Perioperative Medicine最新文献

{"title":"Perioperative predictors of critical care admission following emergency surgical procedures: a comprehensive evaluation of anesthesia management.","authors":"Şebnem Çimen, Büşra Eroğlu, Afra Buse Kavacık Bulut, Burak Uçaner, Ela Erten","doi":"10.1186/s13741-026-00677-2","DOIUrl":"10.1186/s13741-026-00677-2","url":null,"abstract":"<p><p>BACKGROUND: Emergency surgical procedures carry substantial risk, with increased morbidity, mortality, and unplanned intensive care unit (ICU) admissions. Identifying perioperative factors associated with postoperative ICU requirement is essential for improving outcomes and optimizing resource allocation. This study evaluated anesthesia management practices in a large emergency surgery cohort and investigated independent predictors of postoperative ICU admission. METHODS: This retrospective cohort study included 1,984 patients who underwent emergency surgical procedures at a tertiary center between 2022 and 2023. Demographics, trauma status, ASA classification, airway management, anesthetic technique, hemodynamic support, transfusion, and postoperative analgesia were recorded. The primary endpoint was postoperative ICU admission. RESULTS: The ICU admission rate was 12.1%. ICU-admitted patients were older (57.5 ± 19.1 vs. 36.9 ± 15.2 years, p < 0.001) and more frequently presented with trauma (30.8% vs. 16.0%, p < 0.001). Higher ASA scores, vasopressor or inotrope use (19.9% vs. 0.3%, p < 0.001), and transfusion (32.1% vs. 3.6%, p < 0.001) were strongly associated with ICU need. Multivariate analysis identified age (OR:1.027), trauma (OR:1.606), ASA score (OR:4.376), vasopressor or inotrope use (OR:24.408), and transfusion (OR:4.952) as independently associated factors (all p < 0.05). Specialties showed notable variation in anesthetic technique and postoperative practices. CONCLUSIONS: Postoperative ICU requirement in emergency surgery is associated with advanced age, trauma, elevated ASA status, hemodynamic instability, and transfusion. Recognizing these predictors may help inform risk stratification, perioperative planning, and ICU resource utilization. Standardizing anesthesia protocols and strengthening hemodynamic optimization strategies may help inform perioperative risk stratification and ICU resource allocation. </p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13173806/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147628205","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":"Atrial fibrillation versus non-atrial fibrillation in postoperative complications following lumbar surgery: a retrospective case-control study.","authors":"Chaojun Wang, Yiming Mai, Jimei Zhang, Jian Wang, Jiong Lin, Qinfeng Yang, Qin Pan","doi":"10.1186/s13741-026-00678-1","DOIUrl":"10.1186/s13741-026-00678-1","url":null,"abstract":"<p><p>BACKGROUND: With an aging population and high prevalence rate of atrial fibrillation (AF) in older individuals, more elderly patients with AF receive lumbar operations. Nevertheless, there has been little study discussing the perioperative outcomes of AF in lumbar surgery, especially using a national database. METHODS: A population-based, retrospective cohort survey was conducted on adults receiving lumbar surgery who were divided into 2 cohorts based on the diagnosis of AF or not, using the 2016–2019 Nationwide Inpatient Sample database. Propensity score matching was applied to eliminate selection bias. Univariate and multivariate analyses were performed to explore the impact of AF on postoperative complications following AF. RESULTS: Overall, 222,557 lumbar surgical patients were finally involved in the present study, 10,929 (4.9%) of whom had AF. Irrespective of potential confounders, the in-hospital death risk of patients undergoing lumbar surgery with AF was 1.75-fold compared to those without AF. Additionally, AF was an apparently independent risk factor for cardiac arrest, postoperative delirium, pneumonia, pulmonary embolism, acute respiratory failure, continuous trauma ventilation, acute renal failure, urinary tract infection, gastrointestinal bleeding, blood transfusion, pyemia, septicemia, death, wound infection, and hemorrhage/hematoma/seroma. CONCLUSION: AF seems to be associated with increased perioperative mortality and complications. Orthopedists should be cognizant of the adverse impact on patients with AF. </p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13188265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147628245","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":"Post-surgical DKA stems from poor glycemic control prior to surgery and perioperative catecholamine usage: unmatched case-control study.","authors":"Maher Mualla M Alotaibi, Adel Ali Alkenani, Mariam Gryan A L Enezi, Wafa Sattam Alotaibi, Waleed Tharwat Aletreby","doi":"10.1186/s13741-026-00675-4","DOIUrl":"10.1186/s13741-026-00675-4","url":null,"abstract":"<p><p>BACKGROUND AND OBJECTIVE: Surgery is a well-known trigger of Diabetes Ketoacidosis, DKA. Post-surgical DKA is poorly studied in the current literature. This study investigated post-surgical DKA association with poor glycemic control before surgery. METHOD: Unmatched case–control study sampling all post-surgical DKA cases admitted to ICU during the period from 1st of March 2019 to 1st of December 2022 in King Saud Medical City, Riyadh, Saudi Arabia. The control group comprises all other adult post-surgical subjects admitted to ICU without DKA during the same period. Poor glycemic control was considered when the glycosylated hemoglobin, HbA1C, was equal to or more than 7%. Details of surgery were collected from patients’ records. RESULTS: Fifty-seven post-surgical DKA cases were included and the control group consists of 114 subjects. Poor glycemic control was more frequent among postoperative DKA cases with a statistically significant difference (OR 48.2 95% CI: 12.1 – 267.4; p value < 0.001). Sensitivity analysis of fifty-four pairs of cases and controls matched for age and sex had odds ratio of 48.6 (95% CI: 12.1 – 267.4, p < 0.001). Multivariable logistic regression was done for independent predictor of postoperative DKA. Intraoperative catecholamine and insulin usage along with prolonged duration of surgery were statistically significant predictors (p values < 0.05). CONCLUSION: Post-surgical DKA was ascribed to poor glycemic control. The usage of catecholamine during surgery associated with postsurgical DKA and should be considered in future research. </p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13130553/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147531588","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":"Towards routine monitoring for myocardial injury after noncardiac surgery.","authors":"Dushanthi Dissanayake, Su-Yin MacDonell, P J Devereaux, Janny Xue Chen Ke","doi":"10.1186/s13741-026-00660-x","DOIUrl":"10.1186/s13741-026-00660-x","url":null,"abstract":"<p><p>Myocardial injury after noncardiac surgery (MINS) occurs in approximately 13% of adults ≥ 45 years of age who undergo major inpatient noncardiac surgery and is associated with an increased risk of 30-day and 1-year mortality. Routine perioperative troponin monitoring is needed to avoid missing the majority of MINS events. Although there are challenges to the implementation of MINS surveillance, there has been enormous growth in the uptake of MINS monitoring across Canadian centres. In this paper, we explore challenges to routine screening for MINS and strategies to overcome them. The key challenges were stratifying who to monitor, management strategies and outcomes requiring further research, and resource limitations. Several groups have documented high uptake of perioperative troponin monitoring at centres that have established institutional protocols. Strategies to facilitate implementation of the MINS guidelines include multidisciplinary collaboration, standardized clinical pathways, and audit and feedback. Implementation of a routine MINS monitoring program requires concerted multidisciplinary effort throughout the perioperative period, encompassing the preadmission clinic, postoperative wards, and outpatient clinics.</p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":"15 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13014797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147513776","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 virtual reality and neuropsychiatric outcomes: a scoping review.","authors":"Han Li, Michelle Liu, Pareena Sharma, Richa Vijayvargiya, John W Merriman, Nila Radhakrishnan, Juan N Kattan, Kiran Lukose, Naveen Baskaran","doi":"10.1186/s13741-026-00671-8","DOIUrl":"10.1186/s13741-026-00671-8","url":null,"abstract":"<p><p>BACKGROUND: Surgical procedures in older populations carry significant risks, including increased perioperative complications such as anxiety and delirium, which adversely affect outcomes and patient satisfaction. We sought to evaluate the efficacy and methods of virtual reality (VR) interventions in reducing perioperative anxiety and delirium in a scoping review. METHODS: Searches were performed in Embase and PubMed from 2020 to 2025 for studies involving VR in adult surgical patients, focusing on anxiety, pain, and delirium outcomes. RESULTS: Twenty-three studies encompassing 2,227 patients were included, predominantly randomized controlled trials from various countries. No study directly evaluated VR's effect on delirium, but several showed VR's potential in reducing perioperative anxiety and pain, with mixed efficacy results. VR interventions varied in content, technological sophistication, frequency, and duration. Quality assessment indicated limitations due to unblinded designs. CONCLUSIONS: VR shows promise in reducing perioperative anxiety, with potential implications for delirium prevention. However, the effectiveness varies, and further research is needed to refine VR interventions and explore their role in preventing delirium. </p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13137545/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147513855","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 preoperative intranasal insulin on postoperative delirium in adult surgical patients: a systematic review, meta-analysis, and trial sequential analysis.","authors":"Emmanuel Mark M Velasco, Vinicius Sepúlveda Lima, Tulio Caldonazo, Felipe S Passos, Paulo Ricardo Gessolo Lins, Iago Teles Costa Grillo, Pedro Tanaka, Alex Macario, Aleksandar R Zivkovic, João da ManoelSilva, Johannes Ehler, Ricardo Esper Treml","doi":"10.1186/s13741-026-00674-5","DOIUrl":"10.1186/s13741-026-00674-5","url":null,"abstract":"<p><p>BACKGROUND: Postoperative delirium (POD) is a frequent and serious complication, especially in older adults and high-risk surgical patients. Intranasal insulin has emerged as a potential neuroprotective intervention, possibly modulating neuroinflammation and preserving cognitive function. This study aimed to evaluate the efficacy and safety of preoperative intranasal insulin in reducing POD incidence. METHODS: A systematic review and meta-analysis were conducted according to PRISMA guidelines. PubMed, Embase, and the Cochrane Library were searched through March 2025 for randomized controlled trials (RCTs) comparing intranasal insulin versus placebo in adult surgical patients. The primary outcome was the incidence of POD. Secondary outcomes included inflammatory biomarkers (IL-6, TNF-α, CRP), glucose levels, and insulin resistance (HOMA-IR). Odds ratios (OR) and mean differences (MD) with 95% confidence intervals (CI) were calculated using random-effects models. Trial Sequential Analysis (TSA) was also performed. RESULTS: Eight RCTs from China involving 888 patients (481 intranasal insulin, 407 placebo) were included. Intranasal insulin significantly reduced the risk of POD (OR 0.24; 95% CI 0.17 to 0.34; p < 0.001; I2 = 0%). TSA confirmed the robustness of this finding. Significant reductions in IL-6 (MD -2.52; 95% CI -3.45 to -1.58) and TNF-α (MD -5.02; 95% CI -8.67 to -1.36) were observed. No significant differences were found in serum or CSF glucose, or HOMA-IR. No hypoglycemia or serious adverse events were reported. CONCLUSION: Preoperative intranasal insulin is a safe and effective strategy to reduce POD, likely through central anti-inflammatory mechanisms, without compromising glycemic stability. </p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13063771/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147486902","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 ice-lollies on the recovery time after anaesthesia: protocol for a cluster-randomised trial (Icesthesia).","authors":"Agnes S Meidert, Roman Hornung, Anja Laska, Joseph Esser, Florian Brandes, Stephan Berthold, Melanie Borrmann, Volker Huge","doi":"10.1186/s13741-026-00668-3","DOIUrl":"10.1186/s13741-026-00668-3","url":null,"abstract":"<p><p>BACKGROUND: Effective management in the post-anaesthesia care unit (PACU) is essential to ensure patient safety, comfort, and timely progression through the surgical care pathway. Many patients experience side effects such as nausea, vomiting, sore throat, hoarseness, dizziness, and disorientation. These symptoms can prolong recovery time. Ice-lollies are a pragmatic, non-pharmacologic intervention. We aim to test the hypothesis that offering ice-lollies in the PACU shorten the patients' length of stay in post-anaesthesia care. METHODS: Icesthesia is a prospective monocentric cluster-randomised single-blinded controlled clinical superiority trial in 3140 patients admitted to the PACU of a large university medical centre after anaesthesia. Days are randomised to intervention days with ice-lollies plus standard of care and control days with standard of care only. Anonymised patient data is collected. The primary outcome is the length of time spent in the PACU until decision to discharge. Secondary outcomes are pain medication consumption, nausea and vomiting, and postoperative delirium at discharge. DISCUSSION: This trial determines if offering ice-lollies to patients postoperatively reduces the length of stay in the PACU compared to standard of care. TRIAL REGISTRATION: German Clinical Trials Register (DRKS00037179) on 11th June 2025. </p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13064207/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147481182","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":"Development of risk prediction model for chronic pain after knee replacement surgery: protocol for an individual patient data meta-analysis.","authors":"Behnam Sadeghirad, Malahat Khalili, Jason W Busse, Wael Abdelkader, Farid Foroutan, Lawrence Mbuagbaw, Ian Gilron, James Khan, Kim Madden, Daniel Tushinski, Eric Bohm, Maaike G J Gademan, Rudolf W Poolman, Anthony Adili, Anthony V Perruccio, Y Raja Rampersaud, Christiaan Righolt, Harsha Shanthanna, Maram Khaled, Ben Gabbott, Maura Marcucci, Paul Zalzal, Xavier Griffin, Emil Schemitsch, Alfonso Iorio","doi":"10.1186/s13741-026-00672-7","DOIUrl":"10.1186/s13741-026-00672-7","url":null,"abstract":"<p><p>BACKGROUND: Chronic post-surgical pain (CPSP) impacts approximately one in four patients following total knee arthroplasty (TKA) and is associated with reduced function and quality of life. We will conduct a systematic review of prospective studies to identify eligible data and establish an international repository of individual patient data (IPD) on prognostic factors for chronic pain after TKA. This repository will be then used to develop and validate a prediction model for CPSP following TKA. METHODS: We will identify eligible studies through a search of MEDLINE, CINAHL, EMBASE, and Cochrane CENTRAL from January 2005 to August 2025. We will include prospective studies that: (1) enrolled adults undergoing elective TKA, (2) assessed perioperative risk factors for CPSP, and (3) measured knee pain longitudinally at least 3 months post-surgery. Pairs of reviewers will independently screen titles and abstracts of retrieved citations and review the full texts of potentially eligible studies. We will reach out to principal investigators or authors of eligible studies to notify them of our initiative and request to receive their IPD into a secured repository, based on a data sharing agreement. We will use a one-stage approach for IPD meta-analysis of factors associated with CPSP following TKA, and development of a risk prediction model. DISCUSSION: We will use anonymized de-identified data for our IPD meta-analysis. This protocol was reviewed and approved by the Hamilton Integrated Research Ethics Board (HiREB). We will develop an online calculator to support our risk assessment model for research and clinical use. This IPD meta-analysis will facilitate the development of a robust prognostic model to guide clinical decisions or enrolment in interventional studies, with the ultimate goal of identifying pathways to effective CPSP prevention strategies after TKA. TRIAL REGISTRATION: CRD42024591329. </p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13214424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147486949","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 sex on the association between neutrophil percentage-to-albumin ratio and mortality in perioperative patients with chronic kidney disease: a retrospective analysis of the INSPIRE database.","authors":"Bin Pan, Bingwen Lin, Xiaochen Zhang, Yiqing Zou","doi":"10.1186/s13741-026-00670-9","DOIUrl":"10.1186/s13741-026-00670-9","url":null,"abstract":"<p><p>BACKGROUND: This research assessed the relationship between the neutrophil percentage-to-albumin ratio (NPAR) and mortality in perioperative chronic kidney disease (CKD) patients and explored sex-specific differences. METHODS: Using the INSPIRE database (2011–2020), we retrospectively analyzed 2,474 surgical CKD patients that were categorized by admission NPAR tertiles. Cox regression was used to evaluate associations between the NPAR and mortality, and stratified curve fitting was used to reveal sex-specific differences. RESULTS: Analysis of the cohort (mean age 60.8 ± 14.8 years; 65.3% male) revealed that an elevated NPAR was significantly associated with increased mortality risk, particularly in females. For in-hospital mortality, each unit increase in the NPAR (continuous) significantly predicted risk in females across all models (Model 4: HR = 2.56, 95% CI 1.73–3.78, p < 0.001) with the highest tertile (T3) showing a significantly increased risk in the fully adjusted models (T3 vs. T1, Model 4: HR = 2.93, 95% CI 1.48–5.80, p = 0.002). However, this association was not significant in males. For 30-day mortality, the association was even stronger in females (NPAR continuous, Model 4: HR = 4.13, 95% CI 2.61–6.52, p < 0.001; T3 vs. T1, Model 4: HR = 10.87, 95% CI 4.46–26.51, p < 0.001), while males showed no significant association even after full adjustment. Additionally, significant sex-specific interactions were observed for both outcomes (p < 0.05 for trend differences). CONCLUSIONS: Our findings indicate that an elevated NPAR is significantly associated with higher in-hospital and 30-day mortality in female CKD patients who have undergone surgery but this association is not significant in males. </p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13107820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147468507","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 different preoxygenation strategies on dynamic thiol-disulfide homeostasis and blood gas parameters in patients undergoing laparoscopic cholecystectomy.","authors":"Veli Fahri Pehlivan, Seyhan Taskın","doi":"10.1186/s13741-026-00665-6","DOIUrl":"10.1186/s13741-026-00665-6","url":null,"abstract":"<p><strong>Background: </strong>Although oxygen is critical in anesthesia, high-concentration exposure, even for short periods during preoxygenation, may contribute to oxidative stress. In the context of perioperative care optimization, minimizing unnecessary oxidative burden is essential for patient safety. This study investigated the acute effects of standard versus rapid preoxygenation strategies on thiol-disulfide homeostasis and blood gas parameters in patients undergoing laparoscopic cholecystectomy.</p><p><strong>Materials and methods: </strong>This prospective observational study enrolled 62 ASA I-II patients scheduled for elective laparoscopic cholecystectomy. Patients received 100% O₂ via standard preoxygenation using a tight-fitting face mask for 3 min (Group 1) or rapid preoxygenation consisting of eight deep breaths over 30 s to 1 min (Group 2). Blood samples were collected at four perioperative time points: before preoxygenation (T0), after preoxygenation (T1), post-intubation (T2), and at surgery end (T3). Thiol-disulfide homeostasis was evaluated biochemically; blood gas analyses were performed immediately.</p><p><strong>Results: </strong>Group 1 showed a significant decline in total thiol levels and a trend toward increased disulfide levels, indicating elevated oxidative stress. Group 2 exhibited more stable thiol-disulfide dynamics. Blood gas analysis revealed greater acidosis, elevated lactate, and increased pCO₂ in Group 1, while Group 2 demonstrated more favorable acid-base and metabolic profiles. Importantly, these effects were observed despite longer surgical durations and higher smoking rates in Group 2, highlighting the potential of optimized preoxygenation to improve perioperative metabolic stability.</p><p><strong>Conclusion: </strong>Standard preoxygenation was found to induce greater oxidative stress and metabolic disturbances compared to rapid preoxygenation. Incorporating rapid preoxygenation into anesthesia induction protocols may enhance perioperative safety by preserving redox balance and reducing metabolic derangements. These results underscore the need to reevaluate current preoxygenation practices, particularly in metabolically vulnerable patients. Further studies should assess long-term outcomes and applicability in high-risk populations.</p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13101250/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147458991","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}