首页 > 最新文献

Anaesthesia and Intensive Care Medicine最新文献

英文 中文
Acute pain management in the neonate 新生儿急性疼痛的处理
IF 0.3 Q4 ANESTHESIOLOGY Pub Date : 2025-11-01 DOI: 10.1016/j.mpaic.2025.10.005
Bryan Atandi, James Masters, Philip Arnold
Neonates may require painful procedures whilst in hospital. Anaesthetists may be called upon to help manage neonates in pain. Developmental differences in anatomy and physiology cause challenges when considering appropriate analgesic strategies. A multimodal approach, with careful modification of established analgesic practices, is required to both minimize the negative sequelae of pain and limit adverse effects. Those tasked with the care of neonates should be familiar with the different analgesic options at their disposal, utilizing a combination of non-pharmacologic, pharmacologic and interventional strategies in order to improve patient care.
新生儿在住院期间可能需要进行痛苦的手术。麻醉师可能被要求帮助处理新生儿的疼痛。在考虑适当的镇痛策略时,解剖学和生理学的发育差异造成了挑战。需要一种多模式的方法,仔细修改已建立的镇痛方法,以尽量减少疼痛的负面后遗症和限制不良反应。那些负责照顾新生儿的人应该熟悉不同的镇痛选择,利用非药物、药物和介入性策略的组合,以改善病人的护理。
{"title":"Acute pain management in the neonate","authors":"Bryan Atandi,&nbsp;James Masters,&nbsp;Philip Arnold","doi":"10.1016/j.mpaic.2025.10.005","DOIUrl":"10.1016/j.mpaic.2025.10.005","url":null,"abstract":"<div><div>Neonates may require painful procedures whilst in hospital. Anaesthetists may be called upon to help manage neonates in pain. Developmental differences in anatomy and physiology cause challenges when considering appropriate analgesic strategies. A multimodal approach, with careful modification of established analgesic practices, is required to both minimize the negative sequelae of pain and limit adverse effects. Those tasked with the care of neonates should be familiar with the different analgesic options at their disposal, utilizing a combination of non-pharmacologic, pharmacologic and interventional strategies in order to improve patient care.</div></div>","PeriodicalId":45856,"journal":{"name":"Anaesthesia and Intensive Care Medicine","volume":"26 11","pages":"Pages 753-758"},"PeriodicalIF":0.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145528131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Medical illnesses in neonates: implications for anaesthesia 新生儿医学疾病:麻醉的意义
IF 0.3 Q4 ANESTHESIOLOGY Pub Date : 2025-11-01 DOI: 10.1016/j.mpaic.2025.10.007
Jacinth Tan, Katie Misselbrook
Neonates present a specific set of challenges to the anaesthetist due to neonatal anatomy and physiology that is very different from that in children and adults. These challenges increase when the neonate is premature, but also if they have associated co-morbidities. There are certain medical conditions that exclusively affect neonates, or that affects neonates more commonly and significantly. When they present for anaesthesia and surgery, it is essential that the anaesthetist understands the implications of these co-morbid problems. A multidisciplinary approach involving neonatologists and other sub-specialists should be sought to ensure safe perioperative management of the ongoing medical issue. This article aims to address some common medical diagnoses and considerations for safe anaesthesia in these babies.
由于新生儿的解剖和生理与儿童和成人非常不同,新生儿对麻醉师提出了一套特殊的挑战。当新生儿早产时,这些挑战会增加,但如果他们有相关的合并症也会增加。有某些医疗条件只影响新生儿,或者更普遍和显著地影响新生儿。当他们进行麻醉和手术时,麻醉师了解这些共病问题的含义是至关重要的。应寻求涉及新生儿学家和其他专科医生的多学科方法,以确保对正在进行的医疗问题的围手术期安全管理。这篇文章的目的是解决一些常见的医学诊断和安全麻醉这些婴儿的注意事项。
{"title":"Medical illnesses in neonates: implications for anaesthesia","authors":"Jacinth Tan,&nbsp;Katie Misselbrook","doi":"10.1016/j.mpaic.2025.10.007","DOIUrl":"10.1016/j.mpaic.2025.10.007","url":null,"abstract":"<div><div>Neonates present a specific set of challenges to the anaesthetist due to neonatal anatomy and physiology that is very different from that in children and adults. These challenges increase when the neonate is premature, but also if they have associated co-morbidities. There are certain medical conditions that exclusively affect neonates, or that affects neonates more commonly and significantly. When they present for anaesthesia and surgery, it is essential that the anaesthetist understands the implications of these co-morbid problems. A multidisciplinary approach involving neonatologists and other sub-specialists should be sought to ensure safe perioperative management of the ongoing medical issue. This article aims to address some common medical diagnoses and considerations for safe anaesthesia in these babies.</div></div>","PeriodicalId":45856,"journal":{"name":"Anaesthesia and Intensive Care Medicine","volume":"26 11","pages":"Pages 768-773"},"PeriodicalIF":0.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145528133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cardiac disease in neonates 新生儿心脏病
IF 0.3 Q4 ANESTHESIOLOGY Pub Date : 2025-11-01 DOI: 10.1016/j.mpaic.2025.10.008
Mahmoud Ali, Philip Arnold
Congenital heart disease occurs in approximately 8 in every 1000 births, making it the most common significant congenital abnormality. There is a wide range of lesions and the impact of these during neonatal life will be extremely variable: some will require major cardiac surgery in the first weeks of life, whilst other lesions will have little impact on the child’s health. Cardiac disease also has implications for management, and outcome, of neonates undergoing non-cardiac surgery.
先天性心脏病的发生率约为每1000个新生儿中有8个,使其成为最常见的重大先天性异常。有各种各样的病变,这些病变对新生儿生命的影响是极不相同的:有些病变在生命的头几周需要进行大的心脏手术,而其他病变对孩子的健康影响很小。心脏疾病对接受非心脏手术的新生儿的管理和预后也有影响。
{"title":"Cardiac disease in neonates","authors":"Mahmoud Ali,&nbsp;Philip Arnold","doi":"10.1016/j.mpaic.2025.10.008","DOIUrl":"10.1016/j.mpaic.2025.10.008","url":null,"abstract":"<div><div>Congenital heart disease occurs in approximately 8 in every 1000 births, making it the most common significant congenital abnormality. There is a wide range of lesions and the impact of these during neonatal life will be extremely variable: some will require major cardiac surgery in the first weeks of life, whilst other lesions will have little impact on the child’s health. Cardiac disease also has implications for management, and outcome, of neonates undergoing non-cardiac surgery.</div></div>","PeriodicalId":45856,"journal":{"name":"Anaesthesia and Intensive Care Medicine","volume":"26 11","pages":"Pages 774-778"},"PeriodicalIF":0.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145528134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Principles of anaesthesia for neonates 新生儿麻醉原理
IF 0.3 Q4 ANESTHESIOLOGY Pub Date : 2025-11-01 DOI: 10.1016/j.mpaic.2025.10.003
Sarada Gurung, Rhiann M O'Shaughnessy
Neonates possess unique physiological characteristics as they transition from intrauterine to extrauterine life. According to the National Audit Project (NAP) 7, neonates are particularly vulnerable to perioperative cardiac arrest, with an incidence of 1 in 200 compared to 1 in 3333 in the paediatric population. A thorough understanding of their physiology is crucial for providing high-quality perioperative care. Prematurity and low birth weight are two significant risk factors that contribute to increased perioperative morbidity and mortality. It is essential to actively manage temperature and glucose levels. While a term neonate with a postmenstrual age (PMA) of 44 weeks may be suitable for day-surgical care, preterm infants often require inpatient admission until they reach a PMA of 60 weeks.
新生儿在从宫内生活过渡到宫外生活的过程中具有独特的生理特征。根据国家审计项目(NAP) 7,新生儿特别容易发生围手术期心脏骤停,发病率为200分之一,而儿科人群的发病率为3333分之一。全面了解患者的生理状况对于提供高质量的围手术期护理至关重要。早产和低出生体重是导致围手术期发病率和死亡率增加的两个重要危险因素。积极控制体温和血糖水平是非常必要的。虽然经后年龄(PMA)为44周的足月新生儿可能适合进行日间手术护理,但早产儿通常需要住院治疗,直到他们达到PMA 60周。
{"title":"Principles of anaesthesia for neonates","authors":"Sarada Gurung,&nbsp;Rhiann M O'Shaughnessy","doi":"10.1016/j.mpaic.2025.10.003","DOIUrl":"10.1016/j.mpaic.2025.10.003","url":null,"abstract":"<div><div>Neonates possess unique physiological characteristics as they transition from intrauterine to extrauterine life. According to the National Audit Project (NAP) 7, neonates are particularly vulnerable to perioperative cardiac arrest, with an incidence of 1 in 200 compared to 1 in 3333 in the paediatric population. A thorough understanding of their physiology is crucial for providing high-quality perioperative care. Prematurity and low birth weight are two significant risk factors that contribute to increased perioperative morbidity and mortality. It is essential to actively manage temperature and glucose levels. While a term neonate with a postmenstrual age (PMA) of 44 weeks may be suitable for day-surgical care, preterm infants often require inpatient admission until they reach a PMA of 60 weeks.</div></div>","PeriodicalId":45856,"journal":{"name":"Anaesthesia and Intensive Care Medicine","volume":"26 11","pages":"Pages 739-744"},"PeriodicalIF":0.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145528129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Drugs used in the management of hyperglycaemia 用于治疗高血糖的药物
IF 0.3 Q4 ANESTHESIOLOGY Pub Date : 2025-11-01 DOI: 10.1016/j.mpaic.2025.10.011
Paige McGregor, Eilidh Lynch, Andrea Llano
Diabetes is a chronic metabolic disorder characterized by hyperglycaemia which results from insulin deficiency and/or increased resistance to endogenous insulin. Its management is with lifestyle, dietary and pharmacological interventions with the aim of improving glycaemic control and reducing cardiovascular risk and microvascular complications. Newer agents such as glucagon-like peptide 1 receptor agonists and sodium–glucose transporter 2 inhibitors have been shown to improve glycaemic control, promote weight loss and have additional cardio-renal benefits. In this article, drugs used in the treatment of diabetes will be reviewed, including side effects and alterations required in the perioperative period.
糖尿病是一种以高血糖为特征的慢性代谢紊乱,由胰岛素缺乏和/或内源性胰岛素抵抗增加引起。其管理是通过生活方式、饮食和药物干预来改善血糖控制,降低心血管风险和微血管并发症。较新的药物,如胰高血糖素样肽1受体激动剂和钠-葡萄糖转运蛋白2抑制剂,已被证明可以改善血糖控制,促进体重减轻,并具有额外的心脏和肾脏益处。在这篇文章中,将回顾用于治疗糖尿病的药物,包括副作用和围手术期所需的改变。
{"title":"Drugs used in the management of hyperglycaemia","authors":"Paige McGregor,&nbsp;Eilidh Lynch,&nbsp;Andrea Llano","doi":"10.1016/j.mpaic.2025.10.011","DOIUrl":"10.1016/j.mpaic.2025.10.011","url":null,"abstract":"<div><div>Diabetes is a chronic metabolic disorder characterized by hyperglycaemia which results from insulin deficiency and/or increased resistance to endogenous insulin. Its management is with lifestyle, dietary and pharmacological interventions with the aim of improving glycaemic control and reducing cardiovascular risk and microvascular complications. Newer agents such as glucagon-like peptide 1 receptor agonists and sodium–glucose transporter 2 inhibitors have been shown to improve glycaemic control, promote weight loss and have additional cardio-renal benefits. In this article, drugs used in the treatment of diabetes will be reviewed, including side effects and alterations required in the perioperative period.</div></div>","PeriodicalId":45856,"journal":{"name":"Anaesthesia and Intensive Care Medicine","volume":"26 11","pages":"Pages 792-796"},"PeriodicalIF":0.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145528137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Self-assessment 自我评估
IF 0.3 Q4 ANESTHESIOLOGY Pub Date : 2025-11-01 DOI: 10.1016/j.mpaic.2025.10.012
Vijayanand Nadella
{"title":"Self-assessment","authors":"Vijayanand Nadella","doi":"10.1016/j.mpaic.2025.10.012","DOIUrl":"10.1016/j.mpaic.2025.10.012","url":null,"abstract":"","PeriodicalId":45856,"journal":{"name":"Anaesthesia and Intensive Care Medicine","volume":"26 11","pages":"Pages 797-798"},"PeriodicalIF":0.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145528138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Acute management of ischaemic stroke 缺血性脑卒中的急性管理
IF 0.3 Q4 ANESTHESIOLOGY Pub Date : 2025-10-01 DOI: 10.1016/j.mpaic.2025.08.004
Sean Rayappu, Valpuri Luoma, Ugan Reddy
An acute ischaemic stroke (AIS) is a non-specific state of brain injury with neuronal dysfunction, which has several pathophysiological causes and is time critical. More than 60% of cases are due to thrombotic or embolic causes with resultant focal ischaemia and an accompanying neurological deficit. Initial assessment, stabilization and early imaging are important aspects of effective stroke management. Thrombolysis and endovascular thrombectomy have proven beneficial in reversing neurological deficits and improving functional outcomes. Guidelines now support administration of recombinant tissue plasminogen activator (rt-PA) up to 4.5 hours and extension of endovascular thrombectomy (EVT) windows up to 24 hours after onset of symptoms in select patient groups. Other important aspects of management include administration of antiplatelet agents (aspirin) within 48 hours, management within a specialist stroke unit, and decompressive craniectomy for malignant middle cerebral artery (MCA) stroke.
急性缺血性脑卒中(AIS)是一种具有神经功能障碍的非特异性脑损伤状态,它有多种病理生理原因,并且具有时间依赖性。超过60%的病例是由于血栓形成或栓塞引起的局灶性缺血和伴随的神经功能障碍。初步评估、稳定和早期成像是有效脑卒中管理的重要方面。溶栓和血管内取栓已被证明在逆转神经功能缺陷和改善功能预后方面是有益的。指南现在支持重组组织型纤溶酶原激活剂(rt-PA)的给药时间长达4.5小时,并将血管内取栓(EVT)窗口延长至症状出现后24小时。治疗的其他重要方面包括48小时内使用抗血小板药物(阿司匹林),在专门的卒中单位进行治疗,以及恶性大脑中动脉(MCA)卒中的减压颅骨切除术。
{"title":"Acute management of ischaemic stroke","authors":"Sean Rayappu,&nbsp;Valpuri Luoma,&nbsp;Ugan Reddy","doi":"10.1016/j.mpaic.2025.08.004","DOIUrl":"10.1016/j.mpaic.2025.08.004","url":null,"abstract":"<div><div>An acute ischaemic stroke (AIS) is a non-specific state of brain injury with neuronal dysfunction, which has several pathophysiological causes and is time critical. More than 60% of cases are due to thrombotic or embolic causes with resultant focal ischaemia and an accompanying neurological deficit. Initial assessment, stabilization and early imaging are important aspects of effective stroke management. Thrombolysis and endovascular thrombectomy have proven beneficial in reversing neurological deficits and improving functional outcomes. Guidelines now support administration of recombinant tissue plasminogen activator (rt-PA) up to 4.5 hours and extension of endovascular thrombectomy (EVT) windows up to 24 hours after onset of symptoms in select patient groups. Other important aspects of management include administration of antiplatelet agents (aspirin) within 48 hours, management within a specialist stroke unit, and decompressive craniectomy for malignant middle cerebral artery (MCA) stroke.</div></div>","PeriodicalId":45856,"journal":{"name":"Anaesthesia and Intensive Care Medicine","volume":"26 10","pages":"Pages 625-632"},"PeriodicalIF":0.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145323920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Spontaneous intracerebral haemorrhage 自发性脑出血
IF 0.3 Q4 ANESTHESIOLOGY Pub Date : 2025-10-01 DOI: 10.1016/j.mpaic.2025.08.006
Enrico Sorrentino, Jennifer Lewis
Spontaneous intracerebral haemorrhage (ICH) is a devastating form of stroke that carries a high risk of disability and mortality. The main risk factor is chronic arterial hypertension, but it can also be secondary to micro- and macrovascular causes. Patients with ICH should be looked after on an acute stroke unit or on an intensive care unit. Their management is complex and involves stroke physicians, neurointensivists and neurosurgeons, as well as several allied health professionals. The mainstays of medical treatment are blood pressure control and reversal of anticoagulation. Surgical management has traditionally been confined to a small number of cases, but recent promising technological enhancements are allowing the benefits of surgical care to be extended to more patients.
自发性脑出血(ICH)是一种毁灭性的中风形式,具有很高的致残和死亡风险。主要的危险因素是慢性动脉高血压,但它也可能继发于微血管和大血管原因。脑出血患者应在急性卒中病房或重症监护病房接受治疗。他们的管理是复杂的,涉及中风医生,神经强化医生和神经外科医生,以及一些联合卫生专业人员。药物治疗的支柱是控制血压和抗凝逆转。传统上,手术治疗仅限于少数病例,但最近有希望的技术改进使手术治疗的好处扩展到更多的患者。
{"title":"Spontaneous intracerebral haemorrhage","authors":"Enrico Sorrentino,&nbsp;Jennifer Lewis","doi":"10.1016/j.mpaic.2025.08.006","DOIUrl":"10.1016/j.mpaic.2025.08.006","url":null,"abstract":"<div><div>Spontaneous intracerebral haemorrhage (ICH) is a devastating form of stroke that carries a high risk of disability and mortality. The main risk factor is chronic arterial hypertension, but it can also be secondary to micro- and macrovascular causes. Patients with ICH should be looked after on an acute stroke unit or on an intensive care unit. Their management is complex and involves stroke physicians, neurointensivists and neurosurgeons, as well as several allied health professionals. The mainstays of medical treatment are blood pressure control and reversal of anticoagulation. Surgical management has traditionally been confined to a small number of cases, but recent promising technological enhancements are allowing the benefits of surgical care to be extended to more patients.</div></div>","PeriodicalId":45856,"journal":{"name":"Anaesthesia and Intensive Care Medicine","volume":"26 10","pages":"Pages 633-638"},"PeriodicalIF":0.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145323973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Applied cerebral physiology 应用脑生理学
IF 0.3 Q4 ANESTHESIOLOGY Pub Date : 2025-10-01 DOI: 10.1016/j.mpaic.2025.08.007
Elouise S Donaldson, Eleanor L Carter
The brain is an exquisitely sensitive organ, requiring a constant supply of blood, oxygen, and glucose to function. Cerebral blood flow is autoregulated to provide a near constant blood supply despite fluctuations in whole body physiology. The blood–brain barrier acts to ensure that the brain microenvironment remains tightly regulated. The pressure within the cranium must also be tightly controlled to maintain optimal cerebral perfusion and ultimately prevent herniation of brain parenchyma. Several physiological parameters can be monitored including intracranial pressure, cerebral oxygenation and metabolic stress and clinical use is increasing including in traumatic brain injury and subarachnoid haemorrhage patients.
大脑是一个极其敏感的器官,需要持续的血液、氧气和葡萄糖供应才能发挥作用。脑血流量是自动调节的,尽管全身生理波动,但仍能提供近乎恒定的血液供应。血脑屏障的作用是确保大脑微环境保持严格的调控。颅内压力也必须严格控制,以保持最佳的脑灌注,最终防止脑实质疝出。一些生理参数可以监测,包括颅内压,脑氧合和代谢应激和临床应用越来越多,包括创伤性脑损伤和蛛网膜下腔出血患者。
{"title":"Applied cerebral physiology","authors":"Elouise S Donaldson,&nbsp;Eleanor L Carter","doi":"10.1016/j.mpaic.2025.08.007","DOIUrl":"10.1016/j.mpaic.2025.08.007","url":null,"abstract":"<div><div>The brain is an exquisitely sensitive organ, requiring a constant supply of blood, oxygen, and glucose to function. Cerebral blood flow is autoregulated to provide a near constant blood supply despite fluctuations in whole body physiology. The blood–brain barrier acts to ensure that the brain microenvironment remains tightly regulated. The pressure within the cranium must also be tightly controlled to maintain optimal cerebral perfusion and ultimately prevent herniation of brain parenchyma. Several physiological parameters can be monitored including intracranial pressure, cerebral oxygenation and metabolic stress and clinical use is increasing including in traumatic brain injury and subarachnoid haemorrhage patients.</div></div>","PeriodicalId":45856,"journal":{"name":"Anaesthesia and Intensive Care Medicine","volume":"26 10","pages":"Pages 683-688"},"PeriodicalIF":0.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145323928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Anaesthesia for awake craniotomy 清醒开颅术麻醉
IF 0.3 Q4 ANESTHESIOLOGY Pub Date : 2025-10-01 DOI: 10.1016/j.mpaic.2025.08.003
Daniel Lunardi, Judith Dinsmore
Awake craniotomy enables intraoperative assessment of a patient's neurological status. It is most commonly performed for the resection of tumours within eloquent cortex, and it is now considered a standard of care. Other indications include epilepsy surgery and neuromodulation for the treatment of Parkinson's disease, tremor, dystonia, and other intractable movement disorders.
Paradoxically, providing anaesthesia for an ‘awake’ procedure, presents particular challenges for the anaesthetist. Although safe and well tolerated, complications occur which can be reduced by meticulous planning and good communication. An understanding of the stages of the surgical procedure and their unique anaesthetic requirements is required. Various anaesthetic techniques are described but there is no one optimal technique. Each case requires individual planning with regards to most suitable technique. Many drugs can be used to deliver sedation, analgesia, or anaesthesia, each requiring finesse with dosing and titration. Effective local anaesthesia is essential no matter what technique is chosen. Awake craniotomies are rewarding cases, with clear benefits in terms of improved patient outcomes and reduction in hospital stay and costs.
清醒开颅术可以术中评估患者的神经系统状态。它最常用于切除大脑皮层内的肿瘤,现在被认为是一种标准的治疗方法。其他适应症包括癫痫手术和神经调节治疗帕金森病、震颤、肌张力障碍和其他难治性运动障碍。矛盾的是,为“清醒”过程提供麻醉,对麻醉师提出了特殊的挑战。虽然安全且耐受性良好,但并发症的发生可以通过周密的计划和良好的沟通来减少。了解手术过程的各个阶段及其独特的麻醉要求是必要的。描述了各种麻醉技术,但没有一种最佳技术。每种情况都需要针对最合适的技术进行个人规划。许多药物可用于镇静、镇痛或麻醉,每种药物都需要在剂量和滴定上有一定的技巧。无论选择何种技术,有效的局部麻醉都是必不可少的。清醒开颅术是有益的案例,在改善患者预后和减少住院时间和费用方面有明显的好处。
{"title":"Anaesthesia for awake craniotomy","authors":"Daniel Lunardi,&nbsp;Judith Dinsmore","doi":"10.1016/j.mpaic.2025.08.003","DOIUrl":"10.1016/j.mpaic.2025.08.003","url":null,"abstract":"<div><div>Awake craniotomy enables intraoperative assessment of a patient's neurological status. It is most commonly performed for the resection of tumours within eloquent cortex, and it is now considered a standard of care. Other indications include epilepsy surgery and neuromodulation for the treatment of Parkinson's disease, tremor, dystonia, and other intractable movement disorders.</div><div>Paradoxically, providing anaesthesia for an ‘awake’ procedure, presents particular challenges for the anaesthetist. Although safe and well tolerated, complications occur which can be reduced by meticulous planning and good communication. An understanding of the stages of the surgical procedure and their unique anaesthetic requirements is required. Various anaesthetic techniques are described but there is no one optimal technique. Each case requires individual planning with regards to most suitable technique. Many drugs can be used to deliver sedation, analgesia, or anaesthesia, each requiring finesse with dosing and titration. Effective local anaesthesia is essential no matter what technique is chosen. Awake craniotomies are rewarding cases, with clear benefits in terms of improved patient outcomes and reduction in hospital stay and costs.</div></div>","PeriodicalId":45856,"journal":{"name":"Anaesthesia and Intensive Care Medicine","volume":"26 10","pages":"Pages 695-701"},"PeriodicalIF":0.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145323925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Anaesthesia and Intensive Care Medicine
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1