Articles: general-anesthesia.
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It is very common for burn patients to have hypothermia during escharectomy under general anesthesia, which increases the blood transfusion demand of burn patients, and may lead to blood coagulation disorder or even increase the mortality of patients. It is important to predict the occurrence of hypothermia in advance, but we lack a prognostic prediction model. Our study aimed to develop a nomogram to predict the incidence of hypothermia in adult burn patients undergoing escharectomy under general anesthesia to intervention the hazards associated with hypothermia early. ⋯ Hypothermia in burn patients during escharectomy under general anesthesia is associated with burn index, urinary volume, blood transfusion volume and irrigation volume. We successfully developed a practical nomogram to accurately predict hypothermia, which is a practical method helping clinicians rapidly and conveniently diagnose and guide the treatment of hypothermia in burn patients during escharectomy under general anesthesia.
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Curr Opin Anaesthesiol · Feb 2024
ReviewInnovative designs for trials informing the care of cardiac surgical patients: Part II.
This review examines advances in clinical trial methodologies relevant to cardiac anesthesia. It focuses on innovative approaches, including factorial randomization, composite outcomes, and cluster randomized trials, which enhance the efficiency, practical relevance, and generalizability of trial outcomes. ⋯ The evolution of clinical trial designs is marked by a shift towards methodologies that enhance efficiency and provide more nuanced insights into treatment effects. These include factorial designs for simultaneous intervention assessment, composite outcomes for comprehensive physiological representation, and cluster trials for group-level effect analysis. Such advancements are shaping the future of clinical research, making it more relevant, efficient, and broadly applicable.
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Anesthesia and analgesia · Feb 2024
ReviewDepth of Anesthesia and Nociception Monitoring: Current State and Vision For 2050.
Anesthesia objectives have evolved into combining hypnosis, amnesia, analgesia, paralysis, and suppression of the sympathetic autonomic nervous system. Technological improvements have led to new monitoring strategies, aimed at translating a qualitative physiological state into quantitative metrics, but the optimal strategies for depth of anesthesia (DoA) and analgesia monitoring continue to stimulate debate. Historically, DoA monitoring used patient's movement as a surrogate of awareness. ⋯ Generally, nociceptive monitors outperform basic clinical vital sign monitoring in reducing perioperative opioid use. This manuscript describes pupillometry, surgical pleth index, analgesia nociception index, and nociception level index, and suggest how future developments could impact their use. The final section of this review explores the profound implications of future monitoring technologies on anesthesiology practice and envisages 3 transformative scenarios: helping in creation of an optimal analgesic drug, the advent of bidirectional neuron-microelectronic interfaces, and the synergistic combination of hypnosis and virtual reality.
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Randomized Controlled Trial
Effect of noise isolation using noise-cancelling headphones during laparoscopic surgery for postoperative pain reduction: A randomized clinical trial.
Most laparoscopic surgeries under general anesthesia are performed in noisy environments, although the effect of intraoperative noise reduction on postoperative pain remains uncertain. This study aimed to explore whether postoperative pain could be reduced through the intraoperative use of noise-cancelling headphones. ⋯ During laparoscopic surgery under general anesthesia, intraoperative noise isolation using noise-cancelling headphones is a safe and effective strategy for relieving postoperative pain and decreasing total opioid analgesic consumption.
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Paediatric anaesthesia · Feb 2024
Observational StudyAssociation between emergence delirium and brain status parameters in children undergoing general anesthesia: A prospective observational study.
Emergence delirium is a common postoperative neurological complication in children after general anesthesia. There is no valid tool to predict emergence delirium. Wavelet index, pain threshold index, anxiety index, and comfort index are real-time brain status parameters extracted from the electroencephalogram, which have recently been developed. The aim is to evaluate the association between real-time brain status parameters during emergence and emergence delirium in children undergoing general anesthesia. ⋯ AnXi and CFi might be used to guide anesthesiologists to identify and intervene ED in children.