New Updates on Anesthesia and Perioperative Medicine

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Anesthesiology".

Deadline for manuscript submissions: 30 September 2024 | Viewed by 2909

Special Issue Editor


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Guest Editor
Anesthesiology and Operative Intensive Care, University of Augsburg, Augsburg, Germany
Interests: anesthesia; perioperative intensive care; electrical impedance tomography; acute respiratory distress syndrome; emergency medicine

Special Issue Information

Dear Colleagues,

There has been an enormous growth of knowledge in anesthesia and critical care medicine in recent years. In clinical anesthesia, advances in ultrasound-guided regional anesthesia have led to increased safety in the application of nerve blocks and enabled the development of novel block techniques. Additionally, individualized medicine is increasingly finding its way into both the intensive care unit and the operating room. For example, new monitoring techniques such as Electrical Impedance Tomography, offer the possibility to directly observe the effect of interventions and to adapt mechanical ventilation to the patient's individual physiology. In particular, in acute respiratory distress syndrome, a personalized mechanical ventilation approach based on the individual phenotype could lead to a better treatment of this heterogeneous disease and thus to improved outcomes.

This Special Issue addresses and highlights the latest developments in the entire field of anesthesia and perioperative intensive care. Original and experimental papers as well as reviews and systematic reviews are welcome for submission.

Dr. Felix F. Girrbach
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

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Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • clinical anesthesia
  • perioperative intensive care
  • mechanical ventilation
  • acute respiratory distress syndrome, research
  • person-alized medicine

Published Papers (3 papers)

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Research

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13 pages, 1026 KiB  
Article
Comparison of Hemodynamic Parameters Based on the Administration of Remimazolam or Sevoflurane in Patients under General Anesthesia in the Beach Chair Position: A Single-Blinded Randomized Controlled Trial
by Sangho Lee, Jimung Seo, Doh Yoon Kim, YoungYun Lee, Hee Yong Kang, Jeong-Hyun Choi, Youngsoon Kim, Mi Kyeong Kim and Ann Hee You
J. Clin. Med. 2024, 13(8), 2364; https://doi.org/10.3390/jcm13082364 - 18 Apr 2024
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Abstract
Background: We aimed to evaluate whether the administration of remimazolam as a maintenance agent for general anesthesia affects the occurrence of hypotension compared with sevoflurane when switching to the beach chair position (BCP). Methods: We conducted a prospective randomized controlled trial from June [...] Read more.
Background: We aimed to evaluate whether the administration of remimazolam as a maintenance agent for general anesthesia affects the occurrence of hypotension compared with sevoflurane when switching to the beach chair position (BCP). Methods: We conducted a prospective randomized controlled trial from June 2023 to October 2023 in adult patients undergoing orthopedic surgery under general anesthesia in the BCP. A total of 78 participants were randomly allocated to the remimazolam (R) or sevoflurane (S) groups. The primary outcome was the incidence of hypotension that occurred immediately after switching to a BCP. The secondary outcomes included differences between the study groups in perioperative blood pressure (BP), heart rate (HR), endotracheal tube extubation time, postoperative complications, and hospital length of stay (LOS). Results: The incidence of hypotension immediately after switching to a BCP was significantly higher in the S group. The risk factors associated with hypotension included sevoflurane administration and a high baseline systolic BP. In the receiver operating characteristic curve analysis for the occurrence of hypotension after the transition to a BCP, the cutoff value for systolic BP was 142 mmHg. The perioperative BP and HR were higher in the R group at several timepoints. Postoperative endotracheal tube extubation time was shorter in the R group. There were no significant differences in the postoperative complications or hospital LOS between the two groups. Conclusions: Remimazolam should be considered as an anesthetic agent to prevent hypotension when switching to BCP, and hypotension may occur frequently in patients with high baseline BP. Full article
(This article belongs to the Special Issue New Updates on Anesthesia and Perioperative Medicine)
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12 pages, 755 KiB  
Article
Comparison of the Analgesic Efficacy between Levobupivacaine 0.25% and Ropivacaine 0.375% for PENG (Pericapsular Nerve Group) Block in the Context of Hip Fracture Surgery of Elderly Patients: A Single-Center, Randomized, and Controlled Clinical Trial
by Daniel Salgado-García, Agustín Díaz-Álvarez, José Luis González-Rodríguez, María Rocío López-Iglesias, Eduardo Sánchez-López, Manuel Jesús Sánchez-Ledesma and María Isabel Martínez-Trufero
J. Clin. Med. 2024, 13(3), 770; https://doi.org/10.3390/jcm13030770 - 29 Jan 2024
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Abstract
Previous studies have compared levobupivacaine versus ropivacaine in various peripheral nerve blocks in terms of block duration, quality of analgesia, and onset time, but this has not occurred in the PENG block. Here, a single-center, randomized, and controlled clinical trial is presented. One [...] Read more.
Previous studies have compared levobupivacaine versus ropivacaine in various peripheral nerve blocks in terms of block duration, quality of analgesia, and onset time, but this has not occurred in the PENG block. Here, a single-center, randomized, and controlled clinical trial is presented. One hundred and twenty patients older than 65 years suffering from hip fractures and surgically treated at our institution under spinal anesthesia were eligible for participation; of them, one hundred and eight were analyzed. Patients were randomized to receive ultrasound-guided PENG blocks using 20 mL of either 0.25% levobupivacaine or 0.375% ropivacaine (both of which are equipotent concentrations). The primary endpoint was to compare the analgesic duration (time to first rescue) and analgesic quality (pain scores using the VAS, PAINAD, and AlgoPlus scales) between the groups. Secondary endpoints included comparing the onset time, describing the need for and type of rescue analgesics, and possible associated adverse effects. There were no statistically significant differences in analgesic duration between levobupivacaine (median 861.0, IQR 960) and ropivacaine (median 1205.0, IQR 1379; p = 0.069). Likewise, the quality of analgesia and onset time were comparable among the groups. A small number of patients required opioids as rescue analgesics (4.6%). The possible associated adverse effects included postoperative infection (11.1%) and delirium (2.8%). Full article
(This article belongs to the Special Issue New Updates on Anesthesia and Perioperative Medicine)
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Review

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19 pages, 334 KiB  
Review
Perioperative Ketamine and Cancer Recurrence: A Comprehensive Review
by Juan Alberto Rodriguez Arango, Tamara Zec and Maher Khalife
J. Clin. Med. 2024, 13(7), 1920; https://doi.org/10.3390/jcm13071920 - 26 Mar 2024
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Abstract
Cancer is a significant global health threat and a leading cause of death worldwide. Effective early-stage interventions, particularly surgery, can potentially cure many solid tumors. However, the risk of postoperative cancer recurrence remains high. Recent research highlights the influence of perioperative anesthetic and [...] Read more.
Cancer is a significant global health threat and a leading cause of death worldwide. Effective early-stage interventions, particularly surgery, can potentially cure many solid tumors. However, the risk of postoperative cancer recurrence remains high. Recent research highlights the influence of perioperative anesthetic and analgesic choices on the fate of residual cancer cells, potentially affecting recurrence risks. Among these agents, ketamine—a well-known anesthetic and analgesic—has garnered interest due to its antitumor properties, mainly through inhibiting the N-methyl-D-aspartate (NMDA) receptor found in various cancer tissues. Additionally, ketamine’s potential immunomodulatory effects, given the expression of NMDA receptors on immune cells, suggest that it plays a significant role during the perioperative period. This review synthesizes current evidence on ketamine’s impact on cancer cell biology, inflammation, immune modulation, and the role of the gut microbiota, proposing ketamine as a promising agent for enhancing oncological outcomes. Full article
(This article belongs to the Special Issue New Updates on Anesthesia and Perioperative Medicine)
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