Perioperative Medicine最新文献

{"title":"Early implementation of exercise to facilitate recovery after elective colorectal surgery-a randomized clinical pilot trial.","authors":"Maike Hermann, Lisa Kusma, Niki Taebi, Tabea Kluge, Carina Mueller, Vanessa Orth, Maximilian Moeller, Carolin Ecker, Svetlana Hetjens, Julia Hardt, Christoph Reissfelder, Steffen Seyfried","doi":"10.1186/s13741-026-00752-8","DOIUrl":"10.1186/s13741-026-00752-8","url":null,"abstract":"<p><strong>Background: </strong>Early mobilization is a key component of enhanced recovery after elective colorectal surgery. This pilot trial evaluated the safety and feasibility of an early supervised postoperative exercise intervention in addition to standard care.</p><p><strong>Methods: </strong>In this single-center randomized controlled pilot trial, 31 patients undergoing elective colorectal surgery were randomized to an intervention group (n = 16) or control group (n = 15). One patient withdrew after randomization, leaving 30 patients for modified intention-to-treat analysis. The intervention consisted of individualized, physiotherapist-supervised exercise sessions on postoperative days 1, 3, and 5. The control group received standard postoperative care according to the institutional ERAS protocol. The originally registered primary endpoint was time to first bowel movement; prior to final analysis, safety and feasibility were designated as the primary outcomes in accordance with the pilot nature of the study. The change was documented transparently. Secondary outcomes included physical performance (Short Physical Performance Battery [SPPB], handgrip strength), time to first bowel movement, patient-reported outcomes, and postoperative complications.</p><p><strong>Results: </strong>Thirty patients completed the study (retention 96.8%). Adherence to the intervention was 100%, and no intervention-related adverse events occurred. The intervention group showed significantly better preservation of physical performance, reflected by a more favorable change in SPPB score from baseline to postoperative assessment. No significant between-group differences were observed for time to first bowel movement, handgrip strength, postoperative complications, or other secondary outcomes.</p><p><strong>Conclusions: </strong>Early supervised postoperative exercise after elective colorectal surgery was safe and feasible. Although no differences were found for most secondary outcomes, the intervention improved postoperative physical performance. These exploratory findings warrant confirmation in adequately powered randomized trials.</p><p><strong>Trial registration: </strong>German Clinical Trials Register, DRKS00036327 (retrospectively registered, 22.04.2025).</p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":"15 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13675950/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HFpEF in perioperative medicine.","authors":"Maria Giulia Bellicini","doi":"10.1186/s13741-026-00702-4","DOIUrl":"10.1186/s13741-026-00702-4","url":null,"abstract":"<p><p>Recent perioperative literature has increasingly questioned the central role of left ventricular ejection fraction (LVEF) in cardiovascular risk stratification. While patients with preserved LVEF may experience perioperative complications, acute heart failure (AHF) in appears uncommon in the absence of identifiable major structural or hemodynamic dysfunction, such as severe valvular disease, precapillary pulmonary hypertension with cor pulmonale, restrictive cardiomyopathies, or terminal renal disease. This distinction has important implications for the interpretation of perioperative risk in patients with heart failure with preserved ejection fraction (HFpEF).In the absence of these conditions, the HFpEF label may often identify a heterogeneous syndrome dominated by exertional dyspnoea, frequently with substantial extracardiac and peripheral contributors, rather than a cardiac phenotype intrinsically prone to acute decompensation. Perioperative vulnerability in these patients may therefore reflect advanced age, extracardiac comorbidity burden, pulmonary or renal disease, and generalized multisystem frailty, while cardiac systolic performance itself remains largely preserved. A physiology-guided perioperative approach integrating structural abnormalities, pulmonary pressures, congestion, and right ventricular function may therefore provide greater clinical relevance than LVEF-based categorization alone.</p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":"15 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13576252/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148977655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of pre- and intra-operative analgesia of fascia Iliaca compartment block in reducing post-operative delirium of elderly patients following hip fractures: a retrospective study.","authors":"Qing Yang, Jun Zheng, Lei Duan, Haiyan Zhou, Bing Xu, Huadong Lu, Hua Xu, Gengqi Wang","doi":"10.1186/s13741-025-00641-6","DOIUrl":"10.1186/s13741-025-00641-6","url":null,"abstract":"<p><strong>Background: </strong>Hip fractures significantly impact the physiological and psychological well-being of elderly patients. Post-operative delirium (POD) is a common complication after hip fractures in this population, severely affecting treatment outcomes and recovery. Effective pain management during the peri-operative period is crucial for reducing POD, yet the best analgesic approach remains debated.</p><p><strong>Methods: </strong>A retrospective study (from January 2015 to December 2020) included 198 elderly hip fracture patients who received preoperative (PO-) or intraoperative (IO-) fascia iliaca compartment block (FICB) with 50 mL of 0.25% ropivacaine. Over the first 3 days (assessed every 24 h), cognitive function (Mini-Mental State Examination [MMSE]), pain intensity (Visual Analog Scale [VAS]), and systemic inflammatory mediators (CRP, IL-1, IL-6, TNF-α) were evaluated. Postoperative delirium (POD) incidence was daily assessed via the Confusion Assessment Method (CAM) for 72 h by a trained surgeon. Statistical analyses included intergroup comparisons of MMSE/VAS scores and inflammatory markers; cumulative POD incidence was analyzed using Kaplan-Meier curves. Normally distributed data were compared via independent-samples t-test, and categorical data (expressed as percentages) via chi-square (χ²) test.</p><p><strong>Results: </strong>Patients were allocated to two groups: PO-FICB (n = 100) and IO-FICB (n = 98). Postoperatively, the PO-FICB group had significantly higher MMSE scores on days 1-3 (27.85 ± 1.923, 27.49 ± 2.807, 27.23 ± 1.698 vs. 25.80 ± 1.864, 25.73 ± 2.197, 22.57 ± 2.128; all P < 0.01) and lower levels of inflammatory mediators (CRP, IL-1, IL-6, TNF-α; all P < 0.05). VAS pain scores were lower in the PO-FICB group (1.58 ± 0.702, 2.26 ± 0.647, 2.40 ± 0.492 vs. 2.70 ± 0.659, 3.02 ± 0.853, 2.33 ± 0.620), with significant differences on days 1-2 (P < 0.0001) but not day 3 (P = 0.068). POD incidence was significantly lower in the PO-FICB group (5% [5/100]) than in the IO-FICB group (15.3% [15/98]; P = 0.0168). No severe complications or mortality were observed during 12-month follow-up.</p><p><strong>Conclusion: </strong>Compared with IO-FICB, PO-FICB may confer more targeted analgesia and is associated with a lower incidence of POD in elderly hip fracture patients. These associations might relate to PO-FICB's potential early effects of inhibiting inflammation and exerting putative neuroprotective-like actions, which are consistent with current multimodal perioperative management strategies and geriatric neuroprotective concepts. This finding provides preliminary support for considering PO-FICB as a viable option in perioperative regional anesthesia selection for this patient population.</p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13670603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of safety care and clinical nursing pathway in patients undergoing cardiovascular intervention: a randomized controlled trial.","authors":"Yinhua Xi, Tongqing Yao, Cuicui Zhang, Tingting Zhuang","doi":"10.1186/s13741-026-00718-w","DOIUrl":"10.1186/s13741-026-00718-w","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to investigate the effectiveness of safety care and clinical nursing pathways in patients undergoing cardiovascular intervention.</p><p><strong>Methods: </strong>This single-center, single-blind, randomized controlled trial enrolled 100 patients who underwent cardiovascular intervention. Patients were randomly assigned to a control group (receiving standard nursing care) or an experimental group (receiving safety care and clinical nursing pathway interventions in addition to the standard care) (n = 50 each). The primary outcome measure included anxiety and depression symptoms assessed using the Hamilton Anxiety and Hamilton Depression (HAMA and HAMD) rating scales. Secondary outcome measures included cardiac function recovery time, surgery time, surgical vascular puncture success rate, puncture preparation time, and hospital stay, along with adverse events and complications, quality of life, and nursing satisfaction.</p><p><strong>Results: </strong>In the experimental group, post-intervention HAMA (6.42 ± 2.41) and HAMD (6.32 ± 1.44) scores were significantly lower than those in the control group (9.24 ± 1.52, 8.76 ± 1.59) (p < 0.05). The incidence of adverse reactions was lower in the experimental group (12.0%) than in the control group (30.0%) (p < 0.05). Surgery time (45.60 ± 2.98 min) and puncture preparation time (5.08 ± 1.09 min) were shorter, and the vascular puncture success rate was higher (96.0%) in the experimental group; quality-of-life scores and nursing satisfaction were also higher in the experimental group (p < 0.05).</p><p><strong>Conclusion: </strong>Safety care and clinical nursing pathways may be effective in reducing anxiety and depression, lowering adverse reactions, shortening operation and puncture preparation times, increasing the success rate of vascular puncture, improving health knowledge, boosting patient satisfaction, and enhancing quality of life in patients undergoing cardiovascular intervention.</p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660161/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148471966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diabetes mellitus and the risk of postoperative visual and auditory hallucinations after cardiac surgery: insights from the VAACS study.","authors":"Haitham Abu Khadija, Nizar Abu Hamdeh, Abdalaziz Darwish, Duha Najajra, Alaa Dabash, Mohammad Masu'd, Wafiq Othman, Yahya Z Fraitekh, Mohammed Amer Kamel, Taleen Odeh, Noureldin Jarrar, Abeer Sallam, Anwar Zahran, Omar Abu-Khazneh, Saleem Majadleh, Shymai Abdallah, Omar Qasem Heih, Basem Bali, Osama Ewidat, Hamza A Abdul-Hafez, Oday Nana, Qassem Hamoudy, Mohammad Alnees","doi":"10.1186/s13741-026-00722-0","DOIUrl":"10.1186/s13741-026-00722-0","url":null,"abstract":"<p><strong>Objectives: </strong>Postoperative hallucinations are underrecognized neuropsychiatric complications of cardiac surgery. Glycemic control may influence their occurrence, particularly in patients with diabetes. This study aimed to estimate the incidence of visual and auditory hallucinations in diabetic and non-diabetic patients after cardiac surgery, and to identify factors independently associated with hallucinations within each group.</p><p><strong>Methods: </strong>In this prospective multicenter cohort, hallucinations were assessed daily for 7 days using the Questionnaire for Psychotic Experiences. Cox regression identified predictors within diabetic and non-diabetic cohorts.</p><p><strong>Results: </strong>Visual hallucinations occurred in 12.0% of diabetic and 11.2% of non-diabetic patients, while auditory hallucinations occurred in 7.9% and 6.0%, respectively, with no statistically significant between-group difference. Among diabetic patients, elevated preoperative HbA1c independently predicted both visual hallucinations (adjusted HR 1.29; 95% CI, 1.05-1.59) and auditory hallucinations (adjusted HR 1.37; 95% CI, 1.07-1.76). Higher preoperative blood glucose was also independently associated with increased risk of visual hallucinations (adjusted HR 1.011; 95% CI, 1.002-1.020) and auditory hallucinations (adjusted HR 1.013; 95% CI, 1.003-1.024). Morphine use showed an inverse association with auditory hallucinations in diabetic patients, although this did not reach statistical significance after adjustment (adjusted HR 0.57; 95% CI, 0.29-1.12). Longer postoperative mechanical ventilation was inversely associated with auditory hallucinations in diabetic patients (adjusted HR 0.80; 95% CI, 0.71-0.91), although this finding should be interpreted cautiously because hallucination assessment began only after extubation. Among non-diabetic patients, hemodialysis dependence independently predicted visual hallucinations (adjusted HR 6.99; 95% CI, 1.59-30.61), while critical preoperative state (adjusted HR 2.70; 95% CI, 1.23-5.93) and higher EuroSCORE II (adjusted HR 1.10; 95% CI, 1.05-1.15) independently predicted auditory hallucinations.</p><p><strong>Conclusion: </strong>Hallucinations affect a notable prportion of patients after cardiac surgery. Higher preoperative HbA1c and blood glucose were associated with postoperative hallucination risk, particularly in diabetic patients. These findings identify dysglycemia as a clinically relevant risk marker, but do not establish that short-term glycemic optimization would directly prevent hallucinations.</p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13651256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148448597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multimodal analgesia with continuous nerve blocks versus intravenous patient-controlled analgesia for pancreatectomy: a retrospective cohort study.","authors":"Yu-Lien Hsieh, Chung-Ren Lin","doi":"10.1186/s13741-026-00719-9","DOIUrl":"10.1186/s13741-026-00719-9","url":null,"abstract":"<p><strong>Background: </strong>Postoperative pain management after pancreatectomy is challenging due to extensive tissue trauma and visceral pain. Multimodal analgesia (MMA) with continuous peripheral nerve blocks may optimize pain control while reducing opioid consumption. In this study, we aimed to evaluate the efficacy of MMA with continuous peripheral nerve blocks compared with intravenous patient-controlled analgesia (IV PCA).</p><p><strong>Methods: </strong>This single-center retrospective cohort study compared patients who underwent open pancreatectomy (pancreaticoduodenectomy or distal pancreatectomy) between March 2021 and April 2024 using either MMA with continuous peripheral nerve blocks or IV PCA. Our primary outcome was pain scores through postoperative three days. The secondary outcomes included cumulative morphine consumption, time to first mobilization, morbidity and mortality rates, length of hospital stay, and adverse events. We adjusted for confounders using univariable and multivariable regression analyses and applied generalized estimating equations.</p><p><strong>Results: </strong>The study included 104 patients; 42 and 62 patients in the MMA and PCA groups, respectively. Patients in the MMA group had significantly lower pain scores on postoperative day 1 (P = 0.002), lower morphine consumption within 72 hours postoperatively (P < 0.001), earlier mobilization, and fewer 14-day readmissions compared to the PCA group. No significant differences were observed in morbidity, mortality, unexpected intensive care unit admission, or length of hospital stay between the groups. Patients who received MMA experienced less nausea and vomiting than those who received PCA, and no serious adverse events occurred in either group.</p><p><strong>Conclusions: </strong>MMA with continuous peripheral nerve blocks provides effective analgesia, reduces opioid consumption, and facilitates early mobilization compared to IV PCA in pancreatectomy patients. Further randomized controlled trials are required to confirm these findings.</p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13647893/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148448583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perioperative intravenous lidocaine plus esketamine and patient-reported recovery after functional endoscopic sinus surgery.","authors":"Xiaoxia Zheng, Shengjie Xie, Qingping Li, Yang Lan, Li Li, Zhenwei Zheng, Linjing Zhong","doi":"10.1186/s13741-026-00724-y","DOIUrl":"10.1186/s13741-026-00724-y","url":null,"abstract":"<p><strong>Background: </strong>Functional endoscopic sinus surgery (FESS) may be followed by poor early QoR-40-assessed patient-reported recovery and emergence agitation. We performed a secondary analysis to evaluate whether perioperative lidocaine plus esketamine was associated with improved early QoR-40-assessed patient-reported recovery. Inflammatory biomarkers, mood-related symptom scores, and peri-emergence neurobehavioral outcomes were assessed as supportive outcomes.</p><p><strong>Methods: </strong>This secondary analysis included 140 adults (18-65 years) from a single-center randomized four-arm study of FESS: lidocaine + esketamine (LA), lidocaine (L), esketamine (A), or saline (N), 35 per group. Study infusions were administered from 10 min before induction until the end of surgery. The primary endpoint was QoR-40 total score on postoperative day 1 (POD1), defined as the first assessment 24 ± 6 h after extubation; QoR-40 POD2 was the key secondary endpoint; SAS/SDS, emergence agitation (Riker ≥ 5), Nu-DESC-defined PACU delirium-like symptoms, and IL-6/TNF-α (T1-T4) were supportive secondary outcomes. QoR-40 POD7 total score and comparisons of the five QoR-40 domains (Physical, comfort, emotional state, self-care ability/physical independence, social support/patient support, and pain) were exploratory. QoR-40 total/domain scores and SAS/SDS were analyzed using baseline-adjusted ANCOVA.</p><p><strong>Results: </strong>POD1 QoR-40 was available for 137/140 participants, and exploratory POD7 QoR-40 for 136/140. LA was associated with higher QoR-40 than N on POD1 (adjusted mean difference 10.5; 95% CI 5.7-15.3; P = 3.36 × 10^-5) and POD2 (adjusted mean difference 8.2; 95% CI 4.6-11.8; P = 1.56 × 10^-5). Exploratory POD7 total-score and domain analyses were directionally favorable but are interpreted descriptively.In supportive secondary analyses, LA had lower POD1 SAS and SDS (-4.9 and -5.7 points). Agitation was numerically less frequent in LA than N (11.4% vs 31.4%), but the confidence interval crossed unity (RR 0.36; 95% CI 0.13-1.03). At 24 h, IL-6 and TNF-α were lower in LA than N (ratios 0.77 [0.69-0.86] and 0.70 [0.64-0.77]). No serious drug-related adverse events occurred; dreams/hallucinations occurred in 17.1% (LA) and 14.3% (A).</p><p><strong>Conclusions: </strong>In this secondary analysis, perioperative lidocaine plus esketamine during FESS was associated with higher QoR-40-assessed patient-reported recovery on POD1 and POD2, lower early anxiety/depression symptom scores, and lower postoperative inflammatory biomarkers. Exploratory POD7 and QoR-40 domain analyses were supportive but should be interpreted descriptively.</p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13651020/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148448587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound-guided distal peripheral nerve blocks of the ulnar, median, and radial nerves in hand and wrist surgery: a descriptive case series.","authors":"Adriana Vivas, John J Heifner, Angel P Saavedra","doi":"10.1186/s13741-026-00712-2","DOIUrl":"10.1186/s13741-026-00712-2","url":null,"abstract":"<p><strong>Background: </strong>With the increasing prevalence of surgical centers, identifying the safest and most efficient anesthetic techniques is vital. Ultrasound-guided distal peripheral nerve block (US-DPNB) is a technique that has shown promise in published literature for blocking the ulnar, median, and radial nerves at the level of the forearm. This descriptive case series examines 50 patients who underwent hand or wrist surgery with a focus on outcomes following the application of US-DPNB. The technique used in this study was performed by an anesthesiologist, Dr. Angel Saavedra, at an outpatient surgical center. The purpose of this descriptive case series is to describe beneficial clinical outcomes and the feasibility of blocking the median, ulnar, and radial nerves at the level of the forearm in the context of hand and wrist surgeries in surgical centers.</p><p><strong>Methods: </strong>The primary outcomes included a pain scale from 1 to 5, block performance time, and postoperative complications. The secondary outcomes are tourniquet time, patient satisfaction, and return of hand movement. With IRB approval, patients were followed up for up to five days post-surgery to assess outcomes. Either a distal or proximal block was performed at the level of the forearm. Exclusion criteria included repeat surgery on the same hand, procedures expected to exceed 20 min of tourniquet time, and patients with pre-existing peripheral nerve disorders, or prior surgeries affecting nerve anatomy. Data were analyzed using descriptive statistics only; no inferential comparisons between groups were performed.</p><p><strong>Results: </strong>The DFB group presented an average block time of 95.59s, whereas the PFB group presented a mean block time of 73.9s. The pain scores decreased in both groups over the five-day follow-up period. Notably, the only recorded complication was postoperative nausea in one patient in the PFB group.</p><p><strong>Conclusion: </strong>This descriptive case series demonstrates the feasibility of US-DPNB as a primary anesthetic technique for short-duration ambulatory hand and wrist procedures, with low complication rates and high patient satisfaction. As a study without a comparator group, claims regarding economic benefit cannot be formally established; however, the opioid-sparing profile and favorable outcomes observed support further investigation through controlled trials. WGC: 20245045.</p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13647781/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148437388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anesthesia in systemic lupus erythematosus: a review of key considerations and surgical challenges.","authors":"Ali Mohammadi, Vahid Fattahi","doi":"10.1186/s13741-026-00721-1","DOIUrl":"10.1186/s13741-026-00721-1","url":null,"abstract":"<p><p>Systemic Lupus Erythematosus (SLE) presents complex challenges in the perioperative setting due to its multisystem involvement, immune-mediated pathology, and heterogeneous presentation. This narrative review explores the pathogenesis of SLE and its surgical implications, emphasizing how immune dysregulation, vascular endothelial dysfunction, and immunosuppressive therapy influence anesthetic management. It discusses the importance of comprehensive preoperative assessment, focusing on cardiovascular, pulmonary, renal, neurological, and hematological systems, to guide individualized anesthetic planning. Special attention is given to pharmacotherapy management, perioperative monitoring, and strategies to prevent disease flares. The role of spinal, epidural, and general anesthesia in surgical procedures and obstetric care for SLE patients is analyzed, highlighting benefits, risks, and precautions. By synthesizing multidisciplinary strategies and tailoring anesthetic approaches to SLE's variability, this review provides a framework to guide clinicians in optimizing perioperative safety for SLE patients. Future research should focus on standardized protocols and novel monitoring technologies to enhance outcomes.</p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13632196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148412330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of eating lollipop at early stage of recovery after gastrointestinal endoscopy under procedural sedation: a randomized controlled trial.","authors":"Lu Yin, Anna Jia, Jiayao Zhang, Siyuan Huang, Qinqin Yin","doi":"10.1186/s13741-026-00720-2","DOIUrl":"10.1186/s13741-026-00720-2","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Patients undergoing gastrointestinal endoscopy under procedural sedation frequently experience adverse reactions such as hypoglycemia, dizziness, nausea and vomiting during the early post-sedation recovery period. These adverse reactions not only delay the post-procedural recovery process of patients but also further exacerbate their economic and psychological burdens. In light of the significant impact of these adverse reactions on patients' postoperative recovery and quality of life, the present study aimed to evaluate the effect of eating lollipop during early recovery after gastrointestinal endoscopy under procedural sedation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This study was designed as a randomized controlled trial and conducted from November 2023 to December 2024 in a tertiary hospital in Sichuan Province, China. A total of 628 patients undergoing gastrointestinal endoscopy under procedural sedation were enrolled as study participants. Ultimately, 496 patients completed the study, with 248 in the observation group (eating lollipop during recovery) and 248 in the control group (routine care). The primary outcome was hypoglycemia at 30 min after the procedure, defined as fingertip blood glucose ≤ 3.9 mmol/L. Secondary outcomes included nausea/vomiting, pain, dizziness, hunger, post-sedation recovery time, comfort score, and documented safety-related events. Effect estimates and adjusted odds ratios were calculated.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Compared with the control group, patients in the observation group exhibited a significant decrease in the incidence of hypoglycemia (3.2% in the observation group vs. 8.5% in the control group)[absolute risk reduction, 5.2 percentage points (95% CI, 1.1-9.3); relative risk, 0.38 (95% CI, 0.17-0.84)]. After adjustment for clinically relevant covariates, eating lollipop remained associated with lower odds of hypoglycemia (adjusted OR, 0.34; 95% CI, 0.13-0.80; P = 0.020). Additionally, the incidence of nausea and vomiting was also notably reduced in the observation group (4.0% in the observation group vs. 10.5% in the control group, adjusted OR, 0.42; 95% CI, 0.17-0.93; P = 0.039). Comfort scores were higher in the observation group [98 (95, 100) vs. 96 (95, 99); P &lt; 0.001].During the process of eating lollipops, none of the patients in the observation group exhibited adverse events such as aspiration, suffocation, dyspnea, coughing, or choking.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;For patients undergoing gastrointestinal endoscopy under procedural sedation, Eating lollipop during early post-sedation recovery was associated with lower rates of hypoglycaemia and nausea and vomiting, with a small increase in comfort score. These findings should be interpreted cautiously because glucose was measured at a single time point.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Trial registration: &lt;/strong&gt;Clinical trial registration: https://www.chictr.org.cn (ChiCTR2300077983); date of registration: November 27, 2023","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13632044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148412385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}