Anesthesiology and Perioperative Science最新文献

{"title":"Higher educational attainment may reduce the risk of delirium by delaying the initiation and reducing the intensity of smoking: a Mendelian randomization study","authors":"Si Cao,&nbsp;Youjie Zeng,&nbsp;Minghua Chen,&nbsp;Wen Ouyang,&nbsp;Zhendong Ding","doi":"10.1007/s44254-025-00133-2","DOIUrl":"10.1007/s44254-025-00133-2","url":null,"abstract":"<div><h3>Purpose</h3><p>Using Mendelian Randomization (MR) analysis, this study aimed to assess any causal effect of educational attainment on the risk of delirium and to determine whether smoking mediates this association.</p><h3>Methods</h3><p>We obtained genome-wide association study (GWAS) summary-level statistics for educational attainment (<i>n</i> = 765,283), age of smoking initiation (<i>n</i> = 341,427), cigarettes per day (<i>n</i> = 337,334) and delirium (4,381 cases, 469,981 controls) from GWAS repositories. The inverse variance weighted approach served as the main analytical strategy for causal estimation. Multiple sensitivity tests were used to assess the robustness of MR analyses. We evaluated the causal effect of educational attainment on delirium, the effect of educational attainment on smoking-related traits and the effect of smoking-related traits on delirium. We then performed mediation analysis to evaluate the mediating effect of smoking traits on the association between educational attainment and delirium. In addition, we performed linkage disequilibrium score regression (LDSC) to evaluate genetic correlations between traits.</p><h3>Results</h3><p>Higher educational attainment was significantly associated with a lower delirium risk (OR = 0.767, 95% CI: 0.637–0.922, <i>P</i> = 0.005). Age of smoking initiation was positively associated with educational attainment (<i>β</i> = 0.289, <i>P</i> = 8.89 × 10^-133) and inversely associated with delirium risk (OR = 0.553, <i>P</i> = 0.014), whereas cigarettes per day was inversely associated with educational attainment (<i>β</i> = –0.315, <i>P</i> = 1.70 × 10^-32) and positively associated with delirium risk (OR = 1.238, <i>P</i> = 0.022). Sensitivity analyses indicated that the MR results were not affected by heterogeneity or horizontal pleiotropy. Mediation analysis indicated that the age of smoking initiation and cigarettes per day mediated 64.4% (<i>P</i> = 0.014) and 25.3% (<i>P</i> = 0.024) of the total effect, respectively. LDSC analysis revealed a significant negative genetic correlation between educational attainment and delirium, and between age of smoking initiation and delirium. Educational attainment also showed strong correlations with smoking traits, positively with age of initiation and negatively with cigarettes per day.</p><h3>Conclusion</h3><p>The findings of this MR study support the notion that higher educational attainment may reduce the risk of delirium by promoting a later age of smoking initiation and decreasing the number of cigarettes smoked per day.</p></div>","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"3 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-025-00133-2.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145316140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“Anesthesia Guided Diagnostics” (AGD): a novel subspecialty for intraoperative disease discovery","authors":"Shuangqiong Wang,&nbsp;Zhicheng Yue,&nbsp;Qian Li,&nbsp;Cheng Zhou","doi":"10.1007/s44254-025-00137-y","DOIUrl":"10.1007/s44254-025-00137-y","url":null,"abstract":"","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"3 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-025-00137-y.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145316060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Applications of artificial intelligence in anesthesiology","authors":"Xin Shu,&nbsp;Yiziting Zhu,&nbsp;Xiang Liu,&nbsp;Yujie Li,&nbsp;Bin Yi,&nbsp;Yingwei Wang","doi":"10.1007/s44254-025-00131-4","DOIUrl":"10.1007/s44254-025-00131-4","url":null,"abstract":"<div><p>Modern anesthesiology has expanded beyond intraoperative care. It now integrates pain management, critical care, and emergency resuscitation. However, it still faces challenges like biological variability in drug responses, unpredictable intraoperative crises, and complex perioperative complications. Artificial intelligence (AI) emerges as a transformative force, can effectively enhance clinical quality and operational efficiency by extracting critical insights from vast amounts of healthcare data including electronic health records, vital sign waveforms, and imaging databases. AI applications in clinical anesthesia span the entire perioperative period, encompassing preoperative risk assessment, intraoperative physiological monitoring with adverse event prediction and visualized procedural guidance, as well as postoperative outcome forecasting and dynamic adaptive individualized treatment to enhance recovery after surgery. Beyond direct patient care, AI enhances operating room efficiency and revolutionizes anesthesia education. Despite progress, challenges persist in algorithm generalizability, data interoperability, and clinical validation. This review synthesizes the transformative role of AI across anesthesiology subspecialties, analyzes the barriers to implementation, and proposes strategic directions to bridge technological innovation with clinical optimization. </p></div>","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"3 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-025-00131-4.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145256591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of paravertebral transcutaneous electrical nerve stimulation in perioperative analgesia and enhanced recovery after thoracoscopic lobectomy: a randomized, sham-controlled clinical trial","authors":"Huaqing Chu,&nbsp;Baona Wang,&nbsp;Shijing Wei,&nbsp;Xiyuan Xu,&nbsp;Runzhi Zhao,&nbsp;Shuai Li,&nbsp;Qi Hou,&nbsp;Yu Hou,&nbsp;Liang Zou,&nbsp;Wendong Lei,&nbsp;Hui Zheng","doi":"10.1007/s44254-025-00124-3","DOIUrl":"10.1007/s44254-025-00124-3","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Purpose&lt;/h3&gt;&lt;p&gt;Managing postoperative pain remains a significant challenge in video-assisted thoracoscopic surgery (VATS) lobectomy, where inadequate analgesia impedes recovery and increases chronic pain risk. Transcutaneous electrical nerve stimulation (TENS), as a non-invasive neuromodulatory technique, offers potential perioperative analgesia. Based on this rationale, we investigated whether paravertebral TENS (pTENS) could effectively alleviate pain after VATS lobectomy.&lt;/p&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;p&gt;Patients undergoing VATS lobectomy were randomized to receive pTENS or sham-pTENS one day before surgery (T0), intraoperatively (T0′), and on postoperative day 1 (POD 1), and POD 2. Electrodes were placed on the paravertebral skin corresponding to the thoracic nerve segments innervating the incision. Electrical stimulation parameters: pulse width 260 μs, pulse rate 80 Hz. The pTENS group received maximum tolerable current, sham-pTENS group received 0 mA. Primary outcomes were pain scores at rest and during coughing in the post-anesthesia care unit (PACU; T1), at 4 h (T2), 24 h (T3), 48 h (T4), and at discharge (T5) after surgery. Secondary outcomes included intraoperative anesthetics use, dosage and bolus times of the patient-controlled intravenous analgesia (PCIA) pump, incidences of postoperative complications, serum IL-6 and Dyn levels, and post-operative quality-of-life scores at 30 (T6) and 100 days (T7).&lt;/p&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;p&gt;Of 62 enrolled patients, 56 completed the study. Numeric Rating Scale scores of postoperative pain were significantly lower in the pTENS group compared to the sham-pTENS group at T2, T3, T4, and T5. Incidences of chronic postsurgical pain decreased significantly in the pTENS group compared to the sham-pTENS group (2/31 vs. 17/31, &lt;i&gt;P&lt;/i&gt; &lt; 0.001). Intraoperative remifentanil use was significantly lower in the pTENS group compared to the sham-pTENS group (difference in medians [95% CI], 1.2 (0.385 to 1.802), &lt;i&gt;P&lt;/i&gt; = 0.004). Dosage and bolus times of the PCIA pump were significantly lower in the pTENS group on POD 1 and POD 2 (&lt;i&gt;P&lt;/i&gt; &lt; 0.001). The duration of PACU stay (difference in medians [95% CI], 4.29 (1.91 to 6.67), &lt;i&gt;P&lt;/i&gt; = 0.004), the time of thoracic drain tube removal (difference in medians [95% CI], 5 (0 to 11), &lt;i&gt;P&lt;/i&gt; = 0.044), the time of first intestinal exhaust (difference in medians [95% CI], 2 (0 to 5), &lt;i&gt;P&lt;/i&gt; = 0.032), the time of first out-of-bed activity (difference in medians [95% CI], 1.77 (−0.44 to 3.99), &lt;i&gt;P&lt;/i&gt; = 0.007) and the time of first urination (difference in medians [95% CI], 1 (1 to 1), &lt;i&gt;P&lt;/i&gt; &lt; 0.001) were significantly shorter in the pTENS group. IL-6 levels in the pTENS group were significantly lower compared to the control group at T1 (&lt;i&gt;P&lt;/i&gt; &lt; 0.001) and T4 (&lt;i&gt;P&lt;/i&gt; = 0.039). Compared to the Sham-pTENS group, the serum concentrations of Dyn in the pTENS group were significantly increased at T1, T3 and T4 (&lt;i&gt;P&lt;/i&gt; &lt; 0.001). The mean of Mental Compon","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"3 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-025-00124-3.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145210581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Opioid immunomodulation – an enigma?","authors":"David G. Lambert","doi":"10.1007/s44254-025-00130-5","DOIUrl":"10.1007/s44254-025-00130-5","url":null,"abstract":"","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"3 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-025-00130-5.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145062160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of 15-mm universal connectors with different diameters connected to a cricothyrotomy tube on airway resistance","authors":"Takayuki Hasegawa,&nbsp;Satoki Inoue","doi":"10.1007/s44254-025-00128-z","DOIUrl":"10.1007/s44254-025-00128-z","url":null,"abstract":"","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"3 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-025-00128-z.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145057625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reducing perioperative red blood cell transfusion in adult aortic surgery: innovative application and process optimization of autologous plateletpheresis","authors":"Jie Gao,&nbsp;Xurong Gao,&nbsp;Cuntao Yu,&nbsp;Hongwen Ji","doi":"10.1007/s44254-025-00126-1","DOIUrl":"10.1007/s44254-025-00126-1","url":null,"abstract":"<div><h3>Purpose</h3><p>Coagulopathy is a common perioperative complication in aortic surgery, increasing the risk of bleeding and transfusion requirements. This study aimed to evaluate the impact of autologous plateletpheresis on reducing perioperative red blood cell (RBC) transfusion rates in adult aortic surgery patients.</p><h3>Methods</h3><p>This prospective, single-center, single-blind randomized controlled trial enrolled 134 participants undergoing aortic surgery with cardiopulmonary bypass, randomized in a 1:1 ratio. The primary outcome was the perioperative RBC transfusion rate and covariates included patient preoperative characteristics and intraoperative factors. Multivariable logistic regression models of the relative risk were evaluated.</p><h3>Results</h3><p>The intervention group demonstrated several clinical advantages, including significantly reduced perioperative blood transfusion requirements, lower Factor VII usage, and shorter surgical duration (all <i>p</i> &lt; 0.05). Storage of autologous platelet in citrate-containing bags resulted in increased calcium administration (median 3.00g vs 2.00g; <i>p</i> &lt; 0.05) and prolonged time between central venous catheter placement and heparinization in aortic root surgery (52.14 ± 7.75 vs 42.15 ± 6.13 min; <i>p</i> &lt; 0.001).</p><h3>Conclusion</h3><p>The autologous plateletpheresis technique reduces transfusion requirements, shortens surgical duration, enhances clinical outcomes, and accelerates recovery. However, careful calcium ion monitoring and coordination of pre-CPB preparation times are essential to maintain surgical workflow.</p><h3>Trial Registration</h3><p>Registered at the Chinese Clinical Trial Registry on November 16, 2022 (ID ChiCTR2200065834, https://www.chictr.org.cn/showproj.html?proj=185761).</p></div>","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"3 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-025-00126-1.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145050825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of low vs high intraoperative fraction of inspired oxygen on postoperative organ complications: a systematic review and meta-analysis of randomized controlled trials","authors":"Xuefei Li,&nbsp;Yang Han,&nbsp;Huijia Zhuang,&nbsp;Jiali Jiang,&nbsp;Qirong Sun,&nbsp;Hai Yu","doi":"10.1007/s44254-025-00123-4","DOIUrl":"10.1007/s44254-025-00123-4","url":null,"abstract":"<div><h3>Purpose</h3><p>Intraoperative supplemental oxygen may induce postoperative organ complications by aggravating oxidative stress and vasoconstriction. This meta-analysis was to determine whether the higher fraction of inspired oxygen (FiO₂) would increase the risk of organ complications among patients under general anesthesia.</p><h3>Methods</h3><p>We performed a systematic literature review for randomized controlled studies among surgical patients receiving ≥ 60% FiO₂ compared with ≤ 40% FiO₂ and meta-analysis of risk ratios (RR) comparing higher FiO₂ against lower for pulmonary, cardiac, neurological, and kidney complications. We systematically explored MEDLINE, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials to December 2024.</p><h3>Results</h3><p>We included 20 qualifying randomized controlled trials with a total of 5,793 patients. Low FiO₂ was associated with less atelectasis (RR, 0.78; 95% CI, 0.63–0.97), lower percentage of atelectasis (mean difference, –1.80; 95% CI, –3.30 to –0.57), and more acute kidney injury (RR, 1.64; 95% CI, 1.15–2.34). No evidence of association with low FiO₂ was found for other complications in this meta-analysis: cardiac complications (RR, 1.15; 95% CI, 0.96–1.53) and delirium (RR, 1.13; 95% CI, 0.87–1.46).</p><h3>Conclusions</h3><p>The current study indicated that lower intraoperative oxygen reduced postoperative incidence and severity of atelectasis but result in more acute kidney injury. More high-quality trials are warranted regarding the optimal fraction of intraoperative inspired oxygen.</p><h3>Registration</h3><p>Prospectively registered at the International Prospective Registry of Systemic Reviews (CRD42023479131).</p></div>","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"3 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-025-00123-4.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144896961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Administration of dexmedetomidine in critically ill adult patients with hemorrhagic stroke: a retrospective cohort study of the MIMIC-IV database","authors":"Yuyao Zhu,&nbsp;Yao Xiao,&nbsp;Yanchao Shen,&nbsp;Rui Zhong,&nbsp;Bin Yu","doi":"10.1007/s44254-025-00120-7","DOIUrl":"10.1007/s44254-025-00120-7","url":null,"abstract":"<div><h3>Objective</h3><p>Intensive care units (ICUs) widely utilize dexmedetomidine (DEX), which is a sedative agent, for its ability to maintain hemodynamic stability and provide neuroprotection. While preclinical studies have suggested that DEX improves sedation and mitigates brain injury in experimental models of intracerebral hemorrhage, its clinical effects on patients with hemorrhagic stroke (HS) remain inconclusive. This research seeks to investigate the correlation between DEX administration within the first 48 h of ICU admission and in-hospital mortality among HS patients by utilizing a large-scale database, aiming to offer evidence supporting its clinical use.</p><h3>Methods</h3><p>We conducted a retrospective cohort study based on the MIMIC-IV database. Adult patients diagnosed with hemorrhagic stroke were included and classified into a DEX group (<i>n</i> = 320) defined as receiving DEX within 48 h of ICU admission and a non-DEX group (<i>n</i> = 2432). The primary outcome was in-hospital all-cause mortality. Secondary outcomes included the incidence of hypotension, bradycardia, and ICU length of stay. Propensity score matching (PSM) was performed to minimize baseline confounding, followed by Cox proportional hazards regression and Kaplan–Meier survival analyses to assess the association between DEX administration within the first 48 h of ICU admission and in-hospital mortality.</p><h3>Results</h3><p>A total of 2,752 patients were analyzed. Before matching, Kaplan–Meier survival curves demonstrated a significantly lower in-hospital mortality in the DEX group compared with the non-DEX group (log-rank <i>P</i> &lt; 0.001). Cox regression indicated that DEX administration within 48 h of ICU admission significantly reduced the risk of in-hospital death (HR = 0.56; 95% CI: 0.45–0.79; <i>P</i> &lt; 0.001), and this benefit persisted after PSM adjustment. Meanwhile, patients receiving DEX had a significantly longer ICU stay than those not receiving DEX (<i>P</i> &lt; 0.05), which remained consistent after PSM adjustment. No significant differences in hypotension or bradycardia were observed between the two groups.</p><h3>Conclusion</h3><p>In this retrospective cohort study of HS patients from the MIMIC-IV database, DEX administration within the first 48 h of ICU admission was associated with lower in-hospital mortality and no increased risk of hypotension or bradycardia, though it was linked to a longer ICU stay. These findings suggest that early (≤ 48 h) DEX administration may confer survival benefits for patients with hemorrhagic stroke, warranting further prospective validation.</p></div>","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"3 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-025-00120-7.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144868921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post anaesthesia cognitive outcomes in propofol vs. ketamine sedation for colonoscopy: a retrospective cohort study","authors":"Zachary R. Zook,&nbsp;Stephen Chien,&nbsp;Ashley Deng,&nbsp;Eduardo Espiridion","doi":"10.1007/s44254-025-00125-2","DOIUrl":"10.1007/s44254-025-00125-2","url":null,"abstract":"<div><h3>Purpose</h3><p>Colorectal cancer is the third most common malignancy worldwide and the second leading cause of cancer-related mortality. Colonoscopy, the primary screening method for this disease, typically involves sedation to enhance patient comfort and ensure a thorough examination. The choice of sedative is particularly important for older adults, as sedation can have implications on cognitive function. This study aims to evaluate the long-term cognitive effects of propofol and ketamine by examining the risk of developing dementia, disorientation, and depression following colonoscopy.</p><h3>Methods</h3><p>Utilizing data from the TriNetX platform, we compared two cohorts of patients who had undergone a colonoscopy and received either exclusively propofol (<i>n</i> = 1,938) or ketamine (<i>n</i> = 1,938) for sedation. Measures of association and survival were analyzed using TriNetX. Odds ratios (OR) were calculated from logistic regression to compare the cohorts. Survival analysis was conducted using the Cox proportional hazards model to find hazard ratio (HR).</p><h3>Results</h3><p>One of the most notable findings was the association between ketamine use and an increased risk of disorientation, with an odds ratio of 0.489 and a hazard ratio of 0.443 for propofol compared to ketamine. Regarding dementia, the lower OR (0.603) and HR (0.561) associated with propofol suggest that it may have a comparatively safer profile concerning long-term memory and cognitive decline. The findings also demonstrated a significant difference in depression rates, with propofol showing reduced odds (0.740) and risk ratios (0.688) of postprocedural depression compared to ketamine.</p><h3>Conclusion</h3><p>These findings suggest that propofol may offer a safer cognitive profile than ketamine, particularly for older patients and those at risk of cognitive decline. Given the increasing number of older adults undergoing colonoscopy, these results highlight the importance of selecting sedative agents that balance immediate procedural needs with long-term cognitive health.</p></div>","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"3 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-025-00125-2.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144861437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}