BMC Anesthesiology最新文献

{"title":"Ultrasonographic assessment of right internal jugular vein dimensions following passive legs elevation versus hepatic compression: a cross-sectional study.","authors":"Ashok Gautam, Balkrishna Bhattarai, Ashish Ghimire, Jagat Narayan Prasad, Parineeta Thapa, Yogesh Dhakal","doi":"10.1186/s12871-025-03143-6","DOIUrl":"https://doi.org/10.1186/s12871-025-03143-6","url":null,"abstract":"<p><strong>Background: </strong>Central vein cannulation is a common invasive procedure performed in critically ill patients and during major surgeries. This study compares the right internal jugular vein's diameters and cross-sectional area after passive legs elevation and hepatic compression, analyzing these based on age, gender, body mass index and fasting duration.</p><p><strong>Methods: </strong>A cross-sectional study of 184 elective surgery patients (84 males, 84 females) at B.P. Koirala Institute of Health Sciences, Nepal, included 18-75 years.</p><p><strong>Exclusions: </strong>patients on mechanical ventilation, history of right jugular cannulation, neck/abdominal swelling, raised intracranial pressure, lower extremity fracture and refusal of consent. Age, gender, fasting duration and body mass index were recorded. The 6-13 MHz linear probe identified the internal jugular vein by its compressibility and anechoic appearance. Short axis view of transverse and anteroposterior diameters and cross-sectional area were measured in short axis view at the cricoid level using electronic calipers. Maximum diameter and average cross-sectional area were measured in supine with the head rotated 15°- 30° left, after one minute of passive legs elevation at 45° and after hepatic compression for one minute with a 19.6 N force.</p><p><strong>Results: </strong>Hepatic compression increased transverse diameter by 1.64 (0.40) cm, p = 0.035 and cross-sectional area by 1.28 (0.54) cm², p = 0.047. No gender differences were noted. The transverse diameter increased in underweight (p = 0.02) and overweight (p = 0.01) patients. The cross-sectional area increased in overweight (p = 0.03). Passive legs elevation matched hepatic compression for the fasting durations.</p><p><strong>Conclusion: </strong>Hepatic compression better optimizes transverse diameter and cross-sectional area of right internal jugular vein than passive legs elevation.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"280"},"PeriodicalIF":2.3,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191475","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":"Interpretable multi-label classification model for predicting post-anesthesia care unit complications: a prospective cohort study.","authors":"Guoting Ma, Wenjun Yan, Zunqiang Zhao, Yanjia Li, Lingkai Wang","doi":"10.1186/s12871-025-03145-4","DOIUrl":"https://doi.org/10.1186/s12871-025-03145-4","url":null,"abstract":"<p><strong>Background: </strong>There are potential associations between post-anesthesia care unit (PACU) complications that significantly impact enhanced recovery after surgery. Timely identification of these signs is essential for implementing comprehensive, systematic management strategies and delivering personalized anesthetic care. However, relevant studies are currently limited. This study aimed to develop and validate an interpretable multi-label classification model to predict PACU complications concurrently.</p><p><strong>Methods: </strong>This prospective cohort study enrolled adult patients who underwent general anesthesia and elective surgery and were transferred to the PACU after surgery. The patients were dynamically monitored and evaluated for the occurrence of six common PACU complications: respiratory adverse events, hypothermia, hemodynamic instability, nausea/vomiting, agitation/delirium, and pain. A multi-label classification model was developed on the basis of 16 key features, and a Markov network was embedded to quantify and analyze the association network among these complications. The SHapley Additive exPlanations (SHAP) method was applied to conduct interpretability analysis of the model.</p><p><strong>Results: </strong>Of the 16,838 total patients, 6,830 (40.6%) experienced at least one complication. In the training cohort, 2,125 (57.0%) patients experienced two or more complications at the same time. The AUCs for the six complications in the three cohorts ranged from 0.735 to 0.914, 0.720 to 0.920, and 0.693 to 0.928, respectively. Respiratory adverse events performed best. Age, gender, BMI, duration of anesthesia, and postoperative analgesia emerged as the five most important features. The relative importance of respiratory adverse events to hemodynamic instability was the highest.</p><p><strong>Conclusion: </strong>The integration of a multi-label classification model with interpretable methods has significant advantages in simultaneously predicting PACU complications, identifying the risk factors for specific complications, optimizing postoperative resource allocation, and improving patient outcomes.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"278"},"PeriodicalIF":2.3,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191507","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":"Stellate ganglion block for preserving arteriovenous fistula in hemodialysis patients undergoing major lower limb orthopedic surgeries: randomized control trial.","authors":"Ayman Mohamady Eldemrdash, Soudy S Hammad, Tarek S Hemaida, Taha Tairy Dardeer, Ahmed Adel Mohsen, Ahmed Khalaf Fathy, Gamal Hendawy Shams","doi":"10.1186/s12871-025-03150-7","DOIUrl":"https://doi.org/10.1186/s12871-025-03150-7","url":null,"abstract":"<p><strong>Background: </strong>Major lower limb orthopedic surgeries can lead to hemodynamic alterations and increase the risk of arteriovenous (AV)fistula thrombosis. This study assessed the role of stellate ganglion block (SGB) in preserving the AV fistulas in hemodialysis (HD)patients undergoing major lower limb orthopedic surgeries.</p><p><strong>Methods: </strong>In this randomized, controlled, double-blind trial, 50 chronic renal failure patients (ASA physical status III, aged 21-75 years) scheduled for major lower limb orthopedic surgeries were randomized into two groups: Group S received an ultrasound-guided SGB before spinal anesthesia, while Group C received a sham procedure. AVF function was assessed using Doppler ultrasonography on postoperative days 1 and 7. Primary outcome was AVF flow rate. Secondary outcomes included peak systolic velocity (PSV), end-diastolic velocity (EDV), resistive index (RI), thrombosis rate, and functional failure.</p><p><strong>Results: </strong>Group S demonstrated significantly higher AVF flow rates on both postoperative day 1 (276.96 ± 49.66 ml/min vs. 217.44 ± 46.73 ml/min) and day 7 (254.96 ± 49.38 ml/min vs. 204.56 ± 47.11 ml/min), with large effect sizes (Cohen's d = 1.23 and 1.04, respectively; p < 0.001). PSV and EDV were significantly improved, and RI was significantly lower in Group S. Thrombosis (8% vs. 36%) and failure rates (32% vs. 64%) were significantly reduced compared to the control group (p < 0.05).</p><p><strong>Conclusions: </strong>Pre-emptive stellate ganglion block was associated with significantly improved AVF flow rate postoperatively and reduced thrombosis and functional failure, suggesting its clinical benefit in maintaining AVF patency during major surgeries in HD patients.</p><p><strong>Trial registration: </strong>This study was approved by the Ethical Committee of Aswan University Hospitals, Egypt (Institutional Review Board (IRB 900/2/24)) and registered on clinicaltrials.gov (ID: NCT06300658). The registration time of this experiment is 3/09/2024. The study protocol was designed and implemented in accordance with the CONSORT guidelines. The study protocol was conducted in compliance with the relevant guidelines and standards.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"277"},"PeriodicalIF":2.3,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191508","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":"Correction: Comparison of the hemodynamic changes between preeclamptic and normotensive parturients who underwent cesarean section under spinal anesthesia at North Showa zone public hospitals, oromia region, Ethiopia, 2022: a prospective cohort study.","authors":"Bizuwork Girma Belachew, Blen Kassahun Dessu, Birhanu Wondimeneh Demissie, Ashagrie Sintayhu, Getahun Dendir, Abas Ali, Redi Awol, Dugo Angasa, Asaminew Tasew, Oliyad Eshatu, Aschalew Besha Desta, Derara Girma, Getachew Debalke","doi":"10.1186/s12871-025-03152-5","DOIUrl":"https://doi.org/10.1186/s12871-025-03152-5","url":null,"abstract":"","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"279"},"PeriodicalIF":2.3,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191505","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":"Efficiency and safety of double-lumen bronchial tube and bronchial blocker for one-lung ventilation in patients with thoracic surgery: a meta-analysis.","authors":"Yuchen Wu, Yatao Liu, Han Ruan, Zhigang Zhang, Junfen Yang, Ning Li, Guoqiang Wang, Xin Wang","doi":"10.1186/s12871-025-03144-5","DOIUrl":"https://doi.org/10.1186/s12871-025-03144-5","url":null,"abstract":"<p><strong>Objectives: </strong>To compare the efficiency and safety of double-lumen bronchial tube (DLBT) and bronchial blocker (BB) for one-lung ventilation (OLV) in patients with thoracic surgery.</p><p><strong>Methods: </strong>A systematic search was conducted across Chinese databases and English databases from the inception of the databases until December 31, 2024. Two researchers independently screened the literature and extracted data. A meta-analysis was then performed using Review Manager 5 and Stata 18.0 software. The quality of the studies was assessed using the Cochrane bias risk assessment tool, and a summary of findings (SoF) table was generated using GRADEprofiler Version 3.6.1.</p><p><strong>Results: </strong>A total of 39 RCTs were included, comprising 1360 patients in the BB group and 1349 patients in the DLBT group. The excellent rate of lung collapse quality in the BB group was 0.94 times that in the DLBT group [I² = 32%, P = 0.07, fixed-effects; RR = 0.94; 95% CI (0.90, 0.99); P = 0.01]. There was no significant difference in intubation time [I² = 97%, P < 0.00001; SMD = -0.51; 95% CI (-1.17, 0.14); P = 0.12], the success rate of first-attempt intubation [I² = 79%, P < 0.00001; RR = 1.04; 95% CI (0.93, 1.15); P = 0.51] or in the incidence of malposition[I² = 50%, P = 0.01; RR = 1.36; 95% CI (0.95, 1.96); P = 0.10)] between the two groups. However, there was a significant difference in positioning time, with the BB group showing shorter positioning times compared to the DLBT group [I² = 98%, P < 0.00001; SMD = -0.85; 95% CI (-1.50, -0.21); P = 0.004]. Compared to the DLBT group, the BB group was associated with a reduced incidence of hoarseness, sore throat, tracheal mucosal injury, hypoxemia, and pneumonia.</p><p><strong>Conclusion: </strong>The DLBT group demonstrated certain advantages in terms of lung collapse time and quality of lung collapse. However, BB demonstrate significantly shorter positioning time compared to DLBT, and it is also associated with lower risks of multiple complications, including hoarseness, sore throat, tracheal injury, hypoxemia, and pneumonia, highlighting its safety advantage in postoperative care.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"281"},"PeriodicalIF":2.3,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191506","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":"Analysis of the feasibility of a low-anticoagulation strategy in patients undergoing post-cardiotomy extracorporeal membrane oxygenation: a retrospective cohort study.","authors":"Yan Wang, Liangshan Wang, Hongfu Fu, Jin Li, Chenglong Li, Shuai Zhang, Xing Hao, Hong Wang, Zhongtao Du, Xiaotong Hou","doi":"10.1186/s12871-025-03153-4","DOIUrl":"10.1186/s12871-025-03153-4","url":null,"abstract":"<p><strong>Background: </strong>Extracorporeal membrane oxygenation (ECMO) is increasingly used in patients after cardiac surgery; however, anticoagulation management has consistently been challenging. This study aimed to explore the feasibility of a low-anticoagulation strategy for post-cardiotomy ECMO (PC-ECMO).</p><p><strong>Methods: </strong>A retrospective comparison was performed between two anticoagulation targets in adult patients undergoing veno-arterial ECMO after cardiac surgery at the Beijing Anzhen Hospital (Beijing, China) between January 2018 and November 2023. The low-anticoagulation (LAC) strategy group consisted of patients with an activated partial thromboplastin time (APTT) ratio of 1-1.5, whereas the conventional anticoagulation (CAC) strategy group included those with an APTT ratio of 1.5-2.5. The primary outcome was thrombotic complications associated with ECMO. Secondary outcomes included bleeding events, pulmonary infection, need for renal replacement therapy, in-hospital mortality rate, ECMO support duration, hours of mechanical ventilation, anticoagulation fraction, length of hospitalization, and transfusion volume(s).</p><p><strong>Results: </strong>The study included data from 203 patients, who were divided into two groups: LAC (n = 108 [53.2%]) and CAC (n = 95 [46.8%]). Propensity score matching was used to balance confounding variables. A total of 43 patient pairs were successfully matched, and no significant difference was observed in thrombotic complications between the LAC and CAC groups (30.2% versus [vs.] 25.3%, respectively; p = 0.810). Meanwhile, no significant differences were observed in secondary outcomes and subgroups within the matched cohort, except for ECMO support time, which was shorter in the LAC group (119.6 h vs. 146.0 h; p = 0.015).</p><p><strong>Conclusion: </strong>The low-anticoagulation strategy was feasible for PC-ECMO support.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"275"},"PeriodicalIF":2.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12123780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186576","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":"Ivabradine use in critical care: a systematic review and metanalysis of cardiogenic and septic shock patients.","authors":"Lorenzo Antonino Calabrò, Marco Pasetto, Sabino Scolletta, Filippo Annoni, Zoe Demailly, Katarina Halenarova, Katia Donadello, Fabio Silvio Taccone","doi":"10.1186/s12871-025-03121-y","DOIUrl":"10.1186/s12871-025-03121-y","url":null,"abstract":"<p><strong>Introduction: </strong>In patients with acute illness, compensatory tachycardia initially serves to maintain adequate cardiac output, oxygen delivery and tissue oxygenation but may persist despite appropriate fluid and vasopressor resuscitation or may be secondary to inotropic therapy. Sustained tachycardia is a predictor of adverse outcomes in critical illness. Ivabradine, a highly selective inhibitor of the sinoatrial node's pacemaker current (I_f or \"funny\" current), mitigates tachycardia by modulating diastolic depolarization slope without affecting contractility.</p><p><strong>Aim: </strong>To report the existing evidence on the use of ivabradine in critically ill patients and assess its effect on rate control.</p><p><strong>Methods: </strong>A systematic literature search was performed up to May 2024 in the MEDLINE/PubMed®, Cochrane Controlled Clinical Trial register, EMBASE® and Scopus® databases. The search included: P- only original studies conducted in humans admitted to the Intensive Care Unit (ICU); I - when ivabradine administration was tested; C - in presence or absence of a control group; O - for any outcome; S - including case reports, randomized and observational trials, published in English in peer-reviewed journals.</p><p><strong>Results: </strong>After the first screening, 39 studies were assessed for eligibility on a total of 682 records identified. Among those, 29 were excluded; 10 studies (4 randomized controlled trial, 5 case report/series, 1 prospective observational), including a total of 243 patients, were included in the qualitative analysis, 6 studies were included in the quantitative analysis. The use of ivabradine resulted in a pooled mean heart rate reduction of 18.70 [12.70-24.80] bpm (p < 0.01) without a significant decrease in cardiac index (p = 0.59). A significant reduction of noradrenaline dose was reported in one study (-0.134 mcg/kg/min; 95% CI -0.172 to -0.012; p = 0.027). In addition, the combination of dobutamine with ivabradine has been reported to optimize dobutamine inotropic action, while mitigating its positive chronotropic effects, resulting in a more efficient cardiac cycle and improved hemodynamics.</p><p><strong>Conclusions: </strong>Ivabradine may be a useful alternative to beta-blocker in the management of inappropriate sinus tachycardia. Yet, evidence is limited and inconsistent. Larger randomized trials are needed to investigate the potential benefits or hazards of ivabradine use on hemodynamics and long-term outcomes.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"276"},"PeriodicalIF":2.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12125779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186577","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":"Comparison of the effects of two different local anesthetics used in spinal anesthesia on peripheral and central temperature change: a randomized controlled trial.","authors":"Azra Ozanbarcı, Hatice Kılınç, Bünyamin Muslu, Safinaz Karabayırlı, Seyfi Kartal, Güler Eraslan Doğanay, Melek Doğancı, Abdullah Kahraman, Oral Mentes, Yasemin Dayıca","doi":"10.1186/s12871-025-03148-1","DOIUrl":"10.1186/s12871-025-03148-1","url":null,"abstract":"<p><strong>Objective: </strong>In this study, we aimed to compare the effects of two different local anesthetics with different baricity used in spinal anesthesia on thermoregulation.</p><p><strong>Materials and methods: </strong>Our study was conducted on forty full-term pregnant women scheduled for elective cesarean sections under spinal anesthesia. At an operating room temperature of twenty-four degrees Celsius, peripheral body temperature was measured using temperature probes attached to the lower medial parts of the same side's lower and upper extremities, and central body temperature was measured with a tympanic thermometer. Isobaric levobupivacaine and hyperbaric bupivacaine were used in spinal anesthesia applications. After spinal anesthesia, tympanic temperature, arm and leg temperatures, mean arterial pressure, heart rate, and oxygen saturation were measured and recorded at baseline, the first, third, and fifth minutes, and every five minutes thereafter until the end of surgery.</p><p><strong>Results: </strong>In the bupivacaine group, a decrease in tympanic temperature was observed at the third minute and an increase in leg skin temperature at the fifth minute compared to baseline values. In the levobupivacaine group, a decrease in tympanic temperature was observed at the fifth minute, and an increase in leg skin temperature was observed at the third minute. In both groups, within-group comparisons showed a continued decrease in tympanic temperature and increase in leg temperature at all subsequent time points compared to baseline. No statistically significant difference was observed in arm skin temperatures within groups in either group.</p><p><strong>Conclusion: </strong>We observed that the effects of hyperbaric bupivacaine and isobaric levobupivacaine used in spinal anesthesia on thermoregulation were similar.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"271"},"PeriodicalIF":2.3,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12121188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180707","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":"Impact of anesthesia type on postoperative pain and outcomes in primary hip and knee arthroplasty: a retrospective register analysis.","authors":"Keno Sponheuer, Diana Becker-Rux, Stephan Scheike, Lukas Barsch, Christina Pempe, Christian Pfrepper, Andreas Roth, Robert Werdehausen","doi":"10.1186/s12871-025-03127-6","DOIUrl":"10.1186/s12871-025-03127-6","url":null,"abstract":"<p><strong>Background: </strong>This study explores the effects of single-sided spinal versus general anesthesia on patients undergoing hip and knee arthroplasty within a fast-track surgery environment. Although many studies suggest better outcomes with neuraxial anesthesia in lower extremity joint replacement, its benefits in fast-track surgery remain unclear.</p><p><strong>Methods: </strong>A retrospective analysis was performed on data derived from 283 patients. We focused on patients who had undergone primary, elective, and unilateral endoprosthetic fast-track hip or knee joint replacement surgeries between May 15, 2019, and November 30, 2020. The primary objective was to ascertain the correlation between the type of anesthesia and several postoperative parameters, including pain intensity, analgesia requirements, incidence of postoperative nausea and vomiting, perioperative process times, and hospital length of stay, based on the collected data.</p><p><strong>Results: </strong>Our findings indicated no difference in pain intensity and patient satisfaction between the general (n = 195) and single-sided spinal anesthesia (n = 61) groups at the first postoperative day. However, a notable difference was observed in the recovery room, with patients under spinal anesthesia requiring significantly less piritramide than those after general anesthesia. Both groups had a similar incidence of postoperative nausea and length of hospital stay.</p><p><strong>Conclusions: </strong>When analyzed retrospectively, the type of anesthesia applied is not associated with an increased risk of postoperative pain, postoperative nausea and vomiting, or prolonged hospital stay. Overall, neither anesthesia method outperforms the other concerning patient satisfaction, emphasizing the importance of patient preference and individual risk factors in the decision-making process.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"274"},"PeriodicalIF":2.3,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12124000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180716","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":"Comparison of non-intubated and intubated video-assisted thoracoscopic surgery for perioperative complications-a systematic review and meta-analysis.","authors":"Diaofeng Zhang, Jie Wu, Yihan Yang, Ruifang Pu, Zixiao Liu, Yun Li, Wei Deng, Jiale Wang, Bo Hou, Zengcai Ge, Jiao Gao, Jiangang Li, Liming Cheng","doi":"10.1186/s12871-025-03154-3","DOIUrl":"10.1186/s12871-025-03154-3","url":null,"abstract":"<p><strong>Background: </strong>Non-intubated video-assisted thoracic surgery (NIVATS) avoids lung injury and intubation-related complications from mechanical ventilation, but the intraoperative safety and postoperative recovery quality of NIVATS remain controversial. Consequently, we systematically assessed the viability and safety of non-intubated video-assisted thoracic surgery (NIVATS) in comparison to intubated video-assisted thoracic surgery (IVATS). These findings provide evidence for optimizing anesthetic and surgical decision-making.</p><p><strong>Methods: </strong>PubMed, Web of Science, Embase, Cochrane Library, OVID, and Google Scholar were queried from their establishment until October 2024. We included eligible studies that compared non-intubated anesthesia with intubated anesthesia for video-assisted thoracoscopic surgery for thoracic conditions. Following the evaluation of bias risk in these randomized controlled trials (RCTs), a meta-analysis was conducted using Review Manager (Manager 5.4).</p><p><strong>Results: </strong>Nineteen randomized controlled trials were incorporated into the study. NIVATS demonstrated a reduced length of hospital stay, feeding time, and chest-tube dwell time compared to intubated methods. IVATS groups, hypoxemia exhibited a reduced incidence, but perioperative cough and perioperative arrhythmias revealed no statistically significant differences between IVATS and NIVATS groups. The NIVATS groups exhibited a significantly reduced risk compared to the IVATS groups for postoperative pulmonary complications (PPCs), postoperative nausea and vomiting (PONV), and sore throat.</p><p><strong>Conclusions: </strong>NIVATS avoid complications associated with intubation and are able to accelerate patient recovery to a certain extent. Although NIVATS carries intraoperative safety risks, careful patient selection can mitigate these risks.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"272"},"PeriodicalIF":2.3,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12121218/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180568","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}