Journal of anesthesia
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Journal of anesthesia · Dec 2024
Comparative StudyRetrospective comparison of the effects of remimazolam and dexmedetomidine on postoperative delirium in elderly patients undergoing orthopedic surgery of the lower extremities under spinal anesthesia.
Remimazolam is often used for perioperative sedation due to its rapid onset and offset. However, the possible association between remimazolam and postoperative delirium (POD) remains undetermined. The present study evaluated whether remimazolam increased the incidence of POD compared with dexmedetomidine in elderly patients undergoing orthopedic surgery of the lower extremities. ⋯ Compared with dexmedetomidine, remimazolam infusion may be associated with a higher risk of POD in elderly patients undergoing orthopedic surgery of the lower extremities under spinal anesthesia.
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Journal of anesthesia · Dec 2024
Observational StudyPerformance of the ratio of posterior complex length to depth measured by ultrasound as a predictor of difficult spinal anesthesia for elective cesarean delivery: a prospective cohort study.
Ultrasound view of the interlaminar structure is likely to be associated with difficult spinal anesthesia (DSA), and a poor ultrasound view which cannot show the anterior and posterior complex predicts a difficult spinal technique. As our target site is the posterior complex, this study aimed to assess whether the ratio of posterior complex length to depth measured by ultrasound can predict DSA in cesarean delivery. ⋯ ChiCTR2200065171 https://www.chictr.org.cn/showproj.html?proj=180855.
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Journal of anesthesia · Dec 2024
Observational StudyAccuracy of non-invasive core temperature monitoring in infant and toddler patients: a prospective observational study.
Careful perioperative temperature management is important because it influences clinical outcomes. In pediatric patients, the esophageal temperature is the most accurate indicator of core temperature. However, it requires probe insertion into the body cavity, which is mildly invasive. Therefore, a non-invasive easily and continuously temperature monitor system is ideal. This study aimed to assess the accuracy of Temple Touch Pro™ (TTP), a non-invasive temperature monitoring using the heat flux technique, compared with esophageal (Tesoph) and rectal (Trect) temperature measurements in pediatric patients, especially in infants and toddlers. ⋯ Core temperature measurements using TTP in infants and toddlers were more accurate with Tesoph than with Trect. In the future, non-invasive TTP temperature monitoring will help perioperative temperature management in pediatric patients.
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Journal of anesthesia · Dec 2024
Observational StudyPediatric cardiac surgery: machine learning models for postoperative complication prediction.
Managing children undergoing cardiac surgery with cardiopulmonary bypass (CPB) presents a significant challenge for anesthesiologists. Machine Learning (ML)-assisted tools have the potential to enhance the recognition of patients at risk of complications and predict potential issues, ultimately improving outcomes. ⋯ Our machine learning-assisted tools provide an additional perspective and enhance the predictive capabilities of traditional scoring methods. These tools can assist anesthesiologists in making well-informed decisions. Furthermore, we have successfully demonstrated the feasibility of creating a practical white-box model. The next steps involve conducting clinical validation and multicenter cross-validation.
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Journal of anesthesia · Dec 2024
Randomized Controlled TrialA novel stimulating electrode attachment method designed to maintain electromyography-based neuromuscular monitoring detectability during laparoscopic surgery: a single-center randomized, double-blind, controlled pilot study.
We evaluated the electromyography (EMG)-based neuromuscular monitoring detectability of our novel stimulating electrode attachment method compared to the original Nihon-Kohden (Tokyo, Japan) attachment method. ⋯ Crossing the line connecting the anode and cathode with the ulnar nerve stabilizes EMG-based neuromuscular monitoring detectability.