Transversus abdominis plane block combined with intrathecal fentanyl versus intrathecal morphine for post-cesarean analgesia: a randomized non-inferiority clinical trial.

Background: Intrathecal morphine is the standard for post-cesarean analgesia but often causes pruritus and may be unavailable in resource-limited settings. This study assessed whether a combination of bilateral transversus abdominis plane (TAP) block and intrathecal fentanyl provides non-inferior analgesia compared with intrathecal morphine following cesarean delivery within the multimodal analgesia context.

Methods: Eighty mothers were randomized to receive either intrathecal fentanyl 10 µg with bilateral TAP block using 15 mL of 0.

Targeted nutritional strategies in postoperative care.

Immunonutrition, which uses specific nutrients to modulate the immune response, has emerged as a vital adjunct to perioperative care. Surgery-induced stress triggers immune responses that can lead to complications, such as infections and delayed wound healing. Traditional nutritional support often overlooks the immunological needs of surgical patients.

The immune-inflammatory responses on the hypothalamic-pituitary-adrenal axis and the neurovascular unit in perioperative neurocognitive disorder.

Perioperative neurocognitive disorders (PNDs) refer to a wide spectrum of cognitive impairment persisting days to even after a year postoperative with significant morbidity and mortality. However, despite much efforts involving perioperative managements, PNDs are still prevalent with no standard preventative and therapeutic strategy. To overcome PNDs, a better understanding of pathophysiology of PNDs is crucial and a large number of studies have proven that immune-inflammatory responses from surgical stress are involved in the abnormal activation of the hypothalamic-pituitary-adrenal (HPA) axis and destabilization of neurovascular unit (NVU) that lead to PNDs.

Optimizing Intravenous Patient-Controlled Analgesia for Cancer Pain: A Randomized Controlled Trial on Adjusted Background Infusion Rates.

Purpose: Patient-controlled analgesia (PCA) has been considered for managing cancer pain; however, limited research has been conducted on optimizing continuous infusion rates with PCA. This study aimed to evaluate the efficacy and safety of a method that optimizes background infusion (BI) alongside PCA for titrating intravenous (IV) morphine in managing cancer-related pain.

Methods: Forty-four patients with solid tumors who could not manage pain with oral or transdermal opioid analgesics were randomly assigned in a 1:1 ratio to receive IV morphine through PCA or the conventional method.

Peak serum lactate as a robust predictor of imminent death in life-sustaining treatment decisions: A study of 73,927 patients.

Objective: The physician order for life-sustaining treatment has been implemented in clinical practice for several years. However, the determination that a patient is in the terminal phase of life, a prerequisite for the withdrawal of life-sustaining treatment, lacks objective criteria. This study aimed to evaluate whether hyperlactatemia could serve as a reliable objective indicator for determining the terminal phase.

Comparative analysis of analgesic efficacy and functional recovery in open pancreaticoduodenectomy: a randomized controlled trial of local anesthetic wound infiltration, transversus abdominis plane block, and intramuscular electrical stimulation.

Background: Pancreaticoduodenectomy (PD) is associated with severe postoperative pain. Optimized pain management can potentially elevate patients' postoperative quality of life. This study focused on comparing the analgesic efficacy and subsequent functional recovery of three techniques, continuous local wound infiltration (LWI), four-quadrant transversus abdominis plane (4QTAP) block, and needle electrical twitch obtaining intramuscular stimulation (NETOIMS), in patients subjected to open PD.

Comparison of high-flow nasal oxygenation and standard low-flow nasal oxygenation during rigid bronchoscopy: a randomized controlled trial.

Background: The efficacy of high-flow nasal oxygenation (HFNO) in improving oxygenation is influenced by several factors, and its effectiveness is not always guaranteed. Therefore, we aimed to compare the effects of HFNO and standard low-flow nasal oxygenation during rigid bronchoscopy in the apneic patients.

Methods: All patients were administered general anesthesia with full muscle relaxation and were randomly assigned to receive either HFNO (HFNO group) or standard low-flow oxygenation (Standard group).

Early management of adult sepsis and septic shock: Korean clinical practice guidelines.

Background: Despite recent advances and global improvements in sepsis recognition and supportive care, mortality rates remain high, and adherence to sepsis bundle components in Korea is low. To address this, the Korean Sepsis Alliance, affiliated with the Korean Society of Critical Care Medicine, developed the first sepsis treatment guidelines for Korea based on a comprehensive systematic review and meta-analysis.

Methods: A de novo method was used to develop the guidelines.

Evaluation of Handgrip Strength Asymmetry to Assess Sarcopenia in Older Patients with Chronic Low Back Pain: A Retrospective Cross-Sectional Study.

Background: Handgrip strength (HGS) is a crucial measurement for diagnosing sarcopenia, and HGS asymmetry indicates functional impairment and correlates with adverse health outcomes. Although chronic low back pain (CLBP) often coexists with sarcopenia in older people, the association between HGS asymmetry and sarcopenia in that population has not been investigated.

Objectives: This study examines the association between HGS asymmetry and sarcopenia in older patients with CLBP and explores differences in the proportion of sarcopenia and severe sarcopenia according to the severity of HGS asymmetry.

Effects of Desflurane versus sevoflurane on graft outcome of patients with cirrhosis receiving steatotic liver graft in deceased donor liver transplantation.

Study Objective: This study aimed to analyze the effects of two volatile anesthetic agents, desflurane and sevoflurane, on graft outcomes in patients undergoing deceased donor liver transplantation (DDLT) for cirrhosis, with a specific focus on fatty grafts.

Design: A retrospective observational study.

Setting: A tertiary hospital (Severance Hospital, Korea).

Preoperative nutritional scores to predict mortality after liver transplantation: a retrospective cohort study.

Background: Malnutrition is a well-known risk factor for mortality and morbidity. We investigated whether preoperative malnutrition, diagnosed using an objective nutritional index, was associated with postoperative mortality in patients undergoing liver transplantation (LT).

Methods: This retrospective cohort observational study assessed the preoperative nutritional status of 440 patients who underwent LT, using the Nutritional Risk Index (NRI), Prognostic Nutritional Index (PNI), and Controlling Nutritional Status (CONUT) score.

Corrigendum: Effect of sarcopenia on postoperative ICU admission and length of stay after hepatic resection for Klatskin tumor.

[This corrects the article DOI: 10.3389/fonc.2023.

Association between Intraoperative Electroencephalogram Burst Suppression and Postoperative Delirium: A Systematic Review and Meta-analysis.

Background: Electroencephalogram burst suppression can be associated with postoperative delirium; however, the results of relevant studies are discrepant. This systematic review and meta-analysis aimed to assess the association between intraoperative burst suppression and postoperative delirium in adult surgical patients.

Methods: PubMed, MEDLINE, Embase, Google Scholar, and the Cochrane Central Register of Controlled Trials were systematically searched and updated in May 2023.

Di(2-ethylhexyl) phthalate exposure aggravates hypoxia/reoxygenation injury in cerebral endothelial cells by downregulating epithelial cadherin expression.

Di-(2-ethylhexyl) phthalate (DEHP) is a widely used plasticizer that has adverse health effects. Most phthalates exhibit reproductive toxicity and are associated with diseases such as cardiovascular disorders. However, the effect of DEHP exposure on acute hypoxia/reperfusion injury remains unknown.

Transcatheter ventilation with a modified Rapid-O2 oxygen insufflation device.

Background: The Rapid-O2 oxygen insufflation device® (Rapid-O2) was designed primarily for rescue oxygenation in cannot intubate, cannot oxygenate (CICO) events; thus, hypercapnia is inevitable. Rapid-O2 was modified to enhance ventilation using the Venturi effect during expiration.

Methods: To determine the most effective combination of inner catheters (20 G, 18 G, 16 G, 14 G, and 2-mm inner diameter [ID] transtracheal catheter [TTC]) and insufflation catheters (16 G, 14 G, and 2-mm ID TTC) for achieving optimum ventilation, insufflating and expiratory flows were measured at an oxygen flow rate of 15 L/min.

Resorbable Microspheres versus Trisacryl Gelatin Microspheres for Uterine Artery Embolization: A Randomized Controlled Trial.

Background There are insufficient data comparing resorbable microspheres (RMs) with permanent trisacryl gelatin microspheres (TAGMs) for uterine artery embolization (UAE). Purpose To compare therapeutic efficacy and clinical outcomes in participants with symptomatic fibroids after UAE with RMs or TAGMs. Materials and Methods This randomized controlled trial included participants undergoing UAE for symptomatic fibroids at a single institution (from May 2021 to May 2023).

Albumin Leakage Level during Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy Is Associated with Major Complications.

The clinical consequences of perioperative albumin extravasation accompanying major abdominal surgery remain underexplored. We retrospectively reviewed the data of patients who underwent cytoreductive surgery (CRS) and hyperthermic intraoperative peritoneal chemotherapy (HIPEC). Parameters of albumin kinetics, including serum albumin concentration decrease (∆Alb) and extravasated albumin level (Alb), were assessed from surgery until postoperative day (POD) 3.

An online supportive music and imagery intervention to promote ICU nurses' stress management: Preliminary study.

Nurses in intensive care units are subjected to high levels of work-related stress and must cope with psychological distress. This preliminary study explored the effects of an online supportive music and imagery intervention on these nurses' perceived stress, psychological distress, and sleep quality. A prospective pre-post design was employed to investigate the effectiveness of online supportive music and imagery interventions.

Performance of calf circumference in identifying sarcopenia in older patients with chronic low back pain: a retrospective cross-sectional study.

Background: Calf circumference is currently recommended as a case-finding marker for sarcopenia, but its usefulness has not been determined in chronic pain conditions. Therefore, the present study aimed to evaluate the predictive performance of calf circumference in diagnosing sarcopenia in older patients with chronic low back pain.

Methods: Ambulatory adult patients aged ≥ 65 years with chronic low back pain were enrolled.