記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVES: Rising patient numbers and limited resources are creating a challenging environment for healthcare providers recently. Anaesthesiologists are also increasingly faced with complex situations, requiring high adaptability in the operating room. To enhance team adaptability during emergencies, effective communication methods are essential. This study aimed to compare the impact of mobile phones and intercoms on the response time and effectiveness of anaesthesiologist teams in emergency situations. DESIGN: Prospective, observational and simulation study. SETTING: Anaesthesiology and Critical Care, Yokohama City University Medical Center, Yokohama, Japan. PARTICIPANTS AND METHODS: This study, conducted at Yokohama City University Medical Center (Yokohama, Japan), evaluated how communication methods (intercoms vs mobile phones) impact the efficiency of anaesthesiologists in the simulation setting. Two scenarios were tested: (1) retrieving a video laryngoscope during a difficult intubation and (2) gathering support during cardiac arrest. PRIMARY AND SECONDARY OUTCOME MEASURES: Outcomes measured included time to secure equipment, time for assistance to arrive and staff numbers gathered. The Wilcoxon signed-rank test was used to compare the outcomes between the intercom and mobile phone groups. RESULTS: In scenario 1, the time to secure the video laryngoscope was significantly shorter with intercom use compared with mobile phones (intercom vs mobile phone, median (IQR): 29 (25-33) s vs 50 (39-62) s; p=0.013, effect size 20 (95% CI 7 to 31)). In scenario 2, the time from the request for assistance until the first supporting staff member reached the operating room was significantly shorter in using the intercoms (intercom vs mobile phone, median (IQR): 16 (14-18) s vs 35 (31-38) s; p=0.04, effect size 17 (95% CI 6 to 24)), and more personnel were available in the intercom group (intercom vs mobile phone, median (IQR): 3 (3-3.5) persons vs 2 (1-2) persons; p=0.04, effect size 1.5 (95% CI 1 to 3)). CONCLUSION: Real-time information sharing through intercoms improved the ability of the anaesthesiologist team to respond more rapidly and effectively in emergency situations, enhancing overall team adaptability. This approach may improve patients' outcomes by shortening response times and increasing team coordination.

DOI： 10.1136/bmjopen-2025-099979

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: 5-HT3 receptor antagonists, including granisetron, have demonstrated antiemetic effects and the ability to prevent perioperative shivering. We conducted a systematic review of randomized clinical trials to investigate granisetron’s preventive effects on shivering in surgical patients undergoing general or neuraxial anesthesia. METHODS: We searched PubMed, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials from inception to January 7, 2025, without language restrictions, and simultaneously searched study protocols in four registries. Randomized controlled trials comparing granisetron versus placebo in surgical patients were included. We excluded studies in which patients underwent surgeries with cardiopulmonary bypass or in which patients were not expected to be extubated after surgery. The primary outcome was the incidence of shivering, calculated as a risk ratio with 95% CI using a random-effects model. A trial sequential analysis (TSA) of the primary outcome was performed to reduce type 1 errors from repeated meta-analyses, calculating the required information size. The risk of bias was assessed using the Revised Cochrane risk of bias 2 tool. RESULTS: Twenty-four trials, totaling 2,165 patients (1,166 and 999 patients in the granisetron and control groups, respectively), were included. Our meta-analysis showed a significantly lower incidence of shivering in surgical patients who received granisetron (risk ratio, 0.34; 95% CI, 0.28–0.41; I2 = 9%). The Grading of Recommendation Assessment, Development, and Evaluation assessment for granisetron’s effect on shivering prevention was moderate. When only low risk-of-bias trials were included, the Z-cumulative curve crossed the TSA boundary of benefit, confirming a significant reduction in shivering incidence in the granisetron group. The optimal granisetron dose, however, remains unclear in this meta-analysis. CONCLUSION: Our meta-analysis and TSA demonstrated that granisetron administration significantly reduced the incidence of shivering in patients undergoing surgery. While evidence regarding the general effect of granisetron on shivering is extensive, future studies should focus on determining the optimal dosage. TRIAL REGISTRATION: This meta-analysis is registered on PROSPERO(CRD42024616645). SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12871-025-03348-9.

DOI： 10.1186/s12871-025-03348-9

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVES: We aimed to evaluate the effect of projection mapping (PM) on the quality and safety of central venous catheter (CVC) insertion under real-time ultrasound guidance. DESIGN: Prospective, observational, simulation study. SETTING: This study was conducted at the Yokohama City University Medical Center (Yokohama, Japan). Volunteer residents were enrolled over 12 months from January to December 2023. PARTICIPANTS AND METHODS: 12 rotating residents (postgraduation year (PGY) 1 and 2) and eight anaesthesia residents (PGY 3-5) placed the CVC in the internal jugular vein in a simulator under the real-time ultrasound guidance using the short-axis out-of-plane approach. The ultrasound image was provided either just caudad to the puncture site using the PM method or on the monitor of the ultrasound machine (conventional method) placed next to the simulator's right shoulder. Each resident performed four punctures alternating between the PM and conventional methods, and the first method for each resident was chosen randomly. Eye-tracking analysis was also used to evaluate differences in gaze behaviour. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was the procedure time defined as the time from the application of the ultrasound probe on the puncture field until successful puncture of the vein. The secondary outcomes were incidence of complications and eye-tracking analysis data. RESULTS: The time to complete the line placement was significantly shorter for the PM than for the conventional method (median (IQR) 22.5 (15.5-30.6) s vs 30.0 (20.4-95.4) s; p=0.02, Wilcoxon's signed-rank test). The incidence of posterior vessel wall puncture was significantly lower in the PM method (0% vs 25%; p=0.02, McNemar's test). Eye-tracking analysis revealed that the percentage of time spent gazing at the ultrasound image was higher in the PM than in the conventional method (61.6% (55.0-69.2) vs 45.7% (34.1-54.5); p<0.01). CONCLUSIONS: The PM method facilitates ultrasound-guided CVC placement while preventing excessive needle advancement in the inexperienced operators. This was accompanied by enhanced fixation of the participants' line-of-sight on the ultrasound image.

DOI： 10.1136/bmjopen-2024-095803

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Several Japanese educational institutions have begun to train nurse anesthetists. They manage the patient consistently from pre-operation to post-operation in collaboration with the anesthesiologist. This has helped improve the quality of anesthetic management in an anesthesiologist shortage environment in Japan. However, no studies have examined the quality of anesthetic management by nurses worldwide. Therefore, this study investigated the quality of anesthesia among novice anesthesiology residents and nurse anesthetists, focusing on blood pressure control. METHODS: This study included adult patients undergoing breast surgery. Nurse anesthetists or anesthesiology residents oversaw general anesthesia. Intraoperative electronic medical records were used to compare the general anesthesia management of nurses and residents. The primary outcome was the sum of the duration during which the mean blood pressure was < 65 mmHg. This was quantified as a percentage of the total anesthesia time (time under mean 65 mmHg: TUm65). Independent variables included patient demographic characteristics, clinical information, the percentage decrease from baseline in the lowest mean blood pressure during anesthesia, and the hourly infusion volume. RESULTS: No significant difference was observed in the TUm65 (nurse anesthetists vs. anesthesiology residents: median [IQR] 11.3% [3.3-20.7] vs. 18.1% [5.3-24.0], p = 0.078). No significant differences were noted between nurses and residents concerning the other outcomes. CONCLUSION: No significant differences were observed in the intraoperative blood pressure control between the nurse anesthetists and anesthesia residents.

DOI： 10.1186/s12871-025-03080-4

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: During pandemic situations, many guidelines recommend that surgical masks be worn by both healthcare professionals and infected patients in healthcare settings. The purpose of this study was to clarify the levels and changes of oxygen concentration over time while oxygen was administered over a surgical mask. METHODS: Patients scheduled to undergo general anesthesia (n = 99) were enrolled in this study. First, patients were administered oxygen at 6 L/min via an oxygen mask over a surgical mask for 5 min. The patients removed the surgical mask and then took a 3-min break; thereafter, the same amount of oxygen was administered for another 5 min via the oxygen mask. We measured the fraction of inspired oxygen (FiO2), the end-tidal CO2 (EtCO2), and respiratory frequency every minute for 5 min, both while administering oxygen with and without a surgical mask. The FiO2 was measured at the beginning of inspiration and the EtCO2 was measured at the end of expiration. RESULTS: The FiO2 at 5 min was significantly lower when breathing with a surgical mask than that without it (mean difference: 0.08 [95% CI: 0.067-0.10]; p <  0.001). In contrast, the EtCO2 at 5 min was significantly higher when breathing with a surgical mask than that without it (mean difference: 11.9 mmHg [95% CI: 10.9-12.9]; p <  0.001). CONCLUSION: The FiO2 was lower when oxygen was administered over surgical masks than when patients did not wear surgical masks. Oxygen flow may need to be adjusted in moderately ill patients requiring oxygen administration.

DOI： 10.1186/s12871-022-01649-x

PubMed

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J-GLOBAL

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記述言語：日本語  

J-GLOBAL

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記述言語：日本語   出版者・発行元：真興交易(株)医書出版部  

J-GLOBAL

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記述言語：日本語   出版者・発行元：真興交易(株)医書出版部  

J-GLOBAL

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記述言語：日本語   出版者・発行元：日本臨床麻酔学会  

DOI： 10.2199/jjsca.33.539

CiNii Books

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その他リンク： http://search.jamas.or.jp/link/ui/2013371196

記述言語：日本語  

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記述言語：日本語  

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記述言語：日本語  

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