BMC Anesthesiology最新文献

{"title":"Effect of esketamine on postoperative delirium in general anesthesia patients undergoing elective surgery: a meta-analysis of randomized controlled trials.","authors":"Wenhui Zhang, Di Wang, Siru Li, Yutao Chen, Congjie Bi","doi":"10.1186/s12871-024-02833-x","DOIUrl":"10.1186/s12871-024-02833-x","url":null,"abstract":"<p><strong>Background: </strong>Postoperative delirium is a common neurological complication, especially in older patients undergoing surgery, which is closely related to the poor prognosis of patients. The objective was to investigate the effects of esketamine on postoperative delirium in patients with general anesthesia.</p><p><strong>Methods: </strong>The databases of PubMed, Embase, Cochrane Library and the Chinese National Knowledge Infrastructure were searched for all available randomised controlled trials on the effects of esketamine induction on postoperative delirium in patients undergoing elective general anesthesia from inception until April 21, 2024. We used RevMan5.4 software for data analysis. Dichotomous data was analyzed by risk ratios(RR) with a 95% confidence interval(CI), and continuous data by mean differences(MD). We also evaluated the risk of literature bias using the Cochrane Bias Risk Assessment tool.</p><p><strong>Results: </strong>We included a total of 17 randomized controlled trials, including 1286 patients undergoing elective general anesthesia. In 17 studies, esketamine significantly reduced the incidence of postoperative delirium (RR: 0.43; 95%CI: 0.33 ~ 0.57; p < 0.001). Five studies examined the incidence of postoperative adverse events (nausea, vomiting, dizziness and resporatory depression) and showed no statistically significant difference between the esketamine group and the control group (normal saline or dexmedetomidine) (RR: 0.82; 95%CI: 0.65 ~ 1.03; p = 0.08). In addition, this study found that the esketamine group had a lower incidence of hypotension (RR: 0.24; 95%CI: 0.12 ~ 0.48; p < 0.001) and a lower score on the visual analogue scale 24 h after surgery (MD: -0.44; 95%CI: -0.54 ~ -0.33; p < 0.001).</p><p><strong>Conclusion: </strong>According to our meta-analysis, the use of esketamine during anesthesia induction significantly reduced the incidence of postoperative delirium in patients undergoing elective general anesthesia without increasing the incidence of postoperative adverse reactions.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"24 1","pages":"442"},"PeriodicalIF":2.3,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11603621/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142750010","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 acetaminophen use with mortality and renal recovery in patients with sepsis-associated acute kidney injury.","authors":"Long-Zhu Li, Lu-Ming Zhang, Yan Ye, Qing Su, Kan Fat Leong, Hai-Yan Yin, Wan-Jie Gu, Min Ma","doi":"10.1186/s12871-024-02756-7","DOIUrl":"10.1186/s12871-024-02756-7","url":null,"abstract":"<p><strong>Background: </strong>Sepsis-associated acute kidney injury (SA-AKI) is common and associated with poor outcomes in critically ill patients. Acetaminophen is often used as an antipyretic and analgesic drug, but the association of acetaminophen use with mortality and recovery of renal function in SA-AKI patients remain unclear. We aimed to investigate the association between acetaminophen use and outcomes in SA-AKI patients.</p><p><strong>Methods: </strong>This is a retrospective cohort study based on the MIMIC-IV database. Adult patients with SA-AKI were included in the analysis. The exposure was acetaminophen use within 7 days after the onset of SA-AKI. The primary outcome was 28-day mortality. Secondary outcomes included ICU mortality, in-hospital mortality, 90-day mortality, 1-year mortality, and renal recovery. Cox proportional hazards regression models were used to estimate the hazard ratio (HR) with 95% confidence interval (CI) for mortality. Logistic regression models were used to estimate the odd ratio (OR) with 95% CI for renal recovery.</p><p><strong>Results: </strong>6752 patients with SA-AKI were included, and 3892 (57.6%) patients received acetaminophen. Acetaminophen use was associated with decreased 28-day mortality (HR 0.69, 95% CI 0.63-0.75), ICU mortality (HR 0.56, 95% CI 0.50-0.63), in-hospital mortality (HR 0.62, 95% CI 0.57-0.69), 90-day mortality (HR 0.73, 95% CI 0.68-0.79), and 1-year mortality (HR 0.62, 95% CI 0.57-0.69). Acetaminophen use also was associated with improved renal recovery (OR 1.15, 95% CI 1.04-1.28).</p><p><strong>Conclusions: </strong>Acetaminophen use is associated with decreased mortality and improved renal recovery in SA-AKI patients.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"24 1","pages":"440"},"PeriodicalIF":2.3,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11603937/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142738457","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":"Retraction Note: Intravenous lidocaine improves postoperative cognition in patients undergoing laparoscopic colorectal surgery: a randomized, double-blind, controlled study.","authors":"Xian-Xue Wang, Jing Dai, Qi Wang, Hui-Wei Deng, Yun Liu, Gui-Fan He, Hua-Jing Guo, Ya-Lan Li","doi":"10.1186/s12871-024-02835-9","DOIUrl":"10.1186/s12871-024-02835-9","url":null,"abstract":"","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"24 1","pages":"439"},"PeriodicalIF":2.3,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11603646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142738535","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":"A comprehensive analysis of in-hospital adverse events after scopolamine administration: insights from a retrospective cohort study using a large nationwide inpatient database.","authors":"George Sun, Marc C Torjman, Kevin J Min","doi":"10.1186/s12871-024-02824-y","DOIUrl":"10.1186/s12871-024-02824-y","url":null,"abstract":"<p><strong>Background: </strong>Scopolamine is a widely used antiemetic in anesthetic practice, particularly for postoperative and post-discharge nausea and vomiting. Despite its frequent usage and recognized efficacy, concerns have emerged regarding the potential for increased side effects, particularly in elderly patients. Further research is needed to assess safety and determine age thresholds for adverse events. This study hypothesizes associations between perioperative scopolamine use, worse clinical outcomes, increased pneumonia, delirium, urinary retention, and readmissions.</p><p><strong>Methods: </strong>A large, retrospective cohort study was performed using the TriNetX Analytics Network database on patients undergoing major surgical procedures between Jan 1, 2009, and March 21, 2018, to examine the impact of perioperative scopolamine use on in-hospital adverse events. Patients were divided into age groups and compared to a control group. The primary outcomes assessed were delirium, pneumonia, in-hospital death, new antipsychotic use, readmission, and new onset urinary retention within 7 days post-surgery. 1:1 propensity score matching was performed to reduce bias. Relative risk and risk differences with 95% confidence intervals were estimated.</p><p><strong>Results: </strong>After 1:1 propensity score matching, we identified a total of 403,816 (201,908 pairs) perioperative scopolamine users and nonusers. The cohorts of 20-29, 30-39, 40-49, 50-59, 60-69, and 70 + contained 22,910 (11,455 pairs), 44,170 (22,085 pairs), 58,590 (29,295 pairs), 71,660 (35,830 pairs), 88,386 (44,193 pairs), and 118,100 (59,050 pairs) patients respectively. Across older age cohorts, after propensity score matching, perioperative scopolamine recipients had significantly increased relative risk and risk difference of delirium, pneumonia, in-hospital mortality, new antipsychotic use, readmission, and new-onset urinary retention.</p><p><strong>Conclusions: </strong>In this cohort study, perioperative scopolamine usage was associated with a significantly increased risk of in-hospital adverse events, both within the 70 + age cohort and among the 20-29, 30-39, 40-49, 50-59, and 60-69 age cohorts after major surgery. These findings highlight the need for careful assessment of scopolamine's risks and benefits, especially for patients aged 40 and older. Scopolamine may be most suited for post-discharge nausea and vomiting in ambulatory patients and clinicians should reassess its standard use for postoperative nausea and vomiting, favoring shorter-acting agents with fewer side effects.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"24 1","pages":"438"},"PeriodicalIF":2.3,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11604008/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142738454","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 thoracic epidural anesthesia and driving pressure in adult patients undergoing elective major upper abdominal surgery: a randomized controlled trial.","authors":"Xuan Li, Yi Yang, Qinyu Zhang, Yuyang Zhu, Wenxia Xu, Yufei Zhao, Yuan Liu, Wenqiang Xue, Peng Yan, Shuang Li, Jie Huang, Yu Fang","doi":"10.1186/s12871-024-02808-y","DOIUrl":"10.1186/s12871-024-02808-y","url":null,"abstract":"<p><strong>Background: </strong>Thoracic epidural anesthesia (TEA) is associated with a knowledge gap regarding its mechanisms in lung protection and reduction of postoperative pulmonary complications (PPCs). Driving pressure (ΔP), an alternative indicator of alveolar strain, is closely linked to reduced PPCs with lower ΔP values. We aim to investigate whether TEA contributes to lung protection by lowering ΔP during mechanical ventilation.</p><p><strong>Methods: </strong>In this prospective, randomized, patient and evaluator-blinded parallel study, adult patients scheduled for elective major upper abdominal surgery were assigned to either the TEA group with combined thoracic epidural anesthesia and general anesthesia (TEA-GA) (n = 30) or the control group with only general anesthesia (GA) (n = 30).</p><p><strong>Measurements: </strong>The primary outcome was the minimum ΔP determined based on positive end-expiratory pressure (PEEP) after intubation. Secondary outcomes included the incidence of PPCs within seven days, the minimum ΔP at various time points, blood gas analysis, intensive care unit (ICU) admission rates, length of hospital stay, and 30-day mortality rate.</p><p><strong>Results: </strong>The TEA group had a significantly lower minimum ΔP titrated based on PEEP compared to the control group (11.23 ± 2.19 cmH₂O vs. 12.67 ± 2.70 cmH₂O; P = 0.028). Multivariate linear regression analysis showed that intraoperative TEA application (compared with its absence; unstandardized beta coefficient (B) = -1.289; P = 0.008) significantly correlated with ΔP. The incidence of PPCs did not differ significantly between the two groups (8 of 30 [26.7%] vs. 12 of 30 [40%]; P = 0.273), but the incidence of atelectasis in the TEA group was significantly lower than in the control group (5 of 30 [16.7%] vs. 12 of 30 [40.7%]; P = 0.012). Multivariate logistic regression analysis indicated that ΔP was the only variable significantly associated with PPCs (Adjusted Odds Ratio [OR] = 2.190; 95% Confidence Interval [CI]: 1.300 to 3.689; P = 0.003).</p><p><strong>Conclusion: </strong>Compared to GA, TEA-GA can reduce intraoperative ΔP in patients undergoing major upper abdominal surgery, especially those undergoing laparoscopic surgery. However, compared to GA combined with ΔP-guided ventilation, TEA-GA combined with ΔP-guided ventilation does not reduce the risk of PPCs. There was no significant difference in the total use of various vasoactive drugs between the two groups.</p><p><strong>Trial registration: </strong>This study was registered in the Chinese Clinical Trial Registry (registration number ChiCTR2300068778 date of registration February 28, 2023).</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"24 1","pages":"434"},"PeriodicalIF":2.3,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11600644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142738456","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":"Whether monitored anesthesia care is the optimal anesthetic strategy for transcatheter aortic valve implantation surgery? a meta-analysis and systematic review.","authors":"Lili Xie, Zekun Lang, Ying Liu, Haihong Yue, Qiaoli Chen, Guiyan Tao","doi":"10.1186/s12871-024-02834-w","DOIUrl":"10.1186/s12871-024-02834-w","url":null,"abstract":"<p><strong>Objectives: </strong>To explore whether monitored anesthesia care is more beneficial to the outcome of transcatheter aortic valve implantation.</p><p><strong>Methods: </strong>The research methodology involved comprehensive searches across major databases, including the Cochrane Library, PubMed, Scopus, and Web of Science, covering the period from January 1, 2010, to March 1, 2024. The aim was to identify trials comparing different anesthetic methods for transcatheter aortic valve implantation. The primary outcomes assessed were mortality and length of hospital stay, while secondary outcomes included common complications such as bleeding, stroke, paravalvular leakage, renal failure, and others. Data synthesis was conducted using risk ratios or standardized mean differences, along with 95% confidence intervals. The study protocol was prospectively registered with PROSPERO (CRD42024507749).</p><p><strong>Results: </strong>A total of 35 trials and 45,616 patients were included in this study. The results showed that monitored anesthesia care significantly reduced the patient's risk of death, shortened the patient's length of hospital stay, and also reduced the risk of common complications such as paravalvular leakage (RR, 0.80; 95% CI: 0.72 to 0.88; p < 0.00001; I² = 0) and stroke (RR, 0.80; 95% CI: 0.65 to 0.99; p = 0.04; I² = 0).</p><p><strong>Conclusion: </strong>Monitored anesthesia care has an absolute advantage in patient survival and effectively shortens the length of hospitalization. In addition, it also reduces the risk of complications such as paravalvular leakage and stroke. Monitoring care under anesthesia plays a vital role during TAVI surgery, not only helping to ensure the smooth progress of the surgery and patient safety, but also promoting the patient's recovery and recovery.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"24 1","pages":"429"},"PeriodicalIF":2.3,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11600798/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142726123","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 Pericapsular Nerve Group (PENG) block in preoperative rehabilitation (Prehabilitation) for patients with femoral neck fractures: study protocol for a randomized, placebo-controlled, double-blinded trial.","authors":"Zhuan Jin, Daisuke Sugiyama, Fumiya Higo, Takahiro Hirata, Osamu Kobayashi, Hiroshi Morimatsu, Kenichi Ueda","doi":"10.1186/s12871-024-02620-8","DOIUrl":"10.1186/s12871-024-02620-8","url":null,"abstract":"<p><strong>Background: </strong>Despite surgery intervention for femoral neck fractures is recommended within 48 h of admission, achieving timely surgery presents challenges for patients with severe comorbidities, or in resource-limited settings. Preoperative rehabilitation (prehabilitation) reduces bedridden time, enhances mobility, and improves postoperative outcomes for patients scheduled for hip arthroplasty due to femoral neck fractures. However, prehabilitation is hindered by insufficient pain control. The pericapsular nerve group (PENG) block provides effective analgesia while preserving motor function. We designed a study to assess the efficacy of PENG block in facilitating prehabilitation for patients with femoral neck fractures who are scheduled for hip arthroplasty.</p><p><strong>Methods: </strong>This prospective randomized placebo-controlled double-blinded trial aims to enroll 100 patients with Garden 3 or 4 femoral neck fractures who are scheduled for hip arthroplasty. Participants will be randomly assigned to receive a PENG block with 0.375% ropivacaine (PENG group) or with normal saline (placebo group) before the initial prehabilitation session. The prehabilitation program comprises five items: Bed-sitting, Edge-sitting, Stand-up, Maintaining-standing, and Wheelchair-transfer, performed with the assistance of a single physical therapist. The primary outcome is the percentage of patients completing the entire prehabilitation program. Secondary outcomes during the initial prehabilitation session are the achievement of each program item and the Numerical Rating Scale (NRS) pain score. Other secondary outcomes include intraoperative bleeding amounts, thromboembolic events during postoperative day 0 to 7, postoperative 3-day cumulative Cumulated Ambulation Score (CAS), and discharge destination. The postoperative outcomes will be compared between subgroups of patients undergoing surgery within 48 h of admission and those undergoing surgery more than 48 h of admission.</p><p><strong>Discussion: </strong>This is the first study aiming to assess the efficacy of PENG block in prehabilitation for patients with femoral neck fractures who are scheduled for hip arthroplasty. PENG block could be beneficial, especially for patients facing delayed surgery, providing a potential treatment option during the waiting period.</p><p><strong>Trial registration: </strong>Japan Registry of Clinical Trials, jRCT1031220294, registered on August 26, 2022.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"24 1","pages":"436"},"PeriodicalIF":2.3,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11600646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142738510","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":"Effects of propofol on the electrophysiological properties of glutamatergic neurons in the ventrolateral medulla of mice.","authors":"Ya Chen, Tian Yu, Junli Jiang","doi":"10.1186/s12871-024-02813-1","DOIUrl":"10.1186/s12871-024-02813-1","url":null,"abstract":"<p><strong>Background: </strong>Propofol, a commonly used intravenous anesthetic, is associated with various respiratory adverse events, most notably different degrees of respiratory depression, which pose significant concerns for patient safety. Respiration is a fundamental behavior, with the initiation of breathing in mammals dependent on neuronal activity in the lower brainstem. Previous studies have suggested that propofol-induced respiratory depression might be associated with glutamatergic neurons in the pre-Bötzinger complex (preBötC), though the precise mechanisms are not well understood. In this study, we classify glutamatergic neurons in the brainstem preBötC using whole-cell patch-clamp techniques and investigate the effects of propofol on the electrophysiological properties of these neurons. Our findings aim to shed light on the mechanisms of propofol-induced respiratory depression and provide new experimental insights.</p><p><strong>Methods: </strong>We first employed electrophysiological techniques to classify glutamatergic neurons within the preBötC as Type-1 or Type-2. Following this classification, we applied varying concentrations of propofol through bath application to examine its effects on the electrophysiological properties of each type of glutamatergic neuron.</p><p><strong>Results: </strong>We found that Type-1 neurons exhibited a longer latency in excitation, while Type-2 neurons did not show this delayed excitation. On this basis, we further observed that bath application of propofol at concentrations of 5 μM and 10 μM shortened the latency period of Type-1 glutamatergic neurons but did not affect the latency period of Type-2 glutamatergic neurons.</p><p><strong>Conclusion: </strong>Our study focuses on the glutamatergic neurons in the preBötC of adult mice. It introduces a novel method for classifying these neurons and reveals how propofol affects the activity of the two different types of glutamatergic neurons within the preBötC. These findings contribute to understanding the cellular basis of propofol-induced respiratory depression.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"24 1","pages":"432"},"PeriodicalIF":2.3,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11600619/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142738506","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":"Effect of Atracurium versus Cisatracurium on QT interval changes in patients undergoing cataract surgery: a randomized clinical trial.","authors":"Mehdi Karimi, Ali Ghaheri, Kianmehr Saleh, Zahra Cheraghi, Afshin Farahanchi","doi":"10.1186/s12871-024-02820-2","DOIUrl":"10.1186/s12871-024-02820-2","url":null,"abstract":"<p><strong>Background: </strong>Muscle relaxants are used during surgery, but their impact on ECG may differ, potentially affecting cardiac safety. This study aimed to compare the effects of Atracurium versus Cisatracurium on QT interval changes in patients undergoing cataract surgery.</p><p><strong>Method: </strong>This double-blind, parallel-group randomized clinical trial (RCT) was conducted in 2023 in Hamadan, Iran. A total of 80 patients undergoing cataract surgery under general anesthesia were randomly assigned to receive either Atracurium (n = 40) or Cisatracurium (n = 40). QT interval changes were measured at four time points to assess and compare the corrected QT interval (QTc) between the two groups. Data were analyzed using SPSS version 29, and a p-value < 0.05 was deemed significant.</p><p><strong>Results: </strong>Cisatracurium demonstrated significant reductions in QTc from pre-anesthesia to post-anesthesia and through recovery, with values of -9.325 ms (P = 0.045), -9.925 ms (P = 0.038), and - 19.359 ms (P = 0.016), respectively. Atracurium also showed reductions but a notable increase in QTc after anesthesia to the end of surgery (32.322 ms, P = 0.0019). Throughout the procedure, Cisatracurium maintained shorter QTc intervals compared to Atracurium (e.g., T0: 420.07 ms vs. 434.75 ms, P = 0.03), but post-recovery, no significant differences were observed (Cisatracurium: 440.05 ms; Atracurium: 439.80 ms, P = 0.489).</p><p><strong>Conclusions: </strong>Atracurium causes more QT prolongation than Cisatracurium. While both affect QTc intervals, Cisatracurium has a more stable impact on cardiac repolarization, making it safer for patients at risk of QT prolongation. Cisatracurium's minimal impact on cardiovascular function, especially in patients with low ejection fraction, makes it the preferred choice for maintaining cardiac stability.</p><p><strong>Trial registration: </strong>IRCT20120215009014N441.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"24 1","pages":"431"},"PeriodicalIF":2.3,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11600835/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142726106","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":"Preoperative evaluation: Impact on early perioperative hemodynamic and respiratory complications.","authors":"Ozgür Komurcu, Caner Genc, Betül Ciftci Kurt, Olcay Demir, Asuman Akbaş, Dilan Akyurt, Hatice Selçuk Kuşderci, Serkan Tulgar, Mustafa Süren","doi":"10.1186/s12871-024-02821-1","DOIUrl":"10.1186/s12871-024-02821-1","url":null,"abstract":"<p><strong>Background: </strong>The impact of routine preoperative anesthesia evaluations on potential perioperative complications remains unclear. This study aimed to investigate the effect of preoperative evaluation on early perioperative hemodynamic and respiratory complications.</p><p><strong>Methods: </strong>This prospective observational study analyzed data from patients aged 18 to 80 who underwent elective surgery between October 15, 2023, and February 15, 2024. The study evaluated the effect of preoperative anesthesia evaluation on hemodynamic and respiratory complications occurring during surgery and within the first 24 h postoperatively, as well as its impact on the length of hospital stay.</p><p><strong>Results: </strong>The analysis included 1117 patients for whom complete data was available. Hemodynamic and respiratory complications were observed in 545 patients (48.7%), occurring within the first 24 h intraoperatively and postoperatively. Because no additional examinations beyond routine blood tests, radiological imaging, and electrocardiograms were performed in the preoperative period, the impact of these tests on the development of hemodynamic and respiratory complications could not be determined. There was no statistically significant association between the presence or absence of preoperative consultation and the occurrence of early perioperative hemodynamic and respiratory complications [OR (95% CI): 0.879 (0.646-1.195); P = 0.411], nor did it affect the length of hospital stay [median (IQR); 2 (3) vs. 2 (3); P = 0.245].</p><p><strong>Conclusion: </strong>While the impact of routinely requested laboratory and imaging methods before surgery could not be assessed in this study, consultations that were requested did not affect hemodynamic and respiratory complications in the early perioperative period or on the duration of hospital stay.</p><p><strong>Trial registration number: </strong>Samsun University Samsun Training and Research Hospital, following ethics committee approval (Samsun University clinical research ethics committee (KAEK) 2.12.2023) and Clinical Trials (NCT06203171 / 04.18.2024) registration.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"24 1","pages":"435"},"PeriodicalIF":2.3,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11600558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142738533","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}