L’Acta Anaesthesiologica Belgica est le journal de la SBAR, publié 4 fois par an.     L’Acta a été publié pour la première fois en 1950. Depuis 1973 l’Acta est publié dans la langue Anglaise, ce qui a été résulté à un rayonnement plus internationaux.     Depuis lors l’Acta est devenu un journal à ne pas manquer dans le domaine d’Anesthésie Belge, offrant e.a. les textes du congrès annuel, les Research Meetings, …     Vous en trouvez aussi les dates des Research Meetings, du congrès annuel et des autres réunions.

Acta Anaesthesiologica Belgica is the journal of the Belgian Society of Anesthesiology (SBAR), published quarterly. The journal was first published in 1950 and has been published in English since 1973, which has led to an increased international reach. Since then, Acta Anaesthesiologica Belgica has become an essential journal in the field of Belgian Anesthesiology, offering content such as annual congress papers and research meeting reports. It also provides information on the dates of research meetings, the annual congress, and other gatherings.

《Acta Anaesthesiologica Belgica》是比利时麻醉学会（SBAR）出版的期刊，每年出版四期。该期刊首次出版于1950年，自1973年起以英语出版，从而扩大了其国际影响力。自那时起，《Acta Anaesthesiologica Belgica》已成为比利时麻醉学领域不可或缺的期刊，提供包括年会论文、研究会议等内容。此外，期刊还提供研究会议、年会及其他会议的日期信息。

Acta Anaesthesiologica Belgica

Caesarean section is the most performed surgical intervention worldwide. A proportion of these caesarean deliveries will necessitate emergency care for maternal and fetal compromise. Anaes-thetic management in these situations can be challenging and a short decision to delivery interval is burning. Current evidence suggests that multidisciplinary communication is essential to support anaesthetic management and optimise team performance. Communication should be supported by using a standardised classification of urgency tool. The four-grade classification scale has increasingly been adopted internationally. While neuraxial techniques are favoured for caesarean sections, gen-eral anaesthesia has an essential role in category 1 caesarean section (defined as a caesarean section in which there is an immediate threat to life for the mother or fetus). The risks and benefits of general and neuraxial anaesthesia for the woman and her baby must be carefully weighed on an individual base. Beyond the delivery of anaesthesia, other practical strategies, such as multidiscipli-nary team training, can contribute to improved maternal and neonatal outcomes.

S Devroe

M Dhankhar

N Lucas

Anaesthaesia for Category-1 urgency Ceasarean section

1类紧急剖宫产的麻醉

Preoperative anxiety is common among children, resulting in negative postoperative behavior and increased postoperative pain. This review focuses on the practical use, safety, and efficacy of pharmacological strategies to reduce perioperative anxiety in children. The PubMed® database was searched using MeSH terms: ((care, preoperative) AND (children) AND (anti-anxiety drugs); (medication, preanesthetic) AND (child, preschool). An in-dept assessment was performed after which 85 articles were retrieved. Benzodiazepines (midazolam, diazepam), zolpidem, melatonin, opioids (fentanyl, butorphanol), alpha-2-adrenergic receptor agonists (clonidine, dexmedetomidine), ketamine and antihistamines (hydroxyzine, promethazine) were reviewed. Their pharmacological properties, routes of administration, doses, efficacy and (dis)advantages are discussed in this review. Based upon the results of our review, some suggestions can be made. Oral midazolam, oral clonidine, intranasally dexmedetomidine and the combination of oral ketamine and midazolam are recommendable products. Some other products like oral diazepam, butorphanol, ketamine intranasal s-ketamine + midazolam and hydroxyzine can be considered because of their proper safety profile and benefits. Further research should focus on patient selection for specific pharmacological and non-pharmacological interventions to achieve a tailored approach. Standardized assessment of anxiety, clinical significancy and feasibility should be included in the objectives of these studies.

D Knaeps

P Van de Putte

M Van de Velde

Pharmacological strategies to reduce perioperative anxiety in children – a narrative review

儿童围手术期焦虑的药物治疗策略——一项叙述性综述

Artificial intelligence (AI) is rapidly evolving and gaining attention in the medical world. Our aim is to provide readers with insights into this quickly changing medical landscape and the role of clinicians in the middle of this popular technology. In this review, our aim is to explain some of the increasingly frequently used AI terminology explicitly for physicians. Next, we give a summation, an overview of currently existing applications, future possibilities for AI in the medical field of anesthesiology and thoroughly highlight possible problems that could arise from implementing this technology in daily practice. Therefore, we conducted a literature search, including all types of articles published between the first of January 2010 and the 1st of May 2023, written in English, and having a free full text available. We searched Pubmed, Medline, and Embase using “artificial intelligence”, “machine learning”, “deep learning”, “neural networks” and “anesthesiology” as MESH terms. To structure these findings, we divided the results into five categories: preoperatively, perioperatively, postoperatively, AI in the intensive care unit and finally, AI used for teaching purposes. In the first category, we found AI applications for airway assessment, risk prediction, and logistic support. Secondly, we made a summation of AI applications used during the operation. AI can predict hypotensive events, delivering automated anesthesia, reducing false alarms, and aiding in the analysis of ultrasound anatomy in locoregional anesthesia and echocardiography. Thirdly, namely postoperatively, AI can be applied in predicting acute kidney injury, pulmonary complications, postoperative cognitive dysfunction and can help to diagnose postoperative pain in children. At the intensive care unit, AI tools discriminate acute respiratory distress syndrome (ARDS) from pulmonary oedema in pleural ultrasound, predict mortality and sepsis more accurately, and predict survival rates in severe Coronavirus-19 (COVID-19). Finally, AI has been described in training residents in spinal ultrasound, simulation, and plexus block anatomy. Several concerns must be addressed regarding the use of AI. Firstly, this software does not explain its decision process (i.e., the ‘black box problem’). Secondly, to develop AI models and decision support systems, we need big and accurate datasets, unfortunately with potential unknown bias. Thirdly, we need an ethical and legal framework before implementing this technology. At the end of this paper, we discuss whether this technology will be able to replace the clinician one day. This paper adds value to already existing literature because it not only offers a summation of existing literature on AI applications in anesthesiology but also gives clear definitions of AI itself and critically assesses implementation of this technology.

F Gheysen

S Rex

Artificial intelligence in anesthesiology

麻醉学中的人工智能

Obstructive sleep apnea (OSA) is the most common sleep-related breathing disorder among surgical patients and is associated with an increased risk of perioperative cardiopulmonary complications leading to increased health expenses. Therefore, preoperative OSA screening should be instituted to inform patients of their increased perioperative risk and measures can be taken in to decrease this risk. Meanwhile ERAS (Enhanced recovery after surgery) guidelines are becoming standard of care and being widely implemented. The purpose of these recovery programs is to standardize medical care, enhance outcomes and decrease health care expenses using evidence-based protocols. According to the current evidence it is unclear if OSA patients could benefit from these protocols. The first part of this narrative review states the current evidence on OSA definition, classification, pathophysiology and risk factors, postoperative complications, endotypes and their relevance for the anesthesiologist. The second part investigated the feasibility of ERAS measures within the OSA-population. Preoperatively there are many parallels to be drawn between the ERAS measures and Society of Anesthesia and Sleep Medicine (SASM) guidelines on OSA management: Risk stratification by OSA-screening, information counselling on the increased perioperative risk and optimization of preoperative health conditions by initiation of CPAP-therapy. Perioperatively the use short acting anesthetics allows for both early mobilization and avoid postoperative respiratory compromise by sustained drug effect. ERAS measures to maintain the patient in the zone of normovolaemia are advantageous for OSA patients as excessive fluid administration can worsen OSA. The use of multimodal analgesia sparing opioids might be the most important element beneficial for OSA patients they are more prone to develop opioid induced respiratory depression (OIRD). As OSA patients are at risk for venous thromboembolism appropriate thromboprophylaxis should be applied. Postoperatively OSA patients should be closely monitored in the prevention of OIRD. In conclusion many ERAS measures seem to be applicable or of benefit for OSA patients. However, large prospective randomized controlled trials are needed to evaluate if these patients can be managed within an ERAS protocol.

M Ramselaar

A Neyrinck

Can the OSA patient be managed within an ERAS protocol? A narrative review

OSA患者能否在ERAS方案下管理？一项叙述性综述

Background: Minimally invasive cardiac surgery via mini-thoracotomy reduces surgical trauma compared to full sternotomy. However, thoracotomy can cause severe postoperative pain. Managing postoperative pain is challenging but critical for fast rehabilitation and avoidance of chronic pain. Our objective was to compare the efficacy of analgesia of a bolus in combination with continuous local anaesthetics using a serratus anterior plane block (SAPB) catheter versus a wound infiltration catheter (CWI) in patients after minimally invasive cardiac surgery. Design and setting: We conducted a monocentric, prospective, randomized controlled trial between January 2021 and August 2022. The study was performed at Ghent University Hospital, Belgium. Methods: Patients scheduled for minimally invasive cardiac surgery via thoracoscopy and mini-thoracotomy were randomized to receive either a SABP or a CWI catheter. Postoperatively, continuous ropivacaine 0.2% was started at 10ml/h, and a supplementary bolus of 30ml ropivacaine 0.5% was administered one hour before detubation. The catheter remained in place for at least 24 hours. The primary endpoint was opioid consumption during the first 48 hours postdetubation. Secondary endpoints were anti-emetic consumption, Numerical Analogue Score for 48 hours, length of stay in the Intensive Care Unit and hospital, and incidence of chronic pain. Qualitative data were compared using the Chi – Square test, quantitative data were analyzed with the Student’s t-test. Results: During the study period, a total of 21 patients received a SAPB catheter and 26 patients received a CWI catheter. No statistical significant differences were seen in baseline characteristics. In the first 48 hours postdetubation, morphine equivalent consumption was similar in both groups (p= 0.52), with no differences observed in the early, mid- or late postoperative phases. The total morphine equivalent dose was 21.8 mg in the SAPB and 18.6 mg in the CWI group. There were no significant differences in postoperative vomiting and nausea, length of stay in the Intensive Care Unit and in the hospital and chronic thoracic pain (23% and 33% for the SAPB and CWI group, respectively, p=0.54). Conclusion: This prospective study found no significant difference in postoperative opioid consumption between patients who received a serratus anterior plane block catheter and those who received a wound catheter with bolus and continuous ropivacaine, following minimally invasive cardiac surgery via right thoracoscopy and mini-thoracotomy.

B Vanden Bussche

M Vandenheuvel

A Moerman

Catheter-based serratus anterior plane block vs. continuous wound infiltration for postoperative pain control following minimally invasive atrioventricular valve surgery : a randomized, prospective trial

基于导管的锯齿肌前平面阻滞与持续伤口浸润用于微创房室瓣手术后疼痛控制：一项随机前瞻性试验

Background: With 75% of women receiving neuraxial anesthesia for labor and cesarean section (CS) in Flanders, Belgium, obstetric anesthesia is an essential part of perinatal care. Despite advancements in obstetric anesthesia and guidelines being updated regularly, past surveys have shown great variability among hospitals. Objective: This investigation aims to observe current obstetric anesthesia practices, compare them with previous surveys, and assess adherence to guidelines among anesthesiologists. Methods: An online questionnaire-based survey, approved by the KU Leuven Ethics Committee, was conducted focusing on three main topics: analgesia during labor, anesthesia for CS, and postoperative analgesia after CS. The survey, consisting of 127 questions, was distributed via email to the heads of anesthesia departments in 57 Flemish hospitals providing obstetric anesthesia care. Responses were anonymously analyzed. Results: For labor analgesia initiation, a conventional epidural with administration of ropivacaine 0.2% (+- sufentanil) remains the most widespread used technique, although Combined-Spinal Epidural (CSE) has gained significant popularity. Patient-controlled epidural analgesia (PCEA) in combination with continuous epidural infusion (CEI) is the preferred maintenance method, however programmed-intermittent bolus (PIEB) has found its way into standard practice. CSs are mostly done by performing CSE or single shot spinal, using hyperbaric bupivacaine 0.5% with sufentanil. Spinal-induced hypotension is treated with a combination of left lateral tilt, fluid administration and vasopressor administration, usually as a bolus. Post-CS pain is mainly treated by a combination of oral/ parenteral analgesics and neuraxial analgesia (PCEA +- CEI), with only a minority choosing regional techniques such as wound infiltration, transverse abdominal plane blocks, quadratus lumborum blocks, etc. Conclusion: Compared to previous surveys, the Flemish anesthesiologists adhere well to the latest guidelines and gold standards in obstetric anesthesia, consistently modernizing their practices. Nevertheless, with the continual introduction of novel techniques and methods, it is imperative for practitioners to maintain efforts in pursuing ongoing innovation.

G de Smet

A Barbé

E Roofthooft

Update on the Obstetric Anesthesia Practice in Flanders/Belgium: A 10-year follow-up survey and review

佛兰德斯/比利时产科麻醉实践更新：一项10年随访调查与回顾

Background: Despite intensive and better multimodal pain management schemes during bariatric surgery, many obese patients still experience severe early postoperative pain. Furthermore, postoperative pain varies considerably between patients who undergo the same kind of surgery. The main purpose of this study is to investigate psychological and demographic predictors for interpersonal differences of acute postoperative pain after laparoscopic bariatric surgery. Methods: A search of Pubmed, Web of Science, Cochrane database, PsycARTICLES, Google Scholar from 2008 to 2023 was conducted with the following search criteria: psychological, psychometric, catastrophizing, anxiety, pain, fear, stress, depression, vulnerability, self-efficacy, somatization, perception, bariatric surgery and postoperative pain. Results: Younger age, higher ASA physical status, higher educational level, pre-existing anxiety, pre-existing depression and pre-existing alexithymia may contribute to interpersonal differences in acute postoperative pain scores after bariatric surgery. Conclusion: Limited evidence exists on demographic and psychological factors. Further research is warranted to clarify these demographic and psychological predictors of acute postoperative pain in bariatric surgery to provide a more effective intervention and perioperative care.

M Roebersen

J Berghmans

R Lapré

F Van Sprundel

V Saldien

Interpersonal differences in postoperative pain scores after bariatric surgery: a systematic review

减重手术后术后疼痛评分的人际差异：一项系统综述

Luc De Baerdemaeker

Carl Roosens

In Memoriam: Prof. dr. Jan Poelaert

纪念：杨·波拉尔特教授博士

Background: Perioperative management using minimally invasive cardiac surgery (MICS), compared to full sternotomy (FS) cardiac surgery, is considered to improve postoperative recovery, and reduce hospital length of stay (LOS). Methods: A comprehensive systematic search was conducted across MEDLINE/PubMed, Embase, and the Cochrane library to identify RCT comparing MICS to FS approach for aortic valve, mitral valve, and coronary artery bypass surgery. Meta-analysis of extracted data was performed using random effects models. Results: A total of 33 RCTs including 2920 patients were identified. Overall MD (95% CI) for hospital and intensive care unit (ICU) LOS after MICS was significantly shorter compared to FS (-0.88 days (-1.55;-0.20), p&lt;0.013; 2606 patients) and (-0.23 days (-0.41;-0.05), p=0.012; 2242 patients), respectively. Additionally, postoperative blood loss was reduced with the use of MICS, (-192.07 ml (-292.32;-91.82), p=0.002; 718 patients). There was no evidence for differences between both groups in terms of postoperative ventilation times, duration of surgery, reintervention rate, incidence of postoperative atrial fibrillation or stroke, hospital mortality, or 1-year mortality. Conclusion: Within the limitations of a meta-analysis, MICS was found to be effective in promoting faster recovery by reducing postoperative blood loss, ICU, and hospital LOS.

D.F. Hoogma

T van Bos

F Polfliet

P Verbrugghe

W Oosterlinck

J Van den Eynde

Effect of minimally invasive cardiac surgery on hospital length of stay: A systematic review and meta-analysis

微创心脏手术对住院时间的影响：一项系统综述和荟萃分析

Background: Patient safety remains a critical concern in the high-stakes environment of the operating room (OR). Human factors and non-technical skills (NTS) play pivotal roles in surgical performance and in preventing errors. Various assessment tools and methodologies have been developed to evaluate NTS among OR personnel, reflecting the growing recognition of their importance. Objectives: To map and analyze NTS among OR personnel during real-life surgeries using medical video recording systems and to evaluate NTS assessment tools described in existing literature. Methods: Four databases, PubMed, Web of Science, Medline and Embase, were searched for relevant studies. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) protocol was followed. Eligibility criteria included studies focusing on video recordings providing an overview of the entire OR with a focus on NTS. Results: Twenty-four articles were included in this scoping review. A total of eight NTS were assessed, most frequently communication (79%), leadership (54%), teamwork (50%) and situational awareness (50%). Observational methods varied, ranging from one or more cameras to more sophisticated medical data recorders, such as the OR Black Box (ORBB). Additionally, a wide variety of assessment methods were used, mostly validated tools (NOTSS, SPLINTS, ANTS), but also broader systems-based frameworks (SEIPS) or self-developed tools. Conclusions: This scoping review highlights the diverse methodologies used to measure NTS in the OR using medical video recordings, indicating a need for further research to address challenges and standardize practices. Despite the proven potential benefits of video recording in the OR, legal, ethical and logistical challenges may serve as possible barriers to actual implementation.

C Versaevel

B Bruneel

I Van Herzeele

Evaluating performance: a scoping review on video-based assessments of non-technical skills in the operating room

评估表现：手术室中非技术技能视频评估的系统综述

短名	Acta Anaesthesiol. Belg.
Journal Impact	0.20
国际分区	ANESTHESIOLOGY(Q4)

ISSN	0001-5164, 2736-5239
h-index	29

涉及主题	医学麻醉生物外科内科学心理学精神科药理学化学放射科内分泌学重症监护医学物理病理
出版信息	出版商: ARSMB-KVBMG，出版周期: ，期刊类型: journal，开源期刊: 否
基本数据	创刊年份: 2020，原创研究文献占比: 59.09%，自引率:N.A.， Gold OA占比: 0.00%

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