Brazilian Journal of Anesthesiology最新文献

英文中文

Chronic pain after hospital discharge on patients hospitalized for COVID-19: an observational study COVID-19住院患者出院后的慢性疼痛：一项观察性研究。

IF 1.7 4区医学 Q2 ANESTHESIOLOGY

Brazilian Journal of Anesthesiology

Pub Date : 2024-07-01 DOI: 10.1016/j.bjane.2023.08.001

Guilherme Antonio Moreira de Barros, Douglas Inomata Cardoso da Silva, Mariana Lopes Amaral Barbosa, Rafael Abbud Soares, Rodrigo Leal Alves, Claudio Lucas Miranda, Paula Danieli Lopes da Costa, Paulo do Nascimento Júnior, Norma Sueli Pinheiro Módolo

Background

There are few studies related to Coronavirus Disease 2019 (COVID-19) on the prevalence and nature of pain symptoms after hospital discharge, especially in individuals who develop moderate to severe disease forms. Therefore, this study aimed to evaluate the presence of chronic pain in patients discharged after hospitalization for COVID-19, and the relationship between the presence of chronic pain and intensive care stay, demographics, and risk factors for the worst Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) outcome.

Methods

A cross-sectional observational study was carried out on patients with COVID-19 who recovered after hospitalization. Patients were recruited at the least 3 months after discharge and their hospital's health files were prospected. The variables evaluated were demographics, the severity of SARS-CoV-2 infection (considering the need for intensive care), and the presence of chronic pain. The results were shown in a descriptive manner, and multivariate analysis expressed as Odds Ratios (ORs) and respective Confidence Intervals (CIs) for the outcomes studied. Statistical significance was set at p < 0.05.

Results

Of 242 individuals included, 77 (31.8%) reported chronic pain related to COVID-19, with no correlation with the severity of infection. Female sex and obesity were associated with a higher risk for chronic pain with ORs of 2.69 (Confidence Interval [95% CI 1.4 to 5.0]) and 3.02 (95% CI 1.5 to 5.9). The limbs were the most affected areas of the body.

Conclusion

Chronic pain is common among COVID-19 survivors treated in hospital environments. Female sex and obesity are risk factors for its occurrence.

背景：有关冠状病毒病2019（COVID-19）出院后疼痛症状的发生率和性质的研究很少，尤其是发生中重度疾病的患者。因此，本研究旨在评估因COVID-19住院后出院的患者是否存在慢性疼痛，以及慢性疼痛的存在与重症监护住院时间、人口统计学和最坏的严重急性呼吸系统综合征冠状病毒2（SARS-CoV-2）结果的风险因素之间的关系：对住院后康复的 COVID-19 患者进行了横断面观察研究。研究人员在患者出院至少 3 个月后对其进行招募，并查阅了他们在医院的健康档案。评估的变量包括人口统计学、SARS-CoV-2 感染的严重程度（考虑是否需要重症监护）以及是否存在慢性疼痛。研究结果以描述性方式显示，多变量分析以研究结果的比值比（ORs）和各自的置信区间（CIs）表示。统计显著性以 p < 0.05 为标准：在纳入的 242 人中，77 人（31.8%）报告了与 COVID-19 相关的慢性疼痛，但与感染的严重程度无关。女性和肥胖与较高的慢性疼痛风险有关，其OR值分别为2.69（置信区间[95% CI 1.4至5.0]）和3.02（95% CI 1.5至5.9）。四肢是受影响最严重的部位：结论：在医院环境中接受治疗的 COVID-19 幸存者中，慢性疼痛很常见。结论：慢性疼痛在医院环境中接受治疗的 COVID-19 存活者中很常见，女性和肥胖是导致慢性疼痛发生的风险因素。

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引用次数: 0

Glucagon-Like Peptide-1 agonists in perioperative medicine: to suspend or not to suspend, that is the question 围手术期用药中的胰高血糖素样肽-1 激动剂：暂停还是不暂停，这是一个问题。

IF 1.7 4区医学 Q2 ANESTHESIOLOGY

Brazilian Journal of Anesthesiology

Pub Date : 2024-06-27 DOI: 10.1016/j.bjane.2024.844538

Florentino Fernandes Mendes , Lorena Ibiapina M. Carvalho , Maristela Bueno Lopes

引用次数: 0

Virtual parental presence with coaching for reducing preoperative anxiety in children: a feasibility and pilot randomized controlled trial 通过虚拟父母陪伴和辅导减轻儿童术前焦虑：可行性和试点随机对照试验。

IF 1.7 4区医学 Q2 ANESTHESIOLOGY

Brazilian Journal of Anesthesiology

Pub Date : 2024-06-26 DOI: 10.1016/j.bjane.2024.844533

Clyde T. Matava , Martina Bordini , Ben O’ Sullivan , Gabriela Alcaraz Garcia-Tejedor , Nan Gai , Guy Petroz , Conor Mc Donnell , Fahad Alam , Katie Brazel , Monica Caldeira-Kulbakas

Background

Preoperative anxiety in children causes negative postoperative outcomes. Parental presence at induction is a non-pharmacological strategy for relieving anxiety; nevertheless, it is not always possible or effective, namely when parents are overly anxious. Parental presence via video has been demonstrated to be useful in other contexts (divorce, criminal court). This study reports the feasibility of a randomized controlled trial to investigate the effect of video parental presence and parental coaching at induction on preoperative anxiety.

Methods

The study was a randomized, 2 × 2 factorial design trial examining parental presence (virtual vs. physical) and coaching (provided vs. not provided). Feasibility was assessed by enrollment rate, attrition rate, compliance, and staff satisfaction with virtual method with the NASA-Task Load Index (NASA-TLX) and System Usability Scale (SUS). For the children's anxiety and postoperative outcomes, the modified Yale Preoperative Anxiety Scale (mYPAS) and Post-Hospitalization Behavioral Questionnaire (PHBQ) were used. Parental anxiety was evaluated with the State-Trait Anxiety Inventory (STAI) questionnaire.

Results

A total of 41 parent/patient dyads were recruited. The enrollment rate was 32.2%, the attrition rate 25.5%. Compliance was 87.8% for parents and 85% for staff. The SUS was 67.5/100 and 63.5/100 and NASA-TLX was 29.2 (21.5–36.8) and 27.6 (8.2–3.7) for the anesthesiologists and induction nurses, respectively. No statistically significant difference was found in mYPAS, PHBQ and STAI.

Conclusion

A randomized controlled trial to explore virtual parental presence effect on preoperative anxiety is feasible. Further studies are needed to investigate its role and the role of parent coaching in reducing preoperative anxiety.

背景：儿童术前焦虑会导致术后不良后果。父母在诱导时在场是一种非药物缓解焦虑的策略；然而，这种策略并不总是可行或有效，即当父母过度焦虑时。在其他情况下（离婚、刑事法庭），父母通过视频在场已被证明是有用的。本研究报告了一项随机对照试验的可行性，以调查视频父母陪伴和父母在诱导时的指导对术前焦虑的影响：该研究是一项随机、2 × 2 因式设计试验，考察了父母在场（虚拟与实体）和指导（提供与不提供）。通过美国航空航天局任务负荷指数（NASA-TLX）和系统可用性量表（SUS）对虚拟方法的注册率、流失率、依从性和工作人员满意度进行可行性评估。对于儿童的焦虑和术后结果，采用了改良耶鲁术前焦虑量表（mYPAS）和住院后行为问卷（PHBQ）。父母的焦虑程度则通过国家-特质焦虑量表（STAI）问卷进行评估：共招募了 41 个家长/患者二人组。注册率为 32.2%，流失率为 25.5%。家长的依从性为 87.8%，员工的依从性为 85%。麻醉师和诱导护士的 SUS 分别为 67.5/100 和 63.5/100，NASA-TLX 分别为 29.2（21.5-36.8）和 27.6（8.2-3.7）。在 mYPAS、PHBQ 和 STAI 方面没有发现明显的统计学差异：探讨虚拟父母在场对术前焦虑的影响的随机对照试验是可行的。结论：探讨虚拟父母在场对术前焦虑的影响的随机对照试验是可行的，但还需要进一步研究虚拟父母在场在降低术前焦虑方面的作用以及父母指导在降低术前焦虑方面的作用。

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引用次数: 0

Advancing pediatric anesthesia in Brazil: reflections on research and education 推进巴西的儿科麻醉：对研究和教育的思考。

IF 1.7 4区医学 Q2 ANESTHESIOLOGY

Brazilian Journal of Anesthesiology

Pub Date : 2024-06-25 DOI: 10.1016/j.bjane.2024.844535

Norma Sueli Pinheiro Módolo , Débora de Oliveira Cumino , Luciana Cavalcanti Lima , Guilherme Antonio Moreira de Barros

引用次数: 0

Beyond the bite: understanding and managing post-arboviral pain 超越咬伤：了解和处理病毒感染后的疼痛》（Beyond the Bite: Understanding and Managing Post-Arboviral Pain.

IF 1.7 4区医学 Q2 ANESTHESIOLOGY

Brazilian Journal of Anesthesiology

Pub Date : 2024-06-22 DOI: 10.1016/j.bjane.2024.844526

Durval Campos Kraychete , Vinicius Borges Alencar , Eduardo Silva Reis Barreto , César Romero Antunes Júnior , Liliane Elze Falcão Lins-Kusterer , Guilherme Antonio Moreira de Barros , André P. Schmidt

引用次数: 0

Challenges of organizing pediatric anesthesia in low and middle-income countries 中低收入国家组织儿科麻醉面临的挑战。

IF 1.7 4区医学 Q2 ANESTHESIOLOGY

Brazilian Journal of Anesthesiology

Pub Date : 2024-06-19 DOI: 10.1016/j.bjane.2024.844525

Anelise Schifino Wolmeister , Tom G. Hansen , Thomas Engelhardt

引用次数: 0

Unravelling the analgesic effects of perioperative magnesium in general abdominal surgery: a systematic review and meta-analysis of randomized controlled trials 揭示普通腹部手术围手术期镁的镇痛效果：随机对照试验的系统回顾和荟萃分析。

IF 1.3 4区医学 Q2 ANESTHESIOLOGY

Brazilian Journal of Anesthesiology

Pub Date : 2024-06-05 DOI: 10.1016/j.bjane.2024.844524

Yasin Avci, Manikandan Rajarathinam, Neha Kalsekar, Qutaiba Tawfic, Sarah Krause, Derek Nguyen, Eric Liu, Mahesh Nagappa, Yamini Subramani

Background

Prior research has established the effectiveness of magnesium in relieving postoperative pain. This article aims to evaluate magnesium sulfate for perioperative analgesia in adults undergoing general abdominal surgery under general anesthesia.

Objective

The primary aim was to assess pain scores at 6 and 24 hours postoperatively in patients receiving magnesium sulfate vs. the control group. Secondary outcomes were postoperative opioid consumption, perioperative complications, and time to rescue analgesia.

Methods

A comprehensive database search identified studies comparing magnesium sulfate with control in adults undergoing general anesthesia for general abdominal surgery. Using random-effects models, data were presented as mean ± Standard Deviation (SD) or Odds Ratios (OR) with corresponding 95% Confidence Intervals (95% CI). A two-sided p-value < 0.05 was considered statistically significant.

Results

In total, 31 studies involving 1762 participants met the inclusion criteria. The magnesium group showed significantly lower postoperative pain scores at both early (within six hours) and late (up to 24 hours) time points compared to the control group. The early mean score was 3.1 ± 1.4 vs. 4.2 ± 2.3, and the late mean score was 2.3 ± 1.1 vs. 2.7 ± 1.5, resulting in an overall Mean Difference (MD) of −0.72; 95% CI −0.99, −0.44; p < 0.00001. The magnesium group was associated with lower rates of postoperative opioid consumption and shivering and had a longer time to first analgesia administration compared to the saline control group.

Conclusion

Magnesium sulfate administration was linked to reduced postoperative pain and opioid consumption following general abdominal surgery.

背景：先前的研究已证实镁可有效缓解术后疼痛。本文旨在评估硫酸镁对在全身麻醉下接受普通腹部手术的成人围手术期镇痛效果：主要目的是评估接受硫酸镁治疗的患者与对照组患者在术后 6 小时和 24 小时的疼痛评分。次要结果是术后阿片类药物消耗量、围手术期并发症和抢救镇痛时间：通过全面的数据库搜索，确定了对接受腹部手术全身麻醉的成人进行硫酸镁与对照组比较的研究。采用随机效应模型，数据以均数±标准差（SD）或比值比（OR）及相应的 95% 置信区间（95% CI）表示。双侧 P 值小于 0.05 被认为具有统计学意义：共有 31 项研究（涉及 1762 名参与者）符合纳入标准。与对照组相比，镁组在早期（6 小时内）和晚期（24 小时内）的术后疼痛评分都明显较低。早期平均评分为 3.1 ± 1.4 vs. 4.2 ± 2.3，晚期平均评分为 2.3 ± 1.1 vs. 2.7 ± 1.5，总体平均差 (MD) 为 -0.72; 95% CI -0.99, -0.44; p < 0.00001。与生理盐水对照组相比，硫酸镁组的术后阿片类药物用量和哆嗦发生率更低，首次镇痛用药时间更长：结论：硫酸镁可减少普通腹部手术的术后疼痛和阿片类药物的用量。

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引用次数: 0

The role of cannabinoids in chronic pain management: clinical insights and challenges 大麻素在慢性疼痛治疗中的作用：临床见解与挑战。

IF 1.3 4区医学 Q2 ANESTHESIOLOGY

Brazilian Journal of Anesthesiology

Pub Date : 2024-05-31 DOI: 10.1016/j.bjane.2024.844523

André P. Schmidt

引用次数: 0

ICERA: Increasing accessibility to medical education through structured international collaboration ICERA：通过有组织的国际合作提高医学教育的可及性。

IF 1.3 4区医学 Q2 ANESTHESIOLOGY

Brazilian Journal of Anesthesiology

Pub Date : 2024-05-29 DOI: 10.1016/j.bjane.2024.844522

Maxwell B. Baker , Rafael Ortega , Federico Bilotta , Jennifer Wang , Wendy Bernstein

引用次数: 0

Development and evaluation of an educational comic leaflet for pediatric anesthesia care 开发和评估儿科麻醉护理教育漫画传单。

IF 1.3 4区医学 Q2 ANESTHESIOLOGY

Brazilian Journal of Anesthesiology

Pub Date : 2024-05-29 DOI: 10.1016/j.bjane.2024.844521

Fabiano Soares Carneiro , Juliana Lacerda de Oliveira Campos , Stephanie Bruna Camilo Soares de Brito , Flávia Marques de Melo , Eliane Cristina de Souza Soares

引用次数: 0

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Brazilian Journal of Anesthesiology

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