Publications by authors named "Kuratani N"
Background: Comprehensive data on pediatric anesthesia outcomes, particularly severe critical events (SCEs), are scarce in Asia. This highlights the need for standardized research to assess anesthesia safety and quality in the diverse settings.
Aims: The PEACH in Asia pilot study aimed to test the feasibility of a standardized protocol for investigating SCEs in anesthesia practices across Asia, evaluate the data acquisition processes, and determine the sample size for a main study.
Article Synopsis
- Sodium-glucose cotransporter 2 inhibitors (SGLT2is) are common diabetes medications that can lead to ketoacidosis, prompting this study to explore their incidence in surgical patients.
- A multicenter study in Japan tracked surgical patients on SGLT2is to identify occurrences of perioperative ketoacidosis, defined by specific urine and blood criteria, over a monitoring period after surgery.
- The findings showed that only 0.40% of patients exhibited symptoms consistent with ketoacidosis, but all cases were due to respiratory acidosis, leading to an estimated SGLT2i-associated ketoacidosis rate of 0%, suggesting a lower risk than anticipated.
Article Synopsis
- * Collaboration is crucial for enhancing the training and resources of pediatric anesthesiology educators, which in turn improves access to surgical care for children in these regions.
- * The article highlights various collaborative efforts and organizations, such as the World Federation of Societies of Anaesthesiologists and specialized training programs, that work towards improving pediatric anesthesia care globally.
Background: Persistent symptoms are reported in patients who survive the initial stage of COVID-19, often referred to as "long COVID" or "post-acute sequelae of SARS-CoV-2 infection" (PASC); however, evidence on their incidence is still lacking, and symptoms relevant to pain are yet to be assessed.
Methods: A literature search was performed using the electronic databases PubMed, EMBASE, Scopus, and CHINAL and preprint servers MedRχiv and BioRχiv through January 15, 2021. The primary outcome was pain-related symptoms such as headache or myalgia.
Article Synopsis
- Remimazolam is an ultra-short-acting sedative approved in Japan for adults but lacks pediatric-specific guidelines, prompting this study on its safety for kids during procedures.
- The study included 48 children, averaging 7 years old, evaluating factors like dosage, procedure success, and changes in heart rate and blood pressure, with no adverse events reported.
- Results indicated that remimazolam, used alongside propofol or ketamine, is safe for pediatric procedural sedation, even though significant hemodynamic changes were observed; none required treatment for these fluctuations.
Article Synopsis
- Remimazolam, approved in 2020 for adult general anesthesia, is being tested for pediatric use in a study administering it alongside endotracheal anesthesia in children.
- Researchers analyzed medical records from 418 children, mainly around 4.6 years old, who underwent surgeries averaging about 81 minutes, using an adjusted dosing regimen from adult guidelines.
- The study found significant hemodynamic variability in many patients, with nearly half experiencing notable changes in mean arterial pressure, though patients recovered quickly, meeting discharge criteria within about 14 minutes post-anesthesia.
Article Synopsis
- - The study aims to gather real-world data on the incidence of adverse events during pediatric anaesthesia, particularly focusing on difficulties in securing airways and their risk factors, which can help enhance safety protocols in anaesthesia practices.
- - Conducted over three years in four tertiary care hospitals in Japan, the study will track children under 18 undergoing surgery or diagnostic procedures requiring general anaesthesia or sedation, collecting data on patient traits and anaesthesia management methods.
- - With an estimated sample size of 16,000, the study is designed to analyze the correlation between challenging airway features and adverse events, with the findings expected to inform targeted education initiatives for anaesthesia providers.
Article Synopsis
- The recommended preoperative pause for SGLT2 inhibitors was changed in 2020 from 24 hours to 3-4 days to lower the risk of a serious condition called SAPKA (sodium-glucose cotransporter 2 inhibitor-associated perioperative ketoacidosis).
- A review of case studies showed that most patients (about 60%) who reported their preoperative SGLT2 inhibitor pause did so for less than the recommended 3 days, but none with a pause longer than 2 days suffered from SAPKA.
- The authors suggest that sticking to a 3-day cessation could help prevent SAPKA, but emphasize the need for more comprehensive studies to pinpoint other potential risk factors.
Article Synopsis
- Duchenne muscular dystrophy (DMD) poses significant risks for patients undergoing anesthesia due to compromised heart and lung function, leading to a need for improved anesthetic methods like remimazolam, which offers better stability and a reversal agent compared to traditional options like propofol.
- A 4-year-old boy diagnosed with DMD presented with very high serum creatine phosphokinase levels prior to a scheduled hernia surgery, resulting in a postponement of the procedure.
- The boy was later successfully induced with remimazolam for anesthesia during the surgery, alongside fentanyl and remifentanil, with careful monitoring and management to ensure he regained proper muscle function afterward.
Article Synopsis
- - This study focuses on the safety of Sodium-glucose cotransporter 2 (SGLT2) inhibitors, which help lower blood sugar but can lead to complications like ketoacidosis and urinary tract infections, especially after surgery.
- - Researchers will observe 750 adult Japanese patients with diabetes using SGLT2 inhibitors who are undergoing surgery, collecting urine samples and conducting blood tests to identify the occurrence of postoperative ketoacidosis (SAPKA).
- - The study has received ethical approval and aims to share its findings through peer-reviewed publications and presentations at relevant conferences.
Article Synopsis
- * A survey conducted in Kratie Province, Cambodia, assessed the knowledge of surgical symptoms among 91 participants, including medical staff, CHWs, and villagers, revealing no significant differences in their knowledge levels.
- * Findings indicate that while participants exhibited similar knowledge scores, overall knowledge of surgical symptoms was inadequate, emphasizing the need for further training to enhance surgical care in rural communities.
Article Synopsis
- - This study analyzed the effectiveness of forced-air underbody blankets in maintaining body temperature in anesthetized surgical patients compared to other warming methods.
- - Researchers examined 5063 surgical patients and used propensity score matching to minimize biases, finding that those using underbody blankets had a significantly lower rate of hypothermia after surgery.
- - Results indicated that underbody blankets may be more effective in reducing intraoperative hypothermia, suggesting potential benefits for anesthetized patients compared to traditional warming blankets.
Article Synopsis
- This case series assessed the use of remifentanil in neonates undergoing non-cardiac surgeries, recognizing the unique challenges in anesthetic management for this age group.
- The study involved 68 neonates, with 48 receiving remifentanil during their procedures, with no serious complications like postoperative apnea observed.
- The findings suggest that remifentanil is a viable option for anesthesia in neonatal surgeries, emphasizing its safety and suitable pharmacological properties.
Article Synopsis
- The study aims to identify factors that influence the time it takes for children to be extubated after general anesthesia during ambulatory surgery, emphasizing the need for rapid turnover in operating rooms without sacrificing safety.
- Researchers analyzed data from 148 children aged 1-6 years, focusing on various clinical measures such as vital signs and anesthesia types (sevoflurane or propofol) during surgeries lasting less than 2 hours.
- Findings indicate that mean end-tidal carbon dioxide (mETCO) and mean body temperature (mBT) during surgery are significant factors affecting extubation time, highlighting the importance of monitoring these vital signs to prevent delays in recovery.
Study Objective: To evaluate the efficacy of intravenous nitroglycerin (TNG) in preventing intraoperative myocardial ischemia (MI) under general anesthesia. Moreover, we analyzed the hemodynamic changes in heart rate (HR), mean blood pressure (MBP), and pulmonary capillary wedge pressure (PCWP) associated with TNG administration both before and after the induction of anesthesia.
Design: Meta-analysis.
Article Synopsis
- Higher mortality rates are associated with patients admitted to hospitals on weekends compared to weekdays; however, the specific risks based on diagnoses and regions haven't been thoroughly studied.
- A meta-analysis of 88 studies involving over 56 million participants showed a significant increased odds ratio for short-term mortality for weekend admissions (1.12 to 1.16).
- The "weekend effect" was found to vary significantly by diagnosis, impacting 15 out of 24 categories, and suggests the need for more targeted research in this area.
Article Synopsis
- The study aimed to investigate if remifentanil led to more postoperative shivering than other opioids, such as alfentanil, fentanyl, and sufentanil.
- A comprehensive meta-analysis, which included 18 randomized controlled trials, found that remifentanil significantly increased the risk of postoperative shivering, with a relative risk of 2.17.
- The findings also revealed that both low and high doses of remifentanil were linked to increased shivering, especially when combined with propofol or inhalation anesthesia, indicating a notable difference in shivering incidence compared to other opioids.
The Pentax Airway Scope(®) is a single-use optical videolaryngoscope designed to assist with difficult tracheal intubation. We systematically reviewed the efficacy of the Pentax Airway Scope with that of a conventional laryngoscope for tracheal intubation in adults with 'normal' and 'difficult' airways. We included 17 randomised controlled trials with a total of 1801 participants.
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- The study evaluates the effectiveness of videolaryngoscopes (Glidescope, Airtraq, and Pentax-AWS) for nasotracheal intubation compared to the traditional Macintosh laryngoscope.
- A systematic review included data from seven randomized controlled trials with a total of 547 intubations, finding that videolaryngoscopes had a higher success rate and significantly shorter intubation times.
- The results suggest that videolaryngoscopes offer a better alternative for nasotracheal intubation than the Macintosh laryngoscope.