Anesthesiology Research and Practice最新文献

{"title":"Optimal Dose of Magnesium Sulfate Infusion in Obese Patients: A Double-Blind Randomized Trial.","authors":"Silva Filho S E, Matias G F, Dainez S, Gonzalez M A M C, Angelis F, Bandeira C, Soares F B, Vieira J E","doi":"10.1155/anrp/8854830","DOIUrl":"10.1155/anrp/8854830","url":null,"abstract":"<p><p><b>Background:</b> Magnesium sulfate reduces opioid use and its associated side effects. However, no consensus exists on whether the optimal dosing should be based on actual body weight or adjusted ideal body weight. The primary objective of this study was to compare postoperative analgesia after magnesium sulfate infusion, using doses calculated based on actual body weight versus adjusted ideal body weight. <b>Methods:</b> This prospective, randomized, double-blind, controlled clinical trial included 75 participants who underwent target-controlled intravenous general anesthesia. The participants were divided into three groups: a control group (CG), a group receiving magnesium sulfate calculated by actual body weight (AWG), and a group receiving magnesium sulfate calculated based on the adjusted ideal body weight (IWG). <b>Results:</b> The AWG had significantly lower pain scores than the CG (<i>p</i> < 0.001) and IWG (<i>p</i>=0.017). Opioid use was similar between the AWG and IWG, but significantly higher in the CG (AWG = IWG, <i>p</i>=0.08; CG > AWG, <i>p</i> < 0.001; CG = IWG, <i>p</i> 0.03). The increase in magnesium concentration did not reach clinically relevant levels. Neuromuscular blockade latency decreased in the groups receiving magnesium sulfate (<i>p</i> < 0.001 in both comparisons) compared to the CG. <b>Conclusion:</b> Calculating the dose of magnesium sulfate based on actual body weight enhances postoperative analgesia. The increase in magnesium concentration was not clinically significant and did not interfere with the action of cisatracurium in the groups receiving magnesium sulfate. <b>Trial Registration:</b> ClinicalTrials.gov identifier: NCT04645719.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":"2025 ","pages":"8854830"},"PeriodicalIF":1.6,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11944873/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143717922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Laryngoscope-Guided Insertion and Standard Blind Insertion of the Laryngeal Mask Airway: A Systematic Review and Meta-Analysis.","authors":"Zhihao Zheng, Haibo Li, Congcong Dai, Liwei Bi, Wei Sun, Miao Yu, Zhanfei Hu, Xiaodong Liang","doi":"10.1155/anrp/1224567","DOIUrl":"10.1155/anrp/1224567","url":null,"abstract":"<p><p><b>Background:</b> The insertion of a laryngeal mask airway (LMA) using a laryngoscope-guided technique has produced inconsistent outcomes. The use of laryngoscope guidance in facilitating LMA insertion needs further investigation. This meta-analysis compared its effectiveness and safety against standard blind insertion. <b>Method:</b> We systematically searched PubMed, Cochrane Library, Web of Science, and Ovid Medline for randomized controlled trials comparing laryngoscope-guided (Group L) and blind LMA insertion (Group B). The primary outcome measured was fiberoptic staging. The secondary outcomes included oropharyngeal leak pressure (OLP), insertion time, success rate on the first attempt, and the incidence of postoperative sore throat and blood staining. <b>Results:</b> Nine RCTs (1016 patients) were analyzed. The fiberoptic staging in Group L was found to be significantly higher than that in Group B (RR = 1.54; 95% CI: 1.14-2.08; <i>p</i>=0.005). In addition, the OLP of Group L is significantly higher than that of Group B (MD = 2.10 cmH₂O; 95% CI: 0.38 cmH₂O-3.83 cmH₂O; <i>p</i>=0.02). The success rate for the first attempt was also higher in Group L (RR = 1.14; 95% CI: 1.06-1.22; <i>p</i>=0.0005). The insertion time (MD = 3.92 s; 95% CI: -6.69 s-14.52 s; <i>p</i>=0.47), the incidence of sore throat (RR = 0.90; 95% CI: 0.50-1.65; <i>p</i>=0.74), and the incidence of blood staining (RR = 1.19; 95% CI: 0.29-4.79; <i>p</i>=0.81) did not demonstrate statistically significant differences. <b>Conclusion:</b> The use of LMA with laryngoscope guidance may improve fiberoptic staging and OLP and increase the success rate of first-attempt insertion, without significantly raising the incidence of sore throat or blood staining in anesthetized patients.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":"2025 ","pages":"1224567"},"PeriodicalIF":1.6,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11936533/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Diclofenac Suppositories on Post-Cesarean Section Pain: A Systematic Literature Review.","authors":"Sara Agyemang Antwi, Prince Kwabena Agyemang Antwi, Samuel Akwasi Adarkwa, Kwesi Boadu Mensah, Eric Woode","doi":"10.1155/anrp/5457722","DOIUrl":"10.1155/anrp/5457722","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Background:&lt;/b&gt; Managing postoperative pain after Cesarean section is imperative, as acute postoperative pain is considered a risk factor for chronic postoperative pain. We investigated the role of diclofenac suppositories in postoperative pain management after Cesarean section. &lt;b&gt;Methods:&lt;/b&gt; For this systematic review, we searched PubMed, Scopus, the Cochrane Library, Google Scholar, and two other clinical trial registers from database inception up to July 23 to July 26, 2024. We included randomized controlled trials and other studies in which diclofenac suppositories were administered as an intentional intervention. We excluded studies not reported in English and without a focus on the principal medicine (diclofenac suppository). Two researchers independently chose studies and assessed the risk of bias using RoB-2, following the PRISMA-2020 guidelines. Primary outcomes included pain severity or intensity measured with validated clinical scales. We synthesized the studies narratively. The PICO was used to generate the research question: Population-Cesarean section patients, Intervention-diclofenac suppository, Comparison-opioids, Outcome-lower pain scores and a reduced need for more pain medications, Research question-the effectiveness of diclofenac suppositories in preventing postoperative pain and reducing the consumption of pain medicines in Cesarean section patients. &lt;b&gt;Findings:&lt;/b&gt; From an initial pool of 203 records, 20 records were selected for review. Notably, discrepancies in the study design and reporting were observed. This raised concerns about the consistency and reliability of the results obtained from the different studies. The visual analogue scale (VAS) emerged as the frequently used pain assessment tool. Diclofenac suppository was compared against other treatments under three categories: placebo, other nonsteroidal anti-inflammatory drugs (NSAIDs), and opioids or opioid-like medicines. The findings revealed that diclofenac suppository was effective in reducing pain compared to placebo and hence, minimized the need for opioids. The concept of combining pain medicines for postoperative management, known as multimodal analgesia, was central to most of the studies. &lt;b&gt;Interpretation:&lt;/b&gt; Combination of diclofenac suppositories with other pain relief medicines reduces the need for rescue pain medicines, which are usually opioids such as morphine, meperidine, or pentazocine. &lt;b&gt;Clinical Implications:&lt;/b&gt; Patient satisfaction can be improved with these enhanced pain management strategies. Also, reliance on opioids for postoperative pain management and its related side effects will be reduced. This research reinforces the importance of multimodal analgesia in postoperative pain management. The findings also open pathways for further clinical trials to explore the appropriate combinations, dosages, and administration of NSAIDs for specific surgical populations and settings. Future research should focus on standardizing metho","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":"2025 ","pages":"5457722"},"PeriodicalIF":1.6,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11930387/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Comparison of the Effect of Two Doses of Oral Melatonin as Premedication on Orientation Score, Induction Compliance, and Emergency Agitation of Children Undergoing Elective Surgeries: A Double-Blinded Randomized Trial.","authors":"Haider Muhy Al Bareh, Mohammed Jawad Kadhim Al Kidsawi, Zainab Zuhair Knaish Al Ghrabiu, Mohamed Kahloul","doi":"10.1155/anrp/8832216","DOIUrl":"10.1155/anrp/8832216","url":null,"abstract":"<p><p><b>Background:</b> Following sedation or general anesthesia, emergent agitation (EA) presents as a sequence of abrupt, complicated psychomotor problems marked by perceptual abnormalities, delusions, and disorientation. Studies have proved that melatonin significantly decreases the incidence of postoperative agitation in children after anesthesia. The primary objective of this study was to compare the effectiveness of two doses of oral melatonin as a premedication for orientation score, induction compliance, and emergency agitation of children undergoing surgeries. <b>Methods:</b> In this double-blinded randomized controlled trial, 126 children, aged 4-14, of either sex, with an ASA I or II, scheduled for elective surgery were randomly assigned to get either melatonin 0.4 mg/kg (Group M4) or melatonin 0.2 mg/kg (Group M2), with 63 kids in each group. All children have had the same anesthetic strategy. As a primary outcome, orientation score, induction compliance to intravenous induction anesthesia, and decreased emergency agitation were assessed. <b>Results:</b> Both groups were comparable in terms of demographic characteristics and baseline data. Orientation scores were similar between the groups. Preoperatively, all patients were oriented in both time and place. The two groups had no statistically significant difference according to induction compliance distribution (<i>p</i>=0.065). There was a statistically significant difference in agitation behavior after 5, 10, and 15 min postoperatively in M 4, 2, and total participants (<i>p</i> < 0.001). <b>Conclusion:</b> In pediatric surgical patients, the melatonin dosage does not affect children's compliance with induction but impacts their postoperative behavior by reducing the likelihood of agitation. Administering oral melatonin before surgery could potentially aid in managing postoperative delirium in children.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":"2025 ","pages":"8832216"},"PeriodicalIF":1.6,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11928216/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Nomogram of Weaning Failure for Critical Ventilated Patients in High-Altitude Areas: A Single-Center Cohort Study Using Lasso Logistic Regression.","authors":"Bin Wang, Li Cheng, GuoYing Lin, Ci Yang, HuiYing Zhao","doi":"10.1155/anrp/9934525","DOIUrl":"https://doi.org/10.1155/anrp/9934525","url":null,"abstract":"<p><p><b>Objective:</b> This study aimed to develop a predictive model for weaning failure in critically ill patients at high altitudes. <b>Methods:</b> Data of patients requiring invasive mechanical ventilation admitted to the Department of Intensive Care Medicine of Xizang Autonomous Region People's Hospital from January 1, 2023, to November 31, 2023, were retrospectively collected as the train set. The patients were weaned according to the conventional clinical strategy and divided into successful and failed weaning groups. Univariate analysis was performed between the weaning success and weaning failure groups. Indicators with inter-group differences were included in the Lasso regression for further screening and then included in the multivariate logistic regression analysis to establish independent risk factors. Subsequently, a nomogram prediction model was constructed. Data of patients from December 1, 2023, to April 30, 2024, were retrospectively collected as a validation set to verify the prediction model. <b>Results:</b> A total of 226 patients were included in the train set, of which 61 (27.0%) had weaning failure. The length of intensive care unit stay, mechanical ventilation time, mortality, and medical costs of patients in the weaning failure group were higher than those in the success group. After univariate comparison and Lasso regression, hypertension, lower serum albumin, sequential organ failure assessment (SOFA) score, tidal volume, and respiratory rate were identified as independent risk factors for weaning failure. The area under the receiver operating characteristic curve was 0.895 (95% confidence interval (CI): 0.848-0.943) in the training set and 0.886 (95% CI: 0.814-0.958) in the validation set. <b>Conclusions:</b> Hypertension, lower serum albumin, higher SOFA scores, smaller tidal volumes, and faster respiratory rates were independent risk factors for weaning failure in critically ill patients living in high-altitude areas. A prediction model for weaning failure was constructed, and it showed good prediction efficiency after verification.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":"2025 ","pages":"9934525"},"PeriodicalIF":1.6,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11991831/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thromboelastography Reference Values for Third-Trimester Healthy Obstetric Patients in Northern Mexico.","authors":"S Alvarado-Ramos, M R López-Gutiérrez, R D Nuñez-Alvar","doi":"10.1155/anrp/8871619","DOIUrl":"https://doi.org/10.1155/anrp/8871619","url":null,"abstract":"<p><p><b>Objective:</b> This prospective, descriptive, cross-sectional study aimed to establish kaolin-based thromboelastography reference values for previously known healthy third-trimester pregnancy patients. <b>Methods:</b> The study included 280 patients aged 18-38 years who were admitted to labor or scheduled for elective c-sections. Blood specimens collected via IV catheters were immediately mixed with reagents, placed in coagulation cups, and subjected to 60 min of testing at 37°C using a Haemonetics TEG 5000 system. The Hoffman regression method calculated the reference values; furthermore, effect size determination was done using Cohen's <i>δ</i> for comparison of data from other sources. <b>Results:</b> Patients had a median age of 26 (IQR 22-31), and their thromboelastography profile exhibited reference values for: <i>R</i> time (1-7 min), clot kinetics (1-2), angle (59°-82°), maximum amplitude (60-86 mm), and clot lysis at both 30 min (0%-6%) and 60 min (0%-8%). Results revealed significant differences in various thromboelastography parameters when comparing local patient cohorts against published reports, mainly European and North American counterparts. Shorter reaction times, enhanced clot kinetics, larger angles, and higher maximum amplitude, curve amplitude at 30 min, and amplitude at 60 min indicated distinct coagulation profiles and behaviors in the northeastern region of Mexico. <b>Conclusion:</b> Reference values for the Northern region of Mexico have been calculated and are characterized by a shorter clot reaction time, faster clot dynamics, higher angle values, overall greater curve amplitude, and no differences in enzymatic lysis activity compared to samples from other geographic regions.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":"2025 ","pages":"8871619"},"PeriodicalIF":1.6,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11991821/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Communication Between Anaesthesia Providers for Clinical and Professional Purposes: A Scoping Review.","authors":"Hilary Edgcombe, Gatwiri Murithi, Mudola Manyano, Sophie Dunin, Neal Thurley, Helen Higham, Mike English, Claire Blacklock","doi":"10.1155/anrp/3598234","DOIUrl":"https://doi.org/10.1155/anrp/3598234","url":null,"abstract":"<p><p><b>Background:</b> Anaesthesia providers in all contexts need to be able to communicate with colleagues to meet a variety of clinical and professional needs, including physical help, advice and support as well as learning, supervision and mentorship. Such communication can be regarded as a 'social resource' which underpins anaesthesia providers' practice, but which has not itself been extensively studied. The objective of this scoping review is to provide an overview of the literature related to communication among anaesthesia providers to meet clinical and professional goals, focusing on the modalities, contexts and purposes or outcomes of such communication, as well as which providers are involved. <b>Methods:</b> We conducted a scoping review using the JBI methodology to examine the current literature available, searching the Cochrane Database of Systematic Reviews and Cochrane Central Register of Controlled Trials, Medline, Embase, CINAHL and Google Scholar. Papers were eligible for inclusion where they primarily addressed the subject of communication between trained anaesthesia providers for any clinical or professional purpose (excluding purely social interactions). Data were charted for the location and cadre of providers represented, means of communication and the situation, purposes and outcomes of communication. <b>Results:</b> 3872 records were identified for screening, and 225 papers were ultimately included. Communication was reported both as a variable influencing a wide range of clinical and nonclinical outcomes and as an outcome in itself which might be modified by other factors. It was also considered in a smaller group of studies as a resource with varying availability to anaesthesia providers. Physician providers were well represented in included documents, but nurse anaesthetists, clinical officers and other nonphysician, nonnurse anaesthetists were far less commonly included. The majority of identified studies on communication between anaesthesia providers originated from and related to high-income countries. <b>Conclusion:</b> Communication between anaesthesia providers affects all aspects of their practice and has implications for both patient outcomes and workforce capacity. More research is necessary to understand how the availability of communication as a resource affects patient care and health worker well-being, particularly in low- and middle-income contexts and among nonphysician anaesthesia providers.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":"2025 ","pages":"3598234"},"PeriodicalIF":1.6,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11991797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Effectiveness of Epidural Analgesia and Intravenous Lidocaine for Postoperative Pain in Major Abdominal Surgery: A Systematic Review and Meta-Analysis.","authors":"Mohammad Jawwad, Dawar Nadeem Aslam Dar, Rana Faheem Ullah Khan, Aizaz Chaudhry, Faraz Arkam, Asad Gul Rao, Yusra Mir, Mohammad Maheer Mubashir, Aqsa Mir, Haider Imran, Umar Maqbool, Pierina Clementine Pereira","doi":"10.1155/anrp/9822744","DOIUrl":"https://doi.org/10.1155/anrp/9822744","url":null,"abstract":"<p><p><b>Background:</b> Pain management is an integral part of recovery after major abdominal surgeries. Traditionally, epidural analgesia is used for postoperative pain management in major abdominal surgeries. However, intravenous lidocaine has recently been proven to be a good alternative. However, there is very limited evidence comparing their efficacy in major abdominal surgery. The aim of this review is to compare the effectiveness of epidural analgesia with intravenous lidocaine in reducing pain and opioid consumption following major abdominal surgery. <b>Methods:</b> We searched PubMed and Cochrane Library from inception to May 2024 to identify studies that match our topic. We performed all statistical analyses using RevMan. The primary outcome was pain scores. The other outcomes were opioid requirements, postoperative nausea and vomiting, hospital stay duration, and time to pass flatus. <b>Results:</b> Seven studies (six randomized clinical trials and one observational study; <i>n</i> = 643) were included. Our results suggest that epidural bupivacaine significantly reduced pain scores during the first 24 h postoperatively as compared with the patients who received intravenous lidocaine (Std. mean difference: -0.23; 95% confidence interval [CI]: -0.40, -0.06; and <i>p</i>=0.008). There was no difference at 48 h (Std. mean difference: -0.09; 95% CI: -0.27, 0.08; and <i>p</i>=0.028) and 72 h intervals (Std. mean difference: -0.08; 95% CI: -0.25, 0.09; and <i>p</i>=0.037). <b>Conclusion:</b> Our study shows that epidural analgesia, particularly epidural bupivacaine, provides superior pain relief as compared to intravenous lidocaine during the first 24 h postoperatively. However, there was heterogeneity among studies. Thus, in future, large standardized randomized controlled trials are required.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":"2025 ","pages":"9822744"},"PeriodicalIF":1.6,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11991782/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143960393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Study the Effect of Intraperitoneal Dexamethasone, Dexmedetomidine, and Their Combination on PONV After Laparoscopic Cholecystectomy: A Randomized Triple-Blind Trial.","authors":"Hany Bauiomy, Neveen A Kohaf, Mohammed Saad, Zaky Ftouh Rashed, Ahmed M Abosakaya","doi":"10.1155/anrp/4976637","DOIUrl":"10.1155/anrp/4976637","url":null,"abstract":"<p><p><b>Background:</b> Postoperative nausea and vomiting (PONV) are major adverse consequences following laparoscopic cholecystectomy. Several drugs have been used to combat its occurrence. <b>Objective:</b> This study aimed to show the efficacy of the intraperitoneal route and compare different antiemetic effects of dexamethasone, dexmedetomidine, and their combination on PONV after laparoscopic cholecystectomy under general anesthesia in a tertiary care hospital. <b>Design:</b> Prospective randomized triple-blind study. <b>Setting:</b> The trial was conducted at Benha University Hospitals. The trial was done from August 2023 to April 2024. <b>Patients:</b> Two hundred and forty patients aged 20-50 years, Apfel Score 1, the American Society of Anesthesiologists (ASA) physical status Classification I or II who underwent laparoscopic cholecystectomy. Exclusion criteria were a history of psychotic illnesses, Parkinson's disease, motion disorder, and a history of chemotherapy. <b>Interventions:</b> Patients were randomized equally into four groups. Group I (control group) received 20 mL normal saline, Group II (dexamethasone group) received 8 mg dexamethasone, Group III (dexmedetomidine group) received dexmedetomidine 1mic/kg, and Group IV (combination group) received the combination of both dexamethasone (8 mg) + dexmedetomidine (1mic/kg). The medications were diluted in 20 mL normal saline. <b>Main Outcome Measures:</b> The incidence of PONV encountered by patients in the first 24 h following surgery was recorded. <b>Results:</b> Nausea was reported in 26 (43.33%), 10 (16.67%), 11 (18.33%), and 6 (10%) in Groups I, II, III, and IV, respectively. Vomiting was observed in 25 (41.67%), 11 (18.33%), 10 (16.67%), and five (8.33%) in Groups I, II, III, and IV, respectively. Antiemetic medication was required for 24 (40%), 11 (18.33%), 12 (20%), and eight (13.33%) in Groups I, II, III, and IV, respectively. Nausea, vomiting, and antiemetics requirements differed significantly among the four groups (<i>p</i> value < 0.05). <b>Conclusions:</b> Intraperitoneal administration of dexamethasone and dexmedetomidine either alone or in combination decreased the incidence of PONV among patients scheduled for laparoscopic cholecystectomy. <b>Trial Registration:</b> ClinicalTrials.gov identifier: NCT05988671.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":"2025 ","pages":"4976637"},"PeriodicalIF":1.6,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11876534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bispectral Index and Surgical Space Conditions in Day Surgery Benign Gynecological Laparoscopies: A Double-Blinded Randomized Clinical Trial.","authors":"Elena Crescioli, Peter Søndergaard Thyrrestrup, Thale Almås","doi":"10.1155/anrp/4558323","DOIUrl":"https://doi.org/10.1155/anrp/4558323","url":null,"abstract":"<p><p><b>Background:</b> Ambulatory surgery is increased in numbers, healthcare costs are reduced, and patient safety is high when patient characteristics and type of surgery are properly evaluated. To maintain efficiency and patient safety, anesthesia and surgery must be optimized. The bispectral index (BIS) is a widely used and simplified measure of the depth of anesthesia and may provide a more stable anesthesia and avoid insufficient levels of anesthesia. We investigated whether BIS-guided anesthesia could increase the frequency of excellent overview of the surgical field. <b>Methods:</b> This is a single-center double-blinded randomized clinical trial. We enrolled patients undergoing gynecologic laparoscopies on a benign indication from April 2019 to March 2021. Using closed envelopes, patients were randomized to receive either a BIS-assisted anesthesia, or to receive anesthesia without BIS monitoring (i.e., control group). Surgeons graded their surgical field overview using a four-grade numerical scale at three predefined time points. The primary outcome was the proportion of patients graded with an excellent surgical overview. <b>Results:</b> We included 160 women: 80 patients were randomized to the BIS group and 80 to the control group. There was no statistically significant difference between groups in excellent surgical overview at any time point. Among secondary outcomes, a lower remifentanil consumption in the control group was found in comparison with the BIS group. <b>Conclusions:</b> This trial found no clinically relevant differences regarding surgical overview quality during gynecological laparoscopic surgery when using BIS to titrate anesthesia. To our knowledge, this is the first study investigating this aspect. <b>Trial Registration</b>: ClinicalTrials.gov identifier: NCT03911544.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":"2025 ","pages":"4558323"},"PeriodicalIF":1.6,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11872287/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143539972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}