BMC Anesthesiology最新文献

{"title":"Outcomes of rhomboid intercostal plane block on local anaesthesia in cardiac implantable electronic device implantation: a randomized controlled clinical trial.","authors":"Gozde Altun, Ayla Esin, Yasemin Ozsahin, Sukru Arslan, Kerem Erkalp, Ziya Salihoglu","doi":"10.1186/s12871-025-03206-8","DOIUrl":"10.1186/s12871-025-03206-8","url":null,"abstract":"","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"328"},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12220544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538935","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":"Optic nerve sheath diameter is associated with postoperative delirium in patients undergoing open heart surgery.","authors":"Aynur Kaynar, Özgür Kömürcü, Esma Bahşi, Ahmet Ozan Aydın, İlker Hasan Karal, Dilan Akyurt, Serkan Tulgar, Mustafa Süren","doi":"10.1186/s12871-025-03194-9","DOIUrl":"10.1186/s12871-025-03194-9","url":null,"abstract":"<p><strong>Background: </strong>Increased intracranial pressure is a possible cause of postoperative delirium in open heart surgery patients. Optic nerve sheath diameter is a non-invasive measurement method used to monitor intracranial pressure changes. The authors suggested in this study that optic nerve sheath diameter monitoring could identify patients at risk of postoperative delirium.</p><p><strong>Method: </strong>This prospective observational study was conducted by evaluating data from 90 patients undergoing open heart surgery. Optic nerve sheath diameter in patients was recorded before and after anesthesia induction, before and after cardiopulmonary bypass, and after intensive care transfer. Postoperative delirium was evaluated with the Confusion Assessment Method for the Intensive Care Unit scale.</p><p><strong>Results: </strong>The study was completed with 90 patients and postoperative delirium was observed in 20 of the patients (22.2%). Optic nerve sheath diameter (OR, 5.787; 95% CI, 1.489-22.496; P = 0.011), history of alcohol use (OR, 6.032; 95% CI, 1.052-34.604; P = 0.044), and EuroSCORE II (OR, 3.090; 95% CI, 1.453-6.571; P = 0.003) was associated with postoperative delirium.</p><p><strong>Conclusions: </strong>Optic nerve sheath diameter measured by ultrasonography is associated with postoperative delirium. The increase in optic nerve sheath diameter can be used predictively for postoperative delirium in open heart surgery.</p><p><strong>Trial registration: </strong>Samsun University Samsun Training and Research Hospital, following ethics committee approval (Samsun University clinical research ethics committee (KAEK) 2023 11/7) and Clinical Trials (NCT05942183 / 05.09.2024) registration.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"309"},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12210449/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538934","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 clinical significance of thrombocytopenia in sepsis and septic shock: a systematic review and meta-analysis.","authors":"Basel F Alqeeq, Mohammed Ayyad, Maram Albandak, Waseem J Almadhoun, Mahmoud Kullab, Ahmed W Ghabayen, Mohammed Al-Tawil","doi":"10.1186/s12871-025-03188-7","DOIUrl":"10.1186/s12871-025-03188-7","url":null,"abstract":"<p><strong>Background: </strong>Thrombocytopenia (TCP) is a common finding in critically ill patients that has been linked to a worse prognosis. Specifically, sepsis is a major risk factor for TCP. Several observational studies have examined the prognostic role of TCP and its correlation with clinical outcomes in patients with sepsis.</p><p><strong>Methods: </strong>We conducted a systematic search through Medline, Scopus and CENTRAL, from inception until June 2024, in order to identify studies that discussed the effects of TCP on clinical outcomes in patients with sepsis or septic shock. This review was performed in accordance with the Meta-Analysis of Observational Studies in Epidemiology (MOOSE) guidelines. Study endpoints were ICU mortality, 28-day mortality, major bleeding and mechanical ventilation.</p><p><strong>Results: </strong>We included twelve studies enrolling 14,093 patients in this meta-analysis. TCP was diagnosed at intensive care unit (ICU) admission in 5481 (39%) patients; on the other hand, it was encountered during the course of ICU stay in 1474 (10%) cases. Patients with TCP had significantly higher risks of ICU mortality (Odds Ratio: 1.93, 95% CI [1.6-2.33]; p < 0.01). and 28-day mortality (odds ratio: 1.98, 95% CI [1.67, 2.35]; p < 0.00001). Furthermore, patients with severe TCP (platelet count < 50 * 10⁹/L) had even higher odds of ICU mortality (odds ratio: 3.38, 95% CI [2.25, 5.08]; p < 0.00001). Major bleeding events were significantly more frequent in patients with TCP (odds ratio: 3.26, 95% CI [2.26, 4.72]; p < 0.01).</p><p><strong>Conclusion: </strong>TCP exhibits significant clinical implications in critically ill patients admitted with sepsis and is associated with enhanced mortality and worse clinical outcomes. Nonetheless, this meta-analysis quantifies the significant association between TCP and poor clinical outcomes in patients with sepsis and septic shock.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"327"},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12211875/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538940","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":"Ultrasonic volume assessment-guided successful rescue of cardiac arrest caused by intraoperative severe anaphylactic shock: a case report.","authors":"Yin-Guang Yao, Zhi-Lan Dou, Fang Zheng, Kai-Lai Zhu, Jian-Wei Zhou, Jian Zhou, Chuan-Guang Wang","doi":"10.1186/s12871-025-03189-6","DOIUrl":"10.1186/s12871-025-03189-6","url":null,"abstract":"<p><strong>Background: </strong>Perioperative anaphylaxis (POA) is a potentially life-threatening event. The incidence of POA is on the rise, but few case reports are available on cardiac arrest caused by post-anesthesia anaphylactic shock especially those successfully rescued under the guidance of ultrasonic volume assessment.</p><p><strong>Case presentation: </strong>We herein report a case of cardiac arrest caused by intraoperative anaphylactic shock. A patient was admitted to the hospital due to left lumbar pain for two days and was diagnosed with left renal and ureteral calculi accompanied by hydronephrosis and infection. She was scheduled to undergo transurethral flexible ureteroscopic lithotripsy for bilateral renal and ureteral calculi under general anesthesia. Refractory hypotension occurred intraoperatively, so vasoactive drugs were applied, but the effect was unsatisfactory and cardiac arrest occurred later. At that time, the patient did not develop common allergic symptoms such as rash. After cardiopulmonary resuscitation (CPR), the patient's heart rate recovered, but she still presented with persistent hypotension. After the anesthesiologist carried out ultrasonic volume assessment-guided fluid resuscitation, the patient experienced systemic rash, in which case severe anaphylactic shock was confirmed. After epinephrine and antianaphylactic treatment were given, the patient's vital signs tended to become stable, and the operation was successfully completed.</p><p><strong>Conclusion: </strong>With the assistance of the medical team, we successfully rescued a patient with cardiac arrest caused by intraoperative severe anaphylactic shock under the guidance of ultrasonic volume assessment. The operation was successfully completed, and the patient was discharged two days postoperatively and had a good prognosis.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"308"},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12210719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of pneumoperitoneum pressure on cardiac output in laparoscopic surgery.","authors":"Fuwei Qi, Bing Wang, Fan Fei, Qiang Guo, Zhong Zheng, Guangyu Yang, Ke Li","doi":"10.1186/s12871-025-03111-0","DOIUrl":"10.1186/s12871-025-03111-0","url":null,"abstract":"<p><strong>Objective: </strong>To assess the impact of pneumoperitoneum pressure on cardiac output (CO) in patients undergoing laparoscopic surgery using transesophageal echocardiography.</p><p><strong>Methods: </strong>Fifty patients (26 men, 24 women; age, 55-85 years old) who scheduled for laparoscopic colorectal cancer resection under general anesthesia at the First People's Hospital of Taicang (March 2021-December 2022) were enrolled. Patients were randomly assigned to three groups based on pneumoperitoneum pressure: group A (10 mmHg), group B (12 mmHg), and group C (14 mmHg). Left ventricular outflow tract diameter (LVOT) and velocity time integral (VTI) were measured using transesophageal echocardiography to calculate CO).</p><p><strong>Results: </strong>Baseline characteristics and intraoperative data were comparable among groups (P > 0.05). Post-anesthesia, heart rate, mean arterial pressure (MAP), systolic blood pressure (SBP), and diastolic blood pressure (DBP) showed no significant differences among groups (P > 0.05). However, CO in all groups was lower than normal reference values after anesthesia induction (P < 0.05) and further declined following pneumoperitoneum establishment (P < 0.05). Group C exhibited significantly lower CO than Groups A and B five minutes after pneumoperitoneum initiation (P < 0.05).</p><p><strong>Conclusion: </strong>Pneumoperitoneum pressure significantly impacts CO during laparoscopic surgery. Transesophageal echocardiography provides an effective method for monitoring hemodynamic changes and optimizing perioperative management.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"317"},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12211448/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538919","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 high-flow nasal cannula oxygen therapy on the postoperative atelectasis in interventional sclerotherapy: a randomized controlled trial.","authors":"Mai Zifeng, Zhuo Ming, Zhang Longfei, Luo Hao, Han Rui, Wang Lifeng, Zhong Maolin","doi":"10.1186/s12871-025-03192-x","DOIUrl":"10.1186/s12871-025-03192-x","url":null,"abstract":"","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"303"},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12211795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538877","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":"Hemicorporectomy in the ICU: a complex case report.","authors":"Havva Kocayiğit, Burcu Can, Fevzi Sağlam, Ali Fuat Erdem","doi":"10.1186/s12871-025-03184-x","DOIUrl":"10.1186/s12871-025-03184-x","url":null,"abstract":"","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"304"},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12210823/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538918","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":"Parascapular sub-iliocostalis plane block for postoperative analgesia in patients with multiple rib fractures: a randomized controlled trial.","authors":"Qiji Ju, Ping Li, Long Zhang, Liangguang Zhang, Guanyi Liu, Liyong Yuan, Miao Zhu","doi":"10.1186/s12871-025-03181-0","DOIUrl":"10.1186/s12871-025-03181-0","url":null,"abstract":"","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"301"},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12211428/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538936","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":"Nebulization with differently sized 2% lidocaine atomized particles in awake tracheal intubation by video laryngoscopy: a proof-of-concept randomized trial.","authors":"Chenxi Li, Mingyang Sun, Luyao Zhang, Guangzhi Wang, Jie Lu, Zhongcong Xie, Jiaqiang Zhang","doi":"10.1186/s12871-025-03178-9","DOIUrl":"10.1186/s12871-025-03178-9","url":null,"abstract":"<p><strong>Background: </strong>Optimization of the individual topicalization technique during awake tracheal intubation (ATI) is critical, but how to accomplish this is still unknown. We hypothesized that there would be a difference between nebulization with different sizes of 2% lidocaine atomized particles in ATI by video laryngoscopy.</p><p><strong>Methods: </strong>A total of 230 patients scheduled for ATI were recruited from September 2024 through January 2025. Forty-six participants were excluded, and 184 participants were randomly assigned to 4 treatment groups according to the size of the atomized particles of 2% lidocaine: A3 (3-4 μm), A6 (6-7 μm), A9 (9-10 μm), or A11 (11-12 μm).</p><p><strong>Results: </strong>There were statistically significant differences among the four groups. Post hoc analysis using Dunnett test showed that, compared with the A3 group, the A9 group had greater feelings of comfort (cough score: P = 0.005; reaction score: P = 0.024; discomfort score: P = 0.003). the A9 group had lower heart rates at endotracheal tube insertion(P = 0.015), at inflation of the tracheal tube cuff (P = 0.001) and 1 min after endotracheal tube insertion(P = 0.009); The A9 group had fewer applications of the airway spray and fewer times the patient vomited (P<0.001), but exhibited a longer nebulization time (P<0.0001).</p><p><strong>Conclusion: </strong>In conclusion, we demonstrated that there were differences between nebulization with different sizes of 2% lidocaine atomized particles in ATI. In addition, 2% lidocaine administered via a nebulizer with 9-10-µm atomized particles performed better during ATI. Therefore, we recommend a nebulizer and the 9-10-µm particle-size range for patients who need ATI.</p><p><strong>Trial registration: </strong>Clinicaltrials.gov, NCT06420947. Date of Registration: May 12th, 2024.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"321"},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12211172/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538933","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":"Propofol-assisted deep extubation in the dental treatment of pediatrics: a randomized controlled triple-blind trial.","authors":"Wei Cui, Xiang Zhang, Ying Shang, Yun Liu","doi":"10.1186/s12871-025-03170-3","DOIUrl":"10.1186/s12871-025-03170-3","url":null,"abstract":"<p><strong>Objectives: </strong>To verify whether propofol-assisted deep extubation is associated with fewer complications in pediatric patients undergoing dental treatment.</p><p><strong>Materials and methods: </strong>This prospective study enrolled 60 pediatric candidates undergoing elective dental interventions, with randomized allocation to either deep extubation (DE; n = 30) or awake extubation (AE; n = 30) protocols. The primary endpoint was the incidence of at least 1 respiratory adverse event, whereas time to extubation (TOE), time to wake-up (TOW), hemodynamic fluctuations during extubation, incidence of emergence agitation (EA), nasal obstruction, epistaxis, sore throat, and hoarse voice after extubation were the secondary endpoints.</p><p><strong>Results: </strong>The DE group reported significantly lower incidence of at least 1 respiratory adverse event (0.0% VS 23.3%, P = 0.016). The TOE was significantly shorter in the DE group, averaging 2.78 ± 0.87 min, compared to 5.50 ± 1.01 min in the AE group (P < .001). The TOW was longer in the DE group, with an average of 15.03 ± 3.44 min compared to 10.63 ± 1.52 min in the AE group (P < .001). The average value of mean arterial pressure (AVMAP) during extubation was lower in the DE group at 74.70 ± 13.35 mmHg, compared to 87.43 ± 15.31 mmHg in the AE group (P < .001). The average value of heart rate (AVHR) in the DE group was 108.37 ± 13.41 bpm, while in the AE group, it was 127.93 ± 20.74 bpm (P < .001). Additionally, the rates of sore throat and hoarse voice were significantly lower in the DE group (6.7% and 3.3%) than in the AE group (27% and 30%).</p><p><strong>Conclusions: </strong>For pediatric patients undergoing dental treatment, propofol-assisted deep extubation is superior, allowing for less extubation time without increasing airway complications. This technique provides a smoother extubation with fewer hemodynamic fluctuations and lower incidences of voice hoarseness and persistent coughing, provided that certain rules for deep extubation are followed.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"300"},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12210731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538939","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}