Articles: anesthetics.
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Based on the existing literature, the application of designated, processed EEG-monitors to measure anesthetic depth and the associated clinical implications are explained. EEG-monitors quantify the hypnotic portion of anesthesia, but not the nociceptive properties of anesthetics. Depth of anesthesia monitoring is common practice in many German hospitals and helps to visualize the interindividual variability of anesthetics, especially of propofol. ⋯ Nevertheless, depth of anesthesia monitors help to identify patients being especially susceptible to anesthetics. Moreover, they have shown to reduce the incidence of intraoperative awareness and postoperative delirium. The application of processed EEG-monitors to reduce the incidence of postoperative delirium is currently recommended by the European Society of Anaesthesiology and Intensive Care.
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Observational Study
Quantification of muscle tone by using shear wave velocity during an anaesthetic induction: a prospective observational study.
The quantitative assessment of muscle stiffness or weakness is essential for medical care. Shear wave elastography is non-invasive ultrasound method and provides quantitative information on the elasticity of soft tissue. However, the universal velocity scale for quantification has not been developed. The aim of the study is to determine the shear wave velocities of abdominal muscle during anesthetic induction and to identify methods to cancel the effects of confounders for future development in the quantitative assessment of muscle tone using the universal scale. ⋯ The present study suggested that the SWV as reference was 1.79 m/s and that the SWVs at rest and opioid-induced rigidity were ~ 10% and ~ 30% increase from the reference, respectively. The SWV adjusted for the subcutaneous fat thickness may be scale points for the assessment of muscle tone.
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Anxiety is a complex emotional state that can arise from the anticipation of a threatening event, and preoperative anxiety is a common experience among adult patients undergoing surgery. In adult patients, the incidence of preoperative anxiety varies widely across different surgical groups, and it can result in a variety of psychophysiological responses and problems. Despite its negative impact, preoperative anxiety often receives insufficient attention in clinical practice. ⋯ These personalized approaches could involve developing tools to identify individuals who are more likely to experience increased pain and may require additional analgesia. To address this, regular assessments of anxiety levels should be conducted during preoperative visits, and counseling should be provided to patients with high levels of anxiety. Identifying and addressing preoperative anxiety in a timely manner can help reduce its incidence and potential consequences.