Perioperative Medicine最新文献

{"title":"Programmed intermittent paravertebral bolus infusion reduces the incidence of postoperative chronic pain three months after thoracoscopic surgery in elderly patients: an observational study.","authors":"Lu Wang, Yicheng Sun, Guangkuo Gao, Tao Liu, Bin Chen, Wanli Kang, Wei Liu","doi":"10.1186/s13741-026-00649-6","DOIUrl":"10.1186/s13741-026-00649-6","url":null,"abstract":"<p><p>OBJECTIVES: The aim of this study was to examine the association between programmed intermittent paravertebral bolus infusion and chronic post-surgical pain (CPSP), including pain components and pain distribution, following video-assisted thoracoscopic surgery (VATS) in elderly patients. DESIGN: An Observational Study. SETTING: This study was conducted at Beijing Chest Hospital, Capital Medical University. PARTICIPANTS: Elderly patients undergoing VATS. INTERVENTIONS: Patients in the paravertebral group received programmed intermittent paravertebral bolus infusion with local anesthetics postoperatively, while patients in the intravenous group received patient controlled intravenous analgesia (PCIA) with sufentanil. MEASUREMENTS AND MAIN RESULTS: CPSP in our study was defined according to the International Classification of Diseases (ICD-11). Among the 242 elderly patients, Group P had a lower incidence of persistent pain at 3 months postoperatively compared to Group I (3.5% versus 13.4%, p = 0.014). Group P also had a lower incidence of anterior chest pain than Group I at both 1 month (p = 0.005) and 3 months (p = 0.020) postoperatively. Additionally, at 3 months, Group P had a lower incidence of neuropathic pain than the Group I (p = 0.021). Furthermore, Group P demonstrated reduced rates of pricking pain and hyperesthesia compared to Group I (p = 0.024; p = 0.042). CONCLUSIONS: Programmed intermittent paravertebral bolus infusion reduces the incidence of postoperative chronic pain in patients undergoing thoracic surgery. It also decreases the occurrence of neuropathic pain three months after surgery. </p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":" ","pages":"17"},"PeriodicalIF":2.5,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12908372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146019038","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":"Thromboembolic complications were not different between intravenous and epidural analgesia after unilateral knee arthroplasty under neuraxial anesthesia: a propensity-score matched analysis.","authors":"Ja Eun Lee, Soo Joo Choi, Mi Sook Gwak, Dae Kyun Ryu, Jaekyeong Song, Sook Young Woo, Young-Wan Moon, Ji Won Choi","doi":"10.1186/s13741-026-00643-y","DOIUrl":"10.1186/s13741-026-00643-y","url":null,"abstract":"<p><strong>Background: </strong>We aimed to compare thromboembolic (TE) complications between intravenous and epidural analgesia after unilateral total knee arthroplasty (TKA) under neuraxial anesthesia.</p><p><strong>Methods: </strong>In this retrospective study, patients who received spinal anesthesia (SA) and intravenous patient-controlled analgesia (IV-PCA) were allocated to the SA-IV group, and those who received combined spinal-epidural (CSE) anesthesia and epidural PCA were allocated to the CSE-E group. Primary outcome was composite incidence of in-hospital TE events defined as myocardial infarction, stroke, peripheral artery occlusion, pulmonary embolism, or deep vein thrombosis. Secondary outcomes were general complications and pain score. After propensity score matching, outcomes were compared using generalized estimating equation.</p><p><strong>Results: </strong>Among 1,244 cases from 2016 to 2022 at a tertiary hospital, 321 patients in SA-IV and 214 patients in CSE-E were analyzed after matching. The incidence of TE complications was comparable between SA-IV and CSE-E groups [0.9% (n = 3) vs. 2.8% (n = 6); odds ratio (OR) 1.88, 95% confidence interval (CI) 0.89-10.57; p = 0.08]. There were no differences in general complications, delirium, falls, or bedsores. In the CSE-E group, transient motor weakness was more frequent (OR 2.70, 95% CI 9.27-451.78; p < 0.001), and the number of days to joint exercise initiation was higher. However, pain score after TKA was significantly lower in the CSE-E group [5(3-6) vs. 3(2-5); p < 0.001].</p><p><strong>Conclusion: </strong>In this retrospective analysis, the incidence of TE complications after TKA under neuraxial anesthesia was not significantly different between intravenous and epidural analgesia. Epidural analgesia was associated with lower pain intensity, higher incidence of motor weakness, and late initiation of exercise.</p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":" ","pages":"15"},"PeriodicalIF":2.1,"publicationDate":"2026-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12896095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145994210","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 red cell distribution width (RDW) was associated with preoperative deep venous thrombosis (DVT) in hip fractures: a retrospective study.","authors":"Ji-Dong Liang, Shuai-Liang Xu, Bin-Fei Zhang","doi":"10.1186/s13741-025-00604-x","DOIUrl":"10.1186/s13741-025-00604-x","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the association between red cell distribution width (RDW) on admission and preoperative deep venous thrombosis (DVT) in older adult patients with hip fractures.</p><p><strong>Methods: </strong>Older adult patients with hip fractures were screened from January 2015 to September 2019. A multivariate logistic regression model was used to identify the association between RDW on admission and DVT in these patients. Sensitivity analysis was used to test the robustness of the results.</p><p><strong>Results: </strong>A total of 1686 patients were included in this study. The multivariate logistic regression model showed that RDW was associated with DVT after adjusting for confounders (odds ratio (OR) = 1.03, 95% confidence interval (CI): 1.01-1.05; P < 0.001). An increase in one RDW was associated with a rise of 3% in DVT in older adults with hip fractures. In addition, we found that the linear association was stable in sensitivity analysis.</p><p><strong>Conclusions: </strong>The RDW on admission was associated with preoperative DVT in hip fractures.</p><p><strong>Trial registration: </strong>ChiCTR2200057323.</p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":"15 1","pages":"8"},"PeriodicalIF":2.1,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12805716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145990348","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":"Non-placement of nasogastric tube versus early removal of nasogastric tube in the enhanced recovery after surgery of hepatocellular carcinoma: a case control study.","authors":"Zheng-Hua Li, Chen Yang, Wen-Jie Ma, Xiu-Ying Hu","doi":"10.1186/s13741-026-00647-8","DOIUrl":"10.1186/s13741-026-00647-8","url":null,"abstract":"<p><strong>Background: </strong>Non-placement of nasogastric tube (NPGT) before operation for elective abdominal surgery and early removal of nasogastric tube (ERGT) are encouraged in clinical practice. However, it is not clear whether these two measures are applicable to all patients with HCC undergoing hepatectomy.</p><p><strong>Methods: </strong>Demographic characteristics, surgical variables, comfort, and postoperative outcome of 412 patients were retrospectively analyzed.</p><p><strong>Results: </strong>The NPGT group comprised 225 patients, while the ERGT group comprised 187 patients. There was no significant difference between the two groups in sex, age, operation time, body mass index, hepatic function, type of hepatectomy, first anal exhaust time, half-liquid eating time, length of postoperative hospital stays, and incidence of postoperative complications before and after propensity score matching (PSM). Compared with the ERGT group, the postoperative incidence of nasopharyngeal discomfort (23.0% vs. 3.11%), nausea and vomiting (14.44% vs. 8.0%), and sore throat (20.86% vs. 2.22%) was significantly lower in the NPGT group (all P < 0.05), even after PSM. A long operation time, and a history of abdominal surgery were independent risk factors for postoperative nasogastric tube placement in the NPGT group. Receiver operating characteristic curve showed an operation time of > 326 min with a maximum area under the curve of 0.744.</p><p><strong>Conclusions: </strong>Patients with HCC undergoing hepatectomy without prophylactic nasogastric tube placement have a low but measurable risk of postoperative nasogastric tube re-insertion. Preoperative nasogastric tube insertion is recommended for patients with a history of abdominal surgery and/or estimated operation time of > 326 min.</p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":" ","pages":"14"},"PeriodicalIF":2.1,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12888322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145971039","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 auditory stimulation in the recovery of patients receiving surgical care: a narrative review.","authors":"Chengkun Tao, Fang Xu, Yingcai Wu, Niannian Huang, Bin Shu, He Huang, Guangyou Duan","doi":"10.1186/s13741-026-00645-w","DOIUrl":"10.1186/s13741-026-00645-w","url":null,"abstract":"<p><p>Sound is ubiquitous, and it affects all aspects of life, such as relieving stress and causing harm. Moreover, sound has negative and positive effects on hospital patients or medical staff. With the global annual increase in surgical volumes, the effect of perioperative sound stimulation on patients receiving surgical care cannot be ignored. Therefore, this review aimed to summarise the positive and negative effects of perioperative sound on postoperative outcomes and offer recommendations for future management of intraoperative and postoperative procedures. The effect of auditory stimuli on patients receiving surgical care has been demonstrated, showing that perioperative music reduces preoperative anxiety in patients receiving perioperative care. Additionally, intraoperative noise impedes effective communication among medical personnel and negatively influences postoperative outcomes in patients, such as increased postoperative pain and increased susceptibility to sensorineural hearing loss. Postoperative noise can reduce patients' sleep quality and easily cause sleep disorders, which can lead to reduced postoperative pain sensitivity. Conversely, using perioperative music or other positive stimuli alleviates postoperative pain, anxiety, and delirium in patients. In the future, sound stimulation can be used as an effective dual-purpose tool to mitigate the detrimental effects of unnecessary noise pollution in hospitals through noise isolation techniques and other measures and as a non-pharmacological intervention to improve perioperative outcomes in patients, thereby offering additional advantages for medical services and perioperative rehabilitation.</p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":" ","pages":"13"},"PeriodicalIF":2.1,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12888512/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145959961","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":"Preoperative education for reducing patient anxiety in elective hip and knee arthroplasty - a systematic review and meta-analysis.","authors":"Adam Lloyd, Saurabh Verma, Liberty Crane","doi":"10.1186/s13741-025-00638-1","DOIUrl":"10.1186/s13741-025-00638-1","url":null,"abstract":"<p><strong>Background: </strong>Preoperative educational interventions are often implicitly regarded as a useful and cost-effective means of improving arthroplasty care. However, previous research in this area is limited - both in terms of age and clinical heterogeneity. This review adds to the existing literature by investigating the relationship between educational interventions and clinically relevant outcome measures, whilst also incorporating a larger sample size, and more stringently defined eligibility criteria. The primary outcome was preoperative anxiety. Secondary outcomes were patient knowledge score, postoperative pain, time-to-discharge, quality-of-life, and surgical complication rate.</p><p><strong>Methods: </strong>A systematic review and meta-analysis of 19 randomised controlled trials. Inclusion criteria specified an adult population receiving elective hip or knee arthroplasty, an intervention group participating in a structured educational intervention, and a control group receiving no education beyond routine preoperative consenting. Outcome data were independently extracted by the review team, before being pooled for statistical analysis using comparison of mean differences and a random effects model.</p><p><strong>Results: </strong>Results showed small, but statistically significant, improvements for the outcomes of patient anxiety (SMD -0.37, 95% CI -0.63 to -0.11), knowledge (SMD +0.37, 95% CI +0.05 to +0.69), and pain (SMD -0.31, 95% CI -0.47 to -0.15). However, the results for other outcome measures were not statistically significant.</p><p><strong>Conclusions: </strong>Findings show a trend in favour of education for reducing anxiety and postoperative pain, though effect sizes were small, and the amount of practical benefit remains questionable due to inter-trial clinical heterogeneity. It was also observed that multi-format interventions may be beneficial for patients with greater anxiety, learning needs, or pain. Further research is necessary due to a lack of trials with reproducibly described interventions.</p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":" ","pages":"11"},"PeriodicalIF":2.1,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12870307/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145912523","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":"Correction: Data integrity issues: catalyst for a more robust approach to research on perioperative oxygen therapy?","authors":"Alex H Oldman, Andrew F Cumpstey, Daniel S Martin, Michael P W Grocott","doi":"10.1186/s13741-025-00613-w","DOIUrl":"10.1186/s13741-025-00613-w","url":null,"abstract":"","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":"15 1","pages":"2"},"PeriodicalIF":2.1,"publicationDate":"2026-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12764031/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145896767","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":"Early plasma syndecan-1 dynamics and their prognostic value in major thoracic and abdominal surgery: a prospective observational study.","authors":"Lysha M Laurens, María Alonso, Janire Perurena, Marcos de Miguel, Ekaterine Popova, Miriam de Nadal","doi":"10.1186/s13741-025-00642-5","DOIUrl":"10.1186/s13741-025-00642-5","url":null,"abstract":"<p><p>BACKGROUND: Glycocalyx degradation, reflected by syndecan-1 shedding, is implicated in microcirculatory dysfunction and inflammatory responses. The present study aimed to assess early postoperative changes in plasma syndecan-1 levels following major thoracic and abdominal surgery, and their association with 30-days postoperative complications. METHODS: A prospective, single-center observational cohort study included 107 patients. Syndecan-1 levels were measured preoperatively and two and 18 h after surgery. Associations with clinical and intraoperative variables were evaluated using univariate linear regression. The predictive performance of syndecan-1 for major complications and mortality within 30 days was assessed via receiver operating characteristic (ROC) analysis. RESULTS: The median syndecan-1 values after two hours of surgery were 958 pg/mL (IQR 654–2665). No significant associations were found with comorbidities, surgical approach, intraoperative factors, or complications (all p > 0.05). Syndecan-1 showed poor predictive performance for major complications and mortality within 30 days (AUC 0.52; 95% CI: 0.40–0.63; p = 0.765). CONCLUSION: Syndecan-1 levels vary widely postoperatively and are not associated with key perioperative variables or outcomes. These findings suggest limited utility of syndecan-1 as a biomarker for perioperative risk stratification in this setting. </p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":" ","pages":"10"},"PeriodicalIF":2.5,"publicationDate":"2026-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12866521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145896766","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":"Correction: Intraoperative oxygenation in adult patients undergoing surgery (iOPS): a retrospective observational study across 29 UK hospitals.","authors":"Clare M Morkane, Helen McKenna, Andrew F Cumpstey, Alex H Oldman, Michael P W Grocott, Daniel S Martin","doi":"10.1186/s13741-025-00614-9","DOIUrl":"10.1186/s13741-025-00614-9","url":null,"abstract":"","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":"15 1","pages":"1"},"PeriodicalIF":2.1,"publicationDate":"2026-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12764012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145896769","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":"Postoperative nausea and vomiting: translating pathophysiological mechanisms into clinical management.","authors":"Xin Zhao, Wenli Liao, Chen Chen, Yaru Zheng, Li Li, Quanyuan Chang, Lan Qiu, Jiang Shen","doi":"10.1186/s13741-025-00626-5","DOIUrl":"10.1186/s13741-025-00626-5","url":null,"abstract":"<p><p>Postoperative Nausea and Vomiting (PONV) is a potential complication in all people undergoing general anesthesia (GA), causing significant discomfort and potentially leading to serious complications. Despite decades of research and the implementation of various preventive drugs and measures, complete prevention via traditional guidelines continues to pose challenges in clinical settings. This article will review mechanisms, influencing factors (including patient-related, surgery-related, and anesthesia-related factors), and strategies for prevention and treatment, both pharmacological and non-pharmacological, for PONV in adultsunder GA. This manuscript also summarizes randomized trials investigating the incidence of PONV in adults receiving opioid-sparing or opioid-free perioperative GA-based protocols. This review aims to summarize evidence-based guidance amidst traditional guidance, and other recent considerations, for optimizing anesthetic management strategies in clinical practice.</p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":"14 1","pages":"140"},"PeriodicalIF":2.1,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12751930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145857468","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}