BMC Anesthesiology最新文献

{"title":"Minimising the usage of desflurane only by education and removal of the vaporisers - a before-and-after-trial.","authors":"Ferdinand Lehmann, Johannes Mader, Christian Koch, Melanie Markmann, Dominik Leicht, Michael Sander","doi":"10.1186/s12871-025-02982-7","DOIUrl":"10.1186/s12871-025-02982-7","url":null,"abstract":"<p><strong>Background: </strong>By exceeding planetary environmental boundaries, multiple global crises have become imminent in the 21st century. The healthcare system is a contributor to the climate crisis, accounting for approximately 5% of greenhouse gas emissions in Western countries. In anaesthetic clinics, desflurane, a highly potent greenhouse gas and volatile anaesthetic with no compelling indications, accounts for up to two thirds of total emissions. Its use can be drastically reduced using simple measures. In the present study, we investigated whether a relevant and timely reduction in use could be achieved by dismounting desflurane vaporisers and providing information to the team without restricting its use.</p><p><strong>Methods: </strong>The study was conducted in a German university hospital with approximately 1250 beds, over a 12-month period between 2021 and 2022, with a comparison to the corresponding periods of the previous years up to 2017. The interventions were, first, the removal of desflurane vaporisers, and second, staff education on the climate impact of volatile anaesthetics. The primary outcome variable was the reduction of hypnotic-related emissions in CO₂ equivalents per anaesthetic procedure.</p><p><strong>Results: </strong>Prospective data collection and interventions were conducted from 28 March 2021 to 27 March 2022. The amount of CO₂ equivalent emissions per procedure in the form of volatile anaesthetics was reduced by 86% compared with the year before the interventions (p < 0.001). Interestingly, there was already a 52.1% reduction in the year before the procedure (p < 0.001). There were no significant changes in the use of sevoflurane or propofol. Hypnotic-related costs decreased by €14,549, whereas extubation time did not change significantly.</p><p><strong>Conclusions: </strong>Removal of desflurane vaporisers and staff training can quickly and significantly reduce the emissions of an anaesthesia department in a large German teaching hospital. This may also reduce the costs.</p><p><strong>Trial registration: </strong>The trial was registered with the German Clinical Trials Register, identifier DRKS00024973 on 12/04/2021.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"108"},"PeriodicalIF":2.3,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11866676/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143522621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A giant congenital epiglottic cyst in a neonate: a case report.","authors":"Xiao Deng, Min Diao, Jieshu Zhou","doi":"10.1186/s12871-025-02984-5","DOIUrl":"10.1186/s12871-025-02984-5","url":null,"abstract":"<p><p>Congenital epiglottic cysts, though rare, represent a recognized etiology of upper airway obstruction in neonates and infants. Airway management of large epiglottic cysts presents significant challenges due to the inherent risk of catastrophic airway compromise. We present a case of difficult airway management in a neonate with a giant congenital epiglottic cyst, detailing an effective technique for glottic visualization and successful endotracheal intubation.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"107"},"PeriodicalIF":2.3,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11866621/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143522618","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":"Different extubation protocols for adult cardiac surgery: a systematic review and pairwise and network meta-analysis.","authors":"Ruo Yu Luo, Ying Ying Fan, Meng Tian Wang, Chao Yun Yuan, Yuan Yuan Sun, Tian Cha Huang, Ji Yong Jing","doi":"10.1186/s12871-025-02952-z","DOIUrl":"10.1186/s12871-025-02952-z","url":null,"abstract":"<p><strong>Background: </strong>With the advancement of ultra-fast track anesthesia, early extubation following cardiac surgery has become a prevailing trend. While there are significant benefits associated with early extubation, its high failure rate warrants further investigation, and the effectiveness of various extubation strategies in cardiac surgery still requires validation.</p><p><strong>Methods: </strong>An extensive literature search was performed in the PubMed, Scopus, Embase, and Web of Science databases, encompassing studies without language restrictions. Eligible studies were those that compared the outcomes of various extubation strategies.</p><p><strong>Results: </strong>Primary outcome was the success rate of the extubation protocol. Secondary outcomes were time to extubation, intensive care unit (ICU) length of stay (LOS), complications and mortality rate. Data from 12 studies, which included a total of 1454 participants, were included in the analysis. The pairwise meta-analysis revealed that late extubation was significantly more effective than immediate extubation strategies (relative risk [RR] = 1.52, 95% confidence interval [CI] = 1.21-1.91, P = 0.0001). In the network meta-analysis (NMA), the late extubation protocol was associated with a significantly lower risk of extubation failure compared to early extubation and extubation on the table (RR = 0.76, 95% CI: 0.5-1.16; RR = 0.22, 95% CI: 0.05-0.91). Furthermore, according to the SUCRA plot, late extubation was ranked as the most effective strategy for reducing extubation failure (94%).</p><p><strong>Conclusions: </strong>Our findings indicate that a late extubation strategy, as opposed to early (within a specified time frame) or immediate extubation, is correlate with a substantially higher rate of successful extubation. Despite this, the early extubation strategy seems to offer better cost-effectiveness and safety profiles. The selection of an appropriate extubation strategy should be personalized, taking into account the patient's preoperative characteristics and the circumstances encountered during surgery.</p><p><strong>Trial registration: </strong>The study protocol adheres to the PRISMA statement and checklist. The protocol was registered at PROSPERO (CRD42024529051).</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"104"},"PeriodicalIF":2.3,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11863475/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514712","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 perioperative anticoagulation management on free flap survival in reconstructive surgery: a retrospective analysis.","authors":"Saeed Torabi, Remco Overbeek, Fabian Dusse, Sandra E Stoll, Carolin Schroeder, Max Zinser, Matthias Zirk","doi":"10.1186/s12871-025-02975-6","DOIUrl":"10.1186/s12871-025-02975-6","url":null,"abstract":"<p><strong>Background: </strong>Despite advancements in surgical techniques and perioperative care for free flap reconstructive surgery, concerns persist regarding the risk of free flap failure, with thrombosis and bleeding being the most common complications that can lead to flap loss. While perioperative anticoagulation management is crucial for optimizing outcomes in free flap reconstructive surgery, standardized protocols remain lacking. This study aims to investigate the role of anticoagulation and perioperative practices in free flap reconstructive surgery and their impact on surgical outcomes.</p><p><strong>Methods: </strong>This retrospective, single-center study included all adult patients undergoing free flap surgery from 2009 to 2020. Patients were retrospectively divided based on intraoperative (UFH or no UFH) and postoperative anticoagulation management (UFH only, Aspirin and UFH, Aspirin only). The relationship between anticoagulation protocols, PTT values, and flap survival was assessed.</p><p><strong>Results: </strong>A total of 489 free flap surgeries were included. Most flaps were taken from the upper extremity (49.5%), primarily for tumor-related reconstructions (85.7%). Flap loss occurred in 14.5% of cases, with a median time to flap loss of 3 days post-surgery. Intraoperative UFH (20 IU/kg) was administered to 63.6% of patients and significantly predicted flap survival (OR = 0.45, 95% CI [0.24, 0.82]). PTT values on day 1 post-surgery were significantly related to flap survival (P = 0.03), with each unit increase reducing the relative probability of flap loss by 5.2%. There was no significant difference in flap survival between patients treated with heparin alone and those treated with both heparin and aspirin. The small sample size in the aspirin-only group limited the statistical relevance of this subgroup.</p><p><strong>Conclusion: </strong>Our findings highlight the importance of intraoperative UFH and PTT-guided postoperative management in improving free flap survival. Standardized anticoagulation protocols are essential for enhancing outcomes in free flap reconstructive surgery.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"106"},"PeriodicalIF":2.3,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11863428/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514713","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":"Point-of-care ultrasound training among anesthesiology residency programs in the United States.","authors":"Jordon Edwards, Daniel Ahn, Daniel Alcaraz, Collin Chiles, Tina Khuu, Nilam J Soni, Varun Goyal, Crystal Manohar","doi":"10.1186/s12871-025-02929-y","DOIUrl":"10.1186/s12871-025-02929-y","url":null,"abstract":"<p><strong>Background: </strong>Point-of-care ultrasound (POCUS) use has become ubiquitous in the field of anesthesiology. However, POCUS training curriculum in anesthesiology residencies vary widely. We performed a survey study to better understand the structure of existing POCUS training and identify barriers to instituting a POCUS curriculum for anesthesiology trainees.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"105"},"PeriodicalIF":2.3,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11863924/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514715","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 hypotension and postoperative risks in non-cardiac surgery: a meta-analysis.","authors":"Guanchao Qin, Ming-Cheng Du, Ke-Xin Yi, Yuan Gong","doi":"10.1186/s12871-025-02976-5","DOIUrl":"10.1186/s12871-025-02976-5","url":null,"abstract":"<p><strong>Background: </strong>Postoperative complications are often associated with the severity and duration of intraoperative hypotension. However, the optimal approach for managing intraoperative hypotension remains controversial. The aim of this meta-analysis of randomized controlled trials was to compare the incidence of common postoperative complications with different treatment threshold of hypotension.</p><p><strong>Methods: </strong>We searched PubMed, the Cochrane Database, and Embase from August 2014 to August 2024 for studies comparing different treatment threshold of hypotension (low [mean arterial pressure < 60 mmHg], moderate [60-75 mmHg], and high [> 75 mmHg]). Only randomized controlled trials conducted during 2014-2024 were included in this meta-analysis without language restrictions. Studies with the following characteristics were included: randomized controlled study; involved non-cardiac, non-obstetric surgery; included different blood pressure management strategies; evaluated major postoperative complications; and included acute kidney injury, myocardial injury, altered consciousness, or infection. Data included patient age, type of surgery, group criteria, and adverse events. Mantel-Haenszel method was used for analysis. The primary outcomes were postoperative complications, including acute kidney injury. The secondary outcomes included length of hospital stay and all-cause mortality.</p><p><strong>Results: </strong>Of the 2160 studies identified, eight randomized controlled trials with 9108 participants were included. No significant differences in postoperative complications were observed between the moderate and high mean arterial pressure treatment threshold groups (risk ratio = 1.0, 95% confidence interval = 0.86-1.18, P = 0.96). Sensitivity analysis confirmed these findings. Length of hospitalization was not significantly different between the groups (standardized mean difference = -0.39; 95% confidence interval = -0.69 to 1.31; P = 0.03). Limited data prevented meta-analysis of mean arterial pressure management at lower treatment thresholds.</p><p><strong>Conclusion: </strong>The results of this meta-analysis suggest no significant differences in postoperative complications between moderate and high mean arterial pressure management.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"103"},"PeriodicalIF":2.3,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11863555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514714","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 ultrasound-guided superficial cervical plexus block to complete pediatric subglottic stenosis tracheotomy-a case report and literature review.","authors":"Guangyan Zhang, Baoping Wang, Haifeng Li","doi":"10.1186/s12871-025-02973-8","DOIUrl":"10.1186/s12871-025-02973-8","url":null,"abstract":"<p><strong>Background: </strong>Congenital subglottic stenosis is a condition that results in airway narrowing in pediatric patients, presenting significant challenges for anesthesiologists during surgical procedures. This case report describes the successful management of a pediatric patient with congenital subglottic stenosis who underwent tracheotomy using esketamine combined with ultrasound-guided superficial cervical plexus block. The aim is to provide an alternative anesthetic approach for similar complex cases.</p><p><strong>Case presentation: </strong>A 4-year-old child diagnosed with congenital subglottic stenosis and laryngeal obstruction (grade III) required emergency tracheotomy to alleviate the obstruction. Esketamine was selected as the sedative-analgesic agent to maintain spontaneous breathing. Ultrasound-guided bilateral superficial cervical plexus blocks were performed to enhance analgesia. The tracheotomy was successfully completed without any intraoperative movement or coughing. Postoperatively, the patient recovered well and was discharged from the hospital.</p><p><strong>Conclusion: </strong>The combination of esketamine and ultrasound-guided superficial cervical plexus block offers a safe and effective anesthetic approach for this pediatric patient with subglottic stenosis undergoing tracheotomy. Further studies are necessary to confirm the safety and efficacy of this technique.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"101"},"PeriodicalIF":2.3,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11852560/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143499388","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 dexmedetomidine on agitation and inflammatory response during recovery from anesthesia in young children following cochlear implantation surgery.","authors":"Qing Cheng, Chao-Yang Chen, Xiang Li, Li-Jun Wu, Ze-Yu Zhao","doi":"10.1186/s12871-025-02970-x","DOIUrl":"10.1186/s12871-025-02970-x","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the impact of dexmedetomidine (Dex) on agitation and inflammatory response during recovery from anesthesia in young children following cochlear implantation surgery.</p><p><strong>Methods: </strong>We randomly divided 80 children who underwent unilateral cochlear implantation into two equal groups. Group D received an intravenous infusion of Dex after induction of anesthesia, while those in group C received an equal volume of saline infusion. The mean arterial pressure (MAP) and heart rate (HR) of children in the two groups were recorded at four different time intervals: before induction of anesthesia (T₀); 30 min after intravenous infusion of Dex (T₁); upon admission to the post-anesthesia care unit (PACU) (T₂); and at the time of being transferred out of the PACU (T₃). At T3, we also recorded general information.</p><p><strong>Results: </strong>The MAP and HR in group D showed more consistent trends during the anesthesia recovery period when compared to those in group C. Children in group D had a significantly lower crying, requires increased O₂ administration, increased vital signs, expression and sleepless score (CRIES score), pediatric anesthesia emergence delirium (PAED) score, and incidence of agitation than in group C (P < 0.01). The rate of supplementary pain relief for the children was lower in group D than in group C (P < 0.01). At T₃, serum levels of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were lower in children in group D than in group C (P < 0.01). Compared to T₀, the levels of serum IL-6 and TNF-α were higher in both groups at T₃ (P < 0.01).</p><p><strong>Conclusion: </strong>We found that the use of Dex helped reduce the occurrence and severity of agitation during anesthesia recovery in children after cochlear implantation surgery and improved postoperative inflammatory reactions.</p><p><strong>Clinical registration number: </strong>Registration website: https://www.chictr.org.cn/searchproj.html .</p><p><strong>Registration number: </strong>ChiCTR2400080937.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"102"},"PeriodicalIF":2.3,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11852807/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143499391","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 opioid sparing strategies on postoperative pain and perioperative hemodynamics in patients undergoing laparoscopic cholecystectomy: a randomized controlled study.","authors":"Lei Wang, Xinhua Hong, Yiting Xue, Zhen Su","doi":"10.1186/s12871-025-02953-y","DOIUrl":"10.1186/s12871-025-02953-y","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Opioid-sparing anesthesia(OSA) or opioid-free anesthesia(OFA) strategy can reduce postoperative pain, but the effect of different stratigies on postoperative pain for patients with high pain sensitivity remains unclear, and the effect of different stratigies on perioperative haemodynamic fluctuations remains controversial for patients undergoing laparoscopic cholecystectomy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A total of 173 patients scheduled for elective laparoscopic cholecystectomy were randomly assigned into three groups: opioid-free anesthesia group(Group OFA), opioid-sparing anesthesia group(Group OSA) or opioid-based anesthesia group (Group OBA). The preoperative assessment of patients' pain sensitivity was conducted using the Pain Sensitivity Questionnaire (PSQ). The visual analog scale (VAS) scores were recorded at 30 min, 1 h, 2 h, 6 h, 12 h, and 24 h postoperatively. Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP), Mean Arterial Pressure (MAP) and Heart Rate (HR) were recorded at baseline(T0), after admission (T1), after induction(T2), 1 min after tracheal intubation (T3), 1 min after pneumoperitoneum (T4), and calculated as the variability of blood pressure (BPV), coefficient of variation (CV) and average real variability (ARV). Time to awake, acute pain, rescue analgesia, postoperative nausea and vomiting (PONV), and time to first exhaust were also recorded.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Compared with Group OBA, VAS scores were significantly lower in Group OFA and OSA at 2 h, 6 h and 12 h postoperatively (P &lt; 0.05). BPV&lt;sub&gt;SBP&lt;/sub&gt;, BPV&lt;sub&gt;DBP&lt;/sub&gt;, BPV&lt;sub&gt;MAP&lt;/sub&gt;, CV&lt;sub&gt;SBP&lt;/sub&gt;, CV&lt;sub&gt;DBP&lt;/sub&gt;, CV&lt;sub&gt;MAP&lt;/sub&gt;, ARV&lt;sub&gt;DBP&lt;/sub&gt; and ARV&lt;sub&gt;MAP&lt;/sub&gt; were lower in both Group OSA and OBA compared to the Group OFA (P &lt; 0.05). Group OSA exhibited lower BPV&lt;sub&gt;SBP,&lt;/sub&gt; CV&lt;sub&gt;DBP&lt;/sub&gt;, and ARV&lt;sub&gt;DBP&lt;/sub&gt; compared to the OBA group (P &lt; 0.05). In the subgroup analysis of patients with high pain sensitivity, BPV&lt;sub&gt;SBP&lt;/sub&gt;, BPV&lt;sub&gt;DBP&lt;/sub&gt;, BPV&lt;sub&gt;MAP&lt;/sub&gt;, CV&lt;sub&gt;DBP&lt;/sub&gt;, CV&lt;sub&gt;MAP&lt;/sub&gt;, ARV&lt;sub&gt;SBP&lt;/sub&gt;, ARV&lt;sub&gt;DBP&lt;/sub&gt; and ARV&lt;sub&gt;MAP&lt;/sub&gt; were lower in Group OSA compared to Group OFA (P &lt; 0.05). BPV&lt;sub&gt;DBP&lt;/sub&gt;, CV&lt;sub&gt;DBP&lt;/sub&gt;, ARV&lt;sub&gt;SBP&lt;/sub&gt; and ARV&lt;sub&gt;DBP&lt;/sub&gt; were lower in the OSA group compared to the OBA group (P &lt; 0.05). The time to first exhaust was significantly reduced in patients in Group OFA compared with Group OSA and OBA (P &lt; 0.05).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;OSA can effectively control patients' postoperative pain with lower perioperative haemodynamic variability. It also has lower perioperative haemodynamic variability and acute pain in patients with high pain sensitivity, making it suitable for laparoscopic cholecystectomy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Trial registration: &lt;/strong&gt;The trial is registered with the China Clinical Trials Registry Registration Number: ChiCTR2400093036. Retrospectively registered (date of registration: 27/11/202","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"100"},"PeriodicalIF":2.3,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11849303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143490702","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 fospropofol disodium on lipid metabolism and inflammatory response in patients with hyperlipidemia: a randomized trial.","authors":"Chuan Yang, Tian-Bo Chai, Xing-Zhu Yao, Li Zhang, Wen-Ming Qin, Hong Liang, Qiong-Zhen He, Ze-Yu Zhao","doi":"10.1186/s12871-025-02965-8","DOIUrl":"10.1186/s12871-025-02965-8","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to assess the impact of intravenous infusion of fospropofol disodium on lipid metabolism and the inflammatory response in individuals with hyperlipidemia.</p><p><strong>Methods: </strong>A total of 360 preoperative individuals with hyperlipidemia were selected and randomly assigned to either the treatment group or the control group, with 180 participants in each group. The treatment group received an induction dose of fospropofol disodium at 10 mg/kg intravenously, followed by maintenance at a rate of 10 mg/(kg·h). The control group was administered propofol intravenously at 2 mg/kg for induction and maintained at 4 mg/(kg·h). All other medications were consistent between the two groups. Blood samples (3 ml of venous blood) were collected from patients at four-time points: 1 day before surgery (T₀), 3 h after anesthesia induction (T₁), 4 h post-surgery (T₂), and 24 h post-surgery (T3), to measure levels of triglycerides (TG), cholesterol (CHOL), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein A1 (ApoA1), and apolipoprotein B (ApoB). C-reactive protein (CRP) and interleukin-6 (IL-6) levels were assessed at T₀ and T₃. Sedation onset time and adverse reactions were recorded for both groups.</p><p><strong>Results: </strong>At T₀, the control group exhibited increased TG, CHOL, LDL-C, ApoB, and the ApoB/ApoA1 ratio, while the ApoA1 level had decreased. The LDL-C level and the ApoB/ApoA1 ratio showed significant increases (P < 0.01). Both groups showed elevated CRP and IL-6 levels at T₃ (P < 0.01). Compared to the control group, the treatment group demonstrated reduced levels of TG, CHOL, LDL-C, ApoB, and the ApoB/ApoA1 ratio at T₁-T₃, while ApoA1 levels were higher at T1-T2 (P < 0.01 or P < 0.05). The sedation onset time was notably longer in the treatment group, and the incidence of injection-related pain, respiratory depression, hypotension, and other adverse reactions was significantly lower (P < 0.01).</p><p><strong>Conclusion: </strong>Compared with propofol, intravenous infusion of fospropofol disodium for more than 3 h during anesthesia has lesser impact on lipid metabolism in patients with hyperlipidemia and does not increase inflammatory factors levels.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"99"},"PeriodicalIF":2.3,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11849204/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143490721","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}