Journal of anesthesia
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Journal of anesthesia · Feb 2023
Observational StudyPrevalence of pre-operative undiagnosed cognitive impairment and its association with handgrip strength, oral hygiene, and nutritional status in older elective surgical patients in Japan.
Preoperative cognitive impairment is a significant factor influencing post-operative delirium. We have been performing routine pre-operative comprehensive assessments, including evaluation of cognitive function, handgrip strength, oral hygiene, and nutritional status, in patients aged ≥ 65 years since April 2021. This study aimed to examine the completion rate of pre-operative comprehensive assessment and assess the prevalence of pre-operative undiagnosed cognitive impairment. ⋯ Preoperative comprehensive assessment was feasible. The prevalence of pre-operative undiagnosed cognitive impairment was 13%, and poor handgrip strength and worse oral hygiene were significantly associated factors.
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Journal of anesthesia · Feb 2023
ReviewAnalgesia nociception index and high frequency variability index: promising indicators of relative parasympathetic tone.
At present, there is no objective and absolute measure of nociception, although various monitoring techniques have been developed. One such technique is the Analgesia Nociception Index (ANI), which is calculated from heart rate variability that reflects the relative parasympathetic tone. ANI is expressed on a non-unit scale of 0-100 (100 indicates maximal relative parasympathetic tone). ⋯ Unlike ANI, HFVI can be displayed along with other biometric information on the Root® monitor. ANI/HFVI monitoring may affect the prognosis of not only patients in the perioperative period but those in ICU, those who receive home medical care, or outpatients. In this article, we present an updated review on ANI that has been published in the last decade, introduce HFVI, and discuss the outlooks of ANI/HFVI.
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Journal of anesthesia · Feb 2023
Effect of fibrinogen replacement therapy on bleeding outcomes and 1-year mortality in patients undergoing thoracic aortic surgery: a retrospective cohort study.
This study aimed to examine the effect of fibrinogen replacement therapy with cryoprecipitate or fibrinogen concentrate on bleeding outcomes and 1-year mortality in patients undergoing thoracic aortic surgery. ⋯ The results of this study indicate that 2-3 g of fibrinogen replacement reduces the incidence of major bleeding in patients with hypofibrinogenemia during cardiopulmonary bypass in thoracic aortic surgery.
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Journal of anesthesia · Feb 2023
Association between remimazolam and postoperative delirium in older adults undergoing elective cardiovascular surgery: a prospective cohort study.
Postoperative delirium is one of the most common complications after cardiovascular surgery in older adults. Benzodiazepines are a reported risk factor for delirium; however, there are no studies investigating remimazolam, a novel anesthetic agent. Therefore, we prospectively investigated the effect of remimazolam on postoperative delirium. ⋯ Remimazolam was not significantly associated with postoperative delirium when compared with other anesthetic agents.