BMC Anesthesiology最新文献

{"title":"Effect of opioid sparing strategies on postoperative pain and perioperative hemodynamics in patients undergoing laparoscopic cholecystectomy: a randomized controlled study.","authors":"Lei Wang, Xinhua Hong, Yiting Xue, Zhen Su","doi":"10.1186/s12871-025-02953-y","DOIUrl":"https://doi.org/10.1186/s12871-025-02953-y","url":null,"abstract":"<p><strong>Background: </strong>Opioid-sparing anesthesia(OSA) or opioid-free anesthesia(OFA) strategy can reduce postoperative pain, but the effect of different stratigies on postoperative pain for patients with high pain sensitivity remains unclear, and the effect of different stratigies on perioperative haemodynamic fluctuations remains controversial for patients undergoing laparoscopic cholecystectomy.</p><p><strong>Methods: </strong>A total of 173 patients scheduled for elective laparoscopic cholecystectomy were randomly assigned into three groups: opioid-free anesthesia group(Group OFA), opioid-sparing anesthesia group(Group OSA) or opioid-based anesthesia group (Group OBA). The preoperative assessment of patients' pain sensitivity was conducted using the Pain Sensitivity Questionnaire (PSQ). The visual analog scale (VAS) scores were recorded at 30 min, 1 h, 2 h, 6 h, 12 h, and 24 h postoperatively. Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP), Mean Arterial Pressure (MAP) and Heart Rate (HR) were recorded at baseline(T0), after admission (T1), after induction(T2), 1 min after tracheal intubation (T3), 1 min after pneumoperitoneum (T4), and calculated as the variability of blood pressure (BPV), coefficient of variation (CV) and average real variability (ARV). Time to awake, acute pain, rescue analgesia, postoperative nausea and vomiting (PONV), and time to first exhaust were also recorded.</p><p><strong>Results: </strong>Compared with Group OBA, VAS scores were significantly lower in Group OFA and OSA at 2 h, 6 h and 12 h postoperatively (P < 0.05). BPV<sub>SBP</sub>, BPV<sub>DBP</sub>, BPV<sub>MAP</sub>, CV<sub>SBP</sub>, CV<sub>DBP</sub>, CV<sub>MAP</sub>, ARV<sub>DBP</sub> and ARV<sub>MAP</sub> were lower in both Group OSA and OBA compared to the Group OFA (P < 0.05). Group OSA exhibited lower BPV<sub>SBP,</sub> CV<sub>DBP</sub>, and ARV<sub>DBP</sub> compared to the OBA group (P < 0.05). In the subgroup analysis of patients with high pain sensitivity, BPV<sub>SBP</sub>, BPV<sub>DBP</sub>, BPV<sub>MAP</sub>, CV<sub>DBP</sub>, CV<sub>MAP</sub>, ARV<sub>SBP</sub>, ARV<sub>DBP</sub> and ARV<sub>MAP</sub> were lower in Group OSA compared to Group OFA (P < 0.05). BPV<sub>DBP</sub>, CV<sub>DBP</sub>, ARV<sub>SBP</sub> and ARV<sub>DBP</sub> were lower in the OSA group compared to the OBA group (P < 0.05). The time to first exhaust was significantly reduced in patients in Group OFA compared with Group OSA and OBA (P < 0.05).</p><p><strong>Conclusion: </strong>OSA can effectively control patients' postoperative pain with lower perioperative haemodynamic variability. It also has lower perioperative haemodynamic variability and acute pain in patients with high pain sensitivity, making it suitable for laparoscopic cholecystectomy.</p><p><strong>Trial registration: </strong>The trial is registered with the China Clinical Trials Registry Registration Number: ChiCTR2400093036. Retrospectively registered (date of registration: 27/11/202","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"100"},"PeriodicalIF":2.3,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143490702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of fospropofol disodium on lipid metabolism and inflammatory response in patients with hyperlipidemia: a randomized trial.","authors":"Chuan Yang, Tian-Bo Chai, Xing-Zhu Yao, Li Zhang, Wen-Ming Qin, Hong Liang, Qiong-Zhen He, Ze-Yu Zhao","doi":"10.1186/s12871-025-02965-8","DOIUrl":"https://doi.org/10.1186/s12871-025-02965-8","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to assess the impact of intravenous infusion of fospropofol disodium on lipid metabolism and the inflammatory response in individuals with hyperlipidemia.</p><p><strong>Methods: </strong>A total of 360 preoperative individuals with hyperlipidemia were selected and randomly assigned to either the treatment group or the control group, with 180 participants in each group. The treatment group received an induction dose of fospropofol disodium at 10 mg/kg intravenously, followed by maintenance at a rate of 10 mg/(kg·h). The control group was administered propofol intravenously at 2 mg/kg for induction and maintained at 4 mg/(kg·h). All other medications were consistent between the two groups. Blood samples (3 ml of venous blood) were collected from patients at four-time points: 1 day before surgery (T₀), 3 h after anesthesia induction (T₁), 4 h post-surgery (T₂), and 24 h post-surgery (T3), to measure levels of triglycerides (TG), cholesterol (CHOL), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein A1 (ApoA1), and apolipoprotein B (ApoB). C-reactive protein (CRP) and interleukin-6 (IL-6) levels were assessed at T₀ and T₃. Sedation onset time and adverse reactions were recorded for both groups.</p><p><strong>Results: </strong>At T₀, the control group exhibited increased TG, CHOL, LDL-C, ApoB, and the ApoB/ApoA1 ratio, while the ApoA1 level had decreased. The LDL-C level and the ApoB/ApoA1 ratio showed significant increases (P < 0.01). Both groups showed elevated CRP and IL-6 levels at T₃ (P < 0.01). Compared to the control group, the treatment group demonstrated reduced levels of TG, CHOL, LDL-C, ApoB, and the ApoB/ApoA1 ratio at T₁-T₃, while ApoA1 levels were higher at T1-T2 (P < 0.01 or P < 0.05). The sedation onset time was notably longer in the treatment group, and the incidence of injection-related pain, respiratory depression, hypotension, and other adverse reactions was significantly lower (P < 0.01).</p><p><strong>Conclusion: </strong>Compared with propofol, intravenous infusion of fospropofol disodium for more than 3 h during anesthesia has lesser impact on lipid metabolism in patients with hyperlipidemia and does not increase inflammatory factors levels.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"99"},"PeriodicalIF":2.3,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143490721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of postoperative pain severity between primary and repeated cesarean section: a prospective cohort study.","authors":"Zemedkun Getahun, Mebratu Kebede, Mebratu Tilla, Gedion Asnak, Margherita Iuzzolino, Alemu Urmale, Hailemariam Getachew, Abebayehu Zemedkun, Tsegaye Demeke, Milion Abdi, Ashagire Sintayehu, Getahun Dendir","doi":"10.1186/s12871-025-02951-0","DOIUrl":"10.1186/s12871-025-02951-0","url":null,"abstract":"<p><strong>Background: </strong>The cesarean section was associated with moderate to severe postoperative pain. Uncertain differences exist between parturient who undergo a primary cesarean section and a repeat cesarean section in terms of post-operative pain.</p><p><strong>Objective: </strong>To compare the degree of postoperative pain in patients who had primary and repeat cesarean sections.</p><p><strong>Method: </strong>An institutional-based prospective cohort study was conducted on 336 patients who fulfilled eligibility criteria and underwent caesarian section under spinal anesthesia. Study participants were selected by a systematic random sampling technique. An independent sample t test and a Mann-Whitney U test were used to compare symmetric and asymmetric data, respectively. Time to first analgesic request was analyzed using log rank Kaplan-Meier survival curves and cox-regression for covariates. Comparisons of categorical variables between groups were done using the chi-square test. The significance was determined at a P value of < 0.05.</p><p><strong>Results: </strong>There was a high Risk of moderate to severe postoperative pain in repeated caesarean section compared to primary caesarean section in both incisional pain (RR, 1.364[95% CI, 1.12-1.66], p = 0.002) and visceral pain (RR, 1.66[95% CI, 1.40-1.66], p = 0.001). In comparison to the primiparas, parturient with repeated cesarean sections had highest post-operative pain severity in NRS with median NRS of 5(IQR, 3-5) at the 4th hour (p < 0.001) for the incisional pain and 6(IQR, 5-7) at the 8th hour for visceral pain, respectively, for the repeated group. The primiparas group had a longer median time to first rescue analgesic administration (median [minute], 875.7[95% CI, 750.3-1001]; P < 0.001)) than the repeated group (median [minute], 534.8 [95% CI, 426.8-642.8]; P < 0.001.</p><p><strong>Conclusions: </strong>Compared to primary CS, repeated cesarean had a high incidence of moderate to severe postoperative pain, both visceral and incisional; within 48-h. In future endeavors of crafting postoperative analgesic plans, it is imperative to take into account individual variations and distinctions.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"97"},"PeriodicalIF":2.3,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11846434/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476299","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":"Predictive value of the neutrophil-to-lymphocyte ratio for epidural labor analgesia-associated intrapartum fever: a retrospective single-center study.","authors":"Lei Li, Xiao-Tong Yang, Jiang Zou, Jian Zhang, Xiao-Hai Xie, Jing-Hui Liu, Ben-Zhen Chen","doi":"10.1186/s12871-025-02972-9","DOIUrl":"10.1186/s12871-025-02972-9","url":null,"abstract":"<p><strong>Background: </strong>Studies have indicated that epidural analgesia increases the risk of maternal fever during labor, possibly due to non-infectious inflammation. The neutrophil-to-lymphocyte ratio (NLR) is a crucial indicator of inflammation, with a higher NLR potentially signaling worse patient adverse outcomes. The present study explores whether NLR has clinical predictive value for epidural analgesia-related maternal fever (ERMF).</p><p><strong>Methods: </strong>A retrospective analysis was performed for 1602 women who voluntarily requested analgesia for epidural labor from January 2023 to June 2024. Univariate and multivariate logistic regression analyses were applied to identify the factors influencing intrapartum fever, and the association between NLR and ERMF was explored. The receiver operating characteristic (ROC) curve was used to assess the area under the curve (AUC) of NLR for intrapartum fever, and the nearest ascending index was utilized to determine the cut-off value.</p><p><strong>Results: </strong>A total of 1602 parturients were included, of which 160 (10%) had intrapartum fever. Body mass index (BMI) (OR = 1.132, 95% CI: 1.027-1.246, P = 0.012), the duration of the first stage of labor (OR = 1.002, 95% CI: 1.001-1.003, P < 0.001), percentage of lymphocytes (OR = 1.205, 95%CI: 1.073-1.354, P = 0.012) and NLR (OR = 1.964, 95% CI: 1.462-2.639, P < 0.001) were independent risk factors for intrapartum fever. High NLR levels were associated with a higher incidence of ERMF at subgroups of ages < 35 years (OR = 1.343, 95%CI: 1.215-1.486, P < 0.001), ages ≥ 35 years (OR = 1.274, 95%CI: 1.105-1.468, P = 0.01), BMI < 24 kg/m² (OR = 1.326, 95% CI: 1.176-1.495, P < 0.001), BMI ≥ 24 kg/m² (OR = 1.515, 95%CI: 1.147-2.000, P = 0.003), first stage of labor < 600 min (OR = 1.466, 95%CI: 1.241-1.733, P < 0.001), and first stage of labor ≥ 600 min (OR = 1.257, 95%CI: 1.109-1.424, P < 0.001). Maternal NLR levels greater than 6.305 (AUC = 0.702, 95%CI: 0.634-0.768, P < 0.001) were good predicators of intrapartum fever.</p><p><strong>Conclusions: </strong>High NLR is associated with EMRF, and NLR is a viable predictor of early identification of the occurrence of EMRF, which may be beneficial for pregnancy outcomes.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"96"},"PeriodicalIF":2.3,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11846237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476302","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":"Association of impostor phenomenon and burnout among Swiss residents and junior anaesthesiologists: results of a cross-sectional survey.","authors":"Mia Gisselbaek, Melanie Suppan, Sarah Saxena, Patricia Hudelson, Georges L Savoldelli","doi":"10.1186/s12871-025-02957-8","DOIUrl":"10.1186/s12871-025-02957-8","url":null,"abstract":"<p><strong>Background: </strong>Imposter phenomenon (IP) can impact professional performance and has been described as a risk factor for burnout within healthcare workers. We hypothesize that IP and burnout are prevalent among Swiss anaesthesiology residents and junior anaesthesiologists, and that specific risk factors are significantly associated with these conditions.</p><p><strong>Methods: </strong>We conducted a cross-sectional web-based survey of anaesthesiologists working in regions of Switzerland. The survey included demographic questions, the Clance Impostor Phenomenon Scale (CIPS), and the Maslach Burnout Inventory for Medical Personnel (MBI-HSS-MP). Descriptive statistics and logistic regression were used to identify demographic variables predictive of IP and burnout and to examine the association between IP and burnout.</p><p><strong>Results: </strong>A total of 318 people were eligible to participate. Of those, 136 (42.8%) participants completed the CIPS, and 127 (39.9%) completed the MBI-HSS-MP. Among CIPS respondents, 55% (75/136) identified as women, and 59% (80/136) were Swiss nationals. The prevalence of IP was 56% (76/136) and burnout was 10.2% (13/127). Women were more at risk of IP and burnout (p = 0.037). Independent covariates associated with IP were woman gender (p = 0.015) and Swiss nationality (p = 0.023). Additionally, the presence of IP was correlated with an increased likelihood of burnout (p = 0.04).</p><p><strong>Conclusions: </strong>IP was correlated with the presence of burnout in anaesthesiologists in training. Additionally, IP affected more than half of the participants. Two risk factors were identified for IP: being a woman and a Swiss national. The rates of IP and its concerning association with burnout among resident and junior anaesthesiologists needs to be addressed.</p><p><strong>Trial registration: </strong>NCT06097325, https://www.</p><p><strong>Clinicaltrials: </strong>gov/study/NCT06097325.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"98"},"PeriodicalIF":2.3,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11846290/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476271","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":"Use of tranexamic acid in hepatectomy under controlled low central venous pressure: a randomized controlled study.","authors":"Jia-Yan Luo, Chen Zhou, Shu-Xian Shi, Qiu-Xuan Wei, Ying Chen, Jie Ouyang, Yong-Yu Si","doi":"10.1186/s12871-025-02935-0","DOIUrl":"10.1186/s12871-025-02935-0","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to investigate the efficacy and safety of tranexamic acid (TXA) in hepatectomy when administered as per the standardized protocol of controlled low central venous pressure (CLCVP).</p><p><strong>Methods: </strong>This study was a randomized, double-blind, controlled study. Patients who fulfilled the inclusion criteria were randomly assigned to the TXA group (group T) or the placebo group (group N). The central venous pressure (CVP) was maintained at below 5 cmH2O before complete dissection of the liver parenchyma. Patients in group T received an intravenous infusion of 10 mg/kg of TXA 30 min before surgery, and it was continuously pumped intravenously at a rate of 1 mg/(kg.h) until the end of surgery. Patients in group N were infused with 1 mL/kg of normal saline 30 min before surgery, and it was continuously pumped intravenously at a rate of 0.1 mL/(kg.h) until the end of surgery. The primary outcome indicators were intraoperative blood loss, blood transfusion rate, intraperitoneal drainage at 24 h after surgery, and the occurrence of compound bleeding within 30 days.</p><p><strong>Results: </strong>The baseline indicators were similar (P > 0.05), and there was no significant difference in intraoperative blood loss between the two groups, but the red blood cell transfusion rate was lower in the T group than in the N group (P < 0.05). The infusion volume, surgical field grade, and surgery duration were comparable between the two groups (P > 0.05). Patients in group T had a shorter hilar occlusion time, lower D-dimer and fibrinogen degradation products (FDPs) on the day of surgery, and significantly less intraperitoneal drainage at 24 h after surgery (all P < 0.05). There were two cases of compound bleeding and three cases of thromboembolism among patients in group N, but there were no such complications in group T.</p><p><strong>Conclusion: </strong>The use of TXA in hepatectomy under CLCVP reduced the intraoperative blood transfusion rate and improved the postoperative bleeding outcome without increasing the risk of adverse events such as hepatic and renal insufficiency and thrombosis.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"94"},"PeriodicalIF":2.3,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11843753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143472252","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":"Vagal activity mediates the relationship between active housework and delayed neurocognitive recovery in elderly patients: a prospective nested case-control study.","authors":"Junfang Niu, Xiang Liu, Xupeng Wang, Fang Gao, Peixia Yu, Qi Zhou, Qiujun Wang","doi":"10.1186/s12871-025-02968-5","DOIUrl":"10.1186/s12871-025-02968-5","url":null,"abstract":"<p><strong>Background: </strong>Regular physical activity has been shown to ameliorate cognitive decline associated with aging, and to improve autonomic nervous function. However, the effect of active housework, a form of light to moderate physical activity, on postoperative cognitive function in the elderly remain unknown. The aim of this study is to investigate whether active housework exerts a protective effect against delayed neurocognitive recovery (dNCR), and to explore the role of vagal activity in this relationship.</p><p><strong>Methods: </strong>This is a prospective nested case-control study that enrolled 152 elderly patients scheduled for elective knee replacement surgery. The neuropsychological assessments were conducted to evaluate dNCR both preoperatively and one week postoperatively. Physical activity levels were quantified based on the Physical Activity Scale for the Elderly and categorized into active housework and sedentary behavior groups using hierarchical clustering. High-frequency spectral analysis of heart rate variability was used to assess vagal activity. Multivariable logistic regression analysis was employed to examine the association between active housework, vagal activity, and dNCR. Additionally, mediation analysis was performed to explore the possible mediating effect of vagal activity.</p><p><strong>Results: </strong>dNCR occurred in 33/141 (23.4%) patients. Active housework was associated with 84.7% lower odds of developing dNCR [OR = 0.153, 95% CI (0.042 to 0.550), p = 0.004]. There was significant interaction between vagal activity and dNCR [OR = 0.003, 95% CI (0.001 to 0.052), p < 0.001]. Vagal activity mediated the association between active housework and dNCR, accounting for 31.92% of the mediation effect.</p><p><strong>Conclusions: </strong>Active housework is associated with decreased incidence of dNCR, with vagal activity serving as a mediating factor. This study provides valuable insights for predicting and preventing of perioperative neurocognitive disorders in elderly patients.</p><p><strong>Trial registration: </strong>Trial registration number: ChiCTR2300070834, date of registration: April 24, 2023.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"95"},"PeriodicalIF":2.3,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11844074/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143472254","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":"Association between periprocedural cerebral desaturation during transcatheter aortic valve implantation and postprocedural delirium: a prospective observational study.","authors":"Hulya Yilmaz Ak, Baris Sandal, Yasemin Ozsahin, Ziya Salihoglu, Ahmet Yildiz, Esra Erturk Tekin, Mehmet Ali Yesiltas, Mustafa Yildiz, Kerem Erkalp","doi":"10.1186/s12871-025-02950-1","DOIUrl":"10.1186/s12871-025-02950-1","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to investigate whether the level of decrease in cerebral oxygen saturation during the valve placement phase of the transcatheter aortic valve implantation (TAVI) procedure under sedation has an effect on postoperative delirium (POD).</p><p><strong>Methods: </strong>The study initially assessed 50 patients between the ages of 50 and 90 years with an indication for TAVI by the cardiac team. Regional cerebral oxygen saturation (rScO2) was measured using Near-infrared spectroscopy (NIRS) before the procedure (T1), during surgical field sterilization (T2), catheter placement (T3), wire manipulation (T4), valve placement (T5) and access site artery repair (T6). Confusion Assessment Method for The Intensive Care Unit (ICU-CAM) test was performed on intensive care unit and the presence of POD was questioned. Patients were divided into two groups as those without POD (Group 1) and those with POD (Group 2).</p><p><strong>Results: </strong>The study was completed with 41 patients in total. While POD was present in 12 (29.3%) of the patients evaluated intensive care unit, POD was not observed in 29 (70.7%) patients. The rScO2 value measured at T5 was significantly lower in Group 2 compared to Group 1 (p < 0.001).</p><p><strong>Conclusions: </strong>In our study, the rate of POD after TAVI was as high as 29.3%. Low rScO2 during valve placement was associated with delirium. Our findings indicate that NIRS devices could be a useful tool for assessing the risk of POD during the TAVI procedure; however, further research is needed to validate their routine clinical use.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"93"},"PeriodicalIF":2.3,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11841225/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143466410","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":"An ultrasound-guided modified iliac fascia and sacral plexus block application in a critically ill patient undergoing artificial femoral head replacement surgery: a case report.","authors":"Muyan Shi, Ping Huang, Jie Tian, Ruixin Lin, Xiaoqiang Wang, Qiuyue Lian, Diansan Su, Zhenling Huang","doi":"10.1186/s12871-025-02969-4","DOIUrl":"10.1186/s12871-025-02969-4","url":null,"abstract":"<p><strong>Background: </strong>Hip fractures have become a significant clinical concern on a global scale in recent years. The burgeoning aging population has exacerbated this issue, leading to a rise in the number of hip fracture cases coupled with concomitant geriatric ailments. Therefore, it poses a huge challenge to anesthesiologists with the increasing number of critically ill patients who are not suitable for general anesthesia and intrathecal anesthesia. Ultrasound-guided nerve blocks combined with sedation have not previously been documented in critically ill patients.</p><p><strong>Case presentation: </strong>We administered an ultrasound-guided modified iliac fascia block combined with sacral plexus block to an 88-year-old male patient with a left femoral fracture suffering from severe multi-systemic diseases. Concurrently, the patient received intravenous anesthesia via propofol and dexmedetomidine, with monitoring conducted through bispectral index. Subsequently, the surgery was completed smoothly and the patient demonstrated accelerated postoperative recovery without significant discomfort and a successful discharge.</p><p><strong>Conclusions: </strong>This innovative approach significantly contributed to achieving successful surgical anesthesia and postoperative analgesia, thereby facilitating early recovery and discharge from the hospital. We propose that ultrasound-guided nerve blocks with sedation show promise for critically ill patients.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"92"},"PeriodicalIF":2.3,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11841137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143466407","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 modified effect of mechanical ventilation setting on relationship between fluid balance and hospital mortality for sepsis patients: a retrospective study.","authors":"Dawei Zhou, Yi Lv, Chao Wang, Dan Li","doi":"10.1186/s12871-025-02954-x","DOIUrl":"10.1186/s12871-025-02954-x","url":null,"abstract":"<p><strong>Background: </strong>Fluid supplement may be affected by ventilatory management due to physiological interaction between heart and lung. The aim of the present study was to explore the effects of ventilator strategies on the relationship of fluid balance and hospital mortality for sepsis patients.</p><p><strong>Methods: </strong>This was a retrospective cohort study included sepsis patients with invasive mechanical ventilation (MV) over 24 h from Medical Information Mart for Intensive Care (MIMIC) IV database. The accumulative fluid balance increased by 6 h intervals were calculated as fluid intake minus fluid output. The modes (assisted or controlled) and levels (high or low) of positive end-expiratory pressure (PEEP) of MV every 6 h were recorded. The modification effect for modes and levels of PEEP on the relationship of fluid balance and hospital mortality were tested by multivariable regression models, respectively.</p><p><strong>Results: </strong>A total of 4466 sepsis patients with invasive MV were included, of which hospital mortality was 26.5%. Fluid balance seemed to have U-shape relationship with hospital mortality. The majority of patients used controlled ventilation at the beginning, and switched to assisted ventilation gradually; however, the PEEP level did not change a lot during the first 24 h. The relationship between fluid balance and hospital mortality was not modified by the ventilator mode; while the PEEP level may modify the relationship.</p><p><strong>Conclusions: </strong>For sepsis patients admitted to ICU with invasive MV, the PEEP level, but not the mode of MV, appeared to modify the relationship of fluid balance and hospital mortality. The setting of mechanical ventilation may be an important consideration for fluid therapy.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"91"},"PeriodicalIF":2.3,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11841162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143466646","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}