Anesthesiology Research and Practice

The purpose of this study was to investigate if the addition of liposome bupivacaine (LB) to an interscalene block (ISB) had an effect on the number of patients with surgical- or block-related complications.This was a single-center retrospective chart view performed by identifying patients who received an ISB from January 1, 2014, through April 26, 2018, at the University of Minnesota. 1,518 patients were identified who received an ISB (LB = 784, nonliposomal bupivacaine = 734). Patients were divided into two groups those who did receive liposome bupivacaine in their ISB and those who did not receive liposome bupivacaine in their ISB. Medical records were individually reviewed for surgical procedure, block medications, complications related to the block or surgical procedure, phone calls to the healthcare system for issues related to opioids or pain within 3 and within 30 days, readmissions within 30 days, and emergency room visits for complications within 3 and 30 days.There was no significant difference in the number of patients with surgical or anesthetic complications. Only phone calls for pain within 3 days were significantly different. The LB group had 3.2% of patients call compared to 5.6% in the nonliposomal bupivacaine group (aOR = 1.71 (95% CI: 1.04-2.87), p=0.036). We found no significant difference in any of the other secondary outcomes.The use of LB in an ISB demonstrated no significant difference compared to nonliposomal bupivacaine in numbers of complications, emergency room visits, and readmissions.

Jacob L. Hutchins

Jason Habeck

Zac Novaczyk

Richard Campbell

Christopher Creedon

Ellen Spartz

Michael Richter

Jeremy Wolter

Gaurav Suryawanshi

Alexander Kaizer

Aaron A. Berg

Patient Complications after Interscalene Block: A Retrospective Comparison of Liposomal Bupivacaine to Nonliposomal Bupivacaine

肩胛上神经阻滞后患者并发症：脂质体布比卡因与非脂质体布比卡因的回顾性比较

Coadministration of different antiemetics proved to decrease postoperative nausea and vomiting (PONV) after laparoscopic sleeve gastrectomy (LSG). This trial compared aprepitant/dexamethasone (A/D) combination vs mirtazapine/dexamethasone (M/D) combination vs dexamethasone (

Tarek M. Ashoor

Dina Y. Kassim

Ibrahim M. Esmat

A Randomized Controlled Trial for Prevention of Postoperative Nausea and Vomiting after Laparoscopic Sleeve Gastrectomy: Aprepitant/Dexamethasone vs. Mirtazapine/Dexamethasone

一项随机对照试验：阿瑞匹坦/地塞米松与米氮平/地塞米松预防腹腔镜袖状胃切除术后恶心呕吐的效果比较

The aim of this randomized, prospective study was to investigate whether the use of the structured epidural teaching model (SETM) may affect the learning curve for lumbar epidural block in novice trainees when compared with a standard teaching module.There is a paucity of literature regarding the efficacy of teaching epidural blocks and comparisons between the different educational approaches.Forty-four PGY3 anesthesia trainees were randomized to receive (study group) or to not receive (control group) the SDM (structured didactic model) before the beginning of their 6 months clinical practice rotation in labor and delivery suites. A CUSUM learning curve was built for every trainee. The scores were assigned by the staff instructor, who was unaware of the group to which the trainee belonged.The number of subjects who achieved an improvement in performance was 8 trainees from the control group and 14 from the study group. The probability of achieving an improvement was higher (p < 05) in the study group than in the control group, with an aOR of 3.25 (CI: 1.01; 12.1). The proportion of subjects in the study group who completed the epidural without help was 1.21 (1.05-1.41) times the proportion of subjects who completed the epidural without help in the control group. The probability of completing the epidural block without any assistance was 21% higher in the study group than in the control group (p < 05).We have demonstrated that the use of the structured epidural teaching model (SETM) may improve the learning curve (CUSUM) for lumbar epidural block in novice, entirely inexperienced, anesthesia trainees.

Marco Scorzoni

Gian Luigi Gonnella

Emanuele Capogna

Matteo Velardo

Pietro Paolo Giuri

Mariano Ciancia

Giorgio Capogna

Gaetano Draisci

Achieving Lumbar Epidural Block Competency in Inexperienced Trainees after a Structured Epidural Teaching Model: A Randomized, Single Blind, Prospective Comparison of CUSUM Learning Curves

结构化硬膜外教学模型后无经验学员腰椎硬膜外阻滞能力的获得：CUSUM学习曲线的随机、单盲、前瞻性比较

The regulation of brain temperature is largely dependent on the metabolic activity of brain tissue and remains complex. In intensive care clinical practice, the continuous monitoring of core temperature in patients with brain injury is currently highly recommended. After major brain injury, brain temperature is often higher than and can vary independently of systemic temperature. It has been shown that in cases of brain injury, the brain is extremely sensitive and vulnerable to small variations in temperature. The prevention of fever has been proposed as a therapeutic tool to limit neuronal injury. However, temperature control after traumatic brain injury, subarachnoid hemorrhage, or stroke can be challenging. Furthermore, fever may also have beneficial effects, especially in cases involving infections. While therapeutic hypothermia has shown beneficial effects in animal models, its use is still debated in clinical practice. This paper aims to describe the physiology and pathophysiology of changes in brain temperature after brain injury and to study the effects of controlling brain temperature after such injury.

Ségolène Mrozek

Fanny Vardon

Thomas Geeraerts

Brain Temperature: Physiology and Pathophysiology after Brain Injury

脑温：脑损伤后的生理与病理生理

Background: Remimazolam is a newly developed benzodiazepine. Early recovery from anesthesia because of its ultra‐short acting effect and less hemodynamic side effects has been reported as the specific advantages of remimazolam. Therefore, the maintenance of anesthesia with propofol may be sometimes switched to remimazolam anesthesia maintenance during surgery because of the risk of delayed awakening and unstable hemodynamics. In the present study, to determine the influence of switching anesthesia from propofol to remimazolam on the baseline TOF ratio, the TOF ratio under remimazolam anesthesia maintenance without any neuromuscular blocking agents was compared to that calibrated after induction of general anesthesia with propofol. Methods: Twelve patients scheduled for elective surgery under general anesthesia in the supine position were investigated. After induction of general anesthesia with remifentanil and propofol, a supraglottic airway was inserted without neuromuscular blockade, and TOF stimulation every 15 s at the adductor pollicis muscle was started with acceleromyography. After stable baseline responses to TOF stimulation being obtained for at least 10 min under propofol anesthesia, the anesthetic agent was switched to remimazolam and TOF stimulation every 15 s was maintained for a further 60 min without any interruption. In each case, the averaged TOF ratio during the last 10 min of TOF monitoring was compared to that during the 10 min immediately before the beginning of remimazolam infusion using a paired t ‐test. Results: There were no significant differences in the TOF ratios before and after switching anesthesia to remimazolam (1.07 ± 0.03 vs. 1.07 ± 0.03, p = 0.325). Conclusion: Switching anesthesia from propofol to remimazolam does not affect the baseline TOF ratio.

Tomoko Yuruki

Masafumi Fujimoto

Naoyuki Hirata

The Effect of Remimazolam on the Baseline TOF Ratio: A Prospective, Clinical Study

瑞马唑仑对基线TOF比值的影响：一项前瞻性临床研究

Anesthesia providers categorize patients utilizing the American Society of Anesthesiologists Physical Status (ASA-PS) classification originally created by the ASA in 1941. There is published variability and discordance among providers when assigning patient ASA scores in part due to the subjectivity of scoring utilizing patient medical conditions, but variability is also found using objective findings like BMI. To date, there are few studies evaluating the accuracy of anesthesia providers' ASA assignment based on objective body mass index (BMI) alone. The aim of this retrospective chart review is to determine improvement in accuracy of anesthesia providers to correctly assign patient ASA scores, based on BMI criteria added to the ASA-PS in October of 2014, utilizing a multifaceted strategy including creation of an active finance committee in the fall of 2015, multiple e-mail communications about the updated definitions and recommendations for ASA-PS scoring in the fall of 2015 and spring of 2016, a department grand rounds presentation in February 2016, placement of laminated copies of the ASA definitions and recommendations in the anesthesia chartrooms, and the development of a tool embedded into our EMR providing a recommendation of ASA-PS based on patient comorbidity findings.

Matthew W. Dyer

Benjamin T. Kor

Nathan T. Kor

Andrew C. Hanson

Jennifer J. Kor

Todd M. Kor

Thomas M. Stewart

Hans P. Sviggum

Improvement in Accuracy and Concordance of American Society of Anesthesiologist’s Physical Status (ASA-PS) Scoring Assignment over a 11 Year Time Period Using Patient BMI as a Comorbidity Finding

使用患者体重指数作为合并症指标，美国麻醉医师协会生理状态评分（ASA-PS）评分准确性和一致性在11年时间内的改进

Prolonged fasting before surgery has negative effects on the physiology and psychology of patients. Preoperative liberal fasting proposes that patients can drink clear liquids before entering the operating theater, challenging the guideline strategy of a two-hour preoperative liquid fast for adults. In recent years, there have been an increasing number of studies on liberal preoperative fasting in adults. However, currently there is no consensus on the safe amount of fluid consumed, adverse effects, or benefits of this new policy.

Haoyue Gan

Hangcheng Liu

Huaping Huang

Mei He

Liberal Preoperative Fasting in Adults Undergoing Elective Surgery: A Scoping Review Protocol

成人择期手术前自由禁食的概述性综述方案

Objective. To compare the effects of oral gabapentin (GBP) and pregabalin (PGB) in pain control after orthopedic surgery on the upper limb. Methods. In this double-blind randomized clinical trial study, 80 patients who were the candidates for elective orthopedic surgery on one of the parts of the upper limb were divided into two groups using balance-block randomization. For the first group, a 150 mg capsule of PGB (one hour before the surgery) and for the second group, a 300 mg capsule of GBP (two hours before the surgery) were prescribed. Patients were subjected to standard monitoring at the beginning and during surgery. The pain scores were evaluated at before surgery, in PACU (postanesthesia care unit), and 6 and 12 hours after the surgery by VAS (visual analog scale). Results. In this study, 37 subjects were allocated to each group. The participation rate was 92.5%. The mean with 95% confidence interval (CI) of pain scores over 4 times in the PGB group was 4.03 (3.25–4.79), 3.76 (3.02–4.49), 3.65 (3.06–4.23), and 3.41 (2.88–3.93) and in the GBP group was 4.08 (3.33–4.83), 2.78 (2.11–4.45), 2.3 (2.05–2.54), and 2 (1.51–2.50), respectively. The within-group comparisons showed a significant decrease in the pain score over time ( <a:math xmlns:a="http://www.w3.org/1998/Math/MathML" id="M1"><a:mi>P</a:mi><a:mo>&lt;</a:mo><a:mn>0.001</a:mn></a:math> ). Also, the between-group comparison showed significant differences between the two groups in terms of pain score ( <c:math xmlns:c="http://www.w3.org/1998/Math/MathML" id="M2"><c:mi>P</c:mi><c:mo>&lt;</c:mo><c:mn>0.001</c:mn></c:math> ). In the end, results showed that there is a significant interaction between time and intervention for pain score ( <e:math xmlns:e="http://www.w3.org/1998/Math/MathML" id="M3"><e:mi>P</e:mi><e:mo>=</e:mo><e:mn>0.042</e:mn></e:math> ). Conclusion. Although two medicines led to a reduction in the pain score, but the rate reduction in the PGB group was significantly more than that in the GBP group. This trial is registered with IRCT20211013052759N1.

Lida Nouri

Rana Roshanfekr

Azam Biderafsh

Reza Pakzad

Hamed Azadi

The Effect of Oral Gabapentin and Pregabalin as a Prodrug in Pain Control after Orthopedic Surgery on the Upper Limb: A Double-Blind Parallel Randomized Clinical Trial Study

口服加巴喷丁和普瑞巴林作为骨科上肢手术后疼痛控制的药物前体的效果：一项双盲平行随机临床试验研究

The adverse effects of general anesthesia on the long-term cognition of young children and senior adults have become of concern in recent years. Previously, mechanistic and pathogenic investigations focused on neurons, and little is known about the effect of commonly used intravenous anesthetics such as propofol and ketamine on astrocytes. Recently, astrocyte dysfunction has been implicated in a wide range of age-related brain diseases. In this study, we examined the survival and viability of both young and senescent astrocytes in culture after adding propofol and ketamine to the media at varying strengths. Oxidative stimulus was applied to commercially available fetal cell lines of human astrocytes in vitro to induce morphological changes in cellular senescence. Our results indicate that propofol reduces the survival of young astrocytes as compared to controls, as well as to ketamine. These effects were seen in comparisons of total cell count and at both high and low dose concentrations. High doses of propofol also significantly reduced cell viability compared to those exposed to baseline controls and ketamine. Senescent astrocytes, on the other hand, demonstrated cell count reductions as compared to baseline controls and ketamine when exposed to either DMSO or propofol. The data show differential susceptibility of young astrocytes to propofol than to ketamine. The observed cell count reduction may be related to the adverse effects of propofol on mitochondrial function and free radical production, as described in previous studies. We speculate that ketamine may have a more favorable safety profile in infants and young children.

Liang Huang

Ferit Tuzer

Abigail Murtha

Michael Green

Claudio Torres

Henry Liu

Shadi Malaeb

Differential Susceptibility to Propofol and Ketamine in Primary Cultures of Young and Senesced Astrocytes

年轻和衰老星形胶质细胞原代培养物对丙泊酚和氯胺酮敏感性的差异

Purpose. Preoperative oral carbohydrate (CHO) is a rapid postoperative rehabilitation protocol that improves perioperative outcomes and is widely used in adult surgical patients. However, pregnant women are excluded because of the possibility of aspiration due to delayed gastric emptying. This meta-analysis was conducted to evaluate the efficacy of preoperative oral CHO in elective cesarean section. Methods. PubMed, Embase, Web of Science, and the Cochrane Library were searched from inception to July 2023. Randomized controlled trials were included. The risk of bias was assessed using the Cochrane tool. Risk ratios and 95% confidence intervals were calculated. Meta-analysis was performed using random-effects models to estimate risk ratios and mean differences (MDs) with 95% confidence intervals (CIs). The outcomes included thirst and hunger scores, incidence of vomiting and nausea, time to flatus, and homeostatic model assessment of insulin resistance (HOMA-IR). Results. A total of nine studies with 1211 patients were included in the analysis. The levels of thirst and hunger were evaluated using a 10-point visual analog scale, with 0 representing the best and 10 representing the worst. The severity of hunger (weighted mean difference (WMD: −2.34, 95% CI: −3.13 to −1.54), time to flatus (WMD: −3.51 hours, 95% CI: −6.85 to −0.17), and HOMA-IR (WMD: −1.04, 95% CI: −1.31 to −0.77) were significantly lower in the CHO group compared to the control group. However, there were no significant differences in the severity of thirst or the incidence of vomiting and nausea between the CHO and control groups. Conclusion. Preoperative oral CHO during cesarean section alleviates thirst and hunger, shortens the time of postoperative flatus, and reduces HOMA-IR. However, the available evidence is insufficient to reach a clear consensus on the benefits or harms of preoperative oral CHO during cesarean section. Therefore, it is premature to make a definitive recommendation for or against its routine use.

Haibin Shi

Caihong Zheng

Bin Zhu

Effects of Preoperative Oral Carbohydrate on Perioperative Maternal Outcomes Undergoing Cesarean Section: A Systematic Review and Meta-Analysis

术前口服碳水化合物对剖宫产围手术期产妇结局的影响：一项系统评价和Meta分析

Abbreviation	Anesthesiol. Res. Pract.
Journal Impact	1.75
Quartiles(Global)	ANESTHESIOLOGY(Q2)

ISSN	1687-6962, 1687-6970
h-index	28

Publication Information	Publisher: Hindawi Limited，Publishing cycle: ，Journal Type: journal，Open Access Journals: Yes
Basic data	Year of publication: 2008，Proportion of original research papers: 100.00%，Self Citation Rate:0.00%， Gold OA Rate: 100.00%
Journal Fees	$950Details
Average review cycle	网友分享经验：18 Weeks

Anesthesiology Research and Practice

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