Korean Journal of Anesthesiology

Association between preoperative oxygen reserve index and postoperative pulmonary complications: a prospective observational study: Sangho Lee, Halin Hong, Hyojin Cho, Sang-Wook Lee, Ann Hee You, et al.; Korean J Anesthesiol. 2025;78(3):224-235.

Review Article

March 20, 2025

Revisiting anesthesia-induced preconditioning for neuroprotection in the aging brain: a narrative review

Tao Zhang, Woosuk Chung, Beverley A. Orser

Korean J Anesthesiol. 2025;78(3):187-198.

The growing number of older adults undergoing surgery necessitates that we address the adverse effects of overt and covert perioperative stroke. Preclinical studies have suggested that anesthesia-induced preconditioning may provide neuroprotection by preserving mitochondrial function, activating cytosolic signaling pathways, and reducing neuroinflammation. However, these promising findings from animal studies have not yet translated into improved clinical outcomes. The discordance between preclinical and clinical outcomes may be due to age-related mitochondrial dysfunction and other comorbidities in older human populations, which reduce the effectiveness of anesthetic preconditioning. Mitochondria, which are central to the effectiveness of preconditioning, may be therapeutic targets to restore the neuroprotective effects of anesthetic preconditioning in the aging brain....

Statistical Round

March 26, 2025

Comprehensive reporting guidelines and checklist for studies developing and utilizing artificial intelligence models

Sang Gyu Kwak, Jonghae Kim

Korean J Anesthesiol. 2025;78(3):199-214.

Background: The rapid advancement of artificial intelligence (AI) in healthcare necessitates comprehensive and standardized reporting guidelines to ensure transparency, reproducibility, and ethical applications in clinical research. Existing reporting standards are limited by their focus on specific study designs. We aimed to develop a comprehensive set of guidelines and a checklist for reporting studies that develop and utilize AI models in healthcare, covering all essential components of AI research regardless of the study design. Methods: Two experts in statistics from the Statistical Round of the Korean Journal of Anesthesiology developed these guidelines and checklist. The key elements essential for AI model reporting were identified and organized into structured sections, including study design,...

Clinical Research Article

April 17, 2025

Effect of mild hypercapnia during the recovery period on the emergence time from total intravenous anesthesia: a randomized controlled trial

Lan Liu, Xiangde Chen, Qingjuan Chen, Xiuyi Lu, Lili Fang, et al.

Korean J Anesthesiol. 2025;78(3):215-223.

Background: Intraoperative hypercapnia reduces the time to emergence from volatile anesthetics, but few clinical studies have explored the effect of hypercapnia on the emergence time from intravenous (IV) anesthesia. We investigated the effect of inducing mild hypercapnia during the recovery period on the emergence time after total IV anesthesia (TIVA). Methods: Adult patients undergoing transurethral lithotripsy under TIVA were randomly allocated to normocapnia group (end-tidal carbon dioxide [ETCO2] 35–40 mmHg) or mild hypercapnia group (ETCO2 50-55 mmHg) during the recovery period. The primary outcome was the extubation...

Clinical Research Article

February 17, 2025

Association between preoperative oxygen reserve index and postoperative pulmonary complications: a prospective observational study

Sangho Lee, Halin Hong, Hyojin Cho, Sang-Wook Lee, Ann Hee You, et al.

Korean J Anesthesiol. 2025;78(3):224-235.

Background: The oxygen reserve index (ORi) noninvasively measures oxygen levels within the mild hyperoxia range. To evaluate whether a degree of increase in the ORi during preoxygenation for general anesthesia is associated with the occurrence of postoperative pulmonary complications (PPCs). Methods: We enrolled 154 patients who underwent preoperative pulmonary function tests and were scheduled for elective surgery under general anesthesia. We aimed to measure the increase in ORi during preoxygenation before general anesthesia and analyze its association with PPCs. Results: PPCs occurred in 76 (49%) participants. Multivariate logistic regression analysis revealed that the three-minute preoxygenation ORi was significantly associated with PPCs (Odds ratio [OR]: 0.02, 95% CI [0.00–0.16], P < 0.001). The...

Clinical Research Article

February 10, 2025

A simple sonographic approach to thoracic transforaminal epidural injections for zoster-associated pain involving multiple nerves: an exploratory prospective cohort study

Shuyue Zheng, Dan Wang, Li Yue, Liangliang He

Korean J Anesthesiol. 2025;78(3):236-247.

Background: A simple superoposterior approach to thoracic transforaminal epidural injections (TFEIs) under ultrasonographic guidance was proposed to reduce zoster-associated pain (ZAP) involving multiple thoracic nerves and the likelihood of transitioning to postherpetic neuralgia (PHN). Methods: Patients were prospectively enrolled. Primary endpoints were the burden of illness (BOI) scores and epidural contrast spread. Secondary endpoints included number of needle insertion attempts, sensory blockade, hemodynamic changes, procedure time, radiation dose, adverse events, rescue analgesics, PHN incidence and EuroQoL 5-Dimension scores. Results: Thirty-five injections were performed in 27 patients. Median levels of cephalad-caudad epidural contrast...

Clinical Research Article

April 4, 2025

Comparison of combined intranasal dexmedetomidine and ketamine versus chloral hydrate for pediatric procedural sedation: a randomized controlled trial

Young-Eun Jang, Eun-Young Joo, Jung-Bin Park, Sang-Hwan Ji, Eun-Hee Kim, et al.

Korean J Anesthesiol. 2025;78(3):248-260.

Background: We hypothesized that intranasal combination of dexmedetomidine (2 μg/kg) and ketamine (3 mg/kg) (IN DEXKET) improves the success rate of sedation in pediatric patients compared with chloral hydrate (CH; 50 mg/kg). Methods: This prospective, two-center, single-blinded, randomized controlled trial involved 136 pediatric patients (aged < 7 years) requiring procedural sedation. The participants were randomized to receive CH or IN DEXKET via a mucosal atomizer device. The primary outcome was the success rate of sedation (Pediatric Sedation State Scale, scores 1–3) within 15 min. The secondary outcomes included sedation failure...

Clinical Research Article

March 26, 2025

Liver transplantation outcomes in patients with primary tricuspid regurgitation with coaptation defects: a retrospective analysis in a high-volume transplant center

Kyoung-Sun Kim, Sun-Young Ha, Seong-Mi Yang, Hye-Mee Kwon, Sung-Hoon Kim, et al.

Korean J Anesthesiol. 2025;78(3):261-271.

Background: Cardiovascular diseases are the leading cause of mortality after liver transplantation (LT). Although the impact of secondary tricuspid regurgitation (TR) with severe pulmonary hypertension (PH) is well investigated, the impact of primary TR with tricuspid valve incompetence (TVI) on LT outcomes remains unclear. We aimed to investigate the prevalence and impact of primary TR with TVI on LT outcomes in a large-volume LT center. Methods: We retrospectively examined 5 512 consecutive LT recipients who underwent routine pretransplant echocardiography between 2008 and 2020. Patients were categorized based on the presence of anatomical...

Clinical Research Article

March 31, 2025

‘Think Drink’ approach to minimize unnecessary preoperative fasting: 18 years audit experience

Katarzyna A. R. MacDougall, Shahnoor E. S. Bushra, Santhana G. Kannan

Korean J Anesthesiol. 2025;78(3):272-278.

Background: Fasting guidelines have long recommended that patients can have clear fluids until 2 h prior to surgery. Multiple audits in our institution showed that patients had prolonged fluid fasting duration, despite being given preoperative instructions. This paper presents the results of audits in our institution relating to fasting since 2004 and the outcome of interventions undertaken. Methods: Audits conducted in 2004, 2008, 2018, 2021, and 2022 were reviewed, with a focus on fasting duration for clear fluids. Interventions that led to significant improvements were identified. Results: The median fasting duration for clear fluids was 8 h, 8 h 42 min, and 7 h 42 min in 2004, 2008, and...

Three pillars of artificial intelligence research in anesthesiology: welcoming address to the Korean Journal of Anesthesiology’s new guidelines for machine learning and deep learning research Younsuk Lee Korean J Anesthesiol. 2025;78(3):181-182. Editorial May 14, 2025 Full text PubReader ePub PDF	Clinical applications and potential use of the oxygen reserve index during the perioperative period Yu Kyung Bae, Junghee Ryu Korean J Anesthesiol. 2025;78(3):183-186. Editorial May 15, 2025 Full text PubReader ePub PDF
Revisiting anesthesia-induced preconditioning for neuroprotection in the aging brain: a narrative review Tao Zhang, Woosuk Chung, Beverley A. Orser Korean J Anesthesiol. 2025;78(3):187-198. Review Article March 20, 2025 Full text PubReader ePub PDF	Comprehensive reporting guidelines and checklist for studies developing and utilizing artificial intelligence models Sang Gyu Kwak, Jonghae Kim Korean J Anesthesiol. 2025;78(3):199-214. Statistical Round March 26, 2025 Cited By 1 Full text PubReader ePub PDF
Effect of mild hypercapnia during the recovery period on the emergence time from total intravenous anesthesia: a randomized controlled trial Lan Liu, Xiangde Chen, Qingjuan Chen, Xiuyi Lu, Lili Fang, Jinxuan Ren, Yue Ming, Dawei Sun, Pei Chen, Weidong Wu, et al. Korean J Anesthesiol. 2025;78(3):215-223. Clinical Research Article April 17, 2025 Full text PubReader ePub PDF	Association between preoperative oxygen reserve index and postoperative pulmonary complications: a prospective observational study Sangho Lee, Halin Hong, Hyojin Cho, Sang-Wook Lee, Ann Hee You, Hee Yong Kang, Sung Wook Park, Mi Kyeong Kim, Jeong-Hyun Choi Korean J Anesthesiol. 2025;78(3):224-235. Clinical Research Article February 17, 2025 Cited By 1 Full text PubReader ePub PDF Supplementary Material
A simple sonographic approach to thoracic transforaminal epidural injections for zoster-associated pain involving multiple nerves: an exploratory prospective cohort study Shuyue Zheng, Dan Wang, Li Yue, Liangliang He Korean J Anesthesiol. 2025;78(3):236-247. Clinical Research Article February 10, 2025 Full text PubReader ePub PDF	Comparison of combined intranasal dexmedetomidine and ketamine versus chloral hydrate for pediatric procedural sedation: a randomized controlled trial Young-Eun Jang, Eun-Young Joo, Jung-Bin Park, Sang-Hwan Ji, Eun-Hee Kim, Ji-Hyun Lee, Hee-Soo Kim, Jin-Tae Kim Korean J Anesthesiol. 2025;78(3):248-260. Clinical Research Article April 4, 2025 Full text PubReader ePub PDF
Liver transplantation outcomes in patients with primary tricuspid regurgitation with coaptation defects: a retrospective analysis in a high-volume transplant center Kyoung-Sun Kim, Sun-Young Ha, Seong-Mi Yang, Hye-Mee Kwon, Sung-Hoon Kim, In-Gu Jun, Jun-Gol Song, Gyu-Sam Hwang Korean J Anesthesiol. 2025;78(3):261-271. Clinical Research Article March 26, 2025 Full text PubReader ePub PDF	‘Think Drink’ approach to minimize unnecessary preoperative fasting: 18 years audit experience Katarzyna A. R. MacDougall, Shahnoor E. S. Bushra, Santhana G. Kannan Korean J Anesthesiol. 2025;78(3):272-278. Clinical Research Article March 31, 2025 Full text PubReader ePub PDF
Axillary serratus anterior plane block as a novel approach to anesthetizing the intercostobrachial nerve for upper arm arteriovenous fistula creation surgery -three case reports-[commentary-article] Chi Ho Chan, Jia Yin Lim, Abey M.V. Mathews Korean J Anesthesiol. 2025;78(3):279-284. Case Report March 6, 2025 Cited By 1 Full text PubReader PDF Supplementary Material	Successful removal of a large intratracheal tumor using the injection-time-controllable manual jet ventilator via translaryngeal approach -a case report- Darhae Eum, Hyun Joo Kim, Wyun Kon Park Korean J Anesthesiol. 2025;78(3):285-290. Case Report March 5, 2025 Full text PubReader ePub PDF Supplementary Material
Impossible ventilation in a neonate after tracheoesphageal fistula repair: a lesson learned! Harshini Medikondu, Dhruv Jain, Anju Gupta, Vignesh Venkatesan, Mritunjay Kumar Korean J Anesthesiol. 2025;78(3):291-292. Letter to the Editor February 25, 2025 Full text PubReader ePub PDF	A seizure case induced by topical application of tranexamic acid in a local incision Yanping Wu, Xin Xiong, Quan Hu, Meiling Wang, Yongbing Wu Korean J Anesthesiol. 2025;78(3):292-294. Letter to the Editor February 4, 2025 Cited By 2 Full text PubReader ePub PDF
Hypotension after induction of anesthesia with remimazolam or etomidate: a non-inferiority randomized controlled trial in patients undergoing coronary artery bypass grafting Jeong-Jin Min, Eun Jung Oh, Hyun Ji Hwang, Sungwoo Jo, Hyunsung Cho, Chungsu Kim, Jong-Hwan Lee Korean J Anesthesiol. 2025;78(3):295. Corrects: Korean J Anesthesiol 2025 4; 78(2): 139 Corrigendum April 15, 2025 Full text PubReader ePub PDF