Korean Journal of Anesthesiology

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Comparison of the pericapsular nerve group block with the intra-articular and quadratus lumborum blocks in primary total hip arthroplasty: a randomized controlled trial: Tayfun Et, Muhammet Korkusuz; Korean J Anesthesiol. 2023;76(6):575-585.

Review Article

April 19, 2023

Pediatric perioperative fluid management

Hyungmook Lee, Jin Tae Kim

Korean J Anesthesiol. 2023;76(6):519-530.

The purpose of perioperative fluid management in children is to maintain adequate volume status, electrolyte level, and endocrine system homeostasis during the perioperative period. Although hypotonic solutions containing glucose have traditionally been used as pediatric maintenance fluids, recent studies have shown that isotonic balanced crystalloid solutions lower the risk of hyponatremia and metabolic acidosis perioperatively. Isotonic balanced solutions have been found to exhibit safer and more physiologically appropriate characteristics for perioperative fluid maintenance and replacement. Additionally, adding 1–2.5% glucose to the maintenance fluid can help prevent children from developing hypoglycemia as well as lipid mobilization, ketosis, and hyperglycemia. The fasting time should be as short as possible without compromising safety;...

Statistical Round

November 14, 2023

Intention-to-treat versus as-treated versus per-protocol approaches to analysis

EunJin Ahn, Hyun Kang

Korean J Anesthesiol. 2023;76(6):531-539.

Randomized controlled trials (RCTs) are considered the most rigorous study design for testing hypotheses and the gold standard for evaluating intervention effectiveness. However, RCTs are often conducted under the assumption of ideal conditions that may differ from real-world scenarios in which various issues, such as loss to follow-up, mistakes in participant enrollment or intervention, and low subject compliance or adherence, may occur. There are various group-defining strategies for analyzing RCT data, including the intention-to-treat (ITT), as-treated, and per-protocol (PP) approaches. The ITT principle involves analyzing all participants according to their initial group assignments, regardless of study completion and compliance or adherence to treatment protocols. This approach aims to replicate real-world...

Clinical Research Article

September 26, 2023

Predicting optimal endotracheal tube size and depth in pediatric patients using demographic data and machine learning techniques

Hyeonsik Kim, Hyun-Kyu Yoon, Hyeonhoon Lee, Chul-Woo Jung, Hyung-Chul Lee

Korean J Anesthesiol. 2023;76(6):540-549.

Background: Use of endotracheal tubes (ETTs) with appropriate size and depth can help minimize intubation-related complications in pediatric patients. Existing age-based formulae for selecting the optimal ETT size present several inaccuracies. We developed a machine learning model that predicts the optimal size and depth of ETTs in pediatric patients using demographic data, enabling clinical applications. Methods: Data from 37,057 patients younger than 12 years who underwent general anesthesia with endotracheal intubation were retrospectively analyzed. Gradient boosted regression tree (GBRT) model was developed and compared with traditional age-based formulae. Results: The...

Clinical Research Article

February 24, 2023

Association between inflammation-based prognostic markers and mortality of non-cardiac surgery

Ah Ran Oh, Jungchan Park, Jong-Hwan Lee, Kwangmo Yang, Joonghyun Ahn, et al.

Korean J Anesthesiol. 2023;76(6):550-558.

Background: To evaluate the association between inflammation and nutrition-based biomarkers and postoperative outcomes after non-cardiac surgery. Methods: Between January 2011 and June 2019, a total of 102,052 patients undergoing non-cardiac surgery were evaluated, with C-reactive protein (CRP), albumin, and complete blood count (CBC) measured within six months before surgery. We assessed their CRP-to-albumin ratio (CAR), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and modified Glasgow Prognostic Score (mGPS). We determined the best cut-off values by using the receiver operating characteristic (ROC) curves. Patients were divided into high and low groups according to the estimated threshold, and we compared the one-year mortality. Results: The one-year mortality of the entire sample was 4.2%. ROC analysis...

Clinical Research Article

April 24, 2023

Does intravenous patient-controlled analgesia or continuous block prevent rebound pain following infraclavicular brachial plexus block after distal radius fracture fixation? A prospective randomized controlled trial

Jong-hyuk Lee, Ha-jung Kim, Jae Kwang Kim, Sungjoo Cheon, Young Ho Shin

Korean J Anesthesiol. 2023;76(6):559-566.

Background: The purpose of this study was to investigate the role of opioid-based intravenous patient-controlled analgesia (IV PCA) or continuous brachial plexus block (BPB) in controlling rebound pain after distal radius fracture (DRF) fixation under BPB as well as total opioid consumption. Methods: A total of 66 patients undergoing surgical treatment for a displaced DRF with volar plate fixation were randomized to receive a single infraclavicular BPB (BPB only group) (n = 22), a single infraclavicular BPB with IV PCA (IV PCA group) (n = 22), or a single infraclavicular...

Clinical Research Article

May 10, 2023

Quality of recovery in hospital and disability-free survival at three months after major abdominal surgery

Yuki Kinugasa, Mitsuru Ida, Shohei Nakatani, Kayo Uyama, Masahiko Kawaguchi

Korean J Anesthesiol. 2023;76(6):567-574.

Background: The Quality of Recovery-15 (QoR-15) and 12-item World Health Organization Disability Assessment Schedule 2.0 scales are post-surgery patient-reported outcome measures. We aimed to evaluate the association between immediate in-hospital postoperative recovery and mid-term disability-free survival (DFS) after discharge. Methods: We conducted a prospective observational study at a university hospital and enrolled 260 patients aged ≥ 65 years with cancer who were undergoing elective major abdominal surgery. The association between poor postoperative recovery, defined as a QoR-15 score < 90 on postoperative day (POD) 2, and the DFS three months later was assessed using Fisher’s exact test. The odds ratio of poor recovery on POD 2 to DFS was calculated using...

Clinical Research Article

April 4, 2023

Comparison of the pericapsular nerve group block with the intra-articular and quadratus lumborum blocks in primary total hip arthroplasty: a randomized controlled trial

Tayfun Et, Muhammet Korkusuz

Korean J Anesthesiol. 2023;76(6):575-585.

Background: The pericapsular nerve group (PENG) block, quadratus lumborum block (QLB), and intra-articular (IA) local anesthetic injection have been shown to provide effective analgesia in total hip arthroplasty (THA). This randomized study aimed to compare the analgesic efficacy, motor protection, and quality of recovery associated with the PENG block, QLB, and IA injection. Methods: Eighty-nine patients who underwent a unilateral primary THA under spinal anesthesia were randomly assigned to the PENG (n=30), QLB (n=30), or IA (n=29) group. The primary outcome was the numerical rating scale (NRS) score over the first...

Clinical Research Article

March 16, 2023

Effects of dexmedetomidine on pulmonary function in patients receiving one-lung ventilation: a meta-analysis of randomized controlled trial

Lin Yang, Yongheng Cai, Lin Dan, He Huang, Bing Chen

Korean J Anesthesiol. 2023;76(6):586-596.

Background: Mechanical ventilation, particularly one-lung ventilation (OLV), can cause pulmonary dysfunction. This meta-analysis assessed the effects of dexmedetomidine on the pulmonary function of patients receiving OLV. Methods: The Embase, PubMed, MEDLINE, Cochrane Library, ClinicalTrials.gov, and Chinese Clinical Trial Registry databases were systematically searched. The primary outcome was oxygenation index (OI). Other outcomes including the incidence of postoperative complications were assessed. Results: Fourteen randomized controlled trials involving 845 patients were included in this meta-analysis. Dexmedetomidine improved the OI at 30 (mean difference [MD]: 40.49, 95% CI [10.21, 70.78]), 60 (MD: 60.86,...

Clinical Research Article

April 17, 2023

Comparison of different nonsteroidal anti-inflammatory drugs for cesarean section: a systematic review and network meta-analysis

Iona Murdoch, Anthony L Carver, Pervez Sultan, James E O’Carroll, Lindsay Blake, et al.

Korean J Anesthesiol. 2023;76(6):597-616.

Background: Cesarean section is associated with moderate to severe pain and nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly employed. The optimal NSAID, however, has not been elucidated. In this network meta-analysis and systematic review, we compared the influence of control and individual NSAIDs on the indices of analgesia, side effects, and quality of recovery. Methods: CDSR, CINAHL, CRCT, Embase, LILACS, PubMed, and Web of Science were searched for randomized controlled trials comparing a specific NSAID to either control or another NSAID in elective or emergency cesarean section under general or neuraxial anesthesia. Network plots and league tables were constructed, and the quality of evidence was evaluated with Grading of Recommendations Assessment, Development...

Clinical Research Article

December 21, 2022

Effect of magnesium sulfate on oxygenation and lung mechanics in morbidly obese patients undergoing bariatric surgery: a prospective double-blind randomized clinical trial

Marwa M. Mowafi, Marwa A. K. Elbeialy, Rasha Gamal Abusinna

Korean J Anesthesiol. 2023;76(6):617-626.

Background: Respiratory mechanics are often significantly altered in morbidly obese patients and magnesium sulfate (MgSO4) is a promising agent for managing several respiratory disorders. This study aimed to examine the effects of MgSO4 infusions on arterial oxygenation and lung mechanics in patients with morbid obesity undergoing laparoscopic bariatric surgery. Methods: Forty patients with morbid obesity aged 21–60 years scheduled for laparoscopic bariatric surgery under general anesthesia were randomly allocated to either the control (normal saline infusion) or MgSO4 group (30 mg/kg lean body weight [LBW] of...

Experimental Research Article

August 21, 2023

Effects of sevoflurane on metalloproteinase and natural killer group 2, member D (NKG2D) ligand expression and natural killer cell-mediated cytotoxicity in breast cancer: an in vitro study

Hyae Jin Kim, Soeun Jeon, Hyeon Jeong Lee, Jaeho Bae, Hyun-Su Ri, et al.

Korean J Anesthesiol. 2023;76(6):627-639.

Background: We investigated the effects of sevoflurane exposure on the expression of matrix metalloproteinase (MMP), expression and ablation of natural killer group 2, member D (NKG2D) ligands (UL16-binding proteins 1–3 and major histocompatibility complex class I chain-related molecules A/B), and natural killer (NK) cell-mediated cytotoxicity in breast cancer cells. Methods: Three human breast cancer cell lines (MCF-7, MDA-MB-453, and HCC-70) were incubated with 0 (control), 600 (S6), or 1200 μM (S12) sevoflurane for 4 h. The gene expression of NKG2D ligands and their protein expression on cancer cell surfaces were measured...

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Korean Journal of Anesthesiology1968 (v1 n1) to 2008 (v55 n6)

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Journal Impact Factor 2.9

Hemodynamic management during off-pump coronary artery bypass surgery: a narrative review of proper targets for safe execution and troubleshooting. Korean J Anesthesiol. 2023;76:267-279

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