BMC Anesthesiology最新文献

{"title":"A prospective randomized controlled trial comparing subpectineal and interfascial obturator nerve block techniques in preventing adductor muscle spasm during transurethral resection of bladder tumors.","authors":"Yavuz Saygılı, Halil C Köse, Selin G Köse, Ömer T Akkaya","doi":"10.1186/s12871-026-04091-5","DOIUrl":"10.1186/s12871-026-04091-5","url":null,"abstract":"<p><strong>Background: </strong>Obturator nerve block (ONB) is commonly used to prevent adductor muscle spasm during transurethral resection of bladder tumors (TURBT) involving lateral wall lesions. This study aimed to compare the clinical effectiveness and safety of ultrasound-guided subpectineal (proximal) and interfascial (distal) ONB techniques, utilizing an anatomically tailored dosing regimen adapted to the targeted fascial compartments.</p><p><strong>Methods: </strong>This prospective randomized controlled trial included 60 patients scheduled for elective TURBT under spinal anesthesia. Patients were randomly allocated into two equal groups: subpectineal ONB (Group I, n = 30), which received a single 10 mL bolus of 0.375% bupivacaine into the single subpectineal plane, and interfascial ONB (Group II, n = 30), which received a total of 20 mL of 0.375% bupivacaine split into two separate 10 mL injections for the two distinct interfascial planes. Intraoperative adductor muscle spasm was evaluated by a blinded surgeon using a 4-grade scale (Grades I-IV). The primary outcome was the block success rate, defined as the absence of severe spasm (Grade IV) requiring rescue general anesthesia.</p><p><strong>Results: </strong>Baseline demographic characteristics and the number of needle insertions were similar between the groups. No vascular puncture, hematoma, or bladder perforation occurred. The descriptive block success rate was high in both groups, reaching 86.7% (95% Confidence interval: 74.6% to 98.8%) in Group I and 93.3% (95% Confidence Interval: 84.4% to 100%) in Group II, with no statistically significant difference observed (p = 0.671).</p><p><strong>Conclusions: </strong>Both ultrasound-guided ONB techniques demonstrate high descriptive clinical success rates when utilizing an anatomically tailored dosing regimen. Although the non-significant p-value must be interpreted with caution due to sample size limitations, both approaches provide viable and effective options for preventing severe adductor muscle spasm during lateral wall TURBT.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT07481123 (retrospectively registered on 02 March 2026).</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149219860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative analgesic outcomes of fascia iliaca compartment block versus pericapsular nerve group block in hip fracture surgery: a retrospective observational study.","authors":"Sevim Şenol Karataş, Sait Fatih Öner","doi":"10.1186/s12871-026-04118-x","DOIUrl":"10.1186/s12871-026-04118-x","url":null,"abstract":"<p><strong>Background: </strong>Hip fracture surgery is associated with substantial postoperative pain, delayed mobilization, and increased opioid requirements, particularly in older adults. Ultrasound-guided regional nerve blocks are increasingly used as components of multimodal analgesia. This study compared postoperative analgesic outcomes between fascia iliaca compartment block (FICB) and pericapsular nerve group (PENG) block in patients undergoing hemiarthroplasty for hip fracture.</p><p><strong>Methods: </strong>This retrospective single-center cohort study included all 186 eligible adult patients who underwent hemiarthroplasty for hip fracture under spinal anesthesia between October 2022 and October 2024. Patients received either ultrasound-guided FICB (n = 90) or PENG block (n = 96) before surgery. The primary outcome was postoperative visual analogue scale (VAS) score at 6 h. Secondary outcomes included VAS score at 24 h, cumulative tramadol consumption during the first postoperative 24 h, quality of recovery assessed using the QoR-15, hospital length of stay, and intraoperative hemodynamic parameters. Separate multivariable linear regression models were used to adjust for age, sex, and ASA physical status.</p><p><strong>Results: </strong>Baseline characteristics were comparable between groups. Patients receiving PENG block had significantly lower postoperative VAS scores at 6 h (3.42 ± 0.90 vs. 5.04 ± 1.24; mean difference - 1.63, 95% CI - 1.94 to - 1.32; p < 0.001) and at 24 h (5.29 ± 0.86 vs. 6.40 ± 0.91; mean difference - 1.11, 95% CI - 1.36 to - 0.85; p < 0.001). Cumulative 24-hour tramadol consumption was significantly lower in the PENG group (243.98 ± 54.27 mg vs. 347.89 ± 65.87 mg; mean difference - 103.91 mg, 95% CI - 121.32 to - 86.49; p < 0.001). QoR-15 scores were significantly higher following PENG block (91 [88-93] vs. 83 [80-85]; p < 0.001). After adjustment for age, sex, and ASA physical status, PENG block remained independently associated with lower VAS scores at 6 and 24 h and lower 24-hour tramadol consumption.</p><p><strong>Conclusions: </strong>Compared with FICB, PENG block was associated with lower postoperative opioid requirements, lower early postoperative pain scores, and improved patient-reported quality of recovery following hemiarthroplasty for hip fracture. The reduction in postoperative tramadol consumption appears to represent the most clinically relevant finding. Prospective randomized multicenter studies are warranted to confirm these observations.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13589383/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149001232","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 4-in-1 block technique with femoral and adductor canal blocks in arthroscopic anterior cruciate ligament reconstruction: a randomized controlled trial.","authors":"Funda Atar, Fatma Özkan Sipahioğlu, Savaş Altınsoy, Atakan Sezgi, Yusuf Özgüner, Özge Yamankılıç Mumcu, Derya Özkan, Jülide Ergil","doi":"10.1186/s12871-026-04109-y","DOIUrl":"10.1186/s12871-026-04109-y","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this study was to compare the 4-in-1 block technique with femoral nerve block (FNB) and adductor canal block (ACB) in terms of perioperative pain and opioid consumption in patients undergoing arthroscopic anterior cruciate ligament reconstruction (ACLR).</p><p><strong>Methods: </strong>The trial was retrospectively registered. In this randomized controlled trial, patients scheduled for ACLR under general anesthesia were randomly assigned to one of three groups: 4-in-1 block, FNB, or ACB. All blocks were performed under ultrasound guidance with 20 mL of 0.25% bupivacaine approximately 45 min before surgery. Intraoperative remifentanil use, postoperative 24-hour intravenous morphine equivalents (IME) consumption, and pain scores measured by the numerical rating scale (NRS) were recorded. Overall postoperative pain burden was additionally assessed using the 0-24-hour NRS area under the curve (AUC). An exploratory post-hoc non-inferiority analysis was performed.</p><p><strong>Results: </strong>A total of 60 patients were equally divided among the groups. Intraoperative remifentanil consumption, postoperative 24-hour IME consumption, and the 0-24-hour NRS AUC values did not differ significantly among the groups (p = 0.842, p = 0.502, and p = 0.958, respectively). Compared with the ACB group, the 4-in-1 block group used, on average, 0.8 mg less postoperative 24-hour IME (90% confidence interval [CI], - 5.61-4.01). Compared with the FNB group, 24-hour IME use was 2.8 mg greater (90% CI, - 1.48-7.08). In both comparisons, the upper bounds of the two-sided 90% CIs did not exceed the exploratory post-hoc non-inferiority margin (Δ = 10 mg).</p><p><strong>Conclusion: </strong>In patients undergoing ACLR, the 4-in-1 block did not differ significantly from FNB or ACB in terms of analgesic outcomes. These exploratory findings require further investigation to clarify the role of the 4-in-1 block in perioperative pain management for ACLR.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier: NCT05643040. Registered 23 November 2022. Retrospectively registered.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13647784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149135030","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":"Preliminary construction and application of the AFSP risk stratification framework for anesthetic management in airway tumors: a case report.","authors":"Qingxiang Cai, Hongzhen Dong, Caineng Wu, Qingbiao He, Yong Wang, Wuhua Ma","doi":"10.1186/s12871-026-04110-5","DOIUrl":"10.1186/s12871-026-04110-5","url":null,"abstract":"<p><strong>Objective: </strong>To initially construct the Anatomy-Function-Surgery-Patient (AFSP) four-dimensional risk stratification framework, establish a dynamic anesthetic decision-making framework based on this framework, explore its application value in the anesthetic management of patients with airway neoplasms. This is a retrospective analysis of a single patient's multistage treatment course.</p><p><strong>Methods: </strong>The AFSP scoring tool was constructed based on relevant clinical guidelines and literature. A retrospective case of a 77-year-old patient with complex tracheal neoplasms was selected. The AFSP framework was applied to dynamically evaluate perioperative risks in three sequential treatment phases (tumor ablation combined with stent implantation, stent removal, and granulation tissue resection), guide the adjustment of anesthetic strategies, and observe the clinical outcomes.</p><p><strong>Results: </strong>During Stage I (tumor ablation + stent implantation), the patient's AFSP score reached 11 points, categorized as Grade IV (extremely high risk). We adopted general anesthesia supported by extracorporeal membrane oxygenation (ECMO), which effectively prevented the life-threatening cannot intubate cannot oxygenate (CICO) crisis during anesthetic induction. In Stage II (stent removal), the AFSP score decreased to 8 points, falling into Grade III (high risk). The anesthetic strategy was adjusted to rapid sequence induction combined with high‑frequency jet ventilation (HFJV), which precisely targeted key risks including stent adhesion and intraoperative bleeding. For Stage III (granulation tissue resection), the AFSP score remained at 9 points (Grade III, high risk). On the basis of continuing the ventilation strategy used in Stage II, we added preoperative psychological intervention. No severe anesthesia-related complications occurred throughout the three treatment phases, and the patient completed the entire therapeutic course successfully, suggesting the application value of the AFSP framework in the anesthetic management of airway neoplasms.</p><p><strong>Conclusion: </strong>The initially constructed AFSP four-dimensional risk stratification framework may facilitate the evaluation of perioperative risks in patients with airway neoplasms and help guide individualized anesthetic management strategies for those undergoing multistage treatment, potentially improving perioperative safety. This study is based on a single patient with a limited sample size; the universality of the conclusions needs to be further verified in larger cohorts, and the AFSP scoring tool requires optimization with more clinical data.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149219915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of anesthetic effects of different sedative drugs combined with remifentanil for general anesthesia in bronchoscopy: a randomized controlled trial.","authors":"Ting Wang, Ningkang Li, Xiaoqin Li, Runjiang Xuan, Xiaoning Zhu, Yun Wang","doi":"10.1186/s12871-026-04092-4","DOIUrl":"10.1186/s12871-026-04092-4","url":null,"abstract":"<p><strong>Background: </strong>Electronic bronchoscopy, as an important means of invasive diagnosis, exerts strong stimulation on anatomical structures such as the pharynx, glottis, carina. Therefore, selecting an appropriate anesthesia regimen not only enhances patient comfort and satisfaction but also guarantees the safety and the smooth running of the operation. This study aimed to compare the clinical anesthetic effects of different sedative drugs combined with remifentanil-based general anesthesia in patients undergoing bronchoscopy.</p><p><strong>Methods: </strong>A total of 120 patients scheduled for elective painless electronic bronchoscopy were randomly assigned to the ciprofol group (Group C), etomidate group (Group E), and remimazolam group (Group R). The primary observation indicator was the incidence of intraoperative hypotension. Secondary observation indicators included postoperative recovery time and the incidence of perioperative adverse events (such as nausea and vomiting, cough, bronchospasm, dizziness).</p><p><strong>Results: </strong>The incidence of hypotension was 45.0% in Group C, 50.0% in Group R, and 17.9% in Group E. The incidence of hypotension in Group E was significantly lower than that in Groups C and R (χ² = 9.949, P = 0.007). The main perioperative adverse responses were postoperative cough, nausea and vomiting, bronchospasm, and dizziness. There was no statistically significant difference in cough severity among the three groups (χ² = 3.26, P = 0.776). The incidence of postoperative nausea and vomiting (PONV) was 7.50% in Group C, 7.50% in Group R, and 46.15% in Group E. The incidence of PONV in Group E was significantly higher than the other two groups (χ² = 24.331, P < 0.001). No significant differences were observed in recovery time and laryngeal mask removal time across the groups.</p><p><strong>Conclusion: </strong>Etomidate demonstrates superior hemodynamic stability but carries a higher risk of PONV. In contrast, ciprofol and remimazolam offer better postoperative comfort. For patients at high risk of hemodynamic instability, etomidate may be preferred with enhanced PONV prophylaxis; for those at high risk of PONV or desiring rapid and comfortable recovery, ciprofol or remimazolam are more suitable options.</p><p><strong>Trial registration: </strong>Chinese Clinical Trial Registry (ChiCTR2400084332). Registered on May 14, 2024.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13390134/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148547796","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":"Peripherally inserted central catheters versus central venous catheters in critically ill patients under standardized insertion protocols: a propensity score-matched cohort study.","authors":"Xiaofang Wu, Xiujuan Wu, Jiajia Xiong, Min Wang, Qiong Wu, Changguang Lv, Niankai Cheng, Chongjing Mu","doi":"10.1186/s12871-026-04115-0","DOIUrl":"10.1186/s12871-026-04115-0","url":null,"abstract":"<p><strong>Background: </strong>The safety of peripherally inserted central catheters (PICCs) in critically ill patients remains controversial, particularly regarding the risk of thrombosis and infection compared with centrally inserted central venous catheters (CVCs). With the adoption of contemporary vascular access techniques and standardized insertion protocols, the complication profile of these devices may have changed.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study including adult ICU patients who underwent PICC or CVC placement between January 2023 and December 2024. All insertions followed standardized protocols (Safe Insertion of PICCs and Safe Insertion of Central Venous Catheters). Propensity score matching (1:2) was performed to balance baseline characteristics. Primary outcomes were symptomatic deep vein thrombosis (DVT) and central line-associated bloodstream infection (CLABSI). Secondary outcomes included catheter dislodgement and occlusion.</p><p><strong>Results: </strong>A total of 250 patients were included, and 214 remained after propensity score matching (81 PICC vs. 133 CVC). Symptomatic DVT occurred in 2.5% of PICC patients and 3.0% of CVC patients. The corresponding incidence rates were 2.16 and 2.68 events per 1,000 catheter-days, respectively. CLABSI occurred in 2.5% and 2.3% of patients, corresponding to 2.16 and 2.01 events per 1,000 catheter-days, respectively. Because the number of outcome events was small, these estimates were associated with substantial statistical uncertainty.</p><p><strong>Conclusions: </strong>In this single-center matched cohort, no statistically significant differences in symptomatic DVT or CLABSI were observed between PICCs and CVCs. However, the small number of outcome events limited statistical power. These findings should be interpreted as exploratory and hypothesis-generating rather than as evidence of equivalence between catheter types.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13670618/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148547849","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 nasogastric tube or transesophageal echocardiography probe use and head and neck positioning with arytenoid dislocation after endotracheal intubation: a retrospective cohort study.","authors":"Wei Qi, Guo-Rong Wu, Xu-Kai Hu, Jun-Ping Chen","doi":"10.1186/s12871-026-04111-4","DOIUrl":"10.1186/s12871-026-04111-4","url":null,"abstract":"<p><strong>Background: </strong>Postoperative hoarseness is a common complaint following endotracheal intubation. Arytenoid dislocation (AD) is a structural injury that, if unrecognized, can lead to prolonged voice impairment. This study aimed to identify independent risk factors for AD using routinely collected perioperative variables.</p><p><strong>Methods: </strong>This retrospective cohort study included adult patients who underwent general anesthesia with endotracheal intubation at a single institution between January 2022 and December 2024. Patients with documented postoperative hoarseness were included. Demographic, surgical, and anesthetic data were collected. Univariate analysis was followed by multivariable logistic regression to identify independent risk factors for AD. To address potential overfitting due to the limited number of AD events (n = 29), we performed a bootstrap internal validation with 1,000 resamples (bias‑corrected accelerated method).</p><p><strong>Results: </strong>Among 101,204 intubated patients, 141 had documented postoperative hoarseness, and 87 were included after exclusions. Among patients referred for persistent postoperative hoarseness, AD was confirmed in 29 patients (33.3%), with an overall incidence of 0.03%. Multivariable analysis identified nasogastric tube or transesophageal echocardiography probe use (adjusted OR = 13.68; 95% CI: 2.088-89.619; P = 0.006) as an independent risk factor for AD. A secondary finding was that intraoperative head/neck positioning showed a positive association in the primary analysis (adjusted OR = 13.34; 95% CI: 1.417-125.612; P = 0.024), but bootstrap validation demonstrated instability (BCa 95% CI for β crossed zero), indicating that this finding should be interpreted cautiously. Operative time, surgery type, and anesthetist experience were not significant in the multivariable model.</p><p><strong>Conclusions: </strong>Esophageal instrumentation requiring either nasogastric tube or transesophageal echocardiography probe appears associated with increased AD risk, while head/neck positioning showed an association that was unstable in bootstrap validation. Although causal inference is limited by the retrospective design and small event number, clinicians should maintain a high index of suspicion for AD in patients with these risk factors to facilitate early diagnosis and timely intervention.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663125/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535295","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":"Cross-cultural adaptation and psychometric evaluation of the Daycare Anesthesia Satisfaction questionnaire in Turkish-speaking adults undergoing ambulatory surgery.","authors":"Merve Bulun Yediyıldız, Irem Durmus, Hulya Yilmaz Ak, Kubra Taskin, Ayşe Demirden, Gulten Arslan, Kemal Tolga Saraçoğlu","doi":"10.1186/s12871-026-04112-3","DOIUrl":"10.1186/s12871-026-04112-3","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to perform the cross-cultural adaptation of the Daycare Anesthesia Satisfaction (DAS) Questionnaire and to evaluate its psychometric properties in Turkish-speaking adults undergoing ambulatory surgery.</p><p><strong>Methods: </strong>This methodological cross-sectional study was conducted with 560 patients undergoing elective ambulatory surgery. The adaptation procedure followed the established cross-cultural translation procedures, which included forward translation, back translation, expert panel review and cognitive debriefing. Construct validity was evaluated using confirmatory factor analysis (CFA) and convergent validity was assessed using composite reliability (CR) and average variance extracted (AVE) values. Reliability was analyzed using Cronbach's alpha coefficient and the intraclass correlation coefficient (ICC).</p><p><strong>Results: </strong>The scale-level content validity index was 0.95. The Turkish-adapted DAS demonstrated excellent internal consistency for the total score (Cronbach's α = 0.971). Test-retest reliability was excellent (ICC = 0.988, 95% CI: 0.986-0.989). CFA results indicated a mixed fit for the original four-factor structure; while absolute fit indices were acceptable (χ²/df = 3.53, RMSEA = 0.07, SRMR = 0.06), incremental fit indices fell below optimal thresholds (CFI = 0.83, TLI = 0.81). Nevertheless, the CR and AVE values for all factors exceeded the recommended thresholds (> 0.84 and > 0.51), indicating strong convergent validity.</p><p><strong>Conclusion: </strong>The Turkish adapted DAS questionnaire demonstrated excellent reliability and satisfactory content and convergent validity for Turkish-speaking adults undergoing ambulatory surgery. Although CFA provided only partial support for the original four-factor structure, the instrument appears to be a useful tool for assessing patient satisfaction in clinical practice and research. Given that only partial support was obtained for the four-factor structure, this conclusion should be regarded as provisional with respect to structural validity. Further multicentre studies are warranted to confirm the structural validity of the DAS-T and broaden its generalizability.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13505026/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535241","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":"Non-inferiority trial of remimazolam versus propofol for fast-track anesthesia in children undergoing percutaneous closure of atrial septal defect.","authors":"Pengyu Qin, Haijuan Jing, Xiaofei Shen, Haoran Zhang, Lin Qiu, Shubo Song, Hongqi Lin","doi":"10.1186/s12871-026-04106-1","DOIUrl":"10.1186/s12871-026-04106-1","url":null,"abstract":"<p><strong>Background and objective: </strong>Remimazolam, a new member of the benzodiazepine class, has been used as an alternative to propofol during anesthesia induction. In this study, we aimed to examine the effectiveness and safety of remimazolam compared with propofol for both the induction and maintenance of fast-track general anesthesia in children undergoing percutaneous closure of an atrial septal defect (ASD).</p><p><strong>Methods: </strong>We carried out a single-center, prospective, randomized controlled, observer-blinded, non-inferiority trial among 101 children, of whom 57 received remimazolam and 44 received propofol. All children underwent percutaneous closure of an atrial septal defect and had an American Society of Anesthesiologists (ASA) physical status of II before surgery. The primary outcome was the time to laryngeal mask airway (LMA) removal, measured in minutes.</p><p><strong>Results: </strong>We included all 101 patients in the final analysis. Children in the remimazolam group had a significantly shorter time to LMA removal (mean difference [MD]: ‑7.97 min; 95% CI: ‑8.91 to ‑7.02; p < 0.001) and a shorter duration of hospitalization (median 5 vs. 7 days; p < 0.001) than the propofol group. The Pediatric Anesthesia Emergence Delirium (PAED) score was also lower in the remimazolam group (median 3 vs. 6; p < 0.001), indicating a reduced occurrence of postoperative emergence delirium. Fewer children in the remimazolam group required a vasopressor (26% vs. 64%). Mean arterial pressure and heart rate each showed a significant intervention-by-time interaction (their trajectories over time differed between groups), without a significant overall between-group difference in either.</p><p><strong>Conclusions: </strong>This study suggests that remimazolam offers advantages over propofol for fast-track anesthesia in children undergoing percutaneous ASD closure, including faster LMA removal, shorter hospitalization, and a lower incidence of postoperative emergence delirium, with a differing intraoperative mean arterial pressure trajectory and comparable overall hemodynamic stability.</p><p><strong>Trial registration number: </strong>ChiCTR2500109737, Registration date: 24 Sep. 2025. Retrospectively registered.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13540928/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535236","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":"Non-pharmacological preoperative interventions for the prevention of emergence delirium in children under general anesthesia: a systematic review and network meta-analysis.","authors":"Xiyao Zhang, Shan Dai, Qian Li, Huaping Huang","doi":"10.1186/s12871-026-04052-y","DOIUrl":"10.1186/s12871-026-04052-y","url":null,"abstract":"<p><strong>Background: </strong>Emergence delirium (ED) is among the most distressing complications of general anesthesia. Although numerous studies have demonstrated the effectiveness of non-pharmacological interventions in managing pediatric ED, the relative efficacies of these interventions remain unclear. This study aimed to systematically evaluate the efficacies of different non-pharmacological preoperative interventions to prevent ED in children undergoing general anesthesia.</p><p><strong>Methods: </strong>The Embase, Cochrane Library, PubMed, Scopus, and Web of Science databases were searched from their inception to December 31, 2025, to identify relevant randomized controlled trials of non-pharmacological preoperative interventions to prevent ED in children undergoing general anesthesia. Two reviewers independently evaluated the literature, extracted data, and assessed risk of bias. STATA 18.0 software was used for network meta-analysis. Network and contribution plots were generated, inconsistency tests were performed, and interventions were ranked by efficacy using the surface under the cumulative ranking (SUCRA) curve.</p><p><strong>Results: </strong>Eleven randomized controlled trials that involved 1,294 children were included. Network meta-analysis showed that compared to usual care, multimodal preoperative anxiety intervention (odds ratio [OR] = 0.08, 95% confidence interval [CI]: 0.02 to 0.45), preoperative 30-min eye patch training (OR = 0.10, 95%CI: 0.05 to 0.22), and preoperative operating room visitation (OR = 0.10, 95%CI: 0.03 to 0.38) significantly reduced the incidence of ED. SUCRA ranking indicated that the multimodal preoperative anxiety intervention (SUCRA = 85.5%) was likely to perform better in preventing ED, while virtual reality ranked lowest. The inconsistency tests showed no significant inconsistency between direct and indirect evidence (P = 0.09). Considerable heterogeneity was present (I² = 68.7%), which could not be explained by prespecified moderators.</p><p><strong>Conclusions: </strong>Among the included interventions, the multimodal preoperative anxiety intervention showed the most favorable effect in reducing ED, although this finding is based on a single trial and should be considered exploratory. Preoperative operating room visits and eye-patch training have also demonstrated promising applicability under specific conditions. Based on the current evidence, virtual reality showed no significant benefit in this analysis, and no firm recommendation can be made. Further high-quality studies are warranted to validate and refine personalized intervention strategies.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13670551/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535226","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}