BMC Anesthesiology最新文献

{"title":"Comparison of sacovlm™ video laryngeal mask-guided intubation and fastrach combined with flexible bronchoscopy-guided intubation -a prospective study.","authors":"Yusuf Ozguner, Umut Can Özağar, Seyyid Furkan Kına, Atakan Sezgi, Savaş Altınsoy, Julide Ergil","doi":"10.1186/s12871-025-03172-1","DOIUrl":"10.1186/s12871-025-03172-1","url":null,"abstract":"<p><strong>Background: </strong>Laryngeal masks (LMA) are significant in airway management. The newly developed video LMA (SaCoVLM™) allows direct visualization. In our study, we sought to compare the success of intubation between the SaCoVLM™ and the Fastrack LMA using fiberoptic bronchoscopy guidance. Our primary objective was total intubation time, while our secondary objective was postoperative complications.</p><p><strong>Methods: </strong>Patients (101) intubated with the SaCoVLM™ were categorized as Group V, while those intubated with the Fastrach LMA were categorized as Group F. LMA placement time, intubation time, total intubation time, and postoperative complications within the first 24 h were followed.</p><p><strong>Results: </strong>We found a shorter total intubation time with the SaCoVLM™. Moreover, patients in the Fastrack LMA experienced a higher incidence of sore throat and a greater frequency of blood-stained supraglottic airway devices (SADs). (p < 0.05).</p><p><strong>Conclusions: </strong>We found that the SaCoVLM™ is an effective alternative to the Fastrack LMA in terms of LMA placement success and intubation success.</p><p><strong>Trial registration: </strong>NCT06121895.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"315"},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12211361/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538874","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 Intranasal dexmedetomidine and esketamine for premedication on postoperative pain after tonsillectomy and adenoidectomy in children: a randomized clinical trial.","authors":"Jun-Wei Qi, Chuang Li, Xin-Yuan Qiu, Xin-Ge Wen, Hua Yin, Qing-Ling Meng, Li Li, Qian Zhang, Yue-Ying Zhang","doi":"10.1186/s12871-025-03203-x","DOIUrl":"10.1186/s12871-025-03203-x","url":null,"abstract":"<p><strong>Background: </strong>Postoperative acute pain is a common issue in children after surgery. Our study aimed to investigate whether preoperative use of a dexmedetomidine-esketamine combination could reduce postoperative pain in children undergoing tonsillectomy and adenoidectomy and reduce side effects, such as bradycardia, hypotension or emergence delirium.</p><p><strong>Methods: </strong>In this double-blind, randomised controlled clinical trial, 180 children were randomly assigned to 3 groups. 30 min before surgery, the control group received 0.9% saline intranasally (Group C), the dexmedetomidine group received intranasal dexmedetomidine at 2.0 μg·kg^-1 (Group D), and the combination group received intranasal dexmedetomidine at 1.0 μg·kg^-1 and esketamine at 0.6 mg·kg^-1 (Group DS). The primary outcome was the area under the curve (AUC) of the pain score within 24 h after surgery. Secondary outcomes included the incidence of emergence delirium (ED), pain scores after hospital discharge, and incidence of perioperative adverse events.</p><p><strong>Results: </strong>A total of 173 children completed the study. The AUC of the pain score at rest within 24 h after surgery was 37.25 (20.25-51.75) in Group C, which was higher than those in Groups D (19.25 [12.50-39.13], P < 0.001) and DS (9.50 [9.00-16.25], P < 0.001). Compared with the control group, the DS group had a lower incidence of ED (12.3% vs. 44.8%, P = 0.001). Heart rates (HRs) in groups DS (P < 0.001) and C (P < 0.001) were higher than those in the dexmedetomidine group at all time points. No serious adverse events occurred.</p><p><strong>Conclusions: </strong>Intranasal dexmedetomidine combined with esketamine for premedication was associated with reduced postoperative pain in children. It can also prevent ED and had fewer side effects.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"330"},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12217526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538911","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":"Pediatric fascial plane blocks: an educational review with technique, tips & tricks.","authors":"Can Aksu, Hadi Ufuk Yörükoğlu, Sevim Cesur, Alparslan Kuş","doi":"10.1186/s12871-025-03193-w","DOIUrl":"10.1186/s12871-025-03193-w","url":null,"abstract":"<p><p>Pain management in pediatric patients is of utmost importance to ensure their well-being and prompt recovery. Current analgesia methods are not always sufficient, leading to suboptimal pain control and increased morbidity. Almost 80% of patients undergoing surgery experience postoperative pain. Results of many studies show that treatment of postoperative pain in children is inadequate. As such, in recent years, there has been growing interest in fascial plane blocks. Fascial plane blocks involve the injection of local anesthetics into the fascial planes surrounding targeted nerves, providing prolonged analgesia with reduced risk of systemic side effects. Studies have shown the efficacy of fascial plane blocks in providing effective analgesia for a variety of surgical procedures, including abdominal, thoracic, and orthopedic surgeries. With careful patient selection and appropriate technique, use of fascial plane blocks in pediatric patients can improve the quality of postoperative pain management, reducing the risk of adverse effects associated with systemic analgesics or well-known classical neuraxial regional anesthesia techniques. In addition to better pain control, the use of fascial plane blocks, as a part of multimodal analgesia regimen, may also reduce the need for opioid analgesics, thereby decreasing the risk of opioid-related adverse effects such as respiratory depression. In conclusion, fascial plane blocks represent a promising alternative to traditional analgesia methods for pediatric patients undergoing surgery. While further research is needed to establish their safety and efficacy for specific procedures in pediatric patients, the available evidence suggests that they may offer significant benefits in terms of pain management. Although fascial plane blocks are volume-dependent techniques, to minimize the risk of local anesthetic systemic toxicity, it is advisable to avoid using more than 0.3-0.5 mL/kg of local anesthetic and to prefer lower concentrations.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"320"},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12211297/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538938","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 two different partial pressure of end-tidal carbon dioxide levels on cardiac function in patients undergoing carotid endarterectomy: a randomized controlled trial.","authors":"Pei Wang, Chuanyu Liang, Yi An, Lixia Li, Zhongjia Li, Xuefei Jia, Hongyi Song, Tianlong Wang, Lei Zhao","doi":"10.1186/s12871-025-03186-9","DOIUrl":"10.1186/s12871-025-03186-9","url":null,"abstract":"<p><strong>Background: </strong>Most patients undergoing carotid endarterectomy (CEA) are complicated with coronary artery disease and at high risk for cardiovascular events. This study aims to regulate cerebral blood flow by adjusting the level of partial pressure of end-tidal carbon dioxide (P_ETCO₂) to reduce intraoperative blood pressure fluctuations and improve cardiac function.</p><p><strong>Methods: </strong>In this randomized controlled trial, we randomly assigned 44 patients to receive a P_ETCO₂ target of 45-50mmHg during carotid artery occlusion and 30-35mmHg after opening, and 44 patients to receive a P_ETCO₂ target of 35-45mmHg throughout the operation. The primary outcome was E/e' (the peak velocity of early filling/the early diastolic mitral annular velocity). Secondary outcomes included global longitudinal strain (GLS) of the left ventricular myocardium, dMAP (the change rate of mean arterial pressure relative to the baseline level) and the incidence of postoperative complications.</p><p><strong>Results: </strong>Sixty nine patients were finally included, 34 patients in the control group and 35 patients in the intervention group. No significant differences were found between the groups for E/e' (P = 0.614), GLS (P = 0.231), or the incidence of postoperative complications (P > 0.05). The dMAP of patients during carotid artery occlusion in the intervention group was lower than that in the control group (9.1% ±10.5% vs 14.3% ±9.2%, P < 0.05).</p><p><strong>Conclusions: </strong>P_ETCO₂ did not have a significant impact on cardiac function.</p><p><strong>Trial registration: </strong>This trial was registered on the Chinese Clinical Trial Registry ( http://www.chictr.org.cn , ChiCTR2100049772; August 9, 2021).</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"318"},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12210760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538914","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":"Intraoperative titration of positive end-expiratory pressure in urological patients undergoing laparoscopic procedures under lateral position: a randomized controlled trial.","authors":"Lili Pan, Xing Wu, Lingling Gao, Zhanqi Zhao, Li Yang, Jun Zhang","doi":"10.1186/s12871-025-03171-2","DOIUrl":"10.1186/s12871-025-03171-2","url":null,"abstract":"","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"311"},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12210696/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538920","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 effects of prone position on optic nerve sheath diameter and intraocular pressure in elective lumbar disc surgery.","authors":"Resmi Hakan Adas, Sule Batcik, Tolga Koyuncu","doi":"10.1186/s12871-025-03204-w","DOIUrl":"10.1186/s12871-025-03204-w","url":null,"abstract":"","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"324"},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12210980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538941","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 effects of remimazolam and propofol on delirium following anesthesia and sedation in elderly patients: a systematic review and meta-analysis.","authors":"Anhong Li, Yuancheng Zhou, Linjie Wu, Bailong Hu","doi":"10.1186/s12871-025-03167-y","DOIUrl":"10.1186/s12871-025-03167-y","url":null,"abstract":"","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"312"},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12211366/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538942","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 and safety of esketamine hydrochloride injection at different dosages for patients undergoing radical thyroidectomy for thyroid cancer: a randomized trial.","authors":"Yihuan Luo, Hua Fang","doi":"10.1186/s12871-025-03174-z","DOIUrl":"10.1186/s12871-025-03174-z","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to the combination of remimazolam toluene sulfonate and esketamine hydrochloride in reducing postoperative complications and improving recovery outcomes in thyroid surgery patients.</p><p><strong>Methods: </strong>One hundred twenty patients undergoing radical thyroidectomy were randomly assigned to four groups: control group (Group C) and three esketamine groups (Groups S1, S2, S3). Before peeling, groups S1, S2, and S3 were administered with 0.15, 0.25, and 0.35 mg/kg of esketamine via slow intravenous injection, respectively. The primary outcomes was recovery quality (QoR-15). Secondary outcomes included postoperative pain (NRS scores), incidence of coughing (Minogue score), hemodynamic stability, emotional recovery (HADS scores), extubation time, adverse reactions, and sufentanil consumption.</p><p><strong>Results: </strong>Baseline data showed no significant differences (p > 0.05). Pain and HADS scores were significantly lower in Groups S2 and S3 (p < 0.05). QoR-15 scores were significantly higher in all esketamine groups (p < 0.05). Postoperative recovery and extubation times were longer in Groups S2 and S3 (p < 0.05), with Group S3 having the longest. Postoperative cough severity and incidence were significantly lower in Groups S2 and S3 (p < 0.05). HR and SBP increased at t1 in Groups S2 and S3 but normalized by t4, with less pronounced changes in Group S2. No significant differences in adverse reactions (p > 0.05).</p><p><strong>Conclusion: </strong>Esketamine at doses of 0.25 mg/kg/h and 0.35 mg/kg/h improves recovery, reduces pain and coughing, and maintains hemodynamic stability. A dose of 0.25 mg/kg/h offers optimal clinical benefits with faster recovery.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"307"},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12211291/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538916","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":"Acute hyperammonemic encephalopathy masquerading as postoperative delirium in a patient who underwent lung surgery: a case report.","authors":"Chao-Qin Chen, Zhen-Ping Hu, Xu-Jie Ma, Xiao-Dong Tang, Xia Zheng, Yong-Xing Yao","doi":"10.1186/s12871-025-03202-y","DOIUrl":"10.1186/s12871-025-03202-y","url":null,"abstract":"<p><strong>Background: </strong>Acute hyperammonemic encephalopathy (AHE) is a life-threatening condition. Hyperammonemia-induced mental disorders that appear after surgery and general anesthesia can be easily confused with postoperative delirium, especially in patients without signs of liver dysfunction. Currently, no reports of AHE precipitated by operative stress or general anesthesia exists. Here, we describe a patient without obvious liver dysfunction who developed AHE after general anesthesia and was diagnosed with postoperative delirium. Gene sequencing revealed that the patient had ornithine transcarbamylase deficiency (OTCD), which led to AHE and hepatic coma.</p><p><strong>Case presentation: </strong>A 41-year-old man with a history of mild hypertension and depression was scheduled to undergo lung wedge resection under general anesthesia. Laboratory examination revealed low blood urea nitrogen levels. The anesthesia and surgery were uneventful. Four hours after returning to the surgical ward, the patient experienced agitation and developed mental disorders. His Confusion Assessment Method score was positive, and the Nursing Delirium Screening Scale score was 6; therefore, he was medically treated for postoperative delirium. However, his symptoms did not improve over the following days. On the 3rd postoperative day, the patient became unconscious and experienced limb twitching. Blood analysis revealed severe hyperammonemia (498 µmol/L) and respiratory alkalosis. Consequently, the patient underwent tracheal intubation and continuous venovenous hemodiafiltration, along with comprehensive supportive treatments, including intracranial pressure reduction and antiviral and gamma globulin therapy. However, the patient's serum ammonia level remained high. A computed tomography scan of the head revealed diffuse cerebral swelling. On the ninth postoperative day, the patient remained in a deep coma, with loss of brainstem reflex and brain electrical activity, at which point the treatment was terminated by family members. Postmortem genetic sequences revealed that the patient had OTCD.</p><p><strong>Conclusions: </strong>AHE following general anesthesia with no evidence of liver failure can be easily misdiagnosed because of its non-characteristic clinical features. We recommend that in patients who experience refractory mental disorders after surgery, clinicians should remain vigilant for signs of hyperammonemia.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"326"},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12210529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538872","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":"Unilateral postoperative visual loss after percutaneous nephrolithotomy: a case report.","authors":"Guolin Xu, Yuqing Wang, Qing Zhang, Wenjun Yao, Xiaosan Wu, Rui Li","doi":"10.1186/s12871-025-03190-z","DOIUrl":"10.1186/s12871-025-03190-z","url":null,"abstract":"<p><p>Postoperative visual loss (POVL) after non-ocular surgeries is rare, and its occurrence following percutaneous nephrolithotomy (PCNL) is exceedingly uncommon. A 60-year-old male with hypertension and type 2 diabetes mellitus underwent PCNL in the prone position for a right renal calculus. Shortly after surgery, he reported unilateral visual loss. Ophthalmologic assessment revealed profound vision impairment in the right eye. Imaging confirmed occlusion of the right ophthalmic artery. A multidisciplinary team including ophthalmology, neurology, and interventional radiology coordinated prompt intervention. Emergency intra-arterial thrombolysis restored blood flow and led to gradual recovery of visual function. This case illustrates a rare but serious complication of POVL due to ophthalmic artery occlusion after PCNL. Prompt recognition and timely multidisciplinary intervention were key to successful visual recovery. Clinicians should remain vigilant for POVL in high-risk patients undergoing prone-position surgeries.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"310"},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12211418/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538923","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}