Major monitoring and cardiac output during cesarean delivery
(Source: Journal of Anesthesia)
Source: Journal of Anesthesia - January 15, 2022 Category: Anesthesiology Source Type: research

The impact of intraoperative blood pressure variability on the risk of postoperative adverse outcomes in non-cardiac surgery: a systematic review
AbstractHemodynamic stability during surgery seems to account for positive postoperative outcomes in patients. However, little is known about the impact of intraoperative blood pressure variability (IBPV) on the postoperative complications. The aim was to investigate whether IBPV is associated with the development of postoperative complications and what is the nature of this association. We conducted a systematic search in PubMed, Medical Subject Headings, Embase, Web of Science, SCOPUS, clinicaltrials.gov, and Cochrane Library on the 8th of April, 2021. We included studies that only focused on adults who underwent primari...
Source: Journal of Anesthesia - January 13, 2022 Category: Anesthesiology Source Type: research

Differential effects of remimazolam and propofol on heart rate variability during anesthesia induction
ConclusionRemimazolam and propofol decreased autonomic nervous activity during anesthesia induction. Remimazolam preserved the balance of sympathetic and parasympathetic activities, while propofol modulated it to sympathetic dominance. (Source: Journal of Anesthesia)
Source: Journal of Anesthesia - January 13, 2022 Category: Anesthesiology Source Type: research

Risk factors of cardiac arrest and failure to achieve return of spontaneous circulation during anesthesia: a 20-year retrospective observational study from a tertiary care university hospital
ConclusionBlood loss was the most common cause of cardiac arrest and blood loss-induced cardiac arrest was independently associated with failure to achieve ROSC. Further improvements in treatment strategies for bleeding may reduce the future incidence of cardiac arrest and death during anesthesia. (Source: Journal of Anesthesia)
Source: Journal of Anesthesia - January 10, 2022 Category: Anesthesiology Source Type: research

Neurological sedative indicators during general anesthesia with remimazolam
ConclusionsProcessed electroencephalograms (BIS and PSI), and SEF of BIS ® were relatively high during anesthesia with remimazolam, but SEF of Sedline® or pupillary diameter could be a supportive indicator to confirm sedation level during remimazolam anesthesia. (Source: Journal of Anesthesia)
Source: Journal of Anesthesia - January 9, 2022 Category: Anesthesiology Source Type: research

Global research trends in perioperative care for the elderly: a bibliometric and visualized study
ConclusionsThe number of studies on perioperative care for the elderly has increased apparently worldwide. Postoperative cognitive dysfunction and postoperative delirium remain primary research focus areas. Organ function protection appears to be the second most highly researched topic in the perioperative care for the elderly. (Source: Journal of Anesthesia)
Source: Journal of Anesthesia - January 7, 2022 Category: Anesthesiology Source Type: research

Cardiac surgery improves the postoperative frailty score of frail patients
This study included 71 patients over 65  years old who were scheduled for cardiac surgery via sternotomy or thoracotomy. Frailty was prospectively evaluated using the Kihon Checklist (KCL) at 1 and 3 months postoperatively. Patients were divided into three groups based on the preoperative KCL score: nonfrail, prefrail, and frail. The in teraction between the degree of preoperative frailty and the trajectory of postoperative KCL scores was assessed.ResultsThe KCL score changed significantly over time (P 
Source: Journal of Anesthesia - January 4, 2022 Category: Anesthesiology Source Type: research

Correction to: Association between intraoperative hyperglycemia and postoperative end-organ dysfunctions after cardiac surgery: a retrospective observational study
In the original publication of the article, second affiliation was not tagged to corresponding author and affiliations are correctly tagged in this correction. (Source: Journal of Anesthesia)
Source: Journal of Anesthesia - December 4, 2021 Category: Anesthesiology Source Type: research

Peripheral nerve block use in ankle arthroplasty and ankle arthrodesis: utilization patterns and impact on outcomes
ConclusionPNB utilization is associated with substantial reductions in opioid utilization, particularly in the inpatient setting. Our study is in support of a wider use of this analgesic technique, which may translate into more benefits in terms of clinical outcomes and resource utilization.Level of EvidenceIII. (Source: Journal of Anesthesia)
Source: Journal of Anesthesia - November 21, 2021 Category: Anesthesiology Source Type: research

Oral acetaminophen as an adjunct to continuous epidural infusion and patient-controlled epidural analgesia in laboring parturients: a randomized controlled trial
ConclusionThe use of 1  g of oral acetaminophen could be a cheap, safe, and effective adjunct to CEI plus PCEA in labor analgesia. (Source: Journal of Anesthesia)
Source: Journal of Anesthesia - November 21, 2021 Category: Anesthesiology Source Type: research

Oxygen therapy for critically Ill and post-operative patients
AbstractNearly all patients receiving treatment in a peri-operative or intensive care setting receive supplemental oxygen therapy. It is biologically plausible that the dose of oxygen used might affect important patient outcomes. Most peri-operative research has focussed on oxygen regimens that target higher than normal blood oxygen levels. Whereas, intensive care research has mostly focussed on conservative oxygen regimens which assiduously avoid exposure to higher than normal blood oxygen levels. While such conservative oxygen therapy is preferred for spontaneously breathing patients with chronic obstructive pulmonary di...
Source: Journal of Anesthesia - November 21, 2021 Category: Anesthesiology Source Type: research

Postoperative neurological complications after brachial plexus block: a retrospective study conducted at a teaching hospital
ConclusionsThis survey suggests that complications after ultrasound-guided BPB, including blocks performed by trainees, are uncommon.Trial registrationClinicaltrials.gov ID: NCT04451642. (Source: Journal of Anesthesia)
Source: Journal of Anesthesia - November 21, 2021 Category: Anesthesiology Source Type: research

Adrenal function/dysfunction in critically ill patients: a concise narrative review of recent novel insights
AbstractThe “fight or flight” response to critical illness relies on increased cortisol availability, traditionally attributed to several-fold-increased cortisol production via hypothalamus–pituitary–adrenal-axis activation. Recent studies provided evidence against this concept with clinical implication s. First, high cortisol availability during critical illness is driven by suppressed cortisol binding and reduced cortisol breakdown rather than increased cortisol production. This implies reduction of hydrocortisone doses when prescribed in ICU. Second, plasma ACTH is low, explained by feedback inh ...
Source: Journal of Anesthesia - November 21, 2021 Category: Anesthesiology Source Type: research

Clinically relevant concentration of propofol and benzodiazepines did not affect in vitro angiogenesis
AbstractPurposeAngiogenesis, one of regenerative medicine, is essential in the process of wound healing. The detailed effects of intravenous anesthetics and sedatives used during perioperative period have not yet been clarified. We investigated the effects of benzodiazepines and propofol on in vitro capillary tube formation.MethodsThe effects of midazolam, diazepam and propofol (1, 10, 50  µM each) on proliferation of human umbilical vein endothelial cells (HUVEC) and normal human diploid fibroblasts (NHDF) were determined. Quantitation of migration was achieved by measuring the fluorescence of migrating HUVEC u...
Source: Journal of Anesthesia - November 21, 2021 Category: Anesthesiology Source Type: research

Peripheral oxygen saturation to inspiratory oxygen fraction ratio-based identification of critically ill coronavirus disease patients for early therapeutic interventions
AbstractBackgroundEarly identification of critically ill coronavirus disease (COVID-19) patients in clinical settings is crucial in reducing the mortality rate. Therefore, this study aimed to determine whether the saturation of peripheral oxygen (SpO2) to fraction of inspiratory oxygen (FiO2) ratio (SF ratio) at admission is useful for the early identification of severe COVID-19.MethodsThis single-center, retrospective, observational study conducted at the University Hospital, Kyoto, Japan, included 26 patients diagnosed with COVID-19 between January 24 and May 6, 2020. COVID-19 severity was classified into two groups base...
Source: Journal of Anesthesia - November 21, 2021 Category: Anesthesiology Source Type: research

Practical guidelines for the response to perioperative anaphylaxis
AbstractPerioperative anaphylaxis is a severe adverse event during anesthesia that requires prompt diagnosis and treatment by physicians, including anesthesiologists. Muscle relaxants and antibiotics are the most common drugs that cause perioperative anaphylaxis in Japan, as in many countries. In addition, sugammadex appears to be a primary causative agent. Obtaining previous anesthesia records is necessary in a patient with a history of allergic reactions during anesthesia, whenever possible, to avoid recurrence of anaphylaxis. Although medical staff are likely to notice abnormal vital signs because of complete monitoring...
Source: Journal of Anesthesia - November 21, 2021 Category: Anesthesiology Source Type: research

The relationship between core temperature and perioperative shivering during caesarean section under intrathecal anesthesia with bupivacaine and ropivacaine: a randomized controlled study
AbstractPurposeTo assess the incidence rate of perioperative shivering for cesarean section and explore the associations between the occurrence of shivering and hypothermia, core temperature change, local anesthetic.MethodsThis is a prospective, randomized, controlled, double-blinded study of 100 patients consenting for caesarean section under intrathecal anesthesia. Parturients with ASA I or II accepted elective caesarean section with combined spinal-epidural anesthesia (SA). 2 –2.5 ml of 0.5% bupivacaine or 0.5% ropivacaine was intrathecally injected in group B and group R, respectively.ResultsThe intraoperati...
Source: Journal of Anesthesia - November 21, 2021 Category: Anesthesiology Source Type: research

A two-handed airway maneuver of mandibular advancement and mouth opening in the neutral neck position for immobilization of the cervical spine
AbstractPurposeImmobilization of the cervical spine after trauma is recommended as standard care to prevent secondary injury. We tested the hypothesis that a two-handed airway maneuver, consisting of mandibular advancement and mouth opening in the neutral neck position, would minimize changes in the angle of the cervical vertebrae at the C0/4 level and tidal volume in non-obese patients under anesthesia with neuromuscular blockade.MethodsTwenty consecutive patients without cervical spine injury undergoing general anesthesia were enrolled and evaluated. The primary variable was change in the angle of the cervical vertebrae ...
Source: Journal of Anesthesia - November 21, 2021 Category: Anesthesiology Source Type: research

Changes in peripheral perfusion index during intraoperative end-expiratory occlusion tests do not predict the response to fluid administration in patients undergoing lung protective ventilation
ConclusionChanges in perfusion index during intraoperative EEOT in patients undergoing lung-protective ventilation (7  ml/kg) were unable to predict the response to fluid administration. (Source: Journal of Anesthesia)
Source: Journal of Anesthesia - November 21, 2021 Category: Anesthesiology Source Type: research

Tocilizumab in patients with COVID-19: which patient, time, and dose?
AbstractTocilizumab (TCZ) is a recombinant anti-interleukin-6 monoclonal antibody which showed uprising evidence as an anti-inflammatory agent which modulates the cytokine storm in patients with COVID-19. However, proper use of the drug requires selection of the appropriate patient and timing. The two main factors which might improve patient selection are the degree of respiratory failure and systemic inflammation. TCZ can decrease the mortality and progression to invasive mechanical ventilation in patients with severe COVID-19 who are not yet invasively ventilated. However, its use in invasively ventilated patients did no...
Source: Journal of Anesthesia - November 21, 2021 Category: Anesthesiology Source Type: research

Allopurinol attenuates postoperative pain and modulates the purinergic system in patients undergoing abdominal hysterectomy: a randomized controlled trial
AbstractPurposeAllopurinol is a potent inhibitor of the enzyme xanthine oxidase used primarily in the treatment of hyperuricemia and gout. The aim of this study was to compare the analgesic efficacy of preanesthetic allopurinol versus placebo on postoperative pain and anxiety in patients undergoing abdominal hysterectomy.MethodsThis is a prospective, double-blinded, placebo-controlled, randomized clinical trial. We investigated 54 patients scheduled to undergo elective abdominal hysterectomy. Patients were randomly assigned to receive either oral allopurinol 300  mg (n = 27) or placebo (n =&thinsp...
Source: Journal of Anesthesia - November 21, 2021 Category: Anesthesiology Source Type: research

Central venous catheterization site choice based on anatomical landmark technique: a systematic review and meta-analysis
ConclusionsCompared with IJVC, SCVC shows a higher overall success rate while a lower first-attempt success rate in adults, and has involved with less hematoma.PROSPERO RegistrationCRD42020165444. (Source: Journal of Anesthesia)
Source: Journal of Anesthesia - November 21, 2021 Category: Anesthesiology Source Type: research

Intraoperative panic attack in patients undergoing awake craniotomy: a retrospective analysis of risk factors
ConclusionsFor patients undergoing awake craniotomy, intraoperative anxiety and age younger than 39  years were considered risk factors of PA. As PA often necessitates conversion to general anesthesia, intensive perioperative psychological support and pain management are required to achieve patient satisfaction and the surgical goal of awake craniotomy. (Source: Journal of Anesthesia)
Source: Journal of Anesthesia - November 21, 2021 Category: Anesthesiology Source Type: research

The short-term effect of COVID-19 pandemic on disability, pain intensity, psychological status, and exercise habits in patients with chronic pain
ConclusionThe effects of the COVID-19 pandemic on patients with chronic pain were not apparent in the short-term.Clinical trail registration: UMIN000043174 (Source: Journal of Anesthesia)
Source: Journal of Anesthesia - November 21, 2021 Category: Anesthesiology Source Type: research

Effects of intrathecal opioids on cesarean section: a systematic review and Bayesian network meta-analysis of randomized controlled trials
Conclusions: We confirmed that intrathecal opioids benefit postoperative analgesia . Although morphine seems to be the most appropriate agent, some results were inconsistent, and the evidence confidence was often moderate or low, especially for adverse outcomes. Well-designed RCTs with an evidence-based approach are imperative for determining the most appropriate opioid for cesare an sections. (Source: Journal of Anesthesia)
Source: Journal of Anesthesia - November 21, 2021 Category: Anesthesiology Source Type: research

Self-coiling catheter for continuous interscalene block
(Source: Journal of Anesthesia)
Source: Journal of Anesthesia - November 21, 2021 Category: Anesthesiology Source Type: research

Is there a role for pregabalin as premedication in pediatric anesthesia?
(Source: Journal of Anesthesia)
Source: Journal of Anesthesia - November 21, 2021 Category: Anesthesiology Source Type: research

Acknowledgment to reviewers
(Source: Journal of Anesthesia)
Source: Journal of Anesthesia - November 21, 2021 Category: Anesthesiology Source Type: research

Oral acetaminophen as an adjunct to continuous epidural infusion and patient-controlled epidural analgesia in laboring parturients: a randomized controlled trial
ConclusionThe use of 1  g of oral acetaminophen could be a cheap, safe, and effective adjunct to CEI plus PCEA in labor analgesia. (Source: Journal of Anesthesia)
Source: Journal of Anesthesia - November 16, 2021 Category: Anesthesiology Source Type: research

Adrenal function/dysfunction in critically ill patients: a concise narrative review of recent novel insights
AbstractThe “fight or flight” response to critical illness relies on increased cortisol availability, traditionally attributed to several-fold-increased cortisol production via hypothalamus–pituitary–adrenal-axis activation. Recent studies provided evidence against this concept with clinical implication s. First, high cortisol availability during critical illness is driven by suppressed cortisol binding and reduced cortisol breakdown rather than increased cortisol production. This implies reduction of hydrocortisone doses when prescribed in ICU. Second, plasma ACTH is low, explained by feedback inh ...
Source: Journal of Anesthesia - November 16, 2021 Category: Anesthesiology Source Type: research

A two-handed airway maneuver of mandibular advancement and mouth opening in the neutral neck position for immobilization of the cervical spine
AbstractPurposeImmobilization of the cervical spine after trauma is recommended as standard care to prevent secondary injury. We tested the hypothesis that a two-handed airway maneuver, consisting of mandibular advancement and mouth opening in the neutral neck position, would minimize changes in the angle of the cervical vertebrae at the C0/4 level and tidal volume in non-obese patients under anesthesia with neuromuscular blockade.MethodsTwenty consecutive patients without cervical spine injury undergoing general anesthesia were enrolled and evaluated. The primary variable was change in the angle of the cervical vertebrae ...
Source: Journal of Anesthesia - November 16, 2021 Category: Anesthesiology Source Type: research

Prevalence of undernutrition in surgical patients and the effect on length of hospital stay
ConclusionOur results suggest that a low nutrition profile before surgery is associated with a prolonged hospital stay. (Source: Journal of Anesthesia)
Source: Journal of Anesthesia - November 15, 2021 Category: Anesthesiology Source Type: research

Development and modification of new fascial plane blocks
(Source: Journal of Anesthesia)
Source: Journal of Anesthesia - November 15, 2021 Category: Anesthesiology Source Type: research

Comparison of remimazolam and propofol in anesthetic management for awake craniotomy: a retrospective study
In conclusion, remimazolam has the potential for use as an alternative drug in anesthetic management during awake craniotomy. (Source: Journal of Anesthesia)
Source: Journal of Anesthesia - November 15, 2021 Category: Anesthesiology Source Type: research

Reply to the letter regarding double ‐C hold for bag‐mask ventilation during resuscitation
(Source: Journal of Anesthesia)
Source: Journal of Anesthesia - November 14, 2021 Category: Anesthesiology Source Type: research

Clinical features and significance of leukopenia occurring immediately after endovascular surgery
AbstractPurposeInflammation after stent graft surgery is known as postimplantation syndrome (PIS) and it causes leukocytosis. However, we have experienced leukopenia in the very early postoperative phase of endovascular surgery at our institution. We investigated leukopenia, an under-recognized phenomenon that occurred after transcatheter aortic valve implantation (TAVI), endovascular aortic repair (EVAR), and thoracic endovascular aortic repair (TEVAR).MethodsRecords of patients who underwent TAVI, EVAR, and TEVAR between March 2018 and February 2019 were retrospectively reviewed. Primary outcomes were the decline rate of...
Source: Journal of Anesthesia - November 13, 2021 Category: Anesthesiology Source Type: research

Evaluation of gastric contents using ultrasound in full-term pregnant women fasted for 8  h: a prospective observational study
ConclusionAfter 8-h fasting following a standardized meal, full-term pregnant non-laboring women are less likely to have a high residual gastric volume. (Source: Journal of Anesthesia)
Source: Journal of Anesthesia - November 12, 2021 Category: Anesthesiology Source Type: research

Effects of individualized positive end-expiratory pressure combined with recruitment maneuver on intraoperative ventilation during abdominal surgery: a systematic review and network meta-analysis of randomized controlled trials
AbstractLow tidal volume ventilation strategy may lead to atelectasis without proper positive end-expiratory pressure (PEEP) and recruitment maneuver (RM) settings. RM followed by individualized PEEP was a new method to optimize the intraoperative pulmonary function. We conducted a systematic review and network meta-analysis of randomized clinical trials to compare the effects of individualized PEEP  + RM on intraoperative pulmonary function and hemodynamic with other PEEP and RM settings. The primary outcomes were intraoperative oxygenation index and dynamic compliance, while the secondary outcomes were intr...
Source: Journal of Anesthesia - November 10, 2021 Category: Anesthesiology Source Type: research

Steroid treatment in patients with acute respiratory distress syndrome: a systematic review and network meta-analysis
ConclusionThis NMA suggested that the effect of steroids on the outcome in patients with ARDS might depend on the type of the steroid drug administered. Moreover, further studies are needed to identify the optimal type and dosage. (Source: Journal of Anesthesia)
Source: Journal of Anesthesia - November 10, 2021 Category: Anesthesiology Source Type: research

Safety and efficacy of an automated anesthesia delivery system for total intravenous anesthesia with propofol, remifentanil, and rocuronium: a non-inferiority randomized controlled trial versus manually controlled anesthesia
ConclusionThe clinical use of our automated anesthesia control system should allow for the maintenance of adequate anesthesia by adjusting the doses of intravenous anesthetics in the same way as anesthesiologists do. (Source: Journal of Anesthesia)
Source: Journal of Anesthesia - November 5, 2021 Category: Anesthesiology Source Type: research

Penehyclidine for prevention of postoperative nausea and vomiting following bimaxillary orthognathic surgery: a randomized, double-blind, controlled trial
AbstractPurposeTo investigate the efficacy and safety of low-dose bolus plus continuous infusion of penehyclidine in preventing postoperative nausea and vomiting (PONV) following bimaxillary surgery.MethodsThree hundred fifty-four patients were randomly allocated into three groups. In the Control group, placebo (normal saline) was injected before anesthesia and infused over 48  h after surgery; in the Bolus group, 0.5 mg penehyclidine was injected before anesthesia, whereas placebo was infused after surgery; in the Infusion group, 0.25 mg penehyclidine were injected before anesthesia, another 0.25 mg pe...
Source: Journal of Anesthesia - November 5, 2021 Category: Anesthesiology Source Type: research

Difficulty in evaluating the effect of CEA or CRSB
(Source: Journal of Anesthesia)
Source: Journal of Anesthesia - November 2, 2021 Category: Anesthesiology Source Type: research

Quantitative and qualitative analyses of urinary L-FABP for predicting acute kidney injury after emergency laparotomy
ConclusionQuantitative L-FABP analyses is suitable for predicting postoperative AKI earlier in the perioperative period of emergency laparotomy. Conversely, the higher specificity of qualitative L-FABP analysis suggests that it may be useful for excluding the risk of AKI but its overall clinical validity should be further investigated. (Source: Journal of Anesthesia)
Source: Journal of Anesthesia - October 29, 2021 Category: Anesthesiology Source Type: research

Does the oxygen reserve index play a role in oxygen therapy?
(Source: Journal of Anesthesia)
Source: Journal of Anesthesia - October 25, 2021 Category: Anesthesiology Source Type: research

Acknowledgment to reviewers
(Source: Journal of Anesthesia)
Source: Journal of Anesthesia - October 15, 2021 Category: Anesthesiology Source Type: research

Practical guidelines for the response to perioperative anaphylaxis
AbstractPerioperative anaphylaxis is a severe adverse event during anesthesia that requires prompt diagnosis and treatment by physicians, including anesthesiologists. Muscle relaxants and antibiotics are the most common drugs that cause perioperative anaphylaxis in Japan, as in many countries. In addition, sugammadex appears to be a primary causative agent. Obtaining previous anesthesia records is necessary in a patient with a history of allergic reactions during anesthesia, whenever possible, to avoid recurrence of anaphylaxis. Although medical staff are likely to notice abnormal vital signs because of complete monitoring...
Source: Journal of Anesthesia - October 14, 2021 Category: Anesthesiology Source Type: research

TEG6s Platelet Mapping assay for the estimation of plasma fibrinogen concentration during cardiovascular surgery: a single-center prospective observational study
AbstractPurposeThe Activator F (ActF) test on the TEG6s Platelet Mapping assay system is a means of quantifying blood viscoelasticity caused by fibrin network formation, triggered by reptilase and factor XIII, while platelets are inhibited. This unique methodology enables the measurement of blood viscoelasticity, even in highly heparinized blood. Here, we investigated whether fibrinogen concentration could be estimated using the ActF test in blood samples obtained during cardiopulmonary bypass (CPB) and after CPB in patients undergoing cardiovascular surgery.MethodsWe performed a single-center prospective observational stu...
Source: Journal of Anesthesia - October 13, 2021 Category: Anesthesiology Source Type: research

The lymphocyte/monocyte ratio and red blood cell transfusion during radical retropubic prostatectomy
AbstractPurposeDespite improvements of strategy in radical retropubic prostatectomy, blood loss is still a major concern. The lymphocyte/monocyte (LM) ratio is a prognostic indicator for various diseases. We identified the risk factors, including the LM ratio, for red blood cell (RBC) transfusion during radical retropubic prostatectomy.MethodsThis retrospective study assessed patients who underwent radical retropubic prostatectomy between March 2009 and December 2020. To determine the risk factors for RBC transfusion, a multivariate logistic regression analysis was conducted. A receiver operating characteristic (ROC) curve...
Source: Journal of Anesthesia - October 8, 2021 Category: Anesthesiology Source Type: research

Hypoxia-dependent signaling in perioperative and critical care medicine
AbstractA critical goal of patient management for anesthesiologists and intensivists is to maintain oxygen homeostasis in patients admitted to operation theaters and intensive care units. For this purpose, it is imperative to understand the strategies of the body against oxygen imbalance —especially oxygen deficiency (hypoxia). Adaptation to hypoxia and maintenance of oxygen homeostasis involve a wide range of responses that occur at different organizational levels in the body. These responses are greatly influenced by perioperative patient management including factors such as per ioperative drugs. Herein, the influe...
Source: Journal of Anesthesia - September 24, 2021 Category: Anesthesiology Source Type: research

Reply to the letter
(Source: Journal of Anesthesia)
Source: Journal of Anesthesia - September 24, 2021 Category: Anesthesiology Source Type: research