BMC Anesthesiology最新文献

{"title":"Global prevalence of postoperative hypoxemia among adult and pediatric surgical patients: a systematic review and meta-analysis.","authors":"Yosef Belay Bizuneh, Mulualem Endeshaw Zeleke, Ashebir Mamay Gebru, Destaw Fetene Teshome, Fantahun Ayenew Mekonnen, Dessie Abebaw Angaw, Amare Belete Getahun","doi":"10.1186/s12871-025-03146-3","DOIUrl":"10.1186/s12871-025-03146-3","url":null,"abstract":"<p><strong>Background: </strong>Postoperative hypoxemia refers to a condition where oxygen levels in the tissues or blood drop to insufficient levels following surgery. The aim of this review is to determine the global prevalence of postoperative hypoxemia among adult and pediatric surgical patients through a systematic review and meta-analysis.</p><p><strong>Methods: </strong>We performed a comprehensive search across multiple databases, including Pubmed, Embase and Scopus. Additionally, search engines such as Google Scholar and Google. The searching mechanism was using medical subject heading terms combining by Boolean operators. The process adhered to the PRISMA guidelines, ensuring a robust method for the review. The review was registered at PROSPERO with registration number CRD42024534623. Risk of bias or quality assessment was done using a standardized critical appraisal instrument. Publication bias was assessed using a funnel plot and Egger's regression test. Pooled prevalence was estimated using random-effects. Subgroup analyses were conducted based on different factors. Additionally, to identify a single study effect sensitivity analysis was conducted.</p><p><strong>Result: </strong>A total of 20 primary studies with 28,948 participants were included. The pooled prevalence of postoperative hypoxemia was 20.62% (95% CI: 17.02-24.22%). Publication bias was detected, with Egger's regression test (p < 0.0001) indicating small-study effects. After imputing three studies, the pooled prevalence decreased from 20.62% (95% CI: 17.02-24.22%) to 16.76% (95% CI: 13.36-20.15%). Subgroup analysis showed the highest prevalence in Africa at 33.81% (95% CI: 25.51-42.1%) and in low-income countries at 33.81% (95% CI: 25.51-42.1%). Among emergency surgical patients, they had the higher prevalence, 21.38% (95% CI: 11.60-31.15%).</p><p><strong>Conclusion: </strong>This meta-analysis showed a pooled prevalence of postoperative hypoxemia was 20.62%, which may be over reported due to publication bias. After data imputation, the revised prevalence was 16.76%. Higher rates are found in Africa and low-income countries, as well as emergency surgical patients.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"284"},"PeriodicalIF":2.3,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12131438/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144214985","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":"Efficacy of high-flow nasal oxygen in preventing hypoxia during Gastrointestinal endoscopy: a retrospective cohort study.","authors":"Fengli Liu, Chaojin Zhang, Xiaoqiang Wang, Bo Qi, Li Zheng, Yanhua Zhao, Weifeng Yu","doi":"10.1186/s12871-025-03155-2","DOIUrl":"10.1186/s12871-025-03155-2","url":null,"abstract":"<p><strong>Background: </strong>Hypoxia is a common complication, particularly in gastrointestinal endoscopy due to respiratory depression induced by intravenous anesthesia with the use of propofol. This study aimed to investigate the efficacy and safety of high-flow nasal oxygen in preventing hypoxia during gastrointestinal endoscopy.</p><p><strong>Methods: </strong>This single-center retrospective study included 900 patients undergoing gastrointestinal endoscopy at Renji Hospital, Shanghai Jiao Tong University School of Medicine, from June 15th 2023 to August 15th 2023. Patients were categorized into the high-flow nasal oxygen (HFNO) group using a high-flow-specific nasal cannula or the standard nasal oxygen (SNO) group using a standard nasal cannula. The primary outcome of this study was the incidence of hypoxia (mild hypoxia: 75% ≤ SpO₂ < 90% for < 60 s, severe hypoxia: SpO₂ < 75% or 75% ≤ SpO₂ < 90% for > 60 s). Secondary outcomes included the incidence of subclinical respiratory depression (90% ≤ SpO₂ < 95%) and adverse events associated with the nasal cannula. We used the propensity score matching (PSM) with a 1:1 ratio to balance the patient baseline characteristics.</p><p><strong>Results: </strong>884 patients were included in the analysis after PSM. The general characteristics of patients had no statistically significant difference between the two groups. The HFNO group demonstrated significantly better outcomes compared with SNO, including the lower incidence of hypoxia (0% vs. 5.66%, p < 0.001) and subclinical respiratory depression (1.36% vs. 12.67%, p < 0.001), and fewer adverse events associated with the nasal cannula (0% vs. 4.07%, p < 0.001). Furthermore, a multifactorial analysis identified body mass index (BMI) (HR = 1.43, 95% CI [1.17-1.76], p < 0.001) and sedation depth (HR = 10.31, 95% CI [3.68-28.88], p < 0.001) as risk factors for hypoxia in the SNO group.</p><p><strong>Conclusion: </strong>HFNO emerges as a promising approach for preventing hypoxia during gastrointestinal endoscopy, offering a simple, effective, and non-invasive means of respiratory support.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"287"},"PeriodicalIF":2.3,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12131433/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144214984","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 association between neostigmine and postoperative atelectasis in elderly patients undergoing laparoscopic pancreaticoduodenectomy: a retrospective single-center propensity score matched study.","authors":"Rong Luo, Yunfen Ge, Yue Chen, Huizi Liu","doi":"10.1186/s12871-025-03162-3","DOIUrl":"10.1186/s12871-025-03162-3","url":null,"abstract":"<p><strong>Background: </strong>It is uncertain whether neostigmine reversal improves postoperative pulmonary outcomes. This study aimed to evaluate the association between neostigmine and postoperative atelectasis, and other complications in elderly patients undergoing laparoscopic pancreaticoduodenectomy (LPD).</p><p><strong>Methods: </strong>This single-center retrospective cohort study included elderly patients who underwent LPD between 2019 and 2022, using cis-atracurium as the sole neuromuscular blocking agent. Participants were divided into two groups based on exposure to neostigmine: the neostigmine reversal group (exposed) and the control group (not exposed). The primary endpoint was the incidence of atelectasis within the first 3 postoperative days. Secondary endpoints included the incidence of pneumonia, pleural effusion, acute respiratory distress syndrome (ARDS), time to extubation, length of stay in the post-anesthesia care unit (PACU) and hospital, reintubation, postoperative blood gas analysis, 30-day readmission, and 30-day mortality. Propensity score matching (PSM) was performed based on baseline and intraoperative characteristics to minimize potential bias.</p><p><strong>Results: </strong>Of the 501 patients initially included, 302 were successfully matched after PSM at a 1:5 ratio, comprising 89 patients in the neostigmine reversal group and 213 in the control group. Compared to the control group, the incidence of postoperative atelectasis was lower in the neostigmine reversal group (OR 0.43 [95% CI 0.24-0.75], p = 0.003) in elderly patients undergoing elective LPD. For secondary outcomes, time to extubation (Median [IQR] 20.00 [10.00-32.50] min vs. 25.00 [15.00-41.00] min, p < 0.001), and the length of stay in the PACU (Median [IQR] 55.00 [45.00-67.50] min vs. 60.00 [50.00-84.00] min, p = 0.013) were shortened, and the oxygen index (OI) at 2 h after extubation was increased (Median [IQR] 339.00 (275.76-453.03) vs. 310.00 (262.31-378.00), p < 0.001) in the neostigmine reversal group. Binomial logistic regression showed that age (OR 1.08 [95% CI 1.04-1.12], p < 0.001), neostigmine reversal (OR 0.43 [95% CI 0.24-0.76], p = 0.004), and intraoperative total fluid infusion (OR1.00 [95% CI 1.000-1.001], p = 0.009) were significantly associated with atelectasis after LPD.</p><p><strong>Conclusions: </strong>In this single-center PSM study, neostigmine reversal was associated with lower incidence of atelectasis within the first 3 postoperative days, shorter time to extubation, shorter length of stay in the PACU, and increased OI at 2 h after extubation in elderly patients undergoing elective LPD. Postoperative atelectasis was associated with older age, greater intraoperative total fluid infusion, and the absence of neostigmine reversal. These results should be interpreted as hypothesis-generating, and warrant validation through randomized controlled trials.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"285"},"PeriodicalIF":2.3,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12131451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144214988","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":"Low lymphocyte-to-monocyte ratio and accelerated temperature rise in epidural-related maternal fever: a prospective cohort study.","authors":"Jianxiong Huang, Yongle Li, Jiao Duan, Junjian Wen, Jingyou He, Zurong Hu","doi":"10.1186/s12871-025-03157-0","DOIUrl":"10.1186/s12871-025-03157-0","url":null,"abstract":"<p><strong>Background: </strong>Sterile inflammation is a key factor in epidural-related maternal fever (ERMF). While antepartum changes in white blood cell counts have been associated with ERMF, their impact on the occurrence of ERMF remains poorly understood.</p><p><strong>Objective: </strong>To examine the relationship between lymphocyte-to-monocyte ratio (LMR) and ERMF and to assess the potential impact of LMR on ERMF onset in parturients.</p><p><strong>Methods: </strong>This prospective cohort study included 543 parturients who underwent labor epidural analgesia at the Guangdong Women and Children Hospital from January 2022 to September 2024. ERMF was defined as a maternal temperature of ≥ 38 °C on a single occasion or two readings of ≥ 37.5 °C taken 1 h apart. Univariate and multivariate logistic regression models were utilized to explore the association between LMR level and ERMF. Receiver operating characteristic curve analysis was conducted to determine the optimal cutoff value for the LMR associated with ERMF. The Kaplan-Meier curve and log-rank test were used to compare the time to ERMF onset between parturients with higher and lower LMR levels.</p><p><strong>Results: </strong>Totally, 543parturients, 20.4% of whom developed ERMF. Lower LMR was associated with an increased incidence of ERMF (adjusted OR = 0.50, 95% CI: 0.36-0.69, P < 0.001). ROC curve analysis identified an antepartum maternal LMR level ≤ 2.37 as an associative cutoff for ERMF. Compared with parturients with an LMR > 2.37, those with an LMR ≤ 2.37 exhibited a significantly higher odds of developing ERMF (adjusted OR = 5.43, 95% CI: 3.18-9.28, P < 0.001). The onset time of ERMF was shorter in the lower LMR group but did not reach statistical significance (230.6 ± 15.3 min vs. 261.2 ± 18.4 min, P = 0.088). Among parturients exhibiting ERMF, a significantly higher rate of temperature rise to ERMF was observed in parturients with a lower LMR level (0.37 [0.29, 0.55] °C/h vs. 0.31 [0.20, 0.53] °C/h, P = 0.013).</p><p><strong>Conclusion: </strong>Low LMR levels were observed to be associated with an increased risk of ERMF.</p><p><strong>Trial registration: </strong>ChiCTR2200055734 on January 16, 2022.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"283"},"PeriodicalIF":2.3,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12131660/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144214986","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":"Severe intestinal distension following HFNC-assisted awake intubation with conversion to open Nissen fundoplication: a case report.","authors":"Zeynep Yasemin Tavşanoğlu, Ahmet Yüksek, Ali Sait Kavaklı, Ülkü Arslan, Mehmet Yılmaz","doi":"10.1186/s12871-025-03166-z","DOIUrl":"10.1186/s12871-025-03166-z","url":null,"abstract":"<p><strong>Background: </strong>High-flow nasal cannula (HFNC) oxygen therapy is a commonly used respiratory support method delivering heated, humidified air at high flow rates with a positive end-expiratory pressure (PEEP) effect. HFNC improves oxygenation and facilitates awake fiberoptic intubation in the management of difficult airways. However, concerns about HFNC-induced gastric insufflation and intestinal distension have emerged, particularly in patients with lower esophageal sphincter dysfunction or hiatal hernia. We report a case of severe intestinal distension following HFNC-assisted awake fiberoptic intubation in a patient with a hiatal hernia scheduled for laparoscopic Nissen fundoplication.</p><p><strong>Case presentation: </strong>A 50-year-old male patient was scheduled for a Nissen fundoplication procedure. Following preoperative airway examination, it was decided to proceed with awake intubation. HFNC was used as recommended in the guidelines to improve oxygenation. The patient was intubated with minimal sedation and airway topicalization under 40 L/min flow using a fiberoptic bronchoscope. The procedure was uneventful and the patient was handed over to the surgical team. Surgery began laparoscopically. However, excessive intestinal distension did not allow the surgery to continue with an optimum image. Aspirations with an orogastric tube and rectal tube could not improve the image and the patient had to undergo open surgery. The 5-hour open surgical procedure was completed without complications. Postoperative direct abdominal radiography showed dense intestinal air compared to the preoperative radiography.</p><p><strong>Conclusions: </strong>This case underscores the potential risk of HFNC-induced intestinal distension, particularly in patients with predisposing factors such as hiatal hernia. Although HFNC is effective for airway management, careful patient selection and technique optimization are crucial. Further research is needed to clarify the impact of HFNC on gastrointestinal dynamics and to guide its safe application in at-risk populations.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"286"},"PeriodicalIF":2.3,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12131745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144214987","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":"Airway management in pediatric tracheoesophageal fistula repair with tracheostomy and stents: a case report.","authors":"Ying Chen, Ding Han, Guangpu Li, Cuizhu Feng, Shoudong Pan","doi":"10.1186/s12871-025-03115-w","DOIUrl":"10.1186/s12871-025-03115-w","url":null,"abstract":"<p><strong>Background: </strong>The airway management of complex tracheoesophageal fistula repairs in pediatric patients presents unique challenges, particularly in cases involving pre-existing tracheostomy and tracheal stenting. The combination of restricted mouth opening, altered airway anatomy secondary to tracheal stents, and the presence of a tracheostomy creates significant technical obstacles in establishing effective one-lung ventilation during thoracoscopic procedures. This report describes a novel and successful one-lung ventilation strategy in a complex pediatric case, demonstrating the feasibility of one-lung ventilation under these challenging anatomical constraints.</p><p><strong>Case presentation: </strong>A 5-year-old patient presenting with iatrogenic tracheoesophageal fistula secondary to corrosive airway injury underwent thoracoscopic surgical repair, with a complex clinical course marked by tracheal stenosis, tracheal stent placement, and tracheostomy. Successful intraoperative one-lung ventilation was achieved through flexible electronic bronchoscopy-guided orotracheal intubation with a 4.0-mm endotracheal tube, followed by precise positioning of a disposable bronchial blocker in the right main bronchus.</p><p><strong>Conclusions: </strong>Transoral use of a bronchial blocker combined with an existing tracheostomy tube demonstrated technical feasibility for achieving pulmonary isolation in children with tracheal stent and tracheostomy. However, the generalizability of this approach requires further validation through larger cohort studies.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"282"},"PeriodicalIF":2.3,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12131417/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144207702","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":"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":"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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12125746/pdf/","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":"OA","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":"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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12125770/pdf/","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":"OA","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":"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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12125875/pdf/","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":"OA","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":"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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12125853/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}