Perioperative Medicine最新文献

{"title":"Evaluation of routine preoperative testing practices in Sudanese public hospitals 2024: a multicenter prospective study.","authors":"Alaelddin Mohammed, Eltayeb Abdalla","doi":"10.1186/s13741-025-00522-y","DOIUrl":"https://doi.org/10.1186/s13741-025-00522-y","url":null,"abstract":"<p><strong>Background: </strong>The practice of routine preoperative testing is common in clinical settings despite the presence of regulatory guidelines, straining patients financially and further delaying delivery of care. This study aimed to assess the practice of routine preoperative investigations and compliance with the National Institute for Health and Care Excellence (NICE) guidelines for preoperative investigations in Sudan.</p><p><strong>Methods: </strong>A prospective multicenter study was conducted in the main public hospitals at Atbara, Shendi, and Port-Sudan in January 2024; we prospectively studied 90 adults, sampled by covering all consecutive patients who underwent elective operations during the study period. Data were collected during the preanesthetic check-up and evaluated by senior clinicians for compliance with the NICE guidelines.</p><p><strong>Results: </strong>The study included 39 females (43%) and 51 males (56%), with a mean age of 38 ± 14 years. Among the 90 patients, 89 (99%) underwent at least one unnecessary investigation. Overall, out of 586 requested investigations preoperatively, 312 (53.2%) were unnecessary according to the NICE guidelines. The predictors of requesting unnecessary investigations were ASA status (p value 0.020) and surgery grade (< 0.001).</p><p><strong>Conclusion: </strong>This study reported significant overutilization of preoperative testing in Sudanese public hospitals. To address this issue, it is crucial to acknowledge widely recognized guidelines, raise clinicians' awareness of them and monitor their implementation.</p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":"14 1","pages":"40"},"PeriodicalIF":2.0,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance of the early warning system score in predicting postoperative complications in older versus younger patients.","authors":"Annick Stolze, Lisette Vernooij, Dianne de Korte-de Boer, Markus W Hollmann, Wolfgang F F A Buhre, Christa Boer, Peter G Noordzij","doi":"10.1186/s13741-025-00516-w","DOIUrl":"10.1186/s13741-025-00516-w","url":null,"abstract":"<p><strong>Background: </strong>Early warning system (EWS) scores are implemented on surgical wards to identify patients at high risk of postoperative clinical deterioration, but its predictive value in older patients is unclear. This study assessed the prognostic value of EWS scores to predict severe postoperative complications in older patients compared to younger patients.</p><p><strong>Methods: </strong>This study utilized data from the TRACE study. EWS scores were routinely measured on postoperative days one (POD1) and three (POD3). The cohort was divided by age: < 70 years and ≥ 70 years. Performance measures of EWS scores on POD1 and POD3 were assessed to predict severe postoperative complications. Missed event rates (proportion of events not detected by the EWS threshold) and nonevent rates (proportion of EWS values above the threshold without an adverse event) were calculated.</p><p><strong>Results: </strong>Among 4866 patients, 39.3% were ≥ 70 years old. Severe complications occurred in 6.1% of older compared to 5.8% of younger patients (P = 0.658). EWS scores on POD1 and POD3 did not differ between age groups. For severe complications, EWS showed moderate discrimination in both older (POD1: C-statistic 0.65 (95%CI 0.59-0.70); POD3: 0.63 (95%CI 0.57-0.69)) and younger patients (POD1: 0.68 (95%CI 0.65-0.72); POD3: 0.65 (95%CI 0.61-0.70)). Overall, calibration was good. For EWS score ≥ 3, the missed event rate was at least 69% and nonevent rate 75%.</p><p><strong>Conclusions: </strong>Predicted performance of the EWS score was moderate among older and younger patients. A limitation of the EWS score is the high rate of missed events and nonevents.</p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":"14 1","pages":"39"},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11959713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753868","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":"Carotid corrected flow time and Doppler shock index for prediction of post-induction hypotension in patients undergoing elective abdominal surgery: a prospective observational study.","authors":"Tao Sun, Kangli Hui, Liwen Ren, Mengtong Han, Xiaoyun Shen, Jingwei Xiong, Hongwei Qi, Manlin Duan","doi":"10.1186/s13741-025-00519-7","DOIUrl":"https://doi.org/10.1186/s13741-025-00519-7","url":null,"abstract":"<p><strong>Background: </strong>Abdominal surgical patients who have deficient blood volume are at an elevated risk of post-induction hypotension (PIH). New strategies have been adopted, i.e., carotid ultrasound, to evaluate volume status. The study aimed to investigate and compare the predictive value of various carotid ultrasound parameters for PIH.</p><p><strong>Methods: </strong>Adult patients scheduled for abdominal surgery were enrolled. Carotid ultrasound was performed before induction to evaluate the carotid flow time (FT), carotid artery velocity time integral (VTI), and Doppler shock index (the DSI_FTc and DSI_VTI). Both Wodey's (W) and Bazett's (B) formulae determined the corrected flow time (FTc). The predictive ability of these parameters was analyzed via receiver operating characteristic (ROC) curve analysis.</p><p><strong>Results: </strong>Finally, 94 patients were analyzed, and of those, 40 (42.6%) developed PIH. The areas under the curve for FT, FTc(W), 1/DSI_FTc, and FTc(B) were 0.790 (95% CI 0.697-0.883) (P < 0.05), 0.788 (95% CI 0.695-0.881) (P < 0.001), 0.729 (95% CI 0.626-0.832) (P < 0.001), and 0.689 (95% CI 0.582-0.796) (P < 0.05), respectively. The optimal cut-off for FTc(W) was 334.15 ms (sensitivity 82.5%, specificity 70.4%), while for FT, it was 313.33 ms (sensitivity 72.5%, specificity 79.6%), indicating FTc(W) as the best predictor among these various parameters. The 1/DSI_FTc was an inferior predictor of PIH, with an optimal cutoff value of 4.58. The sensitivity (80.0%) and specificity (61.1%) values were obtained.</p><p><strong>Conclusion: </strong>Carotid flow time corrected by Wodey's formula was a reliable indicator of PIH in patients undergoing elective abdominal surgery, superior to FT, DSI_FTc, and FTc(B).</p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":"14 1","pages":"38"},"PeriodicalIF":2.0,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11954297/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743514","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":"Evaluation of postoperative delirium in cardiac surgery patients with the SDACS screening tool: a multicenter-multiphase study.","authors":"Hosein Mahmoudi, Athanasios Chalkias, Ali Moradi, Seyed Tayeb Moradian, Seyed Mohammad Reza Amouzegar, Amir Vahedian-Azimi","doi":"10.1186/s13741-025-00518-8","DOIUrl":"10.1186/s13741-025-00518-8","url":null,"abstract":"<p><strong>Objective: </strong>Postoperative delirium is a prevalent complication in cardiac surgery patients, highlighting the importance of early risk factor identification for optimal management. This study aimed to pinpoint risk factors and devise a novel screening tool, the Screening Tool for Delirium After Cardiac Surgery (SDACS), to predict postoperative delirium in cardiac surgery patients after the first day.</p><p><strong>Materials and methods: </strong>This study employed a multiphase design consisting of three phases. In the first phase, through a scoping review of 38 finally selected published papers, 136 potential risk factors for identifying delirium after cardiac surgery were identified. These risk factors were then incorporated into three Delphi rounds of expert panels to develop a screening tool for postoperative delirium. Finally, 76 potential risk factors were examined on 920 cardiac surgery patients at three academic institutions between 2020 and 2023 (third phase of the study). All predictors were included into a screening instrument (SDACS), and the regression coefficient of each predictor was transformed into a risk score.</p><p><strong>Results: </strong>Delirium was diagnosed in 53% (n = 488) of 920 patients. Four independent predictors of delirium were identified: chronic opioid use (OR: 4.605, 95% CI: 2.163-9.804), hearing impairment (OR: 6.926, 95% CI: 3.630-12.215), benzodiazepine history (OR: 8.506, 95% CI: 5.651-11.805), and poor sleep quality on the first night after cardiac surgery (OR: 9.081, 95% CI: 6.225-12.248). The cross-validated area under receiver operating characteristics curve (AUC) for the screening instrument was 0.897 (95% CI: 0.876-0.916; P < 0.001).</p><p><strong>Conclusion: </strong>Chronic opioid use, hearing impairment, benzodiazepine history, and poor sleep quality post-surgery are linked to postoperative delirium in cardiac surgery patients. The SDACS screening tool effectively forecasts this syndrome early, offering bedside nurses a valuable tool for prompt intervention and improved patient outcomes. The SDACS screening tool aids in early delirium risk assessment, enabling timely interventions and better patient outcomes. By predicting postoperative delirium accurately, nurses can address risk factors proactively, potentially reducing its incidence and severity, leading to improved postoperative outcomes for patients.</p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":"14 1","pages":"37"},"PeriodicalIF":2.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948923/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731056","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":"Prediction of esophagogastric anastomotic leakage by nomogram combined with preoperative nutritional status and clinical factors: a retrospective study of 775 patients.","authors":"Jiang-Shan Huang, Li-Tao Yang, Jia-Fu Zhu, Qi-Hong Zhong, Fei-Long Guo, Zhen-Yang Zhang, Jiang-Bo Lin","doi":"10.1186/s13741-024-00487-4","DOIUrl":"10.1186/s13741-024-00487-4","url":null,"abstract":"<p><strong>Aim: </strong>The purpose was to explore the independent risk factors for esophagogastric anastomotic leakage (EGAL) and establish a nomogram.</p><p><strong>Methods: </strong>Patients who underwent esophagectomy were enrolled and randomly divided into a training cohort and a validation cohort at a ratio of 7:3. The differences between the two groups of factors were analyzed by difference analysis, and multivariate regression analysis was subsequently performed. A nomogram was established, and the feasibility of the nomogram was verified by analyzing the discrimination, calibration, and decision curves.</p><p><strong>Results: </strong>A total of 775 patients were enrolled, including 532 in the training cohort and 223 in the validation cohort. Multivariate regression analysis revealed that age, smoking history, drinking history, nutritional indicators, and anastomotic location were independent risk factors. In terms of discrimination, in the training group, the area under the curve was 0.757 (P = 0.025). In the calibration curve, the curves and fitting lines before and after correction in the training group and the validation group were basically the same. The results of the Hosmer-Lemeshow test showed that the chi-square value of the training cohort was 5.48 (P = 0.791). In the decision curve analysis of the training set, when the threshold probability was in the range of 5-63%, the net benefit of patients was greater than that of the two extreme curves.</p><p><strong>Conclusion: </strong>Preoperative malnutrition is an independent risk factor for EGAL. A diagnostic model, developed on age, anastomotic location, smoking status, and drinking history, was a reliable noninvasive tool to timely predict the occurrence of AL.</p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":"14 1","pages":"36"},"PeriodicalIF":2.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934493/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710772","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":"Effect of pulmonary rehabilitation on lung cancer surgery outcomes: a matched-case analysis.","authors":"Matar Alzahrani, Rajnikant Mehta, Salma Kadiri, Saffana Algaeed, Aya Osman, Mohammed Alsanad, Joan Duda, Fang Gao, Babu Naidu","doi":"10.1186/s13741-025-00510-2","DOIUrl":"10.1186/s13741-025-00510-2","url":null,"abstract":"<p><p>Pulmonary rehabilitation programs for COPD patients are extensively accessible throughout the UK and have demonstrated efficacy in enhancing outcomes, including recovery from exacerbations. Numerous lung cancer surgery patients possess COPD, and the surgery may be regarded as a definitive aggravation of COPD. It is ambiguous in practical application whether referral to pulmonary rehabilitation programs enhances surgical and patient-reported results. We want to address this topic by conducting a propensity-score analysis (PSA) of participants in an enriched cohort trial. Methods An enriched cohort research was conducted, providing rehabilitation both pre- and post-surgery pragmatically through local pulmonary rehabilitation providers for patients undergoing lung cancer resection, and compared to a contemporaneous control group receiving standard treatment. The study enrolled 873 participants (pulmonary rehabilitation (PR) n = 135, non-intervention or control (NG) n = 738). Regression analyses for exposed and unexposed matching, effect estimation, and standard error estimations were conducted.Results A total of 114 participants were matched PR (n = 57) and NG (n = 57). The multivariate-linear regression indicated a reduction in length of stay (LOS) of 0.2 days of LOS compared to the usual care group (EE = - 0.20), and that reduction could potentially go up to 1.8 days (95% CI = - 1.8-1.6). The multivariate log-binomial regression revealed that PR had a reduction of 60% postoperative pulmonary complications (PPC) rate (EE = - 0.60, 95% CI = - 1.8-0.5). Lastly, the multivariate-linear regression showed an improvement in quality of life 6 weeks and 6 months after surgery (QoL) in patients in PR, especially in the physical functioning score in which an improvement of 6.6% was noted for the PR group compared to the NG group following surgery (EE = 6.6). Conclusion Participation in \"real world\" pulmonary rehabilitation prior to and following surgery seems to yield improved patient and clinical results post-lung cancer surgery. Nonetheless, prompt access to pulmonary rehabilitation may be a significant challenge following COVID.</p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":"14 1","pages":"35"},"PeriodicalIF":2.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934484/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710767","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":"Effects of chronic kidney disease on complications and mortality after fracture surgery.","authors":"Bei-Bei Lu, Xu-Rui Liu, Qing-Song Chen, Xiao-Lin Yuan, Qian Luo, Yu-Dong Hu, Xiao-Hui Liao","doi":"10.1186/s13741-025-00514-y","DOIUrl":"10.1186/s13741-025-00514-y","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this meta-analysis was to evaluate the effects of CKD on postoperative complications and the survival of patients with fractures.</p><p><strong>Methods: </strong>The PubMed, Embase, Cochrane Library, and CNKI databases were searched from inception to May 15, 2024. The search strategy focused on two keywords: dialysis and hip fracture. Pooled odds ratios and mean differences were analyzed. RevMan 5.4 was used for data analysis in this meta-analysis.</p><p><strong>Results: </strong>This meta-analysis included 19 studies involving 1,615,440 patients. The CKD group had higher proportions of males, smokers, and patients with preoperative comorbidities such as diabetes, hypertension, heart failure, chronic lung disease, coronary heart disease, peripheral vascular disease, dementia, and wound infection. The CKD group also had a greater likelihood of postoperative myocardial infarction (OR = 1.67, 95% CI = 1.54-1.81, P < 0.00001, I² = 33%). There was no significant difference in cerebrovascular accidents, liver failure, sepsis, and overall complications between the two groups. Additionally, the CKD group had higher mortality rates at 30 days (OR = 2.71, 95% CI = 2.23-3.28, P < 0.00001, I² = 84%), 1 year (OR = 3.17, 95% CI = 2.64-3.82, P < 0.00001, I² = 85%), 2 years (OR = 3.06, 95% CI = 2.88-3.25, P < 0.00001, I² = 8%), and 10 years (OR = 6.85, 95% CI = 5.84-8.03, P < 0.00001, I² = 0%) post-surgery compared to the non-CKD group.</p><p><strong>Conclusion: </strong>Compared with patients in the non-CKD group, patients in the CKD group did not significantly differ in the incidence of most postoperative complications after fracture surgery. However, the CKD group had a significantly greater incidence of myocardial infarction and markedly higher postoperative mortality rates at 30 days, 1 year, 2 years, and 10 years.</p><p><strong>Trial registration: </strong>PROSPERO CRD42025648208.</p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":"14 1","pages":"34"},"PeriodicalIF":2.0,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11929312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693084","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":"Intraoperative fentanyl in endoscopic procedures and their impact on PACU time and costs.","authors":"Miho Akabane, Kelsey Kukuruza, Timothy Angelotti, Subhas Banerjee, Kazuo Ando","doi":"10.1186/s13741-025-00515-x","DOIUrl":"10.1186/s13741-025-00515-x","url":null,"abstract":"<p><strong>Background: </strong>Extended stays in the postanesthesia care unit (PACU) pose challenges in high-volume endoscopies. This study investigates the impact of intraoperative fentanyl use on PACU duration, postoperative pain, and financial implications in outpatient endoscopy.</p><p><strong>Method: </strong>A retrospective analysis of upper/lower endoscopies at our facility (2020-2022) was conducted, focusing on the relationship between fentanyl use, PACU duration, and pain scales. Financial impacts were also assessed.</p><p><strong>Results: </strong>Among 11,488 patients, 5787 (50.4%) received intraoperative fentanyl, and 5225 (45.5%) had a long stay at PACU (> 50 min). A larger proportion of patients in the long-stay group (> 50 min) received fentanyl (56.3% vs. 45.4%, P < 0.01), and they reported higher Numeric Rating Scale (NRS) pain scores (> 5 in 3.6% vs. 1.2%, P < 0.01). The median PACU time was longer for fentanyl recipients (52 vs. 48 min, P < 0.01). Multivariable analysis identified fentanyl use, older age, and higher ASA scores (≥ 3) as significant factors for prolonged PACU durations. Fentanyl did not significantly reduce postoperative pain (scores > 5: 2.8% for fentanyl users vs. 2.2% for nonusers). Furthermore, most patients reported no pain post-surgery (93.0% for fentanyl users vs. 95.2% for nonusers). Fentanyl recipients did not have shorter PACU stays within any pain scale category. Financial simulations suggest that fentanyl-free anesthesia management could notably decrease the financial burden within endoscopy operations. Specifically, our institution could have realized an annual saving of at least US $100,308.</p><p><strong>Conclusion: </strong>Intraoperative fentanyl increases PACU duration by approximately 4 min per patient in endoscopies, without markedly improving pain management. Avoiding fentanyl could lead to significant time and cost savings.</p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":"14 1","pages":"33"},"PeriodicalIF":2.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670616","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":"Impact of mild hypo- and hyperventilation on cerebral oxygen supply during general anesthesia.","authors":"Philipp Groene, Miriam Rapp, Tobias Ninke, Peter Conzen, Klaus Hofmann-Kiefer","doi":"10.1186/s13741-025-00517-9","DOIUrl":"10.1186/s13741-025-00517-9","url":null,"abstract":"<p><strong>Objective: </strong>Cerebral blood flow autoregulation is affected by several physiologic and medical factors. Especially arterial carbon dioxide pressures (PaCO₂) impact cerebral blood flow. Only extensive changes in end-tidal CO₂ have been studied so far. The aim of this study was to evaluate the impact of mild hypo- and hyperventilation on cerebral blood flow as assessed by regional cerebral red blood cell oxygen saturation (rSO₂) in two age groups.</p><p><strong>Methods: </strong>Two groups of patients were compared under general anesthesia before the surgical procedure was started: A younger patient group (age < 40 years; YP) and older patients aged > 60 years (OP). Anesthetic management was standardized. In both groups, end-tidal CO₂ was adjusted either to a low-normal value of 35-37 mmHg or a high-normal value of 43-45 mmHg for 15 min each. The sequence of these interventions was randomized. rSO₂ was estimated by near-infrared spectroscopy (NIRS). The primary outcome was defined as the difference in rSO2 between hypo- and hyperventilation between the two age groups.</p><p><strong>Results: </strong>A total of 78 patients were included. In both groups, there was a statistically significant difference in rSO2 values after 15 min of hypo- versus hyperventilation. In the YP-group, rSO₂ was 74 ± 4% after 15 min of hypoventilation and decreased to 68 ± 6% during hyperventilation (p < 0.001). In the OP-group, rSO₂ was 71 ± 5% and 65 ± 6%, respectively (p < 0.001). There was no difference concerning changes in comparison of younger and elder patient groups (in both groups, Δ rSO₂ = 6 ± 3%; p = 0.732).</p><p><strong>Conclusion: </strong>Even mild hypoventilation increased rSO₂ compared to mild hyperventilation and this difference occurred independent of age.</p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":"14 1","pages":"30"},"PeriodicalIF":2.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11912640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649885","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":"Effect of end-expiratory carbon dioxide monitoring on painless colonoscopy procedures in obstructive sleep apnea patients.","authors":"Pengxia Wang, Qiuxiang Jiang, Kaihui Li, Yinying Zeng, Zhangxing Chen, Shanshan Liu","doi":"10.1186/s13741-025-00509-9","DOIUrl":"10.1186/s13741-025-00509-9","url":null,"abstract":"<p><strong>Background: </strong>Carbon dioxide (CO2) accumulation during prolonged painless colonoscopy procedures in patients with obstructive sleep apnea syndrome (OSAS) can lead to an increased incidence of various complications. The disposable end-expiratory CO2 device monitors the respiratory function and CO2 elimination of patients in real time, providing timely feedback to physicians. This enhances the safety and success of the procedure and improves the overall medical experience for the patient.</p><p><strong>Method: </strong>A total of 158 patients with OSAS underwent colonoscopy and were divided into two groups. The study group received end-expiratory CO₂ monitoring, while the control group underwent routine monitoring. Perioperative interventions, patient satisfaction, and postoperative complications were compared between the two groups using a case-control method. All colonoscopic procedures were performed by surgeons.</p><p><strong>Result: </strong>The study group exhibited a lower incidence of hypoxemia and higher utilization of upper airway ventilation devices, resulting in greater postoperative satisfaction (P = 0.019, P = 0.002, P < 0.001, respectively). Conversely, the control group experienced a higher incidence of postoperative nausea and vomiting as well as abdominal pain and abdominal distension (P = 0.006, P = 0.038, P < 0.012).</p><p><strong>Conclusion: </strong>Employing disposable end-expiratory CO₂ monitoring during painless enteroscopic procedures in patients with OSAS reduces the incidence of hypoxemia, enhances postoperative satisfaction, and decreases the incidence of postoperative complications.</p><p><strong>Trial registration number: </strong>ChiCTR2400083702; Registration date: April 2024.</p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":"14 1","pages":"32"},"PeriodicalIF":2.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11912672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649845","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}