"2026-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145880473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-time visualization for post-pyloric feeding tube placement using a biologically transparent illumination device","authors":"Kazufumi Yaginuma M.D. ,&nbsp;Tatsuya Nagano M.D., Ph.D ,&nbsp;Akihiro Suzuki M.D., Ph.D ,&nbsp;Mamoru Takeuchi M.D., Ph.D","doi":"10.1016/j.jclinane.2025.112122","DOIUrl":"10.1016/j.jclinane.2025.112122","url":null,"abstract":"","PeriodicalId":15506,"journal":{"name":"Journal of Clinical Anesthesia","volume":"109 ","pages":"Article 112122"},"PeriodicalIF":5.1,"publicationDate":"2026-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145880474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}