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Impact of preoperative oral domperidone on gastric residual volume after clear fluid ingestion in patients scheduled for elective surgery: a randomized controlled trial. 术前口服多潘立酮对择期手术患者摄入清流液后胃残余容积的影响:随机对照试验。
IF 1.6 Q2 ANESTHESIOLOGY Pub Date : 2023-01-01 DOI: 10.5114/ait.2023.134221
Sherif S Sultan, Ahmed Abdelhamid Deabes, Gamal Eldin M Elewa, Amin Mohamed Alansary

Introduction: Oral domperidone is a prokinetic drug that enhances gastric emptying, which has a positive effect in decreasing gastric residual volume (GRV), subsequently decreasing the risk of pulmonary aspiration. This study aimed to assess the effect of preoperative oral domperidone on gastric residual volume, detected by ultrasound for patients undergoing elective surgery under general anesthesia.

Material and methods: This randomized double-blinded controlled placebo trial was conducted in 40 patients who were randomly assigned to two equal groups: the domperidone group (D) ( n = 20): patients received 400 mL of apple juice as a clear fluid, two hours preoperatively, and an oral domperidone 10 mg tablet; and the placebo group (P) ( n = 20): patients received 400 mL of apple juice as a clear fluid two hours preoperatively with a placebo tablet. Gastric residual volume detected by ultrasound was the primary outcome and postoperative nausea and vomiting (PONV) was the secondary outcome.

Results: There was no statistically significant difference in the mean gastric residual volume detected by ultrasound between groups after 1 hour ( P > 0.05). However, the mean gastric residual volume detected by ultrasound after 2 hours was statistically significantly lower with domperidone (55.95 ± 6.72 mL) than with the placebo group (70.22 ± 13.00 mL) ( P < 0.05). There was no statistically significant difference between groups regarding PONV, with a P -value > 0.05.

Conclusions: Preoperative oral domperidone intake was effective in decreasing the GRV measured by ultrasound.

简介口服多潘立酮是一种促动力药物,可促进胃排空,对减少胃残余容积(GRV)有积极作用,从而降低肺吸入风险。本研究旨在评估在全身麻醉下接受择期手术的患者术前口服多潘立酮对超声检测胃残余容积的影响:这项随机双盲对照安慰剂试验在 40 名患者中进行,他们被随机分配到两个相同的组别:多潘立酮组(D)(n = 20):患者在术前两小时接受 400 毫升苹果汁作为清水,并口服多潘立酮 10 毫克片剂;安慰剂组(P)(n = 20):患者在术前两小时接受 400 毫升苹果汁作为清水,并口服安慰剂片剂。超声检测胃剩余容积为主要结果,术后恶心和呕吐(PONV)为次要结果:超声检测到的平均胃残余容积在 1 小时后的组间差异无统计学意义(P > 0.05)。然而,多潘立酮组(55.95 ± 6.72 mL)与安慰剂组(70.22 ± 13.00 mL)相比,2 小时后超声检测到的平均胃残余容积在统计学上明显较低(P < 0.05)。在 PONV 方面,组间差异无统计学意义(P 值 > 0.05):结论:术前口服多潘立酮能有效降低超声测量的GRV。
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引用次数: 0
Management of tracheo-innominate artery fistula in the challenging environment of an improvised COVID-19 intensive care unit. 在简易 COVID-19 重症监护病房的艰难环境中处理气管-腹股沟动脉瘘。
IF 1.7 Q2 ANESTHESIOLOGY Pub Date : 2023-01-01 DOI: 10.5114/ait.2023.132916
Kristina Krzelj, Zeljko Duric, Ivan Situm, Dora Karmelic, Ante Erceg, Kristina Kljajic, Mirabel Mazar, Hrvoje Gasparovic, Daniel Lovric
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引用次数: 0
Pheochromocytoma-induced takotsubo syndrome: what does an intensivist need to know? 嗜铬细胞瘤诱导的takotsubo综合征:强化医师需要知道什么?
Q2 ANESTHESIOLOGY Pub Date : 2023-01-01 DOI: 10.5114/ait.2023.132526
Kenan Yalta
AMA Yalta K. Pheochromocytoma-induced takotsubo syndrome: what does an intensivist need to know?. Anaesthesiology Intensive Therapy. 2023. doi:10.5114/ait.2023.132526. APA Yalta, K. (2023). Pheochromocytoma-induced takotsubo syndrome: what does an intensivist need to know?. Anaesthesiology Intensive Therapy. https://doi.org/10.5114/ait.2023.132526 Chicago Yalta, Kenan. 2023. "Pheochromocytoma-induced takotsubo syndrome: what does an intensivist need to know?". Anaesthesiology Intensive Therapy. doi:10.5114/ait.2023.132526. Harvard Yalta, K. (2023). Pheochromocytoma-induced takotsubo syndrome: what does an intensivist need to know?. Anaesthesiology Intensive Therapy. https://doi.org/10.5114/ait.2023.132526 MLA Yalta, Kenan. "Pheochromocytoma-induced takotsubo syndrome: what does an intensivist need to know?." Anaesthesiology Intensive Therapy, 2023. doi:10.5114/ait.2023.132526. Vancouver Yalta K. Pheochromocytoma-induced takotsubo syndrome: what does an intensivist need to know?. Anaesthesiology Intensive Therapy. 2023. doi:10.5114/ait.2023.132526.
嗜铬细胞瘤诱导的takotsubo综合征:强化医师需要知道什么?麻醉学强化治疗。2023。doi: 10.5114 / ait.2023.132526。APA Yalta, K.(2023)。嗜铬细胞瘤诱导的takotsubo综合征:强化医师需要知道什么?麻醉学强化治疗。https://doi.org/10.5114/ait.2023.132526芝加哥,雅尔塔,凯南,2023。“嗜铬细胞瘤诱发的takotsubo综合征:强化医生需要知道什么?”麻醉学强化治疗。doi: 10.5114 / ait.2023.132526。哈佛雅尔塔,K.(2023)。嗜铬细胞瘤诱导的takotsubo综合征:强化医师需要知道什么?麻醉学强化治疗。https://doi.org/10.5114/ait.2023.132526凯南雅尔塔MLA。嗜铬细胞瘤诱导的takotsubo综合征:强化医师需要知道什么?麻醉学强化治疗,2023。doi: 10.5114 / ait.2023.132526。嗜铬细胞瘤诱导的takotsubo综合征:强化医生需要知道什么?麻醉学强化治疗。2023。doi: 10.5114 / ait.2023.132526。
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引用次数: 1
Ideal endotracheal intubation depth at the vocal-cord level to avoid single-lung intubation using the percentage ratio of the tracheal length to body height. 理想的气管插管深度在声带水平,以避免单肺插管使用气管长度与身体高度的百分比。
IF 1.7 Q2 ANESTHESIOLOGY Pub Date : 2023-01-01 DOI: 10.5114/ait.2023.125332
Tomohiro Yamamoto, Ehrenfried Schindler

Introduction: Our previous study revealed racial differences in the tracheal length of cardiac paediatric patients between Germany and Japan. The current study was conducted in two stages, aiming to determine whether the tracheal length differs between cardiac and non-cardiac paediatric patients and whether the results could also be generalised to adults.

Material and methods: The first stage was a retrospective observational evaluation of 335 cardiac and 275 non-cardiac paediatric patients in Japan. The tracheal length, the distance between the vocal cords and carina tracheae, was measured on preoperative chest radiographs taken in the supine position. The second stage was a validation process including 308 Japanese patients. Endotracheal intubation was performed based on the results of the first-stage investigation.

Results: It was revealed that the tracheal length ranged from 7 to 11% of the body height in both the cardiac and non-cardiac Japanese paediatric patients. None of 308 Japanese paediatric and adult patients underwent single-lung intubation after the endotracheal tube was inserted at a depth of 7% of the body height at the vocal-cord level, corresponding to the minimum tracheal length for Japanese patients. The distance between the endotracheal tube tip and carina tracheae on postoperative chest radiographs was generally less than 4% of the body height across all paediatric and adult Japanese patients.

Conclusions: The current study demonstrated that endotracheal intubation avoiding single-lung intubation can be achieved by inserting endotracheal tubes to the minimum tracheal length for a specific ethnic group at the vocal-cord level in paediatric patients, including neonates and premature infants, as well as adults.

我们之前的研究揭示了德国和日本在心脏病患儿气管长度上的种族差异。目前的研究分两个阶段进行,旨在确定心脏病和非心脏病患儿的气管长度是否不同,以及结果是否也可以推广到成人。材料和方法:第一阶段是对日本335例心脏病和275例非心脏病患儿的回顾性观察性评估。在术前仰卧位胸片上测量气管长度,即声带与气管隆突之间的距离。第二阶段是包括308名日本患者在内的验证过程。根据第一阶段的调查结果进行气管插管。结果:日本心脏病和非心脏病患儿的气管长度均为身高的7% ~ 11%。308名日本儿童和成人患者在声带水平插入气管内管深度为身体高度的7%(对应于日本患者的最小气管长度)后,没有一例接受单肺插管。在所有日本儿童和成人患者中,术后胸片上气管插管尖端与隆突气管之间的距离通常小于身高的4%。结论:目前的研究表明,对于特定种族的儿童患者,包括新生儿和早产儿,以及成人,在声带水平插入气管插管至最小气管长度,可以实现气管插管避免单肺插管。
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引用次数: 0
Heart rate variability in anaesthesiology - narrative review. 麻醉中的心率变异性-叙述综述。
IF 1.7 Q2 ANESTHESIOLOGY Pub Date : 2023-01-01 DOI: 10.5114/ait.2023.126309
Magdalena Wujtewicz, Radoslaw Owczuk

Heart rate variability (HRV) is a measure that shows the variation in time between consecutive heartbeats - a physiological phenomenon controlled by the autonomic nervous system. Over the years the analysis of this parameter has been used in many fields of medicine, including anaesthesiology, for scientific and research purposes. We carried out a review of the available literature on the applicability of HRV assessment in anaesthesiology. Several potential applications of HRV in clinical anaesthesia have been identified and proven feasible. As a non-invasive and relatively easy method to gauge the autonomic nervous system, HRV analysis can provide the anaesthesiologist with additional datapoints, potentially useful in assessing efficacy of a blockade and adequacy of analgesia, and in predicting adverse events. However, interpretation of HRV and generalizability of research findings can be problematic due to the multiplicity of factors that influence this parameter and bias in methods introduced by the researchers.

心率变异性(HRV)是一种显示连续心跳之间时间变化的测量方法——一种由自主神经系统控制的生理现象。多年来,该参数的分析已用于医学的许多领域,包括麻醉学,用于科学和研究目的。我们对现有的关于麻醉学中HRV评估的适用性的文献进行了回顾。HRV在临床麻醉中的几个潜在应用已经被确定并证明是可行的。作为一种测量自主神经系统的非侵入性和相对简单的方法,心率波动分析可以为麻醉师提供额外的数据点,在评估阻滞的有效性和镇痛的充分性以及预测不良事件方面可能有用。然而,由于影响HRV参数的多种因素和研究人员引入的方法存在偏差,对HRV的解释和研究结果的普遍性可能存在问题。
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引用次数: 2
Conventional fluid management versus plethysmographic variability index-based goal directed fluid management in patients undergoing spine surgery in the prone position - a randomised control trial. 在俯卧位接受脊柱手术的患者中,传统的液体管理与基于体积描记变异指数的目标导向液体管理——一项随机对照试验。
IF 1.7 Q2 ANESTHESIOLOGY Pub Date : 2023-01-01 DOI: 10.5114/ait.2023.130792
Bassant Abdelhamid, Marina Matta, Ashraf Rady, George Adel, Medhat Gamal

Introduction: The plethysmographic variability index (PVI) is a dynamic approach for assessing volume status. This study aims to compare conventional fluid management and PVI based goal-directed fluid management (GDFM) during elective spine surgery in the prone position.

Material and methods: Sixty-six adult patients, ASA I-II, scheduled for elective lumbar spine procedures under general anaesthesia in the prone position were included. Patients were randomly divided into either the Conventional Group with the conventional fluid management protocol or the PVI Group with the PVI-based GDFM protocol. The total amount of intraoperative crystalloid administered was set as a primary outcome. Intraoperative PVI and perfusion index (PI), mean arterial pressure (MAP), heart rate (HR), the incidence of hypotension after prone positioning in both groups and data from arterial blood gas samples (immediately after induction of anaesthesia [T1] and immediately postoperatively [T2]) were set as secondary outcomes.

Results: The total amount of intraoperative crystalloids, blood transfusion, urine output, and fluid balance were similar in the two groups ( P -values 0.443, 0.317 and 0.273, respectively). The perioperative MAP and HR values showed no significant differences between the two groups at all time points of measurements. The values of pH, PaO 2 , PaCO 2 , HCO 3 , lactate and haemoglobin showed no statistically significant difference between the two groups. The blood lactate value at T2 was significantly increased when compared to T1 values in the two groups.

Conclusions: PVI dependent goal-directed fluid management (GDFM) therapy did not reduce the intraoperative total crystalloid administration or requirements for blood transfusion when compared to conventional fluid management using a fixed fluid rate in patients undergoing spine surgery in a prone position. Clinical trial registration: The study was registered at clinicaltrials.gov (NCT05239286).

简介:体积描记变异指数(PVI)是一种评估体积状态的动态方法。本研究旨在比较俯卧位脊柱选择性手术中传统的液体管理和基于PVI的目标导向液体管理(GDFM)。材料和方法:纳入了66名ASA I-II成年患者,他们计划在俯卧位全身麻醉下进行选择性腰椎手术。患者被随机分为采用常规液体管理方案的常规组或采用基于PVI的GDFM方案的PVI组。术中给予的晶体总量被设定为主要结果。术中PVI和灌注指数(PI)、平均动脉压(MAP)、心率(HR)、两组俯卧位后低血压的发生率以及动脉血气样本数据(麻醉诱导后即刻[T1]和术后即刻[T2])被设定为次要结果。结果:两组术中晶体总量、输血量、尿量和液体平衡相似(P值分别为0.443、0.317和0.273)。两组围手术期MAP和HR值在所有测量时间点均无显著差异。pH值、PaO2、PaCO2、HCO3、乳酸和血红蛋白在两组间无统计学意义。与两组中的T1值相比,T2时的血液乳酸值显著增加。结论:在俯卧位接受脊柱手术的患者中,PVI依赖性目标导向液体管理(GDFM)治疗与使用固定液体速率的传统液体管理相比,并没有减少术中总晶体给药或输血需求。临床试验注册:该研究在clinicaltrials.gov上注册(NCT052392286)。
{"title":"Conventional fluid management versus plethysmographic variability index-based goal directed fluid management in patients undergoing spine surgery in the prone position - a randomised control trial.","authors":"Bassant Abdelhamid,&nbsp;Marina Matta,&nbsp;Ashraf Rady,&nbsp;George Adel,&nbsp;Medhat Gamal","doi":"10.5114/ait.2023.130792","DOIUrl":"https://doi.org/10.5114/ait.2023.130792","url":null,"abstract":"<p><strong>Introduction: </strong>The plethysmographic variability index (PVI) is a dynamic approach for assessing volume status. This study aims to compare conventional fluid management and PVI based goal-directed fluid management (GDFM) during elective spine surgery in the prone position.</p><p><strong>Material and methods: </strong>Sixty-six adult patients, ASA I-II, scheduled for elective lumbar spine procedures under general anaesthesia in the prone position were included. Patients were randomly divided into either the Conventional Group with the conventional fluid management protocol or the PVI Group with the PVI-based GDFM protocol. The total amount of intraoperative crystalloid administered was set as a primary outcome. Intraoperative PVI and perfusion index (PI), mean arterial pressure (MAP), heart rate (HR), the incidence of hypotension after prone positioning in both groups and data from arterial blood gas samples (immediately after induction of anaesthesia [T1] and immediately postoperatively [T2]) were set as secondary outcomes.</p><p><strong>Results: </strong>The total amount of intraoperative crystalloids, blood transfusion, urine output, and fluid balance were similar in the two groups ( P -values 0.443, 0.317 and 0.273, respectively). The perioperative MAP and HR values showed no significant differences between the two groups at all time points of measurements. The values of pH, PaO 2 , PaCO 2 , HCO 3 , lactate and haemoglobin showed no statistically significant difference between the two groups. The blood lactate value at T2 was significantly increased when compared to T1 values in the two groups.</p><p><strong>Conclusions: </strong>PVI dependent goal-directed fluid management (GDFM) therapy did not reduce the intraoperative total crystalloid administration or requirements for blood transfusion when compared to conventional fluid management using a fixed fluid rate in patients undergoing spine surgery in a prone position. Clinical trial registration: The study was registered at clinicaltrials.gov (NCT05239286).</p>","PeriodicalId":7750,"journal":{"name":"Anaesthesiology intensive therapy","volume":"55 3","pages":"186-195"},"PeriodicalIF":1.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e7/41/AIT-55-51314.PMC10496101.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41108285","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
Comparison of intranasal dexmedetomidine-midazolam, dexmedetomidine-ketamine, and midazolam-ketamine for premedication in paediatric patients: a double-blinded randomized trial. 右美托咪定-咪达唑仑、右美托咪定-氯胺酮和咪达唑仑-氯胺酮在儿科患者用药前的比较:一项双盲随机试验。
IF 1.7 Q2 ANESTHESIOLOGY Pub Date : 2023-01-01 DOI: 10.5114/ait.2023.129276
Vaishnavi Bd, Shilpa Goyal, Ankur Sharma, Nikhil Kothari, Narendra Kaloria, Priyanka Sethi, Pradeep Bhatia

Background: Paediatric patients are a population with a high level of anxiety. The prevention of perioperative stress in a frightened child is important to render the child calm and cooperative for smoother induction. Intranasal premedication is easy and safe, and the drug is rapidly absorbed into the systemic circulation, ensuring early onset of sedation in children and good effectiveness.

Methods: 150 patients in the age group 2-4 years, ASA class I, undergoing elective surgical procedures were enrolled. The patients were randomly divided into 3 groups: a DM group (receiving intranasal dexmedetomidine 1 µg kg -1 and midazolam 0.12 mg kg -1 ), a DK group (receiving intranasal dexmedetomidine 1 µg kg -1 and keta-mine 2 mg kg -1 ), and an MK group (receiving intranasal midazolam 0.12 mg kg -1 and ketamine 2 mg kg -1 ). After 30 minutes of administration of the drugs, the patients were assessed for parent separation anxiety, sedation, ease of IV cannulation, and mask acceptance.

Results: The comparison among the 3 groups showed a statistically significant difference for ease of IV cannulation and mask acceptance at 30 minutes, with a P -value of 0.010 with CI of 0.0-0.02, and P -value 0.007 with CI 0.0-0.02, respectively. The parent separation anxiety and sedation score at 30 minutes was statistically insignificant with a P -value of 0.82 with CI of 0.03-0.14 and P -value 0.631 with CI of 0.38-0.58, respectively.

Conclusions: The combination of midazolam and ketamine had a better clinical profile for premedication as compared to other combination drugs used in our study in terms of IV cannulation and acceptance of masks with a comparable decrease in separation anxiety from parents and adequate sedation.

背景:儿科患者是一个焦虑水平较高的人群。预防围手术期的应激对受惊儿童的镇静和配合诱导是很重要的。鼻内预用药简便、安全,药物迅速被体循环吸收,确保儿童镇静起效早、效果好。方法:选取150例年龄2 ~ 4岁ASA I级择期手术患者。将患者随机分为3组:DM组(右美托咪定1µg kg -1,咪达唑仑0.12 mg kg -1), DK组(右美托咪定1µg kg -1,酮胺酮2 mg kg -1), MK组(咪达唑仑0.12 mg kg -1,氯胺酮2 mg kg -1)。给药30分钟后,评估患者的父母分离焦虑、镇静程度、静脉插管难易程度和口罩接受程度。结果:三组比较,30分钟静脉插管难易度和口罩接受度差异有统计学意义,P值分别为0.010,CI为0.0 ~ 0.02;P值分别为0.007,CI为0.0 ~ 0.02。30分钟父母分离焦虑和镇静评分P值为0.82,CI为0.03 ~ 0.14,P值为0.631,CI为0.38 ~ 0.58,差异均无统计学意义。结论:咪达唑仑与氯胺酮联用在用药前的临床表现优于本研究中使用的其他联用药物,在静脉插管和口罩接受方面,与父母分离焦虑的减少和足够的镇静程度相当。
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引用次数: 0
WHO Surgical Safety Checklist and Anesthesia Equipment Checklist efficacy in war-affected low-resource settings: a prospective two-arm multicenter study 世界卫生组织手术安全检查表和麻醉设备检查表在受战争影响的低资源环境中的有效性:一项前瞻性的两组多中心研究
Q2 ANESTHESIOLOGY Pub Date : 2023-01-01 DOI: 10.5114/ait.2023.132531
Kateryna Bielka, Iurii Kuchyn, Michael Frank, Ihor Sirenko, Uliana Kashchii, Artem Yurovich, Hanna Fomina, Ivan Lisnyy, Nataliia Semenko
AMA Bielka K, Kuchyn I, Frank M, et al. WHO Surgical Safety Checklist and Anesthesia Equipment Checklist efficacy in war-affected low-resource settings: a prospective two-arm multicenter study. Anaesthesiology Intensive Therapy. 2023. doi:10.5114/ait.2023.132531. APA Bielka, K., Kuchyn, I., Frank, M., Sirenko, I., Kashchii, U., & Yurovich, A. et al. (2023). WHO Surgical Safety Checklist and Anesthesia Equipment Checklist efficacy in war-affected low-resource settings: a prospective two-arm multicenter study. Anaesthesiology Intensive Therapy. https://doi.org/10.5114/ait.2023.132531 Chicago Bielka, Kateryna, Iurii Kuchyn, Michael Frank, Ihor Sirenko, Uliana Kashchii, Artem Yurovich, and Hanna Fomina et al. 2023. "WHO Surgical Safety Checklist and Anesthesia Equipment Checklist efficacy in war-affected low-resource settings: a prospective two-arm multicenter study". Anaesthesiology Intensive Therapy. doi:10.5114/ait.2023.132531. Harvard Bielka, K., Kuchyn, I., Frank, M., Sirenko, I., Kashchii, U., Yurovich, A., Fomina, H., Lisnyy, I., and Semenko, N. (2023). WHO Surgical Safety Checklist and Anesthesia Equipment Checklist efficacy in war-affected low-resource settings: a prospective two-arm multicenter study. Anaesthesiology Intensive Therapy. https://doi.org/10.5114/ait.2023.132531 MLA Bielka, Kateryna et al. "WHO Surgical Safety Checklist and Anesthesia Equipment Checklist efficacy in war-affected low-resource settings: a prospective two-arm multicenter study." Anaesthesiology Intensive Therapy, 2023. doi:10.5114/ait.2023.132531. Vancouver Bielka K, Kuchyn I, Frank M, Sirenko I, Kashchii U, Yurovich A et al. WHO Surgical Safety Checklist and Anesthesia Equipment Checklist efficacy in war-affected low-resource settings: a prospective two-arm multicenter study. Anaesthesiology Intensive Therapy. 2023. doi:10.5114/ait.2023.132531.
张建军,张建军,张建军,等。世界卫生组织手术安全检查表和麻醉设备检查表在受战争影响的低资源环境中的有效性:一项前瞻性两组多中心研究。麻醉学强化治疗。2023。doi: 10.5114 / ait.2023.132531。APA Bielka, K., Kuchyn, I., Frank, M., Sirenko, I., Kashchii, U., & Yurovich, A.等(2023)。世界卫生组织手术安全检查表和麻醉设备检查表在受战争影响的低资源环境中的有效性:一项前瞻性两组多中心研究。麻醉学强化治疗。https://doi.org/10.5114/ait.2023.132531 Chicago Bielka, Kateryna, urii Kuchyn, Michael Frank, Ihor Sirenko, Uliana Kashchii, Artem Yurovich, and Hanna Fomina等。2023。“世卫组织手术安全清单和麻醉设备清单在受战争影响的低资源环境中的有效性:一项前瞻性两组多中心研究”。麻醉学强化治疗。doi: 10.5114 / ait.2023.132531。哈佛Bielka, K., Kuchyn, I., Frank, M., Sirenko, I., Kashchii, U., Yurovich, A., formina, H., Lisnyy, I.和Semenko, N.(2023)。世界卫生组织手术安全检查表和麻醉设备检查表在受战争影响的低资源环境中的有效性:一项前瞻性两组多中心研究。麻醉学强化治疗。https://doi.org/10.5114/ait.2023.132531 MLA Bielka, Kateryna等。“世界卫生组织手术安全清单和麻醉设备清单在受战争影响的低资源环境中的有效性:一项前瞻性的两组多中心研究。”麻醉学强化治疗,2023。doi: 10.5114 / ait.2023.132531。Vancouver Bielka K, Kuchyn I, Frank M, Sirenko I, Kashchii U, Yurovich A等。世界卫生组织手术安全检查表和麻醉设备检查表在受战争影响的低资源环境中的有效性:一项前瞻性两组多中心研究。麻醉学强化治疗。2023。doi: 10.5114 / ait.2023.132531。
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引用次数: 0
The efficacy of ultrasound-guided triple nerve block (ilioinguinal, iliohypogastric, and genitofemoral) versus unilateral subarachnoid block for inguinal hernia surgery in adults: a randomized controlled trial. 成人腹股沟疝手术中超声引导三神经阻滞(髂腹股沟神经、髂腹股沟神经和股生殖神经)与单侧蛛网膜下腔阻滞的疗效:随机对照试验。
IF 1.6 Q2 ANESTHESIOLOGY Pub Date : 2023-01-01 DOI: 10.5114/ait.2023.134277
Gagan Preet Singh, Gaurav Kuthiala, Anupam Shrivastava, Deepika Gupta, Ritul Mehta

Introduction: The present study was carried out to evaluate the efficacy of ultrasound-guided triple nerve block (ilioinguinal, iliohypogastric, and genitofemoral) versus unilateral subarachnoid block for adult male patients undergoing unilateral inguinal hernia surgery.

Material and methods: Sixty ASA I-III adult male patients > 18 years old, scheduled for unilateral inguinal hernia surgery were randomly allocated into 2 groups of 30 patients each. In Group A ( n = 30) the patients received ultrasound-guided nerve block (ilioinguinal, iliohypogastric, and genitofemoral), and in Group B ( n = 30) the patients received unilateral subarachnoid block. The primary outcome was to assess postoperative analgesic efficacy (visual analogue scale [VAS] scores at rest and during coughing/ambulation). The secondary outcomes were time to first rescue analgesia with morphine, the total dose of morphine used as rescue analgesia, urinary retention, time to first micturition, time to first unassisted walking, and time to discharge from the surgical recovery room.

Results: The mean pain scores at 1, 2, 4, and 6 hours during rest and during coughing/ambulation were significantly lower in Group A when compared to patients in Group B ( P < 0.001). There was no requirement for rescue analgesic opioids in Group A ( P < 0.001). Mean time to first micturition and mobilization occurred earlier in Group A, leading to early discharge from the recovery room ( P < 0.001). No major side effects were observed in any of the study groups.

Conclusions: Ultrasound-guided triple nerve block technique can be used as a sole anaesthetic technique for inguinal hernia surgery because it not only provides optimal anaesthesia intra-operatively but also has a favourable analgesic and opioid-sparing efficacy in the early postoperative period with minimal adverse effects.

导言本研究旨在评估在超声引导下对接受单侧腹股沟疝手术的成年男性患者进行三神经阻滞(髂腹股沟、髂腹股沟和股生殖)与单侧蛛网膜下腔阻滞的疗效:将 60 名 ASA I-III 级、年龄大于 18 岁、计划接受单侧腹股沟疝手术的成年男性患者随机分为两组,每组 30 人。A 组(30 人)患者接受超声引导下的神经阻滞(髂腹股沟神经、髂腹下胃神经和股生殖神经),B 组(30 人)患者接受单侧蛛网膜下腔阻滞。主要结果是评估术后镇痛效果(休息时和咳嗽/行走时的视觉模拟量表[VAS]评分)。次要结果是首次使用吗啡镇痛的时间、用于镇痛的吗啡总剂量、尿潴留、首次排尿时间、首次无助行走时间以及从手术恢复室出院的时间:与 B 组患者相比,A 组患者在 1、2、4 和 6 小时休息和咳嗽/行走时的平均疼痛评分明显较低(P < 0.001)。A 组患者无需使用阿片类镇痛药(P < 0.001)。A 组患者首次排尿和活动的平均时间更早,因此更早离开恢复室(P < 0.001)。所有研究组均未观察到严重的副作用:结论:超声引导下的三神经阻滞技术可作为腹股沟疝手术的唯一麻醉技术,因为它不仅能提供最佳的术中麻醉效果,而且在术后早期具有良好的镇痛和阿片类药物稀释效果,不良反应极小。
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引用次数: 0
Anaesthesia in  SARS-CoV-2 infected children - single-centre experience. A case-control study. 麻醉  严重急性呼吸系统综合征冠状病毒2型感染儿童-单中心体验。病例对照研究。
IF 1.7 Q2 ANESTHESIOLOGY Pub Date : 2023-01-01 DOI: 10.5114/ait.2023.130791
Tomasz Jarymowicz, Artur Baranowski, Justyna Pietrzyk, Izabela Pągowska-Klimek

Introduction: Although manifestation of SARS-CoV-2 infection in children is gene-rally mild or asymptomatic, anaesthetic implications of the infection in children are still a matter of concern. Single reports suggest that patients with SARS-CoV-2 infection are at higher risk of anaesthetic complications.

Material and methods: We performed a retrospective, case control study analysing the risk of general anaesthesia in SARS-CoV-2 infected children admitted to a tertiary paediatric university hospital for the purpose of urgent procedures requiring anaesthesia  between April 1st and September 30 th , 2021. The control group consisted of  SARS-CoV-2 negative children consecutively anaesthetised for the same reasons during the first month of observation. Our hypothesis was: general anaesthesia can be safely performed in SARS-CoV-2 infected children. Study endpoints: primary - anaesthetic respiratory complications (bronchospasm, laryngospasm, intraoperative desaturation below 94%, desaturation below 94% after awakening, unplanned postoperative mechanical ventilation); secondary - hospital length of stay, thrombotic, cardiac, haemorrhagic events, ICU admission, deaths during hospitalisation.

Results: The examined group consisted of 58 SARS-CoV-2 infected children, the matched control group of 198 patients. The rate of complications in both groups was very low, with no significant difference between the groups. The only differences observed were a higher frequency of desaturations in the awakening period and longer time of hospitalisation in SARS-CoV-2 infected patients. Multivariate logistic regression analysis showed that physical status of the patient and duration of the procedure were the main factors influencing the risk of complications.

Conclusions: In our experience anaesthesia of SARS-CoV-2 infected children can be safely performed.

引言:尽管儿童严重急性呼吸系统综合征冠状病毒2型感染的表现在基因上是轻微的或无症状的,但儿童感染的麻醉影响仍然令人担忧。单一报告表明,严重急性呼吸系统综合征冠状病毒2型感染患者出现麻醉并发症的风险更高。材料和方法:我们进行了一项回顾性病例对照研究,分析了因需要麻醉的紧急手术而入住三级儿科大学医院的严重急性呼吸系统综合征冠状病毒2型感染儿童全身麻醉的风险  2021年4月1日至9月30日。对照组包括  在观察的第一个月,严重急性呼吸系统综合征冠状病毒2型阴性儿童因相同原因连续麻醉。我们的假设是:全身麻醉可以安全地在感染严重急性呼吸系统综合征冠状病毒2型的儿童中进行。研究终点:初次麻醉呼吸系统并发症(支气管痉挛、喉痉挛、术中饱和度低于94%、苏醒后饱和度低于94%,术后无计划机械通气);二级-住院时间、血栓性疾病、心脏病、出血事件、ICU入院、住院期间死亡。结果:检查组包括58名严重急性呼吸系统综合征冠状病毒2型感染儿童,匹配的对照组包括198名患者。两组的并发症发生率都很低,两组之间没有显著差异。观察到的唯一差异是严重急性呼吸系统综合征冠状病毒2型感染患者在苏醒期的去饱和频率更高,住院时间更长。多因素logistic回归分析显示,患者的身体状况和手术时间是影响并发症风险的主要因素。结论:根据我们的经验,对感染严重急性呼吸系统综合征冠状病毒2型的儿童进行麻醉是安全的。
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引用次数: 0
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Anaesthesiology intensive therapy
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