BMC Anesthesiology最新文献

{"title":"Barriers and facilitators of pain management in children: a scoping review.","authors":"Shamsi Atefeh","doi":"10.1186/s12871-025-02941-2","DOIUrl":"10.1186/s12871-025-02941-2","url":null,"abstract":"<p><p>Effective pain management in pediatric care is essential to safeguarding the well-being and recovery of children; however, numerous barriers impede optimal pain relief. Identifying and understanding these barriers, along with facilitators that enhance care, is crucial for advancing clinical practices and patient outcomes. This study presented a comprehensive scoping review of the barriers and facilitators to pediatric pain management, synthesizing findings from research published between 2014 and 2024 to inform evidence-based clinical strategies. A systematic search was conducted using key terms such as \"pain management,\" \"children,\" \"barriers,\" and \"facilitators\" across PubMed, ProQuest, Web of Science, and Scopus databases, focusing on English-language articles.The review identified several key barriers to effective pediatric pain management, including deficits in provider knowledge and training, organizational and structural limitations, medication and prescription challenges, environmental and situational constraints, communication gaps, technological barriers, parental factors, policy and systemic issues, logistical difficulties, and context-specific limitations. Conversely, facilitators emerged as essential components for improvement, including professional initiatives by healthcare providers, structural and organizational enhancements, family engagement, targeted educational and training interventions, technological innovations, procedural improvements, remote and virtual care adaptations, policy enhancements, and supportive interprofessional relationships.Addressing these multifaceted barriers requires a holistic approach that integrates enhanced education, organizational support, technological development, and active family involvement. Implementing these facilitators has the potential to significantly improve pain management practices, promoting a higher standard of care and quality of life for pediatric patients.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"148"},"PeriodicalIF":2.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11963635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143762913","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":"Comparative efficacy and safety of local anesthesia combinations for labor pain relief: a network meta-analysis.","authors":"Pan Li, Xiaoting Ma, Meng Zhang, Longlu Cao, Ran Duan, Jianli Li","doi":"10.1186/s12871-025-03014-0","DOIUrl":"10.1186/s12871-025-03014-0","url":null,"abstract":"<p><strong>Background: </strong>Epidural anesthesia stands out as the most commonly employed approach for labor analgesia, frequently complemented by various local anesthetics, and the analgesic effectiveness and safety profiles of distinct local anesthetic regimens are different. To compare the efficacy and adverse reactions of different local anesthetic regimens in relieving labor pain by performing a network meta-analysis.</p><p><strong>Methods: </strong>We systematically searched four electronic databases (PubMed, EMBASE, Web of Science, and Cochrane Library) for randomized controlled trials from the inception of the databases up to March 3, 2025. Included in the study were patients aged 18 to 35 years who underwent painless delivery under epidural anesthesia.</p><p><strong>Results: </strong>The meta-analysis included a total of 59 studies involving 6972 patients. The combination of Ropivacaine_Dexmedetomidine_Sufentanil (Rop_Dex_Suf) was the most effective and fast in reducing Visual Analog Scale (VAS) scores at 30 min after block, compared to most other anesthesia schemes. Labor pain lasted for the longest time with Ropivacaine_Dexmedetomidine(Rop_Dex). Meanwhile, Bupivacaine_Pethidine(Bpv_Pet), Bupivacaine_Dexmedetomidine(Bpv_Dex), Fentanyl(Fen), and Bupivacaine_Diamorphine(Bpv_DiaMor) had the lowest incidence of nausea, vomiting, hypotension, and pruritus. Besides, Bupivacaine_Dexmedetomidine(Bpv_Dex), Ropivacaine_Dexmedetomidine(Rop_Dex), and Ropivacaine_Dexmedetomidine_Sufentanil (Rop_Dex_Suf) have demonstrated outstanding analgesic efficacy and safety.</p><p><strong>Conclusions: </strong>Our study demonstrates that the combination of ropivacaine, dexmedetomidine, and sufentanil is the most effective regimen for alleviating labor pain. Nonetheless, given the limited number of studies on certain protocols, additional high-quality, large-scale randomized controlled trials (RCTs) are anticipated to substantiate our conclusion in the future.</p><p><strong>Prospero registration number: </strong>CRD42023459538.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"146"},"PeriodicalIF":2.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11963270/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143762916","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":"Ultrasonography-guided catheter-over-needle insertion for caudal epidural catheter placement in adults: technical considerations.","authors":"Pei Zhang, Hongzhou Chen, Keqiang Yu, Xia Ran, Rurong Wang, Jing Wu","doi":"10.1186/s12871-025-02889-3","DOIUrl":"10.1186/s12871-025-02889-3","url":null,"abstract":"<p><strong>Background: </strong>Caudal epidural analgesia significantly reduces acute pain after anorectal surgery; however, caudal epidural catheter placement (CECP) remains challenging, and the safety of real-time ultrasonography-guided CECP is uncertain. This study aimed to evaluate the success rate and related complications of real-time ultrasonography-guided CECP and describe the technical considerations.</p><p><strong>Methods: </strong>This prospective, single-center observational study included 233 patients catheterized in the left lateral decubitus position. The sacral hiatus was palpated and then confirmed using ultrasonography. A catheter-over-needle was inserted through the sacrococcygeal ligament under real-time ultrasonographic guidance, the metallic needle was withdrawn through the outer sleeve, and the epidural catheter was placed through the outer sleeve into the sacral canal epidural space. The primary outcome was the success rate of CECP; several surgical variables, the incidence of related complications, and improvement measures were also assessed.</p><p><strong>Results: </strong>CECP through the sacral hiatus was successful in 231 patients. The sacral canal depth at the hiatus apex, the mean distance between the sacral cornua, and the distance from the skin to the inferior margin of the sacrococcygeal ligament were 5.07 ± 1.38, 8.00 ± 1.94, and 14.24 ± 4.18 mm, respectively. The sacral canal depth was > 3 mm in 94.4% of patients. No complications, such as epidural hematoma, dura puncture, and intraspinal infection during postoperative epidural catheter utilization, occurred.</p><p><strong>Conclusion: </strong>Ultrasonography-guided CECP through the sacral hiatus is a simple, feasible, safe, and effective technique for postoperative anorectal analgesia. Additionally, caudal epidural analgesia manages severe pain after anorectal surgery. Therefore, this technology merits comprehensive clinical application.</p><p><strong>Trial registration number: </strong>No. ChiCTR 2,000,038,918.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"149"},"PeriodicalIF":2.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11963432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143762898","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":"Dexmedetomidine improves prognosis in septic patients with myocardial injury and lower APACHE IV scores: a retrospective cohort study.","authors":"Xuan Dai, Hongyan Wei, Dezhi Zou, Yilin Yang, Chenyu Zhang, Jie Chen, Chunlin Hu","doi":"10.1186/s12871-025-02906-5","DOIUrl":"10.1186/s12871-025-02906-5","url":null,"abstract":"<p><strong>Background and objective: </strong>Sepsis is a major cause of mortality, particularly in patients with myocardial injury. The objective of this study was to evaluate the impact of dexmedetomidine, propofol, and midazolam on mortality and various outcomes in this population.</p><p><strong>Methods: </strong>A retrospective cohort study was performed using the eICU database, encompassing 2,171 septic patients with myocardial injury. Patients were categorized into single- and multiple-sedative groups. The primary endpoint was 100-day mortality, with secondary endpoints encompassing hospital stay, intensive care unit (ICU) stay, mechanical ventilation (MV), and dialysis. Statistical analysis was conducted using Cox regression, Kaplan-Meier curves, and propensity score matching.</p><p><strong>Results: </strong>Among 2,171 patients, dexmedetomidine was associated with lower 100-day mortality in patients with APACHE IV scores < 78.9, particularly in specific subgroups. In patients with APACHE IV scores ≥ 78.9, dexmedetomidine provided no mortality advantage over propofol. Midazolam was linked to higher mortality across all score ranges, and its combination with propofol resulted in worse outcomes compared to dexmedetomidine-propofol. No significant differences were found in hospital stay, ICU stay, or MV rates between the groups.</p><p><strong>Conclusion: </strong>Dexmedetomidine improves prognosis in septic patients with myocardial injury, particularly in those with lower severity of illness, highlighting its potential as a preferred sedative choice in this population.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"145"},"PeriodicalIF":2.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11959799/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143762918","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":"Evaluation of inguinal sonoanatomy regarding pericapsular nerve group (PENG) block in children: the relation of femoral artery, femoral nerve, lateral femoral cutaneous nerve and iliopsoas notch.","authors":"Hande Gurbuz, Tuncay Colak","doi":"10.1186/s12871-025-03020-2","DOIUrl":"10.1186/s12871-025-03020-2","url":null,"abstract":"<p><strong>Background: </strong>Pericapsular nerve group (PENG) block is a novel technique that provides analgesia in hip surgeries while preserving motor function. This study aimed to identify developmental differences and variations regarding PENG block sonoanatomy in the inguinal region in children.</p><p><strong>Methods: </strong>A total of 150 children between 28 days and 18 years were included in this prospective, observational, descriptive study. The participants were divided into six groups according to growth and development periods. Ultrasonographic measurements representing block depth, needle length, and the vicinity of femoral nerve (FN) and femoral artery (FA) to the block area were collected.</p><p><strong>Results: </strong>Block depth: 16.2 ± 4.0 mm in infants (28 days-12 months); 33.5 ± 6.1 mm in adolescents (145-215 months). Needle length: 24.2 ± 5.9 mm in infants; 39.3 ± 6.6 mm in adolescents. The distance of FA to the block area: 4.4 ± 2.0 mm in infants; 11.6 ± 5.7 mm in adolescents. The distance of FN to the block area: 0.7 ± 0.8 mm in infants; 2.9 ± 4.0 mm in adolescents. FN-FA distance: 2.2 ± 1.4 mm in infants; 3.8 ± 1.8 mm in adolescents. In 49/150 (32.7%) cases the FN overlapped the perpendicular line between iliopsoas notch and skin. The lateral femoral cutaneous nerve (LFCN) was involved in the ultrasound frame in 11/50 (22%) children under the age of three.</p><p><strong>Conclusions: </strong>Especially in children under three years of age, LFCN should be visualized during the pre-block preparation phase. The out-of-plane approach is not recommended in the PENG block due to the FN's alignment on the path of a vertical needle trace.</p><p><strong>Trial registration: </strong>NCT04860479.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"144"},"PeriodicalIF":2.3,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956313/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751170","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":"Postoperative outcomes in earthquake victims with orthopedic trauma: a focus on mortality and dialysis needs.","authors":"Erdi Huseyin Erdem, Bahar Aydinli, Serkan Dogru, Harun Ozmen, Mevlut Atilla, Inci Yildirim","doi":"10.1186/s12871-025-03015-z","DOIUrl":"10.1186/s12871-025-03015-z","url":null,"abstract":"<p><strong>Background: </strong>This study aims to identify the factors associated with postoperative mortality and the need for dialysis in earthquake survivors presenting with isolated orthopedic injuries, with particular emphasis on crush syndrome and its clinical consequences.</p><p><strong>Methods: </strong>This single-center retrospective study included patients who sustained limb or vertebral injuries during the February 6, 2023, earthquake and underwent surgical intervention following transfer from the disaster zone. Exclusion criteria comprised non-earthquake-related injuries, pre-existing chronic renal or liver failure, prior amputations unrelated to the earthquake, concomitant head, thoracic, or abdominal injuries, pregnancy, and cases with incomplete data. Data on injury location, anesthesia technique, surgical procedures, dialysis requirements, and postoperative outcomes were collected. Surgical interventions were classified into four categories: fasciotomy, amputation, debridement, and osteosynthesis. Intergroup comparisons were conducted by Kruskal-Wallis test. The backward stepwise approach for regression model was employed to minimize suppressor effects-where a predictor's significance is contingent on the presence of another variable-and to reduce the risk of type II errors, thereby ensuring the identification of significant predictors. Analyses were performed using Statistical Package for Social Sciences version 20 program.</p><p><strong>Results: </strong>A total of 561 patients were included in this study. Patients had several injuries as follows: upper extremity in 123 patients (19.6%), thigh in 151 (24.1%), calf and foot in 279 (44.6%) and vertebral column in 72 (11.5%). The findings showed that patients with thigh injury had the highest mortality rate, which was 55% (p = 0.012). A sum of 187 patients (33.3%) were diagnosed as crush syndrome. Dialysis requirement was observed in 25.1% of patients with crush syndrome, highlighting its significant impact on mortality (p = 0.017). A multivariate linear backward regression analysis showed that hematocrit, platelet count, alanine transaminase, and time to admission were the significant predictors for mortality (ß=-0.113, p = 0.039; ß=-0.133, p = 0.007; ß=0.196, p < 0.05; ß=0.158, p = 0.001, respectively).</p><p><strong>Conclusions: </strong>It can be concluded that above-knee injuries and the requirement for dialysis are significant predictors of increased mortality. Early diagnosis and timely therapeutic intervention in these patients are critical to improving clinical outcomes. Furthermore, delayed hospital admission is associated with higher mortality rates, highlighting the importance of rapid medical response and efficient triage in disaster scenarios to optimize patient survival.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"141"},"PeriodicalIF":2.3,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751172","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 percutaneous dilatational tracheostomy with and without flexible bronchoscopy guidance in intensive care units.","authors":"Özlem Öner, Sinem Dağlı, Mehmet Çağatay Gürkok, Ejder Kamil Öztürk, Begüm Ergan, Volkan Hancı, Ali Necati Gökmen, Erdem Yaka","doi":"10.1186/s12871-025-03022-0","DOIUrl":"10.1186/s12871-025-03022-0","url":null,"abstract":"<p><strong>Backgrounds: </strong>The benefit of fiberoptic bronchoscopy (FOB) guidance during percutaneous dilatational tracheostomy (PDT) remains unclear. We aimed to compare PDT performed with and without FOB guidance in terms of procedure duration, number of attempts, and perioperative complications.</p><p><strong>Methods: </strong>A total of 103 patients were divided into two groups, and the PDT procedure was performed either with or without FOB guidance. The primary outcome of our study was the duration of the tracheostomy procedure (PDT procedure time) and the number of attempts. The secondary outcome was the major/minor complications that might develop during and after tracheostomy.</p><p><strong>Results: </strong>The mean PDT procedure time was 8 (4-14) minutes in the FOB (-) group and 7 (3-14) minutes in the FOB (+) group, with no statistically significant difference between them (p = 0.081). The mean number of PDT attempts was the same in both the FOB (-) and FOB (+) groups, 1 (1-3) (p = 0.079). Hypoxemia/desaturation occurred in 1 (2%) patient in the FOB (-) group and in 1 (1.9%) patient in the FOB (+) group (p = 0.748). Cardiac arrhythmia occurred in 2 (3.9%) patients in the FOB (-) group and in 2 (3.8%) patients in the FOB (+) group (p = 0.684). No cases of pneumothorax or pneumomediastinum were observed in either group (p > 0.999).</p><p><strong>Conclusion: </strong>No difference was found between the two groups in terms of procedure duration, number of attempts, and perioperative complications when performing PDT in the intensive care unit with or without fiberoptic bronchoscopy guidance. PDT can be performed effectively and safely in critically ill patients using a standardized approach by an experienced team, with or without bronchoscopy guidance. However, further investigation and advanced studies are needed to evaluate both methods in more detail.</p><p><strong>Trial registration: </strong>Retrospectively registered. Clinical trial number was not applicable.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"142"},"PeriodicalIF":2.3,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956419/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751155","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":"Transesophageal echocardiogram contributes to high-quality cardiopulmonary resuscitation: a case report.","authors":"Qiong Wang, Bin Lu","doi":"10.1186/s12871-025-03021-1","DOIUrl":"10.1186/s12871-025-03021-1","url":null,"abstract":"<p><strong>Background: </strong>Difficulties to identify the cause of cardiac arrest in a short period of time lead to prolonging the time for cardiopulmonary resuscitation (CPR) and to poor survival. Transesophageal echocardiogram (TEE) can assist CPR of long duration and improve outcome.</p><p><strong>Case presentation: </strong>In this case report, a 50-year-old man was scheduled to undergo a endoscopic cervical discectomy under general anesthesia. The patient suffered a sudden cardiac arrest during the operation, and a high-quality CPR was performed with the the help of TEE. Although the exact etiology of cardiac arrest remained unclear and the CPR was performed for up to 90 min, the patient returned to spontaneous circulation, and was discharged after a month of treatment and rehabilitation, resuming his daily activities. After a one year of follow-up, he still was without any sequelae.</p><p><strong>Conclusions: </strong>Perioperative cardiac arrest is unpredictable and catastrophic, so high-quality CPR is essential. TEE's excellent features make it ideal for use on resuscitation and can improve the outcome of cardiac arrest.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"143"},"PeriodicalIF":2.3,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751174","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":"Carotid peak flow velocity variation as a surrogate of aortic peak flow velocity variation in a pediatric population.","authors":"Federico Cristiani, Juan Pablo Bouchacourt, Juan Riva, Pablo Motta","doi":"10.1186/s12871-025-03010-4","DOIUrl":"10.1186/s12871-025-03010-4","url":null,"abstract":"<p><strong>Background: </strong>Carotid peak velocity variation (ΔVpeak_Car) is an alternative to aortic peak velocity variation (ΔVpeak_Ao) and has been used in the pediatric population. Children's physiology and anatomy are heterogeneous throughout their growth. For this reason, the predictive value of ΔVpeakCar as a surrogate of ΔVpeakAo can vary at different ages. We hypothesize that the ability of ΔVpeak_Car as a surrogate of ΔVpeak_Ao changes throughout childhood.</p><p><strong>Aim: </strong>Analyze the concordance and the tracking ability of ΔVpeak_Car and the ΔVpeak_Ao at different stages of development.</p><p><strong>Methods: </strong>Patients from 0 to 12 years were included. Three groups were defined: under 12 months (G1), between 12 and 60 months (G2), and over 60 months (G3). After anesthesia induction and mechanical ventilation, maximal and minimal aortic and carotid peak flow were measured. ΔVpeak_Ao and ΔVpeak_Car were calculated. Pearson test and simple linear regression were performed. Bland-Altman analysis was performed to determine concordance. 4-quadrant analysis was used, followed by polar analysis of the vectors, to complement the concordance analysis and determine the tracking ability of ΔVpeak_Car to surrogate ΔVpeak_Ao.</p><p><strong>Results: </strong>Sixty-seven patients were enrolled. 22 (32.4%) patients in G1, 21 (31.3%) in G2 and 24 (35.8%) in G3. The determination coefficient (r) between ΔVpeak_Ao and ΔVpeak_Car in G1 was 0.44 (p < 0.001) with a slope value of 0.61 (SE = 0.11; 95% CI:0.3-0.91). In G2, r² = 0.56 (p < 0.001) with a slope value of 0.59 (SE = 0.14; 95% CI:0.35-0.82); and in G3, r² = 0.85 (p < 0.001) with a slope value of 1.11 (SE = 0.10; 95% CI:0.91-1.31). Bland-Altman analysis showed to G1 a mean bias of -0.37 (LOA - 7.87 to 7.53), to G2 -0.07 (LOA - 7.37 to 7.23) and G3 0.55 (-3.81 to 4.91). Concordance rates were 100% in G3, 95% in G2, and 93% in G1.</p><p><strong>Conclusions: </strong>ΔVpeak_Car showed good correlation and tracking ability with ΔVpeak_Ao in schoolchildren. In younger children, it was not reliable enough.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"140"},"PeriodicalIF":2.3,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934507/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708688","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 adding dexmedetomidine as adjuvant with bupivacaine in ultrasound-guided intermediate cervical plexus block for thyroidectomy surgery: randomized controlled study.","authors":"Mamdouh Mahmoud Mostafa, Reham M Gamal, Aya M Ahmed Baiomy, Mohamed Elsayed Hassan, Jehan Mohamed Kamal, Thabet Ts, Tamer A Kotb, Mai M Elrawas","doi":"10.1186/s12871-025-02990-7","DOIUrl":"10.1186/s12871-025-02990-7","url":null,"abstract":"<p><strong>Background: </strong>One important aspect of a successful thyroidectomy recovery is the level of pain postoperatively. This research aimed to determine the effectiveness of an ultrasound-guided intermediate cervical plexus block (CPB) for thyroidectomy with dexmedetomidine added as an adjuvant to bupivacaine. The primary outcome was the duration of analgesia defined as the time till the first request for rescue analgesia. The secondary outcomes were the total amount of fentanyl consumed intraoperatively, total patient's opioids requirements within 24 h postoperative, VAS, and complications.</p><p><strong>Methods: </strong>This randomized controlled double-blinded study included 60 patients aged 18 to 60 years, all of whom underwent thyroidectomy for thyroid cancer. Patients were randomly allocated into two equal groups, the B Group (n = 30) received bilateral intermediate CPB, with 20 ml bupivacaine 0.25%, and the DB Group (n = 30) received bilateral intermediate CPB with 20 ml of bupivacaine 0.25% plus 1 µg/kg dexmedetomidine.</p><p><strong>Results: </strong>The DB Group showed a significantly longer duration of analgesia (p < 0.001), significantly less total intraoperative fentanyl consumption (p = 0.005), and significantly less total postoperative morphine consumption (p < 0.001). Also, postoperative pain scores, heart rate, and mean arterial pressure were significantly lower in the DB group than in the B Group and sometimes points.</p><p><strong>Conclusions: </strong>The addition of dexmedetomidine to bupivacaine in ultrasound-guided intermediate CPB for thyroidectomy significantly prolonged analgesia and reduced postoperative opioid consumption.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"139"},"PeriodicalIF":2.3,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934596/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708108","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}