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Effect of transversus abdominis plane block with or without buprenorphine after inguinal hernia surgery on postoperative pain. 腹股沟疝气手术后使用或不使用丁丙诺啡进行腹横肌平面阻滞对术后疼痛的影响。
IF 1.7 Q2 ANESTHESIOLOGY Pub Date : 2023-01-01 DOI: 10.5114/ait.2023.132837
Nirvana Ahmed Elshalakany, Asmaa Mohamed Salah

Introduction: Transversus abdominis plane (TAP) has been mentioned as having bene-ficial effects on chronic pain after hernioplasty. This study assessed the effects of TAP block on acute and persistent postoperative pain after inguinal hernia surgery, with or without buprenorphine.

Material and methods: 64 patients were allocated to group R ( n = 32) and received 20 mL of 0.25% ropivacaine for TAP block; group RB ( n = 32) received 20 mL of 0.25% ropivacaine containing 300 µg of buprenorphine for TAP block. The primary outcome was the analgesic and antihyperalgesic effect of buprenorphine. The duration of analgesia, analgesic consumption, postoperative pain scores at rest and sitting up to 48 hours, and the effect on wound hyperalgesia were evaluated. Secondary outcomes included the incidence of side effects and complications.

Results: The median (IQR) duration of analgesia in group R was 386.5 (37.25) minutes vs. 868 (41.3) minutes in the RB group. Median pain scores on sitting were found to be significantly better in group RB than in group R at 6, 12, and 24 hours ( P < 0.001). The wound hyperalgesia index showed a significant difference between groups ( P < 0.001). The incidence of persistent postoperative pain was 6.25% in the R group, as compared to 0% in the RB group. Otherwise, the patients did not have any further complications associated with the block.

Conclusions: The results demonstrated that TAP block with buprenorphine reduced acute postoperative pain severity, but we did not find a difference between groups in persistent pain.

简介有人提到腹横肌平面(TAP)对疝气成形术后的慢性疼痛有好处。本研究评估了 TAP 阻滞对腹股沟疝手术后急性和持续性术后疼痛的影响,无论是否使用丁丙诺啡。材料和方法:64 名患者被分配到 R 组(32 人),接受 20 mL 0.25% 罗哌卡因进行 TAP 阻滞;RB 组(32 人)接受 20 mL 含有 300 µg 丁丙诺啡的 0.25% 罗哌卡因进行 TAP 阻滞。主要结果是丁丙诺啡的镇痛和抗过敏作用。评估内容包括镇痛持续时间、镇痛剂消耗量、术后休息和坐位 48 小时内的疼痛评分以及对伤口痛觉减退的影响。次要结果包括副作用和并发症的发生率:结果:R组镇痛持续时间的中位数(IQR)为386.5(37.25)分钟,而RB组为868(41.3)分钟。在 6、12 和 24 小时内,RB 组坐位疼痛评分的中位数明显优于 R 组(P < 0.001)。伤口痛觉减退指数在各组之间存在显著差异(P < 0.001)。R 组术后持续疼痛的发生率为 6.25%,而 RB 组为 0%。除此之外,患者没有再出现任何与阻滞相关的并发症:结果表明,使用丁丙诺啡进行 TAP 阻滞可降低术后急性疼痛的严重程度,但我们并未发现各组间在持续性疼痛方面存在差异。
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引用次数: 0
Clarification on viscosity vs. viscoelasticity 澄清粘度与粘弹性
Q2 ANESTHESIOLOGY Pub Date : 2023-01-01 DOI: 10.5114/ait.2023.132522
Marko Oydanich, Valerie Tutwiler, Rotem Naftalovich, Andrew Iskander
AMA Oydanich M, Tutwiler V, Naftalovich R, Iskander A. Clarification on viscosity vs. viscoelasticity. Anaesthesiology Intensive Therapy. 2023. doi:10.5114/ait.2023.132522. APA Oydanich, M., Tutwiler, V., Naftalovich, R., & Iskander, A. (2023). Clarification on viscosity vs. viscoelasticity. Anaesthesiology Intensive Therapy. https://doi.org/10.5114/ait.2023.132522 Chicago Oydanich, Marko, Valerie Tutwiler, Rotem Naftalovich, and Andrew Iskander. 2023. "Clarification on viscosity vs. viscoelasticity". Anaesthesiology Intensive Therapy. doi:10.5114/ait.2023.132522. Harvard Oydanich, M., Tutwiler, V., Naftalovich, R., and Iskander, A. (2023). Clarification on viscosity vs. viscoelasticity. Anaesthesiology Intensive Therapy. https://doi.org/10.5114/ait.2023.132522 MLA Oydanich, Marko et al. "Clarification on viscosity vs. viscoelasticity." Anaesthesiology Intensive Therapy, 2023. doi:10.5114/ait.2023.132522. Vancouver Oydanich M, Tutwiler V, Naftalovich R, Iskander A. Clarification on viscosity vs. viscoelasticity. Anaesthesiology Intensive Therapy. 2023. doi:10.5114/ait.2023.132522.
李建军,李建军,李建军,等。黏性与粘弹性的关系。麻醉学强化治疗。2023。doi: 10.5114 / ait.2023.132522。APA Oydanich, M, Tutwiler, V., Naftalovich, R., & Iskander, A.(2023)。澄清粘度与粘弹性。麻醉学强化治疗。https://doi.org/10.5114/ait.2023.132522芝加哥Oydanich, Marko, Valerie Tutwiler, Rotem Naftalovich和Andrew Iskander. 2023。“澄清粘度与粘弹性”。麻醉学强化治疗。doi: 10.5114 / ait.2023.132522。哈佛Oydanich, M., Tutwiler, V., Naftalovich, R., and Iskander, A.(2023)。澄清粘度与粘弹性。麻醉学强化治疗。https://doi.org/10.5114/ait.2023.132522 MLA Oydanich, Marko等。“澄清粘度与粘弹性。”麻醉学强化治疗,2023。doi: 10.5114 / ait.2023.132522。张建军,李建军,李建军,等。黏性与粘弹性的关系。麻醉学强化治疗。2023。doi: 10.5114 / ait.2023.132522。
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引用次数: 0
Massive saddle embolus following bilateral lung transplantation discovered with transesophageal echocardiogram. 经食道超声心动图发现双侧肺移植术后的大面积鞍状栓塞。
IF 1.7 Q2 ANESTHESIOLOGY Pub Date : 2023-01-01 DOI: 10.5114/ait.2023.134222
Alex Bui, Jamal Hasoon, Sandeep Markan, Anvinh Nguyen
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引用次数: 0
Reply to the Commentary on "An appraisal of neostigmine versus sugammadex for neuromuscular blockade reversal in patients with a prior heart transplant". 对“新斯的明与sugammadex对既往心脏移植患者肌松拮抗作用的评价”评论的回复。
IF 1.6 Q2 ANESTHESIOLOGY Pub Date : 2023-01-01 DOI: 10.5114/ait.2023.130640
Stephania Paredes, Vivian Hernandez Torres, Harold Chaves-Cardona, Steven Porter, Johnathan Ross Renew
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引用次数: 0
Ultrasound-guided fascia iliaca block versus quadratus lumborum block for perioperative analgesia in patients undergoing hip surgery. A randomised controlled trial. 超声引导髂筋膜阻滞与腰方肌阻滞用于髋关节手术患者围手术期镇痛。一项随机对照试验。
IF 1.7 Q2 ANESTHESIOLOGY Pub Date : 2023-01-01 DOI: 10.5114/ait.2023.130643
Sameh Refaat, Mohamed M Ali, Ibrahim M E Elsherief, Marwa M Mohamed
Background Femoral neck fractures are common orthopaedic fractures, especially in old age, and they represent a life-threatening condition requiring surgical intervention. In this study, we aimed to compare 2 regional techniques used to decrease perioperative pain. Methods In this parallel group randomized controlled clinical trial we enrolled 68 patients from both sexes scheduled for hip surgery after femoral neck fractures. The patients were randomly allocated to 2 equal groups with one receiving ultrasound- guided supra-inguinal fascia iliaca block (FIB) and the other receiving ultrasound- guided anterior quadratus lumborum block (QLB). Our primary outcome was the duration of postoperative analgesia. The secondary outcome was measuring the Visual Analog Scale (VAS) during patient positioning while applying the neuraxial block, the total analgesic requirement in the postoperative period, patient satisfaction in the postoperative period, and the frequency of adverse effects. Results The group receiving supra-inguinal FIB had a significantly longer time of postoperative analgesia 18 (4–24), compared to the group receiving anterior QLB 2 (1–24), P = 0.005. They consumed less morphine throughout 24 hours postoperatively, 5.3 ± 0.9 mg compared to 6.9 ± 1.87 mg (95% CI: 6.45–3.92, P = 0.008), and they showed less pain during positioning for spinal anaesthesia. Conclusions Supra-inguinal FIB provides prolonged postoperative analgesia compared to anterior QLB in patients undergoing hip surgery. It was associated with less pain during positioning in spinal anaesthesia and decreased total morphine consumption.
引言:股骨颈骨折是常见的骨科骨折,尤其是在老年人中,它们是一种需要手术干预的危及生命的疾病。在这项研究中,我们旨在比较两种用于减少围手术期疼痛的区域技术。材料和方法:在这项平行组随机对照临床试验中,我们招募了68名男女患者,计划在股骨颈骨折后进行髋关节手术。患者被随机分为两组,一组接受超声引导的腹股沟上髂筋膜阻滞(FIB),另一组接受超声波引导的腰方前肌阻滞(QLB)。我们的主要结果是术后镇痛的持续时间。次要结果是在应用神经轴阻滞的患者定位过程中测量视觉模拟量表(VAS)、术后总镇痛需求、术后患者满意度和不良反应频率。结果:腹股沟上FIB组术后镇痛时间18(4-24)明显长于QLB2前组(1-24),P=0.005。术后24小时内,他们消耗的吗啡较少,分别为5.3±0.9 mg和6.9±1.87 mg(95%可信区间:6.45-3.92,P=0.008),并且在脊柱麻醉定位期间疼痛较少。结论:在髋关节手术患者中,腹股沟上FIB与前QLB相比可延长术后镇痛时间。它与脊柱麻醉中定位时疼痛减轻和吗啡总消耗减少有关。
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引用次数: 1
Cardiac tamponade and cardiogenic shock after central venous catheter cannulation. Analysis of a case. 中心静脉置管后心包填塞和心源性休克。案例分析。
IF 1.7 Q2 ANESTHESIOLOGY Pub Date : 2023-01-01 DOI: 10.5114/ait.2023.126341
María Mora-Aznar
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引用次数: 1
Analgesic efficacy of two different volumes of local anaesthetics in ultrasound-guided modified approach to the thoracolumbar interfascial plane block in patients undergoing lumbar spine surgeries: a randomized controlled trial. 腰椎手术患者在超声引导下胸腰椎筋膜间平面阻滞改良方法中两种不同容量局麻药的镇痛效果:随机对照试验。
IF 1.6 Q2 ANESTHESIOLOGY Pub Date : 2023-01-01 DOI: 10.5114/ait.2023.134196
Bassant Abdelhamid, Eslam Ayman, Tareq Nabil, Waleed Ibrahim Hamimy, Mohamed Abd El-Monem Morsy

Introduction: There is a lack of clarity regarding the ideal local anaesthetic volume for modified thoracolumbar interfascial plane (mTLIP) block. This study was designed to investigate the analgesic efficacy of two different volumes of bupivacaine 0.25% (20 mL, and 10 mL) for ultrasound-guided mTLIP block in patients undergoing lumbar spine surgeries.

Material and methods: A total of 80 patients received single shot of bilateral mTLIP block at the mid- level of the operative intervention and were randomly allocated into one of the two groups to receive either 10 or 20 mL 0.25% bupivacaine on each side. Total morphine consumption in the first 24 hours postoperative was set as the primary outcome. Time to first rescue analgesia and Numeric Rating Scale (NRS) were set as secondary outcomes.

Results: There was no significant difference in the primary outcome: 6.20 ± 2.18 mg (10 mL Group) vs. 5 ± 0.00 mg (20 mL Group), P = 0.056. The time of first request of rescue morphine was significantly shorter in 10 mL Group (7.80 ± 3.98 hours) as compared to the 20 mL Group (13.23 ± 3.00 hours), P < 0.001. NRS at rest and movement in all time measurements was significantly higher in 10 mL Group.

Conclusions: Bilateral mTLIP block using 40 mL of 0.25% bupivacaine (20 mL on each side) increased the postoperative total analgesic duration for lumbar spine surgeries, and was associated with a lower postoperative pain scores compared to 20 mL of 0.25% bupivacaine (10 mL on each side).

Clinical trial registration id: The study was registered at clinicaltrials.gov (ID: NCT05276908) before patient's enrolment.

简介:目前尚不清楚改良胸腰椎筋膜间平面(mTLIP)阻滞的理想局麻药用量。本研究旨在探讨两种不同容量的 0.25% 布比卡因(20 mL 和 10 mL)在超声引导下用于腰椎手术患者 mTLIP 阻滞的镇痛效果:共有80名患者在手术介入中段接受了单次双侧mTLIP阻滞,并被随机分配到两组中的一组,每侧接受10毫升或20毫升0.25%布比卡因。术后 24 小时内的吗啡总消耗量被设定为主要结果。首次镇痛抢救时间和数值评定量表(NRS)为次要结果:主要结果无明显差异:6.20 ± 2.18 毫克(10 毫升组)对 5 ± 0.00 毫克(20 毫升组),P = 0.056。与 20 毫升组(13.23 ± 3.00 小时)相比,10 毫升组首次申请吗啡抢救的时间明显更短(7.80 ± 3.98 小时),P < 0.001。10 mL 组在静息和运动时的 NRS 均明显高于 20 mL 组:双侧 mTLIP 阻滞使用 40 mL 0.25% 布比卡因(每侧 20 mL)可增加腰椎手术的术后总镇痛时间,与 20 mL 0.25% 布比卡因(每侧 10 mL)相比,术后疼痛评分更低:该研究在患者入组前已在 clinicaltrials.gov 注册(ID:NCT05276908)。
{"title":"Analgesic efficacy of two different volumes of local anaesthetics in ultrasound-guided modified approach to the thoracolumbar interfascial plane block in patients undergoing lumbar spine surgeries: a randomized controlled trial.","authors":"Bassant Abdelhamid, Eslam Ayman, Tareq Nabil, Waleed Ibrahim Hamimy, Mohamed Abd El-Monem Morsy","doi":"10.5114/ait.2023.134196","DOIUrl":"10.5114/ait.2023.134196","url":null,"abstract":"<p><strong>Introduction: </strong>There is a lack of clarity regarding the ideal local anaesthetic volume for modified thoracolumbar interfascial plane (mTLIP) block. This study was designed to investigate the analgesic efficacy of two different volumes of bupivacaine 0.25% (20 mL, and 10 mL) for ultrasound-guided mTLIP block in patients undergoing lumbar spine surgeries.</p><p><strong>Material and methods: </strong>A total of 80 patients received single shot of bilateral mTLIP block at the mid- level of the operative intervention and were randomly allocated into one of the two groups to receive either 10 or 20 mL 0.25% bupivacaine on each side. Total morphine consumption in the first 24 hours postoperative was set as the primary outcome. Time to first rescue analgesia and Numeric Rating Scale (NRS) were set as secondary outcomes.</p><p><strong>Results: </strong>There was no significant difference in the primary outcome: 6.20 ± 2.18 mg (10 mL Group) vs. 5 ± 0.00 mg (20 mL Group), P = 0.056. The time of first request of rescue morphine was significantly shorter in 10 mL Group (7.80 ± 3.98 hours) as compared to the 20 mL Group (13.23 ± 3.00 hours), P < 0.001. NRS at rest and movement in all time measurements was significantly higher in 10 mL Group.</p><p><strong>Conclusions: </strong>Bilateral mTLIP block using 40 mL of 0.25% bupivacaine (20 mL on each side) increased the postoperative total analgesic duration for lumbar spine surgeries, and was associated with a lower postoperative pain scores compared to 20 mL of 0.25% bupivacaine (10 mL on each side).</p><p><strong>Clinical trial registration id: </strong>The study was registered at clinicaltrials.gov (ID: NCT05276908) before patient's enrolment.</p>","PeriodicalId":7750,"journal":{"name":"Anaesthesiology intensive therapy","volume":"55 5","pages":"358-365"},"PeriodicalIF":1.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10801459/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139569577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Postoperative rhabdomyolysis due to neuroleptic malignant syndrome associated with droperidol and metoclopramide. 与屈培利多和甲氧氯普胺有关的神经性恶性综合征导致的术后横纹肌溶解症。
IF 1.7 Q2 ANESTHESIOLOGY Pub Date : 2023-01-01 DOI: 10.5114/ait.2023.132910
Guilherme di Camillo Orfali, Henrique Louzan Machado, Pamela Vieira Andrade, Joilson Moura Santos, Mary Santos Silva, José Luiz Gomes do Amaral, Helga Cristina Almeida da Silva
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引用次数: 0
Weaning patients off mechanical ventilation in a chronic ventilation facility – using a standardised approach 在慢性通气设施中使患者脱离机械通气-使用标准化方法
IF 1.7 Q2 ANESTHESIOLOGY Pub Date : 2022-11-14 DOI: 10.5114/ait.2022.121006
P. V. van Heerden, Eleonora Krugman, Estelle Bouhnish
Background We describe the standardised management of patients in a chronic ventilation facility (CVF) and the rate of weaning of chronically ventilated patients off mechanical ventilation. This population of patients is transferred from acute care facilities where they have been deemed “non-weanable” and require prolonged ventilation. Methods Admissions to our CVF were audited over a period of 3 years. We collected demographic and outcome data as well as the patients’ length of stay and disposition. Weaning in our centre proceeds step-wise with a reduction in the adaptive support ventilation (ASV) minute ventilation target. Once the target reaches 50% of minute ventilation, spontaneous breathing trials are introduced and progressively lengthened until the patient is weaned. Results In total, 125 patients were admitted during the 3 years. 109 were not weaned, and 16 were weaned, i.e. 12.8% of patients were safely weaned off mechanical ventilation. Of the patients not weaned, the mortality rate was 34.8%, and 38.5% were discharged alive to either home or another facility. Conclusions Weaning chronically ventilated patients is possible without intensivists or respiratory therapists on staff when a standardised approach/manner is implemented. However, weaning success appears to be mainly related to patients’ co-morbidities.
我们描述了慢性通气设施(CVF)患者的标准化管理和慢性通气患者脱离机械通气的脱机率。这些患者是从被认为“不能断奶”并需要长时间通气的急症护理机构转过来的。方法对我们CVF的入院进行为期3年的审计。我们收集了人口统计和结果数据,以及患者的住院时间和处置情况。在我们的中心,随着自适应支持通气(ASV)分钟通气目标的减少,逐步进行断奶。一旦目标达到每分钟通气的50%,就开始进行自主呼吸试验,并逐渐延长试验时间,直到患者脱机。结果3年内共收治125例患者。109例未脱机,16例脱机,即12.8%的患者安全脱机。在未断奶的患者中,死亡率为34.8%,38.5%的患者活着出院到家中或其他机构。结论:如果采用标准化的方法/方式,慢性通气患者可以在没有重症监护医师或呼吸治疗师的情况下脱机。然而,断奶成功似乎主要与患者的合并症有关。
{"title":"Weaning patients off mechanical ventilation in a chronic ventilation facility – using a standardised approach","authors":"P. V. van Heerden, Eleonora Krugman, Estelle Bouhnish","doi":"10.5114/ait.2022.121006","DOIUrl":"https://doi.org/10.5114/ait.2022.121006","url":null,"abstract":"Background We describe the standardised management of patients in a chronic ventilation facility (CVF) and the rate of weaning of chronically ventilated patients off mechanical ventilation. This population of patients is transferred from acute care facilities where they have been deemed “non-weanable” and require prolonged ventilation. Methods Admissions to our CVF were audited over a period of 3 years. We collected demographic and outcome data as well as the patients’ length of stay and disposition. Weaning in our centre proceeds step-wise with a reduction in the adaptive support ventilation (ASV) minute ventilation target. Once the target reaches 50% of minute ventilation, spontaneous breathing trials are introduced and progressively lengthened until the patient is weaned. Results In total, 125 patients were admitted during the 3 years. 109 were not weaned, and 16 were weaned, i.e. 12.8% of patients were safely weaned off mechanical ventilation. Of the patients not weaned, the mortality rate was 34.8%, and 38.5% were discharged alive to either home or another facility. Conclusions Weaning chronically ventilated patients is possible without intensivists or respiratory therapists on staff when a standardised approach/manner is implemented. However, weaning success appears to be mainly related to patients’ co-morbidities.","PeriodicalId":7750,"journal":{"name":"Anaesthesiology intensive therapy","volume":"54 1","pages":"285 - 289"},"PeriodicalIF":1.7,"publicationDate":"2022-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45839560","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
Effect of cannabis use on propofol requirement for ICU sedation 大麻使用对ICU镇静丙泊酚需求量的影响
IF 1.7 Q2 ANESTHESIOLOGY Pub Date : 2022-11-09 DOI: 10.5114/ait.2022.121002
Maryam Farasatinasab, Somayyeh Nasiripour, A. Aghabiklooei
1Department of Clinical Pharmacy, Clinical Research Development Centre (FCRDC), Iran University of Medical Sciences, Tehran, Iran 2Department of Clinical Pharmacy, Rasoul-e Akram Hospital, Iran University of Medical Sciences, Tehran, Iran 3Department of Legal Medicine and Toxicology, Clinical Research Development Centre (FCRDC), Iran University of Medical Sciences, Tehran, Iran LetterS to the editor
1伊朗德黑兰伊朗医学科学大学临床研究发展中心临床药学部2伊朗德黑兰伊朗医科大学Rasoul-e Akram医院临床药学部,伊朗给编辑的信
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引用次数: 0
期刊
Anaesthesiology intensive therapy
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