Journal of anesthesia
-
Journal of anesthesia · Feb 2025
Randomized Controlled Trial Comparative StudyEffect of restrictive versus liberal fluid therapy for laparoscopic gastric surgery on postoperative complications: a randomized controlled trial.
Currently, laparoscopic surgery is a standard technique in the field of abdominal surgery. However, the most adequate fluid regimen during laparoscopic surgery remains unclear. The aim of this trial is to compare a restricted fluid therapy with a liberal fluid therapy for laparoscopic abdominal surgery. Our hypothesis was that restrictive fluid therapy would reduce postoperative complications better than liberal fluid therapy. ⋯ Restricted fluid therapy and liberal fluid therapy did not show any statistical differences in postoperative complications after laparoscopic gastric surgery.
-
Journal of anesthesia · Feb 2025
Comparative Study Observational StudyRisk of postoperative pneumonia after extubation with the positive pressure versus normal pressure technique: a single-center retrospective observational study.
A normal pressure extubation technique (no lung inflation before extubation), proposed by the Japanese Society of Anesthesiologists to prevent droplet infection during the coronavirus disease 2019 (COVID-19) pandemic, could theoretically increase postoperative pneumonia incidence compared with a positive pressure extubation technique (lung inflation before extubation). However, the normal pressure extubation technique has not been adequately evaluated. This study compared postoperative pneumonia incidence between positive and normal pressure extubation techniques using a dataset from the University of Tsukuba Hospital. ⋯ Clinical trial number: UMIN000048589 https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000055364.
-
Journal of anesthesia · Feb 2025
Anesthetic and obstetric predictors of general anesthesia in urgent or emergent Cesarean delivery: a retrospective case-control study.
While regional anesthesia (RA) is considered preferable to general anesthesia (GA) for Cesarean delivery (CD), certain situations necessitate GA. This study reviewed the practice patterns around the use of GA for CD to identify modifiable predictors of GA with the goal of reducing GA rates. ⋯ Abnormal fetal heart rate, specifically bradycardia, was the most common obstetrical indication of GA for urgent/emergent CD, while inadequate neuraxial anesthesia was the most modifiable anesthetic indication. Our data suggest aFHR and cord/fetal prolapse as potentially modifiable risk factors for GA in certain situations.
-
Journal of anesthesia · Feb 2025
Preoperative hypoxic biomarkers and postoperative delirium in patients with obstructive sleep apnea.
Postoperative delirium (POD) in patients with obstructive sleep apnea (OSA) is associated with increased mortality and healthcare costs. In this study, we investigated the association of OSA risk, serum biomarkers for central nervous ischemia (S100B and NSE), and POD. ⋯ We found a trend of decreasing POD incidence with increasing OSA risk, which was not robust in a complete case analysis. Our results possibly support the phenomenon of hypoxic preconditioning.
-
Journal of anesthesia · Feb 2025
Observational StudyUltrasound assessment of the frequency and variation of arteries in the interscalene region.
Given the abundance of arteries in the neck, a significant risk of puncturing arteries exists when performing a brachial plexus block. Therefore, it is important to confirm the presence of arteries when performing a brachial plexus block via the interscalene approach. This study aimed to investigate the frequency and variations of arteries in the interscalene region in healthy Japanese adults using ultrasonography. ⋯ Interscalene observations using ultrasound devices revealed a high artery frequency, with numerous topographic variations.