Anesthesiology Research and Practice最新文献

{"title":"Single-Shot Intrathecal Bupivacaine With Fentanyl vs. Dexmedetomidine for Labor Analgesia: A Randomized Controlled Trial.","authors":"Ayman Mohamady Eldemrdash, Taha Tairy Dardeer Elsawy, Zaher Zaki Zaher, Jehan Sadek Younan, Ahmed Mohammed Reda Ragheb","doi":"10.1155/anrp/6685169","DOIUrl":"10.1155/anrp/6685169","url":null,"abstract":"<p><strong>Background: </strong>Labor pain is one of the most intense physiological pains experienced by women. Single-shot spinal analgesia (SSSA) offers rapid and reliable labor pain relief. Combining bupivacaine with adjuvants like fentanyl or dexmedetomidine has been proposed to enhance analgesic efficacy and maternal comfort.</p><p><strong>Methods: </strong>In this randomized, double-blind clinical trial, 90 full-term parturients in active labor were randomly allocated into three equal groups: Group B: 2.5 mg intrathecal bupivacaine with 0.5 mL of saline; Group BF: 2.5 mg bupivacaine with 25 μg fentanyl; Group BD: 2.5 mg bupivacaine with 5 μg dexmedetomidine. We compared the duration and onset of analgesia, pain scores on the visual analog scale (VAS), maternal satisfaction using the short assessment of patient satisfaction (SAPS), adverse effects, and neonatal outcomes.</p><p><strong>Results: </strong>Group BD demonstrated the fastest onset of analgesia (2.1 ± 0.7 min) and the longest duration (124.2 ± 15.4 min), compared to Group BF (3.6 ± 0.9 min; 106.2 ± 18.9 min) and Group B (4.2 ± 1.0 min; 80.4 ± 14.6 min) (<i>p</i> < 0.001). The pattern of pain reduction over time varied across treatments; Group BD showed the most rapid and sustained decrease in pain intensity, while Group B exhibited the slowest decline. A significant time × group interaction (<i>p</i> < 0.001, partial <i>η</i> ² = 0.67, i.e., large effect size) was observed. Maternal satisfaction scores were significantly higher in Group BD (26.63 ± 2.03) than in BF (22.00 ± 3.29) or B (15.27 ± 3.68) (<i>p</i> < 0.01). The incidence of itching and nausea was higher in the BF group, and mild bradycardia was found in the BD group. Apgar scores at 1 and 5 min were similar in all groups.</p><p><strong>Conclusion: </strong>Dexmedetomidine added to intrathecal bupivacaine produced good labor analgesia with high maternal satisfaction, with low side effects, and could be used as a better substitute for fentanyl. <b>Trial Registration:</b> ClinicalTrials.gov: NCT06823349.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":"2026 ","pages":"6685169"},"PeriodicalIF":1.5,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13125853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147809426","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 Between Two Different Directions of Landmark-Guided Femoral Vein Puncture: A Prospective Randomized Controlled Trial.","authors":"Feng Liu, Xin Wang, Zhaoming Guan, Wang Shen, Longqiu Yang, Bing Tang","doi":"10.1155/anrp/9638063","DOIUrl":"10.1155/anrp/9638063","url":null,"abstract":"<p><strong>Background: </strong>Anatomic variations in the spatial relationship between the femoral vein and artery are recognized as predisposing factors for iatrogenic vascular injury during percutaneous procedures. There have been few clinical studies comparing different directions of femoral vein puncture. Here, we conducted a prospective randomized controlled trial comparing two directions of femoral vein puncture.</p><p><strong>Methods: </strong>A cohort of patients undergoing percutaneous femoral venous catheterization was randomized into two groups of comparable size, with punctures executed via either the lateral or orthogonal approach. The primary outcome was the first-attempt success rate. Secondary outcomes included overall success rate, number of puncture attempts, puncture time, and complications.</p><p><strong>Results: </strong>Among 108 patients, the lateral approach group demonstrated a higher first-attempt success rate (76% vs. 52%; risk difference: 24%, 95% CI: 6% to 40%; <i>p</i> = 0.009) and overall success rate (91% vs. 61%; risk difference: 30%, 95% CI: 14% to 45%; <i>p</i> < 0.001), fewer puncture attempts (<i>p</i> = 0.004), and a shorter puncture time (median difference: -6.0 s, 95% CI: -13.0 to 0.0; <i>p</i> = 0.042). The advantages of the lateral approach were more significant when there was a lumen overlap between the femoral vein and artery. There were similar complication rates between approaches.</p><p><strong>Conclusions: </strong>When relying on anatomical landmarks for femoral vein puncture, the lateral approach is conducive to improving the success rate and reducing operating time without raising the risk of local complications. This is particularly beneficial in cases where the femoral artery and vein partially or fully overlap. <b>Trial Registration:</b> Chinese Registry of Clinical Trials: ChiCTR2500096775.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":"2026 ","pages":"9638063"},"PeriodicalIF":1.5,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13267157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148262822","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":"Association Between Digit Ratio and Postoperative Nausea and Vomiting: A Single-Center Prospective Cohort Study.","authors":"Yoshihiko Chiba, Yusuke Iizuka, Shinnosuke Ohama, Kyoko Chiba, Koichi Yoshinaga, Kyosuke Takahashi, Masamitsu Sanui","doi":"10.1155/anrp/8897870","DOIUrl":"10.1155/anrp/8897870","url":null,"abstract":"<p><strong>Background: </strong>Postoperative nausea and vomiting (PONV) occurs even with preventive measures. Several reports suggest that PONV is associated with sex hormones. However, estimating individual hormone levels remains challenging. The digit ratio, the length ratio of the second to the fourth fingers, is a noninvasive predictor of hormone levels, with a ratio ≥ 1 being more feminine. We investigated whether digit ratio predicts PONV.</p><p><strong>Methods: </strong>This single-center prospective study included patients aged > 18 years who underwent general anesthesia for scheduled surgery at the Jichi Medical University Saitama Medical Center. PONV prophylaxis was administered according to the number of risk factors defined by the well-established Apfel simplified risk score (female, nonsmoking, history of motion sickness or PONV, and postoperative opioid usage). The primary endpoint was PONV incidence within 24 h postoperatively, stratified by the digit ratio. As a subgroup analysis, we analyzed the impact of the digit ratio on the incidence of PONV, which was further categorized according to sex, age, and type of surgery. Univariable and multivariable logistic regression analyses were also conducted to identify the risk factors associated with PONV.</p><p><strong>Results: </strong>Overall, 792 patients were included, with 19.1% having a digit ratio ≥ 1 and 80.9% < 1. Significant differences were observed in sex and age between the groups. PONV incidence within 24 h was 18.5% in the digit ratio ≥ 1 group and 18.7% in the digit ratio < 1 group, with no significant difference. Subgroup analyses by sex and younger age also showed no significant differences, except for a higher PONV incidence in abdominal surgery patients with digit ratio ≥ 1. Regression analysis identified the Apfel simplified risk score as a significant risk factor for PONV.</p><p><strong>Conclusions: </strong>Digit ratio was not associated with PONV in the overall patient population. However, an association was found in patients who underwent abdominal surgery, suggesting that digit ratio might be a risk predictor in this subgroup. Future studies should focus on larger sample sizes of patients undergoing high-risk surgeries to validate these findings. <b>Trial Registration:</b> University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR); UMIN000048615.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":"2026 ","pages":"8897870"},"PeriodicalIF":1.5,"publicationDate":"2026-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13159081/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147925625","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 Adverse Reactions Between Remimazolam and Propofol in Hysteroscopic Surgery in Mainland China: A Meta-Analysis and Systematic Review.","authors":"Zirui Liu, Kexu Zhu, Zidong Zhao, Qi Zeng","doi":"10.1155/anrp/4206976","DOIUrl":"10.1155/anrp/4206976","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this meta-analysis was to compare the adverse reactions of remimazolam and propofol in hysteroscopic anesthesia and to evaluate the efficacy of remimazolam in alleviating adverse reactions.</p><p><strong>Methods: </strong>We conducted a database search using China National Knowledge Infrastructure (CNKI), PubMed, and the Cochrane Library to identify randomized controlled trials (RCTs) comparing the use of remimazolam with propofol for hysteroscopy procedures. We extracted data on the occurrence of adverse reactions such as hypotension, respiratory depression, dizziness, nausea, and vomiting for meta-analysis. Literature published until July 2024 was screened from each database, and the quality of the included studies was assessed using the bias risk assessment tool recommended by Cochrane. Data analysis was performed using RevMan 5.3 software, developed by the Cochrane Collaboration in the United Kingdom.</p><p><strong>Results: </strong>The pooled results demonstrated significant differences in favor of remimazolam when compared to propofol for procedural sedation. Patients receiving remimazolam showed a lower risk of respiratory depression (RR: 0.19; 95% CI: [0.11, 0.33]; <i>I</i> ² = 0%; <i>p</i> < 0.00001), dizziness (RR: 0.10; 95% CI: [0.04, 0.31]; <i>I</i> ² = 0%; <i>p</i> < 0.0001), and postoperative nausea and vomiting (RR: 0.60; 95% CI: [0.15, 2.46]; <i>I</i> ² = 0%; <i>p</i> = 0.48). No significant differences were observed in anesthesia recovery time between the remimazolam and propofol groups (MD: -0.07; 95% CI: [-0.18-1.04]; <i>I</i> ² = 98%; <i>p</i> = 0.90).</p><p><strong>Conclusion: </strong>Compared to propofol, remimazolam reduces the occurrence of hypotension, respiratory depression, dizziness, and postoperative nausea and vomiting in the anesthesia management of hysteroscopy procedures.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":"2026 ","pages":"4206976"},"PeriodicalIF":1.5,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12771604/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145916703","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":"Analgesic Efficacy of Epidural Neuroplasty via Racz Catheter During Lumbar Fixation In Situ for Lumbosacral Spondylolisthesis: A Randomized Controlled Trial.","authors":"Ahmed Shehata Abd Elhamid, Mohammed Said Elsharkawy, Mostafa Mohamed Shaheen, Khaled Hamama, Ahmed Nada, Taysser M Abdelraheem","doi":"10.1155/anrp/1031307","DOIUrl":"10.1155/anrp/1031307","url":null,"abstract":"<p><strong>Background: </strong>Effective pain management after lumbar fixation in situ is crucial for improving recovery and quality of life. Epidural neuroplasty via the Racz catheter is a potential method to enhance analgesia by targeting epidural inflammation and nerve compression. This work assessed the analgesic efficacy of epidural neuroplasty via a Racz catheter during lumbar fixation in situ for lumbosacral spondylolisthesis.</p><p><strong>Methods: </strong>This randomized, double-blinded, controlled study was conducted on 50 patients aged 18-65 years, of both sexes, who had Grade 1 spondylolisthesis, facet osteoarthropathy, and a small disc on radiological findings. Participants were randomly assigned to two equal groups. Group S received epidural neuroplasty via a Racz catheter during lumbar fixation, and Group C received conventional lumbar steroid injections.</p><p><strong>Results: </strong>Visual analog scale and Oswestry low back disability questionnaire scores were significantly diminished immediately postprocedure and at 1, 2, 4, and 6 m in Group S than in Group C (<i>p</i> < 0.05). Hypotension, paraesthesia, bleeding, and headache exhibited comparability between the two groups. The patient satisfaction level was significantly elevated in the Racz catheter group as opposed to the conventional lumbar group (<i>p</i> < 0.05).</p><p><strong>Conclusions: </strong>Epidural neuroplasty using a Racz catheter during lumbar fixation provides enhanced short-term analgesia, functional recovery, and patient satisfaction compared with conventional lumbar treatment in Grade-1 spondylolisthesis, without increased adverse effects, providing preliminary evidence that warrants validation in larger, long-term studies. <b>Trial Registration:</b> ClinicalTrials.gov identifier: NCT06684821.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":"2026 ","pages":"1031307"},"PeriodicalIF":1.5,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12771631/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145916636","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":"Association Between Serum Anion Gap and Risk of Postoperative Delirium in Patients Undergoing Gastric Surgery in ICU: A Retrospective Study From the MIMIC-IV Database.","authors":"Simin Yang, Xinwei Su","doi":"10.1155/anrp/8776973","DOIUrl":"10.1155/anrp/8776973","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to investigate the association between serum anion gap (AG) levels and postoperative delirium (POD) incidence in intensive care unit (ICU) patients undergoing gastric surgery.</p><p><strong>Methods: </strong>We conducted a retrospective study using data from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. Patients who underwent gastric surgery were included to investigate the potential association between serum AG and POD risk. Restricted cubic spline (RCS) regression was used to evaluate nonlinear relationships, and receiver operating characteristic (ROC) curves were used to assess predictive performance. Subgroup and sensitivity analyses were performed to verify the reliability and consistency of the results.</p><p><strong>Results: </strong>Among the 2467 ICU patients who underwent gastric surgery, elevated serum AG levels were independently associated with increased POD risk. The RCS analysis revealed a nonlinear positive correlation between serum AG levels and the risk of POD. ROC curve analysis indicated that serum AG levels had a statistically significant but limited predictive value for POD, with an area under the curve (AUC) of 0.606 (95% CI: 0.584-0.628). Both subgroup and sensitivity analyses confirmed the robustness of these findings.</p><p><strong>Conclusions: </strong>This study establishes an independent association between serum AG and increased POD risk in ICU patients following gastric surgery, suggesting that serum AG may serve as a biomarker of physiological vulnerability for POD.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":"2026 ","pages":"8776973"},"PeriodicalIF":1.5,"publicationDate":"2026-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12757772/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145899075","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":"Simulation-Based Comparison of Standard Versus Rotational Laryngeal Mask Airway Insertion Techniques in Novice Anesthesiologists: A Randomized Controlled Crossover Trial.","authors":"Kumar D, Kala C","doi":"10.1155/anrp/7850095","DOIUrl":"10.1155/anrp/7850095","url":null,"abstract":"<p><strong>Background: </strong>Anesthesia trainers frequently experienced desaturation, airway trauma, and failed intubation with novice hands-on training for facemask and endotracheal intubation. Laryngeal mask airway (LMA) adaptation in anesthesia practice has ensured trainers' ease in safely transforming sufficient airway management skills to develop competency among novice trainees. This study was designed to evaluate the manikin-based standard versus rotational LMA insertion techniques to analyze insertion ease and priority LMA insertion technique among novice anesthesia trainees.</p><p><strong>Methods: </strong>Our randomized controlled crossover trial has enrolled 13 novice anesthesia trainees from multicenter hospitals. The study comprised three phases. Initially, the study participants were inquired on a preformed questionnaire for supraglottic airway device knowledge, insertion techniques, and experiences. In the second phase, trainees have undergone educational tutorial, video presentation, and hands-on practice on a manikin for standard and rotational LMA insertion techniques. Following that, the participants were divided into two study groups to evaluate LMA insertion, 10 times each with standard and rotational in a crossover manner. The third phase of the study was also questionnaire-based; trainees were inquired about the preferred LMA insertion technique for beginners.</p><p><strong>Result: </strong>The trainee's prior knowledge of supraglottic airway devices and practical experience were equivocal. There were no insertion failure attempts with both standard and rotational LMA insertion techniques. The time duration for the first attempt with standard LMA insertion was significantly shorter (7.92 ± 2.43 s) compared to the time duration for the first attempt with rotational LMA insertion (11.80 ± 3.41 s) on manikin. The post-study analysis revealed trainees' preference for the standard LMA insertion technique.</p><p><strong>Conclusion: </strong>Our study concludes that the standard LMA insertion technique is relatively easy to learn and practice on manikin compared to the rotational technique. Besides this, the novice anesthesia trainees have preferred standard LMA insertion as a priority technique in their clinical practice.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier: NCT05544838.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":"2025 ","pages":"7850095"},"PeriodicalIF":1.5,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12755117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145888148","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 Systematic Review of Temporary Peripheral Nerve Stimulation for Postoperative Pain Management in Orthopedic Surgery.","authors":"Joshua C Harris, Chris J Pierson, Chaitanya Konda, Nitin B Jain","doi":"10.1155/anrp/8477771","DOIUrl":"10.1155/anrp/8477771","url":null,"abstract":"<p><strong>Background/objectives: </strong>Over 18 million orthopedic procedures were performed in the United States in 2022 with pharmacological management being the primary mode of analgesia. Percutaneous neuromodulation in the form of temporary peripheral nerve stimulation (tPNS) may provide a new method of postsurgical analgesia devoid of systemic side effects and the potential for substance addiction. tPNS can also be used for chronic pain long after surgery.</p><p><strong>Methods: </strong>The initial literature search of PubMed/MEDLINE, Web of Science, and Cochrane was conducted on September 21, 2023, and repeated on May 23, 2025. Included studies had patients over 18 years of age with implanted tPNS in the first 2 years following orthopedic surgery of the knee, shoulder, hip, foot, or ankle.</p><p><strong>Results: </strong>Eleven articles of nine distinct studies were found: eight articles from six randomized trials and three articles from three case series. Seven publications assessed implanted tPNS in the acute perioperative phase, and four publications assessed implanted tPNS for chronic postoperative pain. This systematic review's aim was to compile current literature on the safety and efficacy of percutaneous tPNS both immediately after orthopedic surgery and for longer-term postsurgical persistent pain. This collection of evidence suggests using percutaneous tPNS is safe and may reduce pain and postoperative opioid consumption.</p><p><strong>Conclusions: </strong>This emerging treatment may reduce postoperative pain and opioid consumption, is safe, and warrants further robust trials. Future studies with robust, multimodal treatment designs are needed to specifically delineate the role of tPNS within the context of current pain management.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":"2025 ","pages":"8477771"},"PeriodicalIF":1.5,"publicationDate":"2025-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12706534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145772894","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 Effect of Acupuncture on Pain, Prostaglandin E2, and Interleukin-6 in Septorhinoplasty Operations: A Randomized Clinical Trial.","authors":"Yavuz Orak, Filiz Alkan Baylan, Fatma Bilgen, Filiz Orak, Alper Ural, Sedat Yildiz, Saime Sagiroglu, Harun Karaduman, Adem Doganer","doi":"10.1155/anrp/7816719","DOIUrl":"10.1155/anrp/7816719","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this study was to investigate the effects of acupuncture on pain, prostaglandin E2 (PGE2), and interleukin-6 (IL-6) levels during septorhinoplasty surgeries.</p><p><strong>Materials and methods: </strong>This randomized, controlled study included 70 patients. The patients were divided into two groups: an acupuncture group (<i>n</i> = 35) and a control group (<i>n</i> = 35). The acupuncture group received bilateral press needle acupuncture at the PC 6 and ST 36 points 24 h before surgery. Blood samples were collected for analysis and comparison of preoperative and postoperative levels of IL-6 and PGE2. The primary outcomes were the postoperative visual analog scale (VAS) scores.</p><p><strong>Results: </strong>In terms of evaluating postoperative pain, no statistically significant differences were observed between the study groups with regard to VAS scores. At 30 min after surgery, fewer patients in the acupuncture group needed analgesics than in the control group (<i>p</i> = 0.044). Postoperative IL-6 levels were lower in the acupuncture group than in the control group (<i>p</i> = 0.014). There was no significant difference in postoperative PGE2 levels between the groups (<i>p</i> = 0.568). The acupuncture group had lower diastolic blood pressure (DBP) and mean arterial blood pressure (MAP) at 30 min intraoperatively and lower DBP at 60 min (<i>p</i> = 0.012, <i>p</i> = 0.026, and <i>p</i> = 0.012, respectively). At 15 min into the operation, the heart rate was higher in the acupuncture group than in the control group (<i>p</i> = 0.039). After surgery, the acupuncture group had lower blood pressure at 5 min and 6 h after surgery than the control group (<i>p</i> = 0.034 and <i>p</i> = 0.041, respectively).</p><p><strong>Conclusions: </strong>The evidence from this study suggests that acupuncture can reduce the need for pain medication after septorhinoplasty surgery, and by decreasing IL-6 levels, it may contribute to the inflammatory process.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov: NCT04009070.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":"2025 ","pages":"7816719"},"PeriodicalIF":1.5,"publicationDate":"2025-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12682433/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145707084","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":"Hemodynamic Stability Between Spinal and General Anesthesia in Patient Undergoing Primary Total Knee Arthroplasty: A Retrospective Study.","authors":"Thomas Jeandin, Eric Albrecht, Jean-Benoit Rossel, Julien Wegrzyn, Matthieu Cachemaille","doi":"10.1155/anrp/9045822","DOIUrl":"10.1155/anrp/9045822","url":null,"abstract":"<p><strong>Background: </strong>Total knee arthroplasty (TKA) is a common surgical procedure that may be associated with blood loss. The aim of this study is to evaluate intraoperative hemodynamic stability during TKA under general (GA) or spinal anesthesia (SA).</p><p><strong>Methods: </strong>Any adult undergoing primary TKA under GA or SA was retrospectively selected over a 10-year period and compared. The primary outcome was the presence of intraoperative hemodynamic instability, defined by starting a norepinephrine infusion, as the variation of the patient's blood pressure exceeded 30% of its baseline value for more than 5 min. Secondary outcomes included intraoperative dose of ephedrine, phenylephrine, blood loss, and volume of fluid administered. Demographic and intraoperative anesthetic variables associated with norepinephrine use were entered in a multivariate logistic regression model.</p><p><strong>Results: </strong>The analysis included 1,441 patients; 59% received a SA. 3.6% of patients under SA required a norepinephrine infusion versus 10.4% under GA (<i>p</i> < 0.001). Ephedrine administered was lower in the SA group (mean dose 19 mg vs. 31 mg, <i>p</i> < 0.001), while phenylephrine was not statistically different (414 μg for SA and 481 μg for GA, <i>p</i> = 0.09). Intraoperative blood loss was identical in both groups (402 mL for SA and 415 mL for GA, <i>p</i> = 0.35), while mean intraoperative fluid income was higher in the GA group (862 mL vs. 725 mL, <i>p</i> < 0.001). Variables associated with norepinephrine use were GA and age, among others.</p><p><strong>Conclusions: </strong>GA requires more norepinephrine infusion compared to SA in patients during primary TKA, suggesting intraoperative hemodynamic stability is better preserved during neuraxial anesthesia.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":"2025 ","pages":"9045822"},"PeriodicalIF":1.5,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12675302/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145699375","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}