Anesthesiology Research and Practice最新文献

{"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}

{"title":"Perfusion Index Predicts the Effectiveness of Supraclavicular Brachial Plexus Block in Children Under General Anesthesia: A Randomized Controlled Trial.","authors":"Tiantian Chu, Siqi Zhou, Ting Peng, Hong Tao, Han Chen, Xu Yan, Yueyang Xin, Zhang Tian, Jinxu Wang, Lingli Deng, Aijun Xu","doi":"10.1155/anrp/5583145","DOIUrl":"https://doi.org/10.1155/anrp/5583145","url":null,"abstract":"<p><p><b>Objectives:</b> This study aimed to assess the predictive value of perfusion index (PI) in determining the effectiveness of supraclavicular block (SCB) in children under sevoflurane or propofol general anesthesia. <b>Methods:</b> In this randomized controlled study, 104 children who underwent elective upper extremity surgery under sevoflurane or propofol anesthesia were scheduled to be enrolled. The primary outcome was the effects of PI in predicting the effectiveness of SCB under general anesthesia. The PI value was obtained through pulse oximetries. Secondary outcomes include hemodynamic data, supplementary opioid doses, agitation score, pain score, and postoperative complications. <b>Results:</b> A total of 103 pediatric patients were analyzed. PI increased rapidly after anesthesia induction, and there was no significant difference in PI in the blocked side between the propofol group (PRO group) and sevoflurane group (SEV group). At 10 min after the block, PI in the blocked side was higher than that in the unblocked side in both groups (<i>p</i> < 0.05). However, PI showed low sensitivity and specificity in predicting the effect of SCB at 10 min in both groups. At PACU, PI exhibited a high sensitivity (0.837 vs. 0.796) and specificity (0.721 vs. 0.898) for SCB at cutoff values of 5.91 and 6.67 in both PRO and SEV groups. The area under the receiver operating characteristic curve (AUROC) values were 0.834 (95% CI 0.750-0.918) and 0.895 (95% CI 0.832-0.959). <b>Conclusion:</b> PI demonstrates limited sensitivity and specificity in predicting the effect of SCB at 10 min after block under general anesthesia. However, PI may serve as a more appropriate indicator to guide the necessity for supplemental analgesia in PACU. <b>Trial Registration:</b> ClinicalTrials.gov identifier: NCT04216823.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":"2025 ","pages":"5583145"},"PeriodicalIF":1.6,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11871980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143539973","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":"On-Pump FIBTEM-A5 Accurately Predicts the A5 Values After Protamine Administration.","authors":"Stanislaw Vander Zwaag, Matus Tomko, Tomas Madej, Jens Fassl","doi":"10.1155/anrp/2924468","DOIUrl":"10.1155/anrp/2924468","url":null,"abstract":"<p><p><b>Introduction:</b> In the present study, we aimed to investigate whether the measurements of the fibrinogen-dependent clot firmness in FIBTEM-one of the rotational thromboelastometry (ROTEM) assays-during cardiopulmonary bypass (CPB) accurately predict the values after protamine administration. <b>Materials and Methods:</b> In this single-center retrospective observational study, we analyzed a database of patients undergoing on-pump surgeries between May 2022 and February 2024. We included patients in whom an intraoperative ROTEM examination during CPB and a follow-up examination directly after protamine infusion were performed. We excluded patients who received either fibrinogen concentrate or fresh frozen plasma between the two examinations. FIBTEM A5 values in both examinations were compared. The Wilcoxon signed rank test was used to compare non-normally distributed data. Linear regression analysis was used to investigate the relationship between the on-pump and postprotamine FIBTEM A5 values. <b>Results:</b> Seventy patients were included in the statistical analysis. There was a slight but statistically significant difference between FIBTEM A5 during CPB (median 16.0 mm, IQR 10.0-22.0) and after protamine administration (median 15.5 mm, IQR 8.7-22.3, <i>p</i> = 0.021). However, in linear regression analysis, FIBTEM A5 values during the last 30 min of the extracorporeal circulation were a significant predictor of FIBTEM A5 after protamine administration (<i>R</i> = 0.902, <i>R</i> ² = 0.813, adjusted <i>R</i> ² = 0.810, F(df regression, df residual) = 295.980, <i>p</i> < 0.001). The equation: <i>y = </i>0.911<i>x</i> <i>+</i> 1 describes the line of best fit. <b>Conclusions:</b> Within the normal range limits, there is a very strong correlation between on-pump FIBTEM A5 values and FIBTEM A5 values after protamine administration.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":"2025 ","pages":"2924468"},"PeriodicalIF":1.6,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11824858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432217","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":"Assessment of the Association Between Neuraxial Anesthesia and Back Pain After Delivery: A Systematic Review and Meta-Analysis.","authors":"Sara Timerga, Getaw Walle, Wondwosen Mebratu, Aynalem Befkadu","doi":"10.1155/anrp/2105413","DOIUrl":"10.1155/anrp/2105413","url":null,"abstract":"<p><p><b>Background:</b> Back pain after delivery both under cesarean section and spontaneous vaginal delivery is the most common pregnancy-related musculoskeletal problem. There are multiple studies that emphasize the effect of epidural anesthesia and spinal anesthesia on the incidence and severity of postdelivery back pain. There are others stating no association between the two. <b>Objective:</b> The aim of this study is to summarize the relationship between back pain after delivery and neuraxial anesthesia. <b>Methods:</b> Studies identified from database: Cochrane Library, The Virtual Health Library, National Library of Medicine PubMed, Google Scholar, and citation searching with both experimental and observational study design were included. Exposed and nonexposed incidence of back pain was extracted to analyze the pooled odds ratio assessing the association of postpartum back pain and neuraxial anesthesia. Heterogeneity was checked across studies using Cochrane <i>Q</i> test statistic and <i>I</i> ². Small study effect was assessed using a funnel plot graphically and nonparametric rank correlation (Begg) test. <b>Results:</b> Four RCT and 11 observational studies were identified for analysis. The studies included mothers delivering under cesarean section and vaginal delivery with epidural anesthesia, spinal anesthesia, and combined spinal epidural anesthesia. Based on the 15 studies included in this meta-analysis, the pooled odds ratio according to random effect restricted maximum-likelihood model was 1.2 (95% CI (0.77-1.86)) with <i>p</i> value = 0.43. There was a significant heterogeneity with <i>I</i> ² = 97.76%, <i>H</i> ² = 44.58, and Cochrane <i>Q</i> statistics <i>p</i> value = 0.001. <b>Conclusion:</b> Our result suggests neuraxial anesthesia may not be the cause or the risk factor for the overwhelmingly high incidence of back pain women experience after delivery.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":"2025 ","pages":"2105413"},"PeriodicalIF":1.6,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11824844/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432216","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}