BMC Anesthesiology最新文献

{"title":"Preliminary study on the use of perfluoropropane contrast agent in monitoring drug diffusion during fascial plane blocks.","authors":"Zhicheng Zhang, Yue Zhang, Yong Ni, Lina Wang, Lixiang Nie, Xianda Zhao","doi":"10.1186/s12871-025-03028-8","DOIUrl":"https://doi.org/10.1186/s12871-025-03028-8","url":null,"abstract":"<p><strong>Objectives: </strong>This research aims to preliminarily verify the feasibility of utilizing a novel perfluoropropane ultrasound contrast agent (UCA) for observing the spread of drugs within the fascial plane.We demonstrated the feasibility of this method by conducting transverse abdominis plane block(TAPB) using two-dimensional (2D) ultrasound.</p><p><strong>Methods: </strong>Firstly, to explore the optimal dilution ratio of UCA mixed with local anesthetics (LA), this study conducted in vitro simulation experiments by diluting the UCA with 0.375% ropivacaine hydrochloride(ROP) at various ratios (0, 10x, 30x, 100x, 300x, 1000x).The contrast of images under 2D ultrasound was observed and measured in a six-well plate. After selecting two relatively suitable doses, TAPB was performed using rabbits to determine the best dilution ratio. Next, 0.375% ROP was mixed with UCA at the selected optimal dilution ratio (with the addition of methylene blue). TAPB was performed, and the diffusion area of the contrast agent was recorded in real-time under 2D ultrasound. After dissection, photographs were taken to record the spread range of methylene blue, and the correlation and consistency between the two methods of observing drug diffusion were compared. Finally, we conducted in vitro and in vivo experiments to evaluate the muscular and neural toxicity of the novel UCA when combined with 0.375% ROP.</p><p><strong>Results: </strong>Using 2 ml of 0.375% ROP in combination with perfluoropropane UCA, without further dilution, produced stable and high-contrast 2D ultrasound images in an in vitro simulation experiment and TAPB in rabbits.This mixture ratio was subsequently used to observe drug diffusion and toxicity in further studies. A paired t-test analysis showed no statistically significant difference in the measured area between the spread of 0.375% ROP + perfluoropropane UCA in 2D ultrasound imaging and the spread of methylene blue (MB) after dissection.The area recorded by ultrasound images exhibited a strong correlation with the distribution range of LA as reflected by MB after dissection (R = 0.70, P = 0.02).Bland-Altman analysis showed that the mean difference in the measured area between the two methods was 0.65 cm2, and the 95% confidence interval (CI) of the difference was [-1.38 cm2, 1.16 cm2]. Only one data point was outside the 95% CI.Neither in vivo nor in vitro studies have found that perfluoropropane UCA increases the known muscular and neural toxicity of 0.375%ROP.</p><p><strong>Conclusions: </strong>Our preliminary study demonstrates the potential feasibility and safety of real-time monitoring of LA diffusion in rabbits using the novel perfluoropropane UCA under 2D ultrasound.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"234"},"PeriodicalIF":2.3,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12060423/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965611","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":"Esketamine combined with low-dose propofol induction strategy for category-1 cesarean section: a case series.","authors":"Guang-Qiu Zhu, Yu Wang, Xiao-Xia Wang, Hai-Tao Cong, Wan-Lan Mou","doi":"10.1186/s12871-025-03098-8","DOIUrl":"https://doi.org/10.1186/s12871-025-03098-8","url":null,"abstract":"<p><strong>Background: </strong>General anesthesia (GA) is the most accepted option for category-1 emergency cesarean sections (CSs). A low dose of esketamine has been used as an excellent adjunct to neuraxial anesthesia (NA) with little effect on newborns. However, literature on the use of esketamine for GA induction in emergency CS is limited. This case series describes our experience with an esketamine-based combined low-dose propofol induction strategy for category-1 CS.</p><p><strong>Methods: </strong>We retrospectively analyzed esketamine-based anesthesia induction for category-1 emergency CS at our hospital between November 2022 and November 2024. Modified rapid sequence induction included 0.5 mg/kg esketamine, 1 mg/kg propofol, and 1 mg/kg rocuronium, respectively. Anesthesia was maintained by propofol infusion at 4 mg/kg/h and inhalation of 1.5% sevoflurane. The dose of propofol and sevoflurane was adjusted to maintain the BIS value at 40-60.</p><p><strong>Results: </strong>The final cohort comprised 11 patients. The median 1-minute Apgar score was 9 points [range, 6-10], and the 5-minute Apgar score was 10 points for all newborns. The mean decision-to-delivery interval (DDI) was 10.9 ± 2.4 min. Only one newborn required temporary mask ventilation due to acute fetal distress, mainly caused by major placental abruption. No newborns were admitted to the intensive care unit (ICU). No episodes of hypotension (MAP < 70 mmHg) were observed from anesthesia induction to delivery of the newborns. In all cases, there was no intraoperative awareness, reflux aspiration, or adverse psychiatric effects.</p><p><strong>Conclusions: </strong>The esketamine-based combination low-dose propofol induction strategy can effectively maintain maternal hemodynamic stability without causing neonatal depression, making it suitable for category-1 emergency CSs. However, further randomized controlled trials are needed to confirm these findings.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"232"},"PeriodicalIF":2.3,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12060548/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143962622","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 impact of different inspired oxygen concentrations combined with nebulized prostaglandin E1 on oxygenation in patients undergoing one-lung ventilation: a randomized controlled trial.","authors":"Lingxi Xing, Halisa Paerhati, Yuyan Ding, Yihu Zhou, Jiaqi Chang, Xiaolan Gu, Lianbing Gu","doi":"10.1186/s12871-025-03081-3","DOIUrl":"https://doi.org/10.1186/s12871-025-03081-3","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;One-lung ventilation (OLV) requires a high inspired oxygen concentration (FiO&lt;sub&gt;2&lt;/sub&gt;) to promote oxygenation improvement, yet it increases the risk of postoperative pulmonary complications. Therefore, this study aimed to investigate the effects of prostaglandin E&lt;sub&gt;1&lt;/sub&gt; (PGE&lt;sub&gt;1&lt;/sub&gt;) in reducing FiO&lt;sub&gt;2&lt;/sub&gt; during general anesthesia and mechanical ventilation on oxygenation and postoperative complications in patients undergoing OLV.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Method: &lt;/strong&gt;A total of 120 patients scheduled for elective left thoracotomy esophageal cancer surgery were randomly divided into four groups (n = 30): Group L (FiO&lt;sub&gt;2&lt;/sub&gt; = 0.4, PGE&lt;sub&gt;1&lt;/sub&gt; = 0.1 µg /kg), Group M (FiO&lt;sub&gt;2&lt;/sub&gt; = 0.5, PGE&lt;sub&gt;1&lt;/sub&gt; = 0.1 µg /kg), Group H (FiO&lt;sub&gt;2&lt;/sub&gt; = 0.6, PGE&lt;sub&gt;1&lt;/sub&gt; = 0.1 µg /kg), and Group C (FiO&lt;sub&gt;2&lt;/sub&gt; = 0.4, normal saline solution). The primary outcome was oxygenation during OLV. Secondary outcomes included intrapulmonary shunt (Qs/Qt), incidence of postoperative pulmonary complications, and changes in inflammatory cytokines.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Group H exhibited higher PaO&lt;sub&gt;2&lt;/sub&gt; values than Groups L, M, and C at all time points T1-T6. Group M also showed higher PaO&lt;sub&gt;2&lt;/sub&gt; values than Groups L and C at all time points T1-T6. In contrast, Group L demonstrated significantly higher PaO&lt;sub&gt;2&lt;/sub&gt; values than Group C at time points T2-T4. The nebulization groups (L, M, H) had significantly higher PaO&lt;sub&gt;2&lt;/sub&gt;/FiO&lt;sub&gt;2&lt;/sub&gt; than Group C at time points T2-T4. Group H had higher Qs/Qt values than Groups L, M, and C at all time points T1-T6. At time points T2-T4, Group L had significantly lower Qs/Qt values compared to both Group C and Group M, which in turn had significantly lower values than Group C. Regarding interleukin-6 (IL-6) levels, Group C was significantly higher than the nebulization groups at time points T5-T8, while Group L was significantly lower than Groups M and H at T8. In terms of tumor necrosis factor-α(TNF-α) levels, Group C was significantly higher than the nebulization groups at time points T7-T8. With respect to clinical pulmonary infection score (CPIS), Group L was significantly lower than Groups M, H, and C. There was no statistically significant difference in the overall incidence of postoperative complications probability (PPCs) among the four groups, nor were there statistically significant differences in pneumothorax, pulmonary infection, anastomotic leakage, ICU stay duration, or total hospital stay duration among the groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;PGE&lt;sub&gt;1&lt;/sub&gt; demonstrates a significant advantage in reducing the incidence of hypoxemia, effectively improving oxygenation status in patients undergoing OLV with lower FiO&lt;sub&gt;2&lt;/sub&gt;. Given the effects of PGE&lt;sub&gt;1&lt;/sub&gt; on oxygenation and inflammatory factors, as well as the CPIS, the results of this study suggest that a clinical regimen of 0.4 FiO&lt;sub&gt;2&lt;/sub&gt; + 0.1 µg /kg ","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"229"},"PeriodicalIF":2.3,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12057253/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062338","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":"Risk factors for adverse reactions to nurse-administered propofol during outpatient endoscopy: a cross-sectional study.","authors":"Renzo Inca Villanueva, Cynthia Bazán Montero, María Estela Bulnes-Montánchez, Lary Salazar Alva, José Salvador Carrillo, Alejandra Zevallos, Fernando Salazar","doi":"10.1186/s12871-025-03012-2","DOIUrl":"https://doi.org/10.1186/s12871-025-03012-2","url":null,"abstract":"<p><strong>Background: </strong>Endoscopic procedures are essential for diagnosing and managing gastrointestinal conditions, often requiring sedation for patient comfort. Propofol is a common choice for outpatient sedation due to its rapid onset and predictable recovery time. Although propofol has an established safety profile, adverse drug reactions (ADRs) can still occur. This study investigated the prevalence and risk factors associated with ADRs related to nurse-administered propofol sedation during outpatient endoscopic procedures at a private hospital in Peru.</p><p><strong>Method: </strong>We conducted a retrospective study. The clinical records of 919 Peruvian patients who underwent endoscopic interventions under propofol sedation were reviewed. This study included patients between the ages of 18 and 69 years who had American Society of Anesthesiologists (ASA) physical status classification scores of I-III and who were hemodynamically stable with an oxygen saturation (SO2) > 90% before the procedure. Sedation was nurse-administered using standardized protocols. ADR data, including severity and causality assessment data, were collected. Data were collected and analyzed by SPSS, Inc., and the statistical significance was calculated at the p < 0.05 level.</p><p><strong>Results: </strong>A total of 693 patients were included in the study, 30.9% of whom experienced at least one ADR, predominantly cardiovascular or respiratory events such as hypotension and hypoxia, with causality scores classified as probable or definitive. Among the ADRs, 35.8% (n = 87) were moderately severe, and 64.2% (n = 143) were mildly severe. There were no reports of any serious adverse events. An ASA class III status (p = 0.048, PR adjusted (PRa) = 1.73, 95% CI: 1.01-2.99) and a procedure time of more than 20 min (p < 0.0001, PRa = 2.05, 95% CI: 1.53-2.73) were significant risk factors for ADR occurrence. Patients with ADRs had longer recovery times than did those without ADRs (22 min ± 22.5 vs. 14 min ± 8, respectively; p < 0.001).</p><p><strong>Conclusion: </strong>In our work, moderate propofol sedation administered by trained nursing staff to outpatients undergoing interventional endoscopic procedures was generally safe but not free from risks. Vital parameters should be monitored regularly during long-term interventions and when patients are classified as ASA III.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"228"},"PeriodicalIF":2.3,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12054303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143954415","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":"Nonpharmacological interventions for decreasing anxiety during anesthesia induction in children: a systematic review and Bayesian network meta-analysis.","authors":"Yuanyuan Li, Shanshan Peng, Xueqin Xia, Lin Yin, Limei Liao","doi":"10.1186/s12871-025-03077-z","DOIUrl":"https://doi.org/10.1186/s12871-025-03077-z","url":null,"abstract":"<p><strong>Background: </strong>Anxiety during anesthesia induction can lead to various negative outcomes and psychological burdens in children undergoing surgery. Nonpharmacological interventions are available for reducing anxiety in this context. However, due to a lack of evidence from head-to-head randomized controlled trials (RCTs), the specific effects of these methods on children with anxiety during anesthesia induction remain unclear.</p><p><strong>Objective: </strong>This network meta-analysis aimed to evaluate the comparative effects of all known nonpharmacological interventions for reducing anxiety in children during anesthesia induction and to rank these interventions based on their practical applicability.</p><p><strong>Design: </strong>Systematic review and Bayesian network meta-analysis.</p><p><strong>Methods: </strong>We searched PubMed, Embase, CINAHL, Cochrane Library, and Web of Science to identify articles published up to August 2024. Two reviewers independently assessed eligibility of potential studies and extracted data. Outcome measures of the meta-analysis were the anxiety levels of children during anesthesia induction, the anxiety levels of parents, and the child's compliance during anesthesia induction. A consistency model was selected to conduct a network meta-analysis to evaluate the relative effects and rank probabilities of different nonpharmacological interventions.</p><p><strong>Results: </strong>A total of 34 RCTs with 3,040 participants and six intervention methods were included. All trials confirmed the safety of the six intervention methods, with no significant adverse events reported. The network meta-analysis showed that the Passive Distraction Intervention (PDI)-Parental Presence at Induction of Anesthesia (PPIA), Interactive Distraction Intervention (IDI)-PPIA, IDI, PDI, and PPIA interventions were associated with more substantial reductions in anxiety than usual care. However, the studied interventions showed no statistically significant differences for reducing parental anxiety. The PPIA, IDI, and IDI-PPIA interventions also improved compliance during anesthesia induction.</p><p><strong>Conclusions: </strong>Our study confirmed that some nonpharmacological interventions are effective at reducing anxiety in children and enhancing compliance during anesthesia induction. Therefore, we recommend several interventions for clinical practice, including the PDI-PPIA, IDI-PPIA, PDI, IDI, and PPIA when working with children undergoing anesthesia induction.</p><p><strong>Registration: </strong>We registered this network meta-analysis with PROSPERO (registration no. CRD42022262874).</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"226"},"PeriodicalIF":2.3,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12049003/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143964509","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 nebulized dexmedetomidine on gag reflex suppression and sedation quality in pediatric patients undergoing gastrointestinal endoscopy: a randomized controlled trial.","authors":"Esra Turunc, Yasemin Burcu Ustun, Sezgin Bilgin, Cengiz Kaya, Ersin Koksal, Burhan Dost","doi":"10.1186/s12871-025-03106-x","DOIUrl":"10.1186/s12871-025-03106-x","url":null,"abstract":"<p><strong>Background: </strong>Pediatric patients undergoing upper gastrointestinal (GI) interventions frequently require sedation and analgesia due to the challenges associated with endoscopic probe placement, particularly the gag reflex. This study investigates the effects of nebulized dexmedetomidine as a premedication on the gag reflex in pediatric patients undergoing gastrointestinal endoscopy.</p><p><strong>Methods: </strong>We conducted a single-center, prospective, randomized controlled trial at the Pediatric Gastroenterology Clinic of Ondokuz Mayis University School of Medicine from January to April 2024. Participants aged 2-17 years scheduled for upper GI endoscopy were randomized to receive nebulized dexmedetomidine (2 µg /kg) or no premedication. The primary outcome measured was the severity of the gag reflex during the procedure. Secondary outcomes included cough incidence, separation anxiety, postoperative agitation, and endoscopist satisfaction. Statistical analyses were performed with significance set at p < 0.050.</p><p><strong>Results: </strong>A total of 120 patients were analyzed. The dexmedetomidine group demonstrated a significantly lower incidence of gag reflex (88.3% with no gag reflex vs. 30% in the control group, p < 0.001) and coughing (95% vs. 55%, p < 0.001). Separation anxiety scores were also significantly lower in the dexmedetomidine group (p < 0.005). Additionally, the need for additional anesthetics was reduced, and endoscopist satisfaction was significantly higher. No significant differences in complications were observed between the two groups (p = 0.600).</p><p><strong>Conclusions: </strong>Nebulized dexmedetomidine is a safe and effective premedication for pediatric patients undergoing endoscopic procedures, significantly reducing gag and cough reflexes, decreasing anesthetic requirements, and enhancing endoscopist satisfaction. This approach improves the comfort and safety of pediatric endoscopy procedures.</p><p><strong>Trials registration: </strong>ClinicalTrials.gov: NCT06218797, date of registration 27/12/2023.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"227"},"PeriodicalIF":2.3,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12048968/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143980832","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 transversus abdominis plane block for gastric surgery: a meta-analysis.","authors":"Hao Zhang, Hong Pan, Xiaodong Chen","doi":"10.1186/s12871-025-03097-9","DOIUrl":"https://doi.org/10.1186/s12871-025-03097-9","url":null,"abstract":"<p><strong>Background: </strong>Multimodal analgesia is an important component of Enhanced Recovery After Surgery (ERAS). Transversus abdominis plane (TAP) block helps achieve this pain management in various types of surgeries. To evaluate the efficacy of TAP block versus non-TAP approaches for postoperative pain management and recovery after gastric surgery.</p><p><strong>Methods: </strong>A systematic literature search across four databases (Cochrane, Embase, Web of Science, PubMed) until February 2024 identified relevant randomized controlled trials (RCTs) evaluating TAP block in gastric surgery. Two independent reviewers screened studies, extracted data, and assessed analyses.</p><p><strong>Primary outcome: </strong>postoperative pain scores.</p><p><strong>Secondary outcomes: </strong>postoperative opioid consumption, hospital stay, time to ambulation, and time to flatus.</p><p><strong>Results: </strong>Twelve RCTs involving 841 participants were included. Compared to non-TAP, the TAP group demonstrated significantly lower visual analog scale (VAS) pain scores at 1, 3, 6, 12, 24, and 48 h postoperatively (WMD range: -0.62 to -0.97). Time to first ambulation (SMD - 0.46; 95% CI: -0.92, 0.00) and first flatus (WMD - 5.17; 95% CI: -8.58, -1.77) were shorter in the TAP group. Postoperative opioid consumption was reduced with TAP (WMD - 1.89; 95% CI: -2.41, -1.37), with no difference in hospital stay between groups.</p><p><strong>Conclusion: </strong>TAP block effectively relieves pain after gastric surgery, decreases postoperative morphine requirements, and modestly shortens bed rest duration while promoting intestinal function recovery. However, it does not significantly affect the overall hospital length of stay.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"225"},"PeriodicalIF":2.3,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12049037/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143954375","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":"Investigating the effect of ondansetron in reducing myoclonic movements caused by intravenous administration of etomidate.","authors":"Mohammad Alipour, Seyed Javad Purafzali Firuzabadi","doi":"10.1186/s12871-025-03099-7","DOIUrl":"https://doi.org/10.1186/s12871-025-03099-7","url":null,"abstract":"<p><strong>Background: </strong>Etomidate is a short-acting intravenous anesthetic used to induce general anesthesia. However, myoclonus caused by the administration of etomidate is seen in 50-80% of untreated patients. Due to the high prevalence of myoclonus following etomidate injection, the present study aimed to investigate the effect of ondansetron in reducing myoclonic movements caused by the intravenous administration of etomidate.</p><p><strong>Method: </strong>The current research was a double-blind clinical study conducted on 72 adult patients who were candidates for elective eye surgery and had visited Khatam Al-Anbia Eye Hospital affiliated to Mashhad University of Medical Sciences between November to December 2022. Before sampling, the designed proposal was approved by the Ethics Committee of Mashhad University of Medical Sciences and clinical trial was registered by the code IRCT20190510043545N2 at 2021-10-02. Candidate patients for elective eye surgery with ASA class I-II were selected using the available sampling method. Prior to study entrance the study protocol was fully explained and an informed constant was obtained from each participant. The patients were randomly assigned into two groups; 4 mg (IV) ondansetron was prescribed for the study group and 5 cc of normal saline (IV) was administered for the placebo group. The mentioned drugs were administered as a pre-medication 180 s before etomidate induction with a dosage of 0.3 mg/kg. After examining and recording the induced myoclonus, a full dose of narcotics and muscle relaxants was prescribed for each patient.</p><p><strong>Results: </strong>Each group consisted of 36 patients who did not differ significantly in terms of age, gender, comorbidities and ASA class. The mean time of myoclonus in the placebo and ondansetron groups was 43.48 ± 53.17 and 14.07 ± 5.75, respectively, which was significantly shorter in the ondansetron group (Z=-5.19, P < 0.005). The severity (χ2 = 14.62, P < 0.005) and incidence (χ2 = 25.89, P < 0.005) of myoclonus were also significantly lower in the ondansetron group compared to placebo.</p><p><strong>Conclusion: </strong>The administration of ondansetron in combination with etomidate can have a remarkable effect on reducing the duration and severity of myoclonus induced by etomidate.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"224"},"PeriodicalIF":2.3,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12042511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965608","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":"Risk factors for postoperative hypothermia in non-cardiac surgery patients: a systematic review and meta-analysis.","authors":"Ruyi Tan, Yuyin Chen, Dan Yang, Xiuhong Long, Hongli Ma, Chang Yang","doi":"10.1186/s12871-025-03089-9","DOIUrl":"https://doi.org/10.1186/s12871-025-03089-9","url":null,"abstract":"<p><strong>Background: </strong>Postoperative hypothermia seems to be a common problem in surgical patients but is easily ignored. This study aimed to identify risk factors for postoperative hypothermia in non-cardiac surgery patients.</p><p><strong>Methods: </strong>We searched databases including PubMed, Embase, Web of Science, Cochrane Library, CINAHL, VIP, Wan Fang, CNKI, and CBM from inception to April 2025. The studies were selected using inclusion and exclusion criteria. Two reviewers screened studies, extracted data, and independently evaluated the risk of bias. The quality of the study was assessed with the Newcastle-Ottawa Scale, and a meta-analysis was carried out with Revman 5.4 software.</p><p><strong>Results: </strong>A total of 17 studies were included. Age ≥ 60 (odds ratio [OR] = 1.80), BMI < 18.5 kg/m² (OR = 1.83), ASA III-IV (OR = 1.87), endoscopic surgery (OR = 1.93), intraoperative blood loss ≥ 100ml (OR = 2.35), intravenous fluid ≥ 1000ml (OR = 1.87), blood transfusion (OR = 1.80), duration of anesthesia > 1 h (OR = 1.99) and duration of surgery > 1 h (OR = 2.34) were significant risk factors that contributed to postoperative hypothermia in non-cardiac surgery patients.</p><p><strong>Conclusion: </strong>There are many risk factors for postoperative hypothermia in patients undergoing non-cardiac surgery. The results of this research may improve clinician awareness, risk stratification, and prevention of postoperative hypothermia in non-cardiac surgery patients.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"223"},"PeriodicalIF":2.3,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12042493/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143982092","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":"Hypotension prediction index: comparison between invasive and non-invasive pressure inputs.","authors":"Kamron Sarhadi, Justin Hamman, Jorge Avila, Zhongping Jian, Neal W Fleming","doi":"10.1186/s12871-025-03086-y","DOIUrl":"10.1186/s12871-025-03086-y","url":null,"abstract":"<p><strong>Background: </strong>The Hypotension Prediction Index (HPI) derived using an Acumen™ arterial pressure transducer can decrease the incidence of intraoperative hypotension and possibly decrease perioperative complications. The HPI can also be obtained from the ClearSight™ continuous non-invasive blood pressure monitor. Concurrent comparison of HPI values obtained from these two pressure inputs is limited and additional comparisons could increase clinician confidence in non-invasive hemodynamic monitoring, expand its applications and improve patient outcomes.</p><p><strong>Methods: </strong>Simultaneous hemodynamics were recorded using two HemoSphere monitors with the HPI software and either intra-arterial Acumen^® (hereinafter invasive) or ClearSight™ (hereinafter non-invasive) pressure inputs. Data collected from the non-invasive system was compared to corresponding invasive, intra-arterial data using Bland-Altman analysis, Spearman correlation, concordance analysis and relative performance with respect to prediction of hypotensive events using ROC analysis and HPI alerts agreement analysis.</p><p><strong>Results: </strong>6,862 paired data points were available from 36 patients. Bland-Altman comparisons demonstrated a bias of -8.4 (± 23) with limits of agreement from - 53 to 36. The correlation between HPI values was strong with an r value of 0.76 (95%CI:0.75-0.77). Concordance was also strong at 74% (10% exclusion zone). Using ROC analysis, the AUC for prediction of hypotension was similar and at 5 min was 0.883 [0.786,0.953] for the invasive pressure and 0.860 [0.770,0.939] for the non-invasive pressure inputs. At the same time points, the agreement between HPI alerts was high with an accuracy of 86.3%.</p><p><strong>Conclusion: </strong>HPI values and predictive performance were comparable when derived from either invasive or non-invasive pressure inputs.</p><p><strong>Trial registration: </strong>The study was approved by the UC Davis Institutional Review Board (IRB #1791102-1) and registered on ClinicalTrials.gov (NCT05025176) before the enrollment of the first patient.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"221"},"PeriodicalIF":2.3,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12038980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143982083","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}