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Risk factors for chloral hydrate sedation failure in pediatric patients: a retrospective analysis. 儿科患者水合氯醛镇静失败的风险因素:回顾性分析。
IF 4.2 4区 医学 Q1 ANESTHESIOLOGY Pub Date : 2024-10-01 Epub Date: 2024-07-02 DOI: 10.4097/kja.24125
Young-Eun Jang, Jung-Bin Park, Pyoyoon Kang, Sang-Hwan Ji, Eun-Hee Kim, Ji-Hyun Lee, Hee-Soo Kim, Jin-Tae Kim

Background: This study aimed to investigate the risk factors for chloral hydrate sedation failure and complications in a tertiary children's hospital in South Korea.

Methods: A retrospective analysis of pediatric procedural sedation with chloral hydrate between January 1, 2021, and March 30, 2022, was performed. The collected data included patient characteristics, sedation history, and procedure. Multivariable regression analysis was performed to identify the risk factors for procedural sedation failure and complications.

Results: A total of 6,691 procedural sedation were included in the analysis; sedation failure following chloral hydrate (50 mg/kg) occurred in 1,457 patients (21.8%) and was associated with a higher rate of overall complications compared to those with successful sedation (17.5% [225/1457] vs. 6.2% [322/5234]; P < 0.001, odds ratio: 3.236). In the multivariable regression analysis, the following factors were associated with increased risk of sedation failure: general ward or intensive care unit inpatient (compared with outpatient); congenital syndrome; oxygen dependency; history of sedation failure or complications with chloral hydrate; procedure more than 60 min; and magnetic resonance imaging, radiotherapy, or procedures with painful or intense stimuli (all P values < 0.05). Factors contributing to the complications included general ward inpatient, congenital syndromes, congenital heart disease, preterm birth, oxygen dependency, history of complications with chloral hydrate, and current sedation failure with chloral hydrate (all P values < 0.05).

Conclusions: To achieve successful sedation with chloral hydrate, the patient's sedation history, risk factors, and the type and duration of the procedure should be considered.

背景:本研究旨在调查韩国一家三级儿童医院水合氯醛镇静失败和并发症的风险因素:本研究旨在调查韩国一家三级儿童医院水合氯醛镇静失败和并发症的风险因素:方法:对 2021 年 1 月 1 日至 2022 年 3 月 30 日期间使用水合氯醛进行儿科手术镇静的情况进行了回顾性分析。收集的数据包括患者特征、镇静史和手术过程。进行了多变量回归分析,以确定手术镇静失败和并发症的风险因素:共有 6691 例手术镇静纳入分析;1457 例患者(21.8%)在使用水合氯醛(50 毫克/千克)后镇静失败,与镇静成功的患者相比,总并发症发生率更高(17.5% [225 / 1457] vs. 6.2% [322 / 5234];P < 0.001;几率比 3.236)。在多变量回归分析中,以下因素与镇静失败风险增加有关:普通病房或重症监护室住院患者(与门诊患者相比);先天性综合征;氧依赖;水合氯醛镇静失败或并发症史;手术时间超过 60 分钟;磁共振成像、放射治疗或有疼痛或强烈刺激的手术(所有 P 值均小于 0.05)。导致并发症的因素包括普通病房住院病人、先天性综合症、先天性心脏病、早产、氧气依赖、水合氯醛并发症史以及目前水合氯醛镇静失败(所有 P 值均小于 0.05):要成功使用水合氯醛镇静,应考虑患者的镇静史、风险因素、手术类型和持续时间。
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引用次数: 0
The effect of non-steroidal anti-inflammatory drugs on postoperative delirium: a meta-analysis. 非甾体抗炎药对术后谵妄的影响:一项荟萃分析。
IF 4.2 4区 医学 Q1 ANESTHESIOLOGY Pub Date : 2024-10-01 Epub Date: 2024-08-06 DOI: 10.4097/kja.24325
Su Yeon Kim, Hyo-Seok Na, Jung-Hee Ryu, Hyun-Jung Shin

Background: Neuroinflammation is postulated as a potential mechanism underlying postoperative delirium. This study aimed to investigate the impact of non-steroidal anti-inflammatory drug (NSAID) use on postoperative delirium.

Methods: We conducted a literature search in electronic databases, including PubMed, EMBASE, CENTRAL, and Web of Science, to identify eligible randomized controlled studies. The primary outcome was the incidence of postoperative delirium, and the secondary outcomes included pain scores and the amounts of opioid used at 24 h postoperatively. We estimated the effect size through calculating the odds ratios (ORs) or mean differences (MDs) with 95% CIs, as appropriate.

Results: In the analysis of eight studies involving 1,238 participants, the incidence of postoperative delirium was 11% and 19% in the NSAID and control groups, respectively, with a significant reduction in the NSAID group (OR: 0.54, 95% CI [0.38, 0.7], P = 0.0001, I2 = 0%). NSAID use had a significant effect on postoperative pain reduction (MD: -0.75, 95% CI [-1.37, -0.13], P = 0.0172, I2 = 88%). Significant lower postoperative opioid consumption was observed in the NSAID group (MD: -2.88, 95% CI [-3.54, -2.22], P = 0.0000; I2 = 0%).

Conclusions: NSAID administration reduced the incidence of postoperative delirium, severity of pain, and opioid dose used.

背景:神经炎症被认为是导致术后谵妄的潜在机制。本研究旨在调查非甾体抗炎药(NSAID)的使用对术后谵妄的影响:我们在电子数据库(包括 PubMed、EMBASE、CENTRAL 和 Web of Science)中进行了文献检索,以确定符合条件的随机对照研究。主要结果是术后谵妄的发生率,次要结果包括疼痛评分和术后 24 小时阿片类药物的使用量。我们通过计算几率比(OR)或平均差(MD)以及 95% CI(视情况而定)来估计效应大小:在对涉及 1238 名参与者的 8 项研究进行的分析中,非甾体抗炎药组和对照组的术后谵妄发生率分别为 11% 和 19%,非甾体抗炎药组的发生率显著降低(OR,0.54;95% CI,0.38 至 0.76;P = 0.0001;I2 = 0%)。使用非甾体抗炎药对减轻术后疼痛有显著效果(MD,-0.75;95% CI,-1.37 至 -0.13;P = 0.0172;I2 = 88%)。非甾体抗炎药组的术后阿片类药物用量显著降低(MD,-2.88;95% CI,-3.54 至 -2.22;P = 0.000;I2 = 0%):结论:服用非甾体抗炎药可降低术后谵妄的发生率、疼痛的严重程度和阿片类药物的使用剂量。
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引用次数: 0
Comprehensive guidelines for appropriate statistical analysis methods in research. 研究中适当统计分析方法的综合指南。
IF 4.2 4区 医学 Q1 ANESTHESIOLOGY Pub Date : 2024-10-01 Epub Date: 2024-08-30 DOI: 10.4097/kja.24016
Jonghae Kim, Dong Hyuck Kim, Sang Gyu Kwak

Background: The selection of statistical analysis methods in research is a critical and nuanced task that requires a scientific and rational approach. Aligning the chosen method with the specifics of the research design and hypothesis is paramount, as it can significantly impact the reliability and quality of the research outcomes.

Methods: This study explores a comprehensive guideline for systematically choosing appropriate statistical analysis methods, with a particular focus on the statistical hypothesis testing stage and categorization of variables. By providing a detailed examination of these aspects, this study aims to provide researchers with a solid foundation for informed methodological decision making. Moving beyond theoretical considerations, this study delves into the practical realm by examining the null and alternative hypotheses tailored to specific statistical methods of analysis. The dynamic relationship between these hypotheses and statistical methods is thoroughly explored, and a carefully crafted flowchart for selecting the statistical analysis method is proposed.

Results: Based on the flowchart, we examined whether exemplary research papers appropriately used statistical methods that align with the variables chosen and hypotheses built for the research. This iterative process ensures the adaptability and relevance of this flowchart across diverse research contexts, contributing to both theoretical insights and tangible tools for methodological decision-making.

Conclusions: This study emphasizes the importance of a scientific and rational approach for the selection of statistical analysis methods. By providing comprehensive guidelines, insights into the null and alternative hypotheses, and a practical flowchart, this study aims to empower researchers and enhance the overall quality and reliability of scientific studies.

背景:在研究中选择统计分析方法是一项关键而细致的任务,需要采取科学合理的方法。使所选方法与研究设计和假设的具体内容相一致至关重要,因为这会对研究成果的可靠性和质量产生重大影响:本研究探讨了系统选择适当统计分析方法的综合指南,尤其侧重于统计假设检验阶段和变量分类。通过对这些方面进行详细研究,本研究旨在为研究人员做出明智的方法决策奠定坚实的基础。除了理论方面的考虑,本研究还深入到实践领域,研究了针对特定统计分析方法的零假设和备择假设。本研究深入探讨了这些假设与统计方法之间的动态关系,并提出了一个精心制作的统计分析方法选择流程图:根据流程图,我们考察了典范研究论文是否恰当地使用了与所选变量和研究假设相一致的统计方法。这一迭代过程确保了该流程图在不同研究背景下的适应性和相关性,有助于为方法决策提供理论见解和实际工具:本研究强调了科学合理地选择统计分析方法的重要性。通过提供全面的指导原则、对零假设和备择假设的见解以及实用的流程图,本研究旨在增强研究人员的能力,提高科学研究的整体质量和可靠性。
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引用次数: 0
Utilization of the pericapsular nerve group block in preoperative rehabilitation of patients with femoral neck fractures -a case series. 在股骨颈骨折患者术前康复中使用肩周神经组阻滞:病例系列。
IF 4.2 4区 医学 Q1 ANESTHESIOLOGY Pub Date : 2024-10-01 Epub Date: 2024-06-19 DOI: 10.4097/kja.24232
Zhuan Jin, Daisuke Sugiyama, Fumiya Higo, Takahiro Hirata, Osamu Kobayashi, Hiroshi Morimatsu, Kenichi Ueda

Background: Elderly patients with femoral neck fractures, particularly those with severe comorbidities or living in regions with limited medical resources, may experience delays in surgical treatment. Although the benefits of preoperative rehabilitation (prehabilitation) in hip arthroplasty have been reported, pain management remains a challenge. The pericapsular nerve group (PENG) block, known for its exceptional analgesic effect and motor function preservation, may be a promising intervention during prehabilitation in these patients.

Case: We enrolled ten patients with Garden classification 3-4 femoral neck fractures scheduled for hip arthroplasty. After receiving a PENG block with 20 ml of 0.375% ropivacaine, all patients underwent initial prehabilitation sessions comprising 9 mobility levels, ranging from bed-sitting to walking. One patient was excluded due to experiencing high blood pressure during prehabilitation. Six of the nine remaining patients (66.7%) were successfully transferred from bed to wheelchair.

Conclusions: The PENG block enhanced prehabilitation for patients with femoral neck fractures undergoing hip arthroplasty.

背景:股骨颈骨折的老年患者,尤其是合并症严重或生活在医疗资源有限地区的患者,可能会延误手术治疗。尽管有报道称髋关节置换术术前康复(pre-habilitation)有诸多益处,但疼痛治疗仍是一项挑战。髋关节周围神经群(PENG)阻滞以其卓越的镇痛效果和运动功能保护而著称,可能是这些患者术前康复过程中一种很有前景的干预方法:我们选取了十名因股骨颈骨折(Garden分类3-4级)而计划接受髋关节置换术的患者。在接受了 20 毫升 0.375% 罗哌卡因的 PENG 阻滞后,所有患者都进行了初步的预康复训练,包括 9 个活动度级别,从坐床到行走。一名患者因在康复训练期间出现高血压而被排除在外。其余九名患者中有六名(66.7%)成功地从床上转移到了轮椅上:结论:PENG训练块增强了接受髋关节置换术的股骨颈骨折患者的预康复效果。
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引用次数: 0
Effect of lipid emulsion on vasoconstriction induced by epinephrine or norepinephrine in isolated rat aorta. 脂质乳液对离体大鼠主动脉由肾上腺素或去甲肾上腺素引起的血管收缩的影响
IF 4.2 4区 医学 Q1 ANESTHESIOLOGY Pub Date : 2024-10-01 Epub Date: 2024-06-25 DOI: 10.4097/kja.24093
Soo Hee Lee, Kyeong-Eon Park, Kibaek Eum, Yeran Hwang, Seong-Ho Ok, Gyujin Sim, Dumidu Perera, Henri K M Ravald, Youngho Park, Susanne K Wiedmer, Ju-Tae Sohn

Background: Epinephrine (EPI) or norepinephrine (NOR) is widely used to treat cardiovascular collapse during lipid emulsion (LE) resuscitation for drug toxicity. However, the effect of LE on the vasoconstriction caused by EPI or NOR remains unknown. The purpose of this study was to examine the effect of an LE (Intralipid) on the vasoconstriction caused by EPI and NOR in isolated rat aorta.

Methods: The effect of LE on the vasoconstriction caused by EPI or NOR in isolated rat aorta was examined. Additionally, the effect of LE on the calcium increase caused by EPI or NOR was investigated. The distribution constant (KD: lipid to aqueous phase) of EPI or NOR between a LE (1%) and an aqueous phase was determined.

Results: LE (1 and 2%) did not significantly alter vasoconstriction caused by EPI or NOR in isolated endothelium-intact aorta. Moreover, the LE did not significantly alter the increased calcium level caused by EPI or NOR. The log KD of EPI in the LE (1%) was -0.71, -0.99, and -1.00 at 20, 50, and 100 mM ionic strength, respectively. The log KD of NOR in the LE (1%) was -1.22, -1.25, and -0.96 at 20, 50, and 100 mM ionic strength, respectively.

Conclusions: Taken together, the Intralipid emulsion did not alter vasoconstriction induced by EPI or NOR that seems to be due to the hydrophilicity of EPI or NOR, leading to sustained hemodynamic support produced by EPI or NOR used during LE resuscitation.

背景:肾上腺素(EPI)或去甲肾上腺素(NOR)被广泛用于治疗药物中毒的脂质乳剂(LE)复苏过程中的心血管衰竭。然而,LE 对 EPI 或 NOR 引起的血管收缩的影响仍然未知。本研究的目的是探讨一种脂质乳剂(Intralipid)对EPI和NOR在离体大鼠主动脉中引起的血管收缩的影响:方法:研究了LE对EPI或NOR引起的离体大鼠主动脉血管收缩的影响。此外,还研究了 LE 对 EPI 或 NOR 引起的钙增加的影响。测定了 EPI 或 NOR 在 LE(1%)和水相之间的分布常数(KD:脂相到水相):结果:LE(1% 和 2%)没有明显改变 EPI 或 NOR 在离体内皮接触主动脉中引起的血管收缩。此外,LE 对 EPI 或 NOR 引起的钙水平升高也无明显改变。在 20、50 和 100 mM 离子强度下,LE(1%)中 EPI 的对数 KD 分别为-0.71、-0.99 和-1.00。在 20、50 和 100 mM 离子强度下,LE(1%)中 NOR 的对数 KD 分别为-1.22、-1.25 和 -0.96:综上所述,Intralipid乳液不会改变EPI或NOR诱导的血管收缩,这似乎是由于EPI或NOR的亲水性所致,从而导致在LE复苏过程中使用EPI或NOR产生持续的血流动力学支持。
{"title":"Effect of lipid emulsion on vasoconstriction induced by epinephrine or norepinephrine in isolated rat aorta.","authors":"Soo Hee Lee, Kyeong-Eon Park, Kibaek Eum, Yeran Hwang, Seong-Ho Ok, Gyujin Sim, Dumidu Perera, Henri K M Ravald, Youngho Park, Susanne K Wiedmer, Ju-Tae Sohn","doi":"10.4097/kja.24093","DOIUrl":"10.4097/kja.24093","url":null,"abstract":"<p><strong>Background: </strong>Epinephrine (EPI) or norepinephrine (NOR) is widely used to treat cardiovascular collapse during lipid emulsion (LE) resuscitation for drug toxicity. However, the effect of LE on the vasoconstriction caused by EPI or NOR remains unknown. The purpose of this study was to examine the effect of an LE (Intralipid) on the vasoconstriction caused by EPI and NOR in isolated rat aorta.</p><p><strong>Methods: </strong>The effect of LE on the vasoconstriction caused by EPI or NOR in isolated rat aorta was examined. Additionally, the effect of LE on the calcium increase caused by EPI or NOR was investigated. The distribution constant (KD: lipid to aqueous phase) of EPI or NOR between a LE (1%) and an aqueous phase was determined.</p><p><strong>Results: </strong>LE (1 and 2%) did not significantly alter vasoconstriction caused by EPI or NOR in isolated endothelium-intact aorta. Moreover, the LE did not significantly alter the increased calcium level caused by EPI or NOR. The log KD of EPI in the LE (1%) was -0.71, -0.99, and -1.00 at 20, 50, and 100 mM ionic strength, respectively. The log KD of NOR in the LE (1%) was -1.22, -1.25, and -0.96 at 20, 50, and 100 mM ionic strength, respectively.</p><p><strong>Conclusions: </strong>Taken together, the Intralipid emulsion did not alter vasoconstriction induced by EPI or NOR that seems to be due to the hydrophilicity of EPI or NOR, leading to sustained hemodynamic support produced by EPI or NOR used during LE resuscitation.</p>","PeriodicalId":17855,"journal":{"name":"Korean Journal of Anesthesiology","volume":" ","pages":"555-564"},"PeriodicalIF":4.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11467498/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141469076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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
A new treatment option for chronic refractory coccygodynia: ultrasound-guided sacral erector spinae plane block. 慢性难治性尾骨痛的新治疗方案:超声引导下的骶骨竖脊肌平面阻滞。
IF 4.2 4区 医学 Q1 ANESTHESIOLOGY Pub Date : 2024-10-01 Epub Date: 2024-07-18 DOI: 10.4097/kja.24226
Tuba Tanyel Saraçoğlu, Burak Erken, Ergün Mendeş
{"title":"A new treatment option for chronic refractory coccygodynia: ultrasound-guided sacral erector spinae plane block.","authors":"Tuba Tanyel Saraçoğlu, Burak Erken, Ergün Mendeş","doi":"10.4097/kja.24226","DOIUrl":"10.4097/kja.24226","url":null,"abstract":"","PeriodicalId":17855,"journal":{"name":"Korean Journal of Anesthesiology","volume":" ","pages":"570-571"},"PeriodicalIF":4.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11467500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141633882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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
Comment on "Retro superior costotransverse ligament space block as an effective analgesia after laparoscopic gastrectomy". 上肋横韧带后间隙阻滞是另一种横突间阻滞。
IF 4.2 4区 医学 Q1 ANESTHESIOLOGY Pub Date : 2024-10-01 Epub Date: 2024-07-12 DOI: 10.4097/kja.24283
Raghuraman M Sethuraman
{"title":"Comment on \"Retro superior costotransverse ligament space block as an effective analgesia after laparoscopic gastrectomy\".","authors":"Raghuraman M Sethuraman","doi":"10.4097/kja.24283","DOIUrl":"10.4097/kja.24283","url":null,"abstract":"","PeriodicalId":17855,"journal":{"name":"Korean Journal of Anesthesiology","volume":" ","pages":"571-572"},"PeriodicalIF":4.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11467496/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141590681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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
Effects of remimazolam versus dexmedetomidine on recovery after transcatheter aortic valve replacement under monitored anesthesia care: a propensity score-matched, non-inferiority study. 经导管主动脉瓣置换术后在监测麻醉护理下使用雷马唑仑与右美托咪定对恢复的影响:倾向得分匹配、非劣效性研究。
IF 4.2 4区 医学 Q1 ANESTHESIOLOGY Pub Date : 2024-10-01 Epub Date: 2024-07-23 DOI: 10.4097/kja.24138
Ji-Hyeon Kim, Jae-Sik Nam, Wan-Woo Seo, Kyung-Woon Joung, Ji-Hyun Chin, Wook-Jong Kim, Dae-Kee Choi, In-Cheol Choi

Background: Minimalist transcatheter aortic valve replacement (TAVR) under monitored anesthesia care (MAC) emphasizes early recovery. Remimazolam is a novel benzodiazepine with a short recovery time. This study hypothesized that remimazolam is non-inferior to dexmedetomidine in terms of recovery after TAVR.

Methods: In this retrospective observational study, remimazolam was compared to dexmedetomidine in patients who underwent TAVR under MAC at a tertiary academic hospital between July 2020 and July 2022. The primary outcome was timely recovery after TAVR, defined as discharge from the intensive care unit within the first day following the procedure. Propensity score matching was used to compare timely recovery between remimazolam and dexmedetomidine, applying a non-inferiority margin of -10%.

Results: The study included 464 patients, of whom 218 received remimazolam and 246 received dexmedetomidine. After propensity score matching, 164 patients in each group were included in the analysis. Regarding timely recovery after TAVR, remimazolam was non-inferior to dexmedetomidine (152 of 164 [92.7%] in the remimazolam group versus 153 of 164 [93.3%] in the dexmedetomidine group, risk difference [95% CI]: -0.6% [-6.7%, 5.5%]). The use of remimazolam was associated with fewer postoperative vasopressors/inotropes (21 of 164 [12.8%] vs. 39 of 164 [23.8%]) and temporary pacemakers (TPMs) (76 of 164 [46.3%] vs. 108 of 164 [65.9%]) compared to dexmedetomidine.

Conclusions: In patients undergoing TAVR under MAC, remimazolam was non-inferior to dexmedetomidine in terms of timely recovery. Remimazolam may be associated with better postoperative recovery profiles, including a lesser need for vasopressors/inotropes and TPMs.

背景:在监测麻醉护理(MAC)下进行经导管主动脉瓣置换术(TAVR)强调早期恢复。雷马唑仑是一种新型苯二氮卓类药物,恢复时间短。本研究假设,就TAVR术后恢复而言,雷马唑仑不劣于右美托咪定:在这项回顾性观察研究中,对 2020 年 7 月至 2022 年 7 月期间在一家三级学术医院接受 MAC 下 TAVR 的患者进行了雷马唑仑与右美托咪定的比较。主要研究结果是 TAVR 术后的及时康复,即术后第一天内从重症监护室出院。采用倾向得分匹配法比较雷马唑仑和右美托咪定的及时恢复情况,非劣效性差值为-10%:研究共纳入 464 名患者,其中 218 人接受了雷马唑仑治疗,246 人接受了右美托咪定治疗。经过倾向评分匹配后,每组各有164名患者纳入分析。在TAVR术后及时恢复方面,雷马唑仑的效果不劣于右美托咪定(雷马唑仑组164例中有152例[92.7%],右美托咪定组164例中有153例[93.3%],风险差异[95% CI]:-0.6% [-6.7% to 5.5%])。与右美托咪定相比,使用瑞马唑仑可减少术后使用血管加压剂/肌注(164例中的21例[12.8%]对164例中的39例[23.8%])和临时起搏器(TPM)(164例中的76例[46.3%]对164例中的108例[65.9%]):结论:对于在 MAC 下接受 TAVR 的患者,就及时恢复而言,雷马唑仑不优于右美托咪定。雷马唑仑可能与更好的术后恢复情况有关,包括对血管抑制剂/肌注和TPM的需求较少。
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引用次数: 0
Pediatric sedation and monitored anesthesia care: from chloral hydrate to remimazolam. 小儿镇静和监测麻醉护理:从水合氯醛到瑞咪唑仑。
IF 4.2 4区 医学 Q1 ANESTHESIOLOGY Pub Date : 2024-10-01 Epub Date: 2024-09-23 DOI: 10.4097/kja.24632
Won-Jung Shin
{"title":"Pediatric sedation and monitored anesthesia care: from chloral hydrate to remimazolam.","authors":"Won-Jung Shin","doi":"10.4097/kja.24632","DOIUrl":"10.4097/kja.24632","url":null,"abstract":"","PeriodicalId":17855,"journal":{"name":"Korean Journal of Anesthesiology","volume":"77 5","pages":"491-492"},"PeriodicalIF":4.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11467499/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142361730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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
Ramped versus sniffing position for Ambu® AuraGainTM insertion in patients with obesity: a randomized controlled study. 在肥胖症患者中插入 Ambu® AuraGain™ 时采用斜坡体位还是嗅觉体位:随机对照研究。
IF 4.2 4区 医学 Q1 ANESTHESIOLOGY Pub Date : 2024-10-01 Epub Date: 2024-08-19 DOI: 10.4097/kja.24255
Hye-Won Jeong, Hong-Beom Bae, Leyeoin Lee, Woojeong Lee, Joungmin Kim

Background: The ramped position facilitates mask ventilation and endotracheal intubation in patients with obesity. This study aimed to determine whether the ramped position improves supraglottic airway (SGA) insertion in patients with obesity.

Methods: In this prospective, randomized, single-center trial, 48 obese patients undergoing elective surgery were randomized into either ramped or sniffing position groups. The Ambu® AuraGainTM (Ambu A/S), a second-generation SGA, was used. The primary outcome was the time required for the AuraGain insertion. Secondary outcomes included ease and number of insertion attempts, oropharyngeal leak pressure (OLP), and complications. The number needed to treat (NNT) was calculated to ensure ease of insertion.

Results: The time required for the AuraGain insertion was significantly shorter in the ramped group than in the sniffing group (13.0 [11.0, 16.0] vs. 24.0 [21.0, 28.0], P < 0.001). The insertion was easier in the ramped group than in the sniffing group (23/24 vs. 13/24, NNT = 2.4 [95% CI, 1.6, 5.0], P = 0.003). The first-attempt success rate was higher in the ramped group than in the sniffing group, although the difference was not statistically significant (22/24 vs. 18/24, P = 0.319). The OLP and postoperative complication rates were not significantly different between the groups.

Conclusions: The ramped position reduced the time required for the AuraGain insertion in obese patients while providing comparable airway sealing without increasing adverse events. Therefore, a ramped position may be a more suitable option for SGA insertion in this population.

背景:斜坡体位有利于肥胖患者的喉罩通气和气管插管。本研究旨在确定斜坡体位是否能改善肥胖患者的声门上气道(SGA)插入:在这项前瞻性、随机、单中心试验中,48 名接受择期手术的肥胖患者被随机分为斜坡体位组和嗅觉体位组。使用的是第二代 SGA Ambu® AuraGain™(Ambu A/S, Ballerup, Denmark)。主要结果是插入 AuraGain 所需的时间。次要结果包括插入的难易程度和尝试次数、口咽漏压(OLP)和并发症。为确保插入的简易性,计算了治疗所需次数(NNT):结果:斜坡组插入 AuraGain 所需的时间明显短于嗅吸组(13.0 [11.0-16.0] vs. 24.0 [21.0-28.0],P < 0.001)。斜坡组比嗅吸组更容易插入(23 / 24 vs. 13 / 24,NNT = 2.4 [95% CI, 1.6-5.0],P = 0.003)。斜坡组的首次尝试成功率高于嗅吸组,但差异无统计学意义(22 / 24 vs. 18 / 24,P = 0.319)。两组的OLP和术后并发症发生率无明显差异:斜坡式体位减少了肥胖患者插入 AuraGain 所需的时间,同时提供了相当的气道密封性,而不会增加不良反应。因此,斜坡式体位可能更适合在这类人群中插入 SGA。
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引用次数: 0
期刊
Korean Journal of Anesthesiology
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