Journal of Clinical Anesthesia最新文献

{"title":"Response to comment on: “Effect of remimazolam versus propofol on hypotension after anesthetic induction in patients undergoing coronary artery bypass grafting: A randomized controlled trial”","authors":"Karam Nam MD, PhD, Jae-Woo Ju MD","doi":"10.1016/j.jclinane.2024.111643","DOIUrl":"10.1016/j.jclinane.2024.111643","url":null,"abstract":"","PeriodicalId":15506,"journal":{"name":"Journal of Clinical Anesthesia","volume":"99 ","pages":"Article 111643"},"PeriodicalIF":5.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142358319","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":"National trends in perioperative epidural analgesia use for surgical patients","authors":"Dale N. Bongbong ,&nbsp;Waseem Abdou ,&nbsp;Engy T. Said ,&nbsp;Rodney A. Gabriel","doi":"10.1016/j.jclinane.2024.111642","DOIUrl":"10.1016/j.jclinane.2024.111642","url":null,"abstract":"<div><h3>Study objective</h3><div>Newer regional anesthesia techniques and minimally invasive surgeries have yielded decreased postoperative pain scores, potentially leading to decreased need for perioperative epidural analgesia. Limited literature is available on trends in usage rates of epidurals. The objective of this study was to identify trends in perioperative epidural analgesia rates among multiple fields of surgery.</div></div><div><h3>Methods</h3><div>All patients undergoing general, thoracic, urologic, plastic, vascular, orthopedic, or gynecological surgery in 2014–2020 were included from the National Surgical Quality Improvement Program database of over 700 hospitals in the U.S. and 11 different countries. Annual trends in epidural analgesia for all surgeries and each surgical specialty were assessed by mixed effects multivariable logistic regression. The odds ratios (OR) and 99 % confidence intervals (CI) were reported.</div></div><div><h3>Results</h3><div>There were 3,111,435 patients from 2014 to 2020 that were included in the final analysis, in which 107,209 (3.4 %) received perioperative epidural analgesia. Among all surgeries combined, epidural use throughout the study period decreased (OR 0.98 per year, 99 % CI 0.97–0.98, <em>P</em> &lt; 0.001). When only analyzing the surgeries with the top 5 most frequent epidural use per specialty, there was no statistically significant trend in epidural utilization (OR 0.99 per year, 99 % CI 0.99–1.00, <em>P</em> = 0.09). However, there was an increasing trend in epidural utilization in general surgery (OR 1.05 per year, 99 % CI 1.03–1.07, <em>P</em> &lt; 0.001) and vascular surgery (OR 1.08 per year, 99 % CI 1.05–1.10, <em>P</em> &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>Rates of perioperative epidural analgesia use has decreased in recent years overall, however, among surgeries within the general surgery and vascular surgery specialty, utilization has increased for procedures that have the highest rates of usage.</div></div>","PeriodicalId":15506,"journal":{"name":"Journal of Clinical Anesthesia","volume":"99 ","pages":"Article 111642"},"PeriodicalIF":5.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142358317","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":"Letter to the editor regarding “Effect of remimazolam versus propofol on hypotension after anesthetic induction in patients undergoing coronary artery bypass grafting: A randomized controlled trial”","authors":"Jacopo D'Andria Ursoleo MD,&nbsp;Alice Bottussi MD,&nbsp;Viviana Teresa Agosta MD,&nbsp;Fabrizio Monaco MD","doi":"10.1016/j.jclinane.2024.111644","DOIUrl":"10.1016/j.jclinane.2024.111644","url":null,"abstract":"","PeriodicalId":15506,"journal":{"name":"Journal of Clinical Anesthesia","volume":"99 ","pages":"Article 111644"},"PeriodicalIF":5.0,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142358318","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":"General anesthesia and the subsequent development of attention-deficit/hyperactivity disorder: A subgroup analysis on geographic region","authors":"Chih-Ping Yang ,&nbsp;Ting-Sian Yu ,&nbsp;Kuo-Chuan Hung ,&nbsp;Kuo-Mao Lan","doi":"10.1016/j.jclinane.2024.111639","DOIUrl":"10.1016/j.jclinane.2024.111639","url":null,"abstract":"","PeriodicalId":15506,"journal":{"name":"Journal of Clinical Anesthesia","volume":"99 ","pages":"Article 111639"},"PeriodicalIF":5.0,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142327954","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":"Dissecting the efficacy of erector spinae plane block: A cadaveric study analysis of anesthetic spread to ventral rami","authors":"Alessandro De Cassai ,&nbsp;Burhan Dost ,&nbsp;Giulia Aviani Fulvio ,&nbsp;Esra Turunc ,&nbsp;Paolo Navalesi","doi":"10.1016/j.jclinane.2024.111638","DOIUrl":"10.1016/j.jclinane.2024.111638","url":null,"abstract":"","PeriodicalId":15506,"journal":{"name":"Journal of Clinical Anesthesia","volume":"99 ","pages":"Article 111638"},"PeriodicalIF":5.0,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142327953","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":"Association between lactate-to-albumin ratio and short-time mortality in patients with acute respiratory distress syndrome","authors":"He-Xuan Wang ,&nbsp;Xue-Hua Huang ,&nbsp;Li-Qing Ma ,&nbsp;Zhou-Jing Yang ,&nbsp;Hai-Lian Wang ,&nbsp;Bo Xu ,&nbsp;Meng-Qiang Luo","doi":"10.1016/j.jclinane.2024.111632","DOIUrl":"10.1016/j.jclinane.2024.111632","url":null,"abstract":"<div><h3>Study objective</h3><div>The lactate-to-albumin ratio (LAR) has been confirmed to be an effective prognostic marker in sepsis, heart failure, and acute respiratory failure. However, the relationship between LAR and mortality in patients with acute respiratory distress syndrome (ARDS) remains unclear. We aim to evaluate the predictive value of LAR for ARDS patients.</div></div><div><h3>Design</h3><div>A retrospective cohort study.</div></div><div><h3>Setting</h3><div>Medical Information Mart for Intensive Care IV (v2.2) database.</div><div>Patients.</div><div>769 patients with acute respiratory distress syndrome(ARDS).</div></div><div><h3>Interventions</h3><div>We divided the patients into two subgroups according to the primary study endpoint (28-days all-cause mortality): the 28-day survivors and the 28-day non-survivors.</div></div><div><h3>Measures</h3><div>Multivariate Cox Regression, Receiver Operator Characteristic (ROC) and Kaplan–Meier survival analysis were used to investigate the relationship between LAR and short-time mortality in patients with ARDS.</div></div><div><h3>Main results</h3><div>The 28-day mortality was 38 % in this study. Multivariable Cox regression analysis showed that LAR was an independent predictive factor for 28-day mortality (HR 1.11, 95 %CI: 1.06–1.16, <em>P</em> &lt; 0.001). The area under curve (AUC) of LAR in the ROC was 70.34 % (95 %CI: 66.53 % - 74.15 %) that provided significantly higher discrimination compared with lactate (AUC = 68.00 %, <em>P</em> = 0.0007) or albumin (AUC = 63.17 %, <em>P</em> = 0.002) alone. LAR was also not inferior to SAPSII with the AUC of 73.44 % (95 %CI: 69.84 % - 77.04 %, <em>P</em> = 0.21). Additionally, Kaplan-Meier survival analysis displayed that ARDS patients with high LAR (&gt; the cut-off value 0.9055) had a significantly higher 28-day overall mortality rate (<em>P</em> &lt; 0.001) and in-hospital mortality rate (<em>P</em> &lt; 0.001). However, patients in high LAR group had shorter length of hospital stay (<em>P</em> &lt; 0.001), which might be caused by higher in-hospital mortality.</div></div><div><h3>Conclusions</h3><div>We confirmed that there was a positive correlation between LAR and 28-day mortality. This could provide anesthesiologists and critical care physicians with a more convenient tool than SAPSII without being superior for detecting ARDS patients with poor prognosis timely.</div></div>","PeriodicalId":15506,"journal":{"name":"Journal of Clinical Anesthesia","volume":"99 ","pages":"Article 111632"},"PeriodicalIF":5.0,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142324128","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":"Outpatient anesthesiology: A fact for the future.","authors":"Richard P Dutton","doi":"10.1016/j.jclinane.2024.111633","DOIUrl":"https://doi.org/10.1016/j.jclinane.2024.111633","url":null,"abstract":"","PeriodicalId":15506,"journal":{"name":"Journal of Clinical Anesthesia","volume":" ","pages":"111633"},"PeriodicalIF":5.0,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142347661","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":"Sex dependence of postoperative pulmonary complications – A post hoc unmatched and matched analysis of LAS VEGAS","authors":"Tom D. Vermeulen MD ,&nbsp;Liselotte Hol MD ,&nbsp;Pien Swart BSc ,&nbsp;Michael Hiesmayr MD, PhD ,&nbsp;Gary H. Mills MD, PhD ,&nbsp;Christian Putensen MD, PhD ,&nbsp;Werner Schmid MD, PhD ,&nbsp;Ary Serpa Neto MD, PhD ,&nbsp;Paolo Severgnini MD, PhD ,&nbsp;Marcos F. Vidal Melo MD, PhD ,&nbsp;Hermann Wrigge MD, PhD ,&nbsp;Markus W. Hollmann MD, PhD ,&nbsp;Marcelo Gama de Abreu MD, PhD ,&nbsp;Marcus J. Schultz MD, PhD ,&nbsp;Sabrine N. Hemmes MD, PhD ,&nbsp;David M. van Meenen MD, PhD","doi":"10.1016/j.jclinane.2024.111565","DOIUrl":"10.1016/j.jclinane.2024.111565","url":null,"abstract":"<div><h3>Study objective</h3><div>Male sex has inconsistently been associated with the development of postoperative pulmonary complications (PPCs). These studies were different in size, design, population and preoperative risk. We reanalysed the database of ‘Local ASsessment of Ventilatory management during General Anaesthesia for Surgery study’ (LAS VEGAS) to evaluate differences between females and males with respect to PPCs.</div></div><div><h3>Design, setting and patients</h3><div>Post hoc unmatched and matched analysis of LAS VEGAS, an international observational study in patients undergoing intraoperative ventilation under general anaesthesia for surgery in 146 hospitals across 29 countries. The primary endpoint was a composite of PPCs in the first 5 postoperative days. Individual PPCs, hospital length of stay and mortality were secondary endpoints. Propensity score matching was used to create a similar cohort regarding type of surgery and epidemiological factors with a known association with development of PPCs.</div></div><div><h3>Main results</h3><div>The unmatched cohort consisted of 9697 patients; 5342 (55.1%) females and 4355 (44.9%) males. The matched cohort consisted of 6154 patients; 3077 (50.0%) females and 3077 (50.0%) males. The incidence in PPCs was neither significant between females and males in the unmatched cohort (10.0 vs 10.7%; odds ratio (OR) 0.93 [0.81–1.06]; <em>P</em> = 0.255), nor in the matched cohort (10.5 vs 10.0%; OR 1.05 [0.89–1.25]; <em>P</em> = 0.556). New invasive ventilation occurred less often in females in the unmatched cohort. Hospital length of stay and mortality were similar between females and males in both cohorts.</div></div><div><h3>Conclusions</h3><div>In this conveniently–sized worldwide cohort of patients receiving intraoperative ventilation under general anaesthesia for surgery, the PPC incidence was not significantly different between sexes.</div></div><div><h3>Registration</h3><div>LAS VEGAS was registered at <span><span>clinicaltrial.gov</span><svg><path></path></svg></span> (study identifier <span><span>NCT01601223</span><svg><path></path></svg></span>).</div></div>","PeriodicalId":15506,"journal":{"name":"Journal of Clinical Anesthesia","volume":"99 ","pages":"Article 111565"},"PeriodicalIF":5.0,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0952818024001946/pdfft?md5=12235754cc5b4b4f0ca9b417fe062239&pid=1-s2.0-S0952818024001946-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142310886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minimally-invasive tracheostomy (MIT): A care bundle for safety improvement in high-risk critically ill patients","authors":"Dennis Christoph Harrer ,&nbsp;Patricia Mester ,&nbsp;Clara-Larissa Lang ,&nbsp;Tanja Elger ,&nbsp;Tobias Seefeldt ,&nbsp;Lorenz Wächter ,&nbsp;Judith Dönz ,&nbsp;Nina Doblinger ,&nbsp;Muriel Huss ,&nbsp;Georgios Athanasoulas ,&nbsp;Lea U. Krauß ,&nbsp;Johannes Heymer ,&nbsp;Wolfgang Herr ,&nbsp;Tobias Schilling ,&nbsp;Stephan Schmid ,&nbsp;Martina Müller ,&nbsp;Vlad Pavel","doi":"10.1016/j.jclinane.2024.111631","DOIUrl":"10.1016/j.jclinane.2024.111631","url":null,"abstract":"<div><h3>Background</h3><p>Detailed reports are scarce on minimally-invasive tracheostomy (MIT) techniques for critically ill patients with challenging anatomy or complex coagulopathies. In such high-risk patients, conventional percutaneous dilatational tracheostomy (PDT) may lead to severe complications.</p></div><div><h3>Methods</h3><p>Aiming to broaden the scope of MIT for patients previously excluded due to high risks, we developed a new care bundle (MIT technique), specifically designed for intensive care specialists. Our study examined the outcomes of MIT in 32 high-risk patients treated in an ICU of a University Hospital with specific focus on gastrointestinal and liver diseases.</p></div><div><h3>Results</h3><p>We have modified the conventional PDT technique by incorporating an initial skin incision, blunt dissection, diaphanoscopy-guided probe puncture, and continuous bronchoscopic monitoring. Our care bundle also introduces an anterolateral approach for tracheal entry, a significant advancement for patients with complex neck anatomy or dense vasculature, where an anterolateral trajectory avoids midline blood vessels. This enhanced method has proven to be safer than traditional PDT, with a notable absence of post-procedural hemorrhages, cannula misplacements, or infections.</p></div><div><h3>Conclusion</h3><p>The use of our refined care bundle enabled swift minimally-invasive tracheostomy in high-risk patients without the occurrence of serious complications.</p></div>","PeriodicalId":15506,"journal":{"name":"Journal of Clinical Anesthesia","volume":"99 ","pages":"Article 111631"},"PeriodicalIF":5.0,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0952818024002605/pdfft?md5=73c90f2ccff19bd45f4af267857f346f&pid=1-s2.0-S0952818024002605-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142272492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the editor regarding “Assessing different brain oxygenation components in elderly patients under propofol or sevoflurane anesthesia: A randomized controlled study”","authors":"Guanyu Yang,&nbsp;Qinjun Chu","doi":"10.1016/j.jclinane.2024.111634","DOIUrl":"10.1016/j.jclinane.2024.111634","url":null,"abstract":"","PeriodicalId":15506,"journal":{"name":"Journal of Clinical Anesthesia","volume":"99 ","pages":"Article 111634"},"PeriodicalIF":5.0,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142271790","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}