BMC Anesthesiology最新文献

{"title":"Knowledge, fear and acceptance rate of spinal anesthesia among pregnant women scheduled for cesarean section: a cross-sectional study from a tertiary care hospital in Karachi.","authors":"Nida Shahid, Asim Masroor Rashid","doi":"10.1186/s12871-024-02736-x","DOIUrl":"10.1186/s12871-024-02736-x","url":null,"abstract":"<p><strong>Background: </strong>Worldwide, the cesarean section (c-section) rate is rising. Globally, regional anesthesia in the form of spinal anesthesia (SA) is considered the first choice in uncomplicated c-section cases for safe maternal and neonatal outcomes. This study aimed to ascertain knowledge, acceptance, and fears of SA among patients scheduled for c-section in a tertiary care hospital.</p><p><strong>Methods: </strong>This cross-sectional study was performed in the Anesthesia Department, Hamdard University Hospital, Karachi, from April to September 2023. Knowledge was assessed using a self-designed questionnaire with a total of 7 questions. Data was entered in SPSS version 26 to perform statistical analysis.</p><p><strong>Results: </strong>A total of 303 females were enrolled, with a mean age of 26.5 ± 4.5 years and a median gestational age of 37 (IQR = 36-37) weeks. 93.7% of women agreed to receive SA. 63% heard the term regional anesthesia before, 12.2% heard about general anesthesia, and 17.5% heard about SA. 23.4% of participants scored 7 out of 7, 39.9% had a score of 6 out of 7, and 36.6% had a score of ≤ 5. Among 129 (42.6%) females having fear, the commonest fear was limiting lower limb functions post-surgery (93.8%), followed by post-operative vaginal pain (91.5%), intra-operative pain (80.6%), post-operative backache (76.7%), having visuals of surgery (72.9%), back injury (56.6%), headache (46.5%), nausea/vomiting (31%), and being nude (24%).</p><p><strong>Conclusion: </strong>The present study analyzed that although the majority of female agreed to receive spinal anesthesia, they had a fear of it. Knowledge of spinal anesthesia was not remarkable among the study population. Proper education regarding anesthesia should be given to patients to overcome fears related to spinal anesthesia.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"24 1","pages":"408"},"PeriodicalIF":2.3,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11555949/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142614497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of GlideScope, Pentax Airway Scope, and Macintosh Blade on the incidence of postoperative sore throat: a cohort study of 9,881 patients.","authors":"Chun-Hsien Fu, Chao-Hsien Sung","doi":"10.1186/s12871-024-02798-x","DOIUrl":"10.1186/s12871-024-02798-x","url":null,"abstract":"<p><strong>Background: </strong>Postoperative sore throat (POST) is a common complaint after general anesthesia. POST is defined by the presence of a self-reported foreign body sensation or a painful sensation in the throat after general anesthesia. This condition may affect recovery and patient satisfaction and is associated with many factors, including intubation tools. Previous studies have reported conflicting results on POST. This retrospective cohort study, with sample size of 9,881 patients, was conducted to confirm the hypothesis that the use of video laryngoscopy (VL) is associated with a lower incidence of POST compared with direct laryngoscopy (DL).</p><p><strong>Methods: </strong>Data were extracted from a prospectively maintained quality improvement database. A total of 9,881 patients were included in the study. Statistical analysis was conducted for comparisons of demographic characteristics and to determine the effect of intubation tools on the incidence of POST.</p><p><strong>Results: </strong>The patients had similar baseline demographic characteristics. Compared with DL, VL was associated with a lower incidence of POST (12.98% vs. 17.49%, P < 0.001). In addition, the use of Pentax Airway Scope (AWS) was associated with a lower incidence of POST compared with the use of GlideScope (GVL, 8.14% vs. 16.25%, P < 0.001). To better adjust for possible confounding factors, mixed-effects generalized linear model analysis revealed that older age (odds ratio [OR]: 0.995, 95% confidence interval [CI]: 0.992-0.999, P = 0.006), AWS compared to DL (OR: 0.416, 95% CI: 0.350-0.494, P < 0.001), and male sex (OR: 0.836, 95% CI: 0.747-0.935, P = 0.002) are associated with reduced incidence of POST.</p><p><strong>Conclusion: </strong>Compared with DL, VL is associated with a lower incidence of POST. In addition, the use of AWS is associated with a lower incidence of POST compared with the use of GVL.</p><p><strong>Trial registration: </strong>Retrospectively registered, NCT06515808, date of registration: 23/07/2024.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"24 1","pages":"409"},"PeriodicalIF":2.3,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11555873/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142614286","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":"Ciprofol versus propofol for anesthesia induction in cardiac surgery: a randomized double-blind controlled clinical trial.","authors":"Le Yu, Xiang Liu, Xiang Zhao, Xiu Shan, Evelyne Bischof, Hui-Hong Lu","doi":"10.1186/s12871-024-02795-0","DOIUrl":"10.1186/s12871-024-02795-0","url":null,"abstract":"<p><strong>Background: </strong>Ciprofol, a novel intravenous general anesthetic with a chemical structure similar to propofol, exhibits significantly enhanced potency. It offers a rapid onset, reduced incidence of injection pain, and has comparable effects on heart rate and blood pressure to propofol. However, clinical data on its use for anesthesia induction in cardiac surgery remain limited.</p><p><strong>Methods: </strong>Seventy-eight patients undergoing coronary artery bypass grafting or valve replacement surgery were randomly assigned to receive either ciprofol (N = 40) or propofol (N = 38) for anesthesia induction. Variables recorded included changes in mean arterial pressure and heart rate during anesthesia, alterations in the oxygenation index and lactic acid concentration before and 10 min after anesthesia induction, and the incidence of adverse events such as bradycardia, hypotension, and injection pain.</p><p><strong>Results: </strong>The incidence of anesthesia-induced injection pain was significantly lower in the ciprofol group compared to the propofol group (3% vs. 18%, P < 0.05). The incidence of other adverse events was similar between the groups. No significant differences in hemodynamics or oxygenation index were observed during anesthesia induction between ciprofol and propofol.</p><p><strong>Conclusions: </strong>Ciprofol demonstrated a significantly lower incidence of injection pain compared to propofol, potentially improving patient comfort during anesthesia induction. Additionally, ciprofol showed comparable circulatory stability to propofol during anesthesia induction in cardiac surgery, suggesting it may be a suitable alternative to propofol for this application.</p><p><strong>Trial registration: </strong>The trial was registered at the ClinicalTrials.gov on 03/10/2024 (NCT06312345).</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"24 1","pages":"412"},"PeriodicalIF":2.3,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11556191/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142615107","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":"Do patients receiving extracorporeal membrane-oxygenation need antibiotic prophylaxis? A systematic review and meta-analysis on 7,996 patients.","authors":"Daniele Orso, Caterina Maria Fodale, Sara Fossati, Sergio Venturini, Federico Fonda, Francesco Cugini, Irene Comisso, Massimo Crapis, Luisa Cacciavillani, Tiziana Bove","doi":"10.1186/s12871-024-02796-z","DOIUrl":"10.1186/s12871-024-02796-z","url":null,"abstract":"<p><strong>Background: </strong>Patients undergoing Extracorporeal Membrane Oxygenation (ECMO) are particularly susceptible to infections: 42% experience sepsis and 26% develop a nosocomial infection (NI). Whether antibiotic prophylaxis is effective in reducing mortality and its effects on the rate of NIs is currently unclear.</p><p><strong>Research question: </strong>Can antibiotic prophylaxis decrease 30-day mortality for patients on ECMO? Can antibiotic prophylaxis prevent the occurrence of NIs in these patients?</p><p><strong>Study design and methods: </strong>A systematic review and meta-analysis was conducted. We searched PubMed, Scopus, and CINAHL libraries from inception to June 12, 2024. Two researchers were involved in abstract screening and three researchers were involved in full text selection.</p><p><strong>Results: </strong>A pooled population of 7,996 patients is represented by 5 retrospective studies. Reported mortality ranges between 46 and 58% and the NIs rate is between 14 and 62%. Regarding 30-day mortality, the random-effects model (I² = 65%) indicates a non-statistically significant difference between the antibiotic prophylaxis group and the non-prophylaxis group (OR 0.76; 95%CI 0.37-1.59). For the NIs rate, a fixed-effect model (I² = 36%) shows an OR of 0.81 (95%CI 0.71-0.92) in favor of the antibiotic prophylaxis group, with a number-needed-to-treat (NNT) of 39.7 patients.</p><p><strong>Conclusion: </strong>According to a very low degree of certainty, antibiotic prophylaxis appears to have no impact on the 30-day mortality rate of ECMO recipients. The risk of NIs seems to decrease with antibiotic prophylaxis, even though the NNT is high. Prospective high-quality studies that address these specific clinical questions are necessary.</p><p><strong>Clinical trial registration: </strong>PROSPERO: International prospective register of systematic reviews, 2024, CRD42024567037.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"24 1","pages":"410"},"PeriodicalIF":2.3,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11556216/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142613729","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 intravenous lidocaine on catheter‑related bladder discomfort, postoperative pain and opioid requirement in complex fusion lumbar spinal surgery: a randomized, double blind, controlled trial.","authors":"Ekasak Chantrapannik, Sithapan Munjupong, Natirat Limprasert, Sarita Jinawong","doi":"10.1186/s12871-024-02789-y","DOIUrl":"10.1186/s12871-024-02789-y","url":null,"abstract":"<p><strong>Background: </strong>Catheter-related bladder discomfort (CRBD) and pain commonly arises postoperatively in patients who undergo intra-operative urinary catheterization. The study aims to demonstrate the effectiveness of intravenous lidocaine to prevent CRBD and postoperative pain in complex lumbar spinal surgery.</p><p><strong>Methods: </strong>Eighty male patients, aged 20-79 years, scheduled for elective fusion spine surgery at least two levels were randomly assigned to receive either intravenous lidocaine (1.5 mg/kg followed by 2 mg/kg/h) (Group L) or a parallel volume of normal saline (Group C). The primary outcome was incidence of moderate to severe CRBD in a postanesthetic care unit (PACU) between the two groups. Secondary outcomes included postoperative pain, 24-hour post operative opioid requirement, mild and moderate to severe CRBD at 1, 2, 6 and 24 h postoperatively, patient satisfaction on Global Perceived Effect Scale (GPES), and the adverse effects of lidocaine and surgical complications.</p><p><strong>Results: </strong>Group L showed a significantly lower incidence of moderate-to-severe CRBD compared to Group C in the PACU (P = 0.002) and at 1 h postoperatively (P = 0.039). Additionally, Group L experienced a significantly lower average pain scores compared to Group C at all time points (P < 0.001, P < 0.001, P = 0.001, P < 0.001 and P < 0.001 at 0, 1, 2, 6 and 24 h, respectively) and demonstrated a significantly reduced postoperative morphine requirement across all time intervals (P < 0.05). Group L also reported significantly higher satisfaction on GPES compared to group C (P < 0.001). No adverse outcome was observed in either group.</p><p><strong>Conclusion: </strong>Intravenous lidocaine administration significantly reduced the incidence of moderate-to-severe CRBD at PACU and at 1 h postoperatively. Additionally, its use in complex spine surgery led to reductions in postoperative pain, opioid requirement, and improved patient satisfaction, without any observed side effects.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"24 1","pages":"405"},"PeriodicalIF":2.3,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11552165/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142614259","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 prediction score for high spinal block in patients undergoing cesarean delivery: a retrospective cohort study.","authors":"Pannawit Benjhawaleemas, Baramee Brahmasakha Na Sakolnagara, Jutarat Tanasansuttiporn, Sunisa Chatmongkolchart, Maliwan Oofuvong","doi":"10.1186/s12871-024-02799-w","DOIUrl":"10.1186/s12871-024-02799-w","url":null,"abstract":"<p><strong>Background: </strong>High spinal block is a serious complication of spinal anesthesia. However, findings regarding its associated risk factors are inconsistent, and no studies have reported a relevant risk prediction score. We aimed to determine the risk prediction score for high spinal block in patients who were induced spinal anesthesia for cesarean delivery.</p><p><strong>Methods: </strong>This retrospective cohort study was conducted at a hospital in Southern Thailand between 2019 and 2020. We recorded demographic characteristics, gestational age (GA), hyperbaric bupivacaine dose, sensory block level, pre- and post-procedure blood pressure, and birth weight. High spinal block was defined as a decrease in pinprick sensation > T4. Risk scores, adjusted odds ratios (OR), and 95% confidence intervals (CI) were determined. Risk scores were derived from the coefficients of the final multivariate logistic regression model.</p><p><strong>Results: </strong>The incidence of high spinal block was 22.4% among the 1003 parturients. Our risk prediction tool for high spinal block had a sensitivity and specificity of 76% and 49%, respectively, and was classified into high (> 21), intermediate (15-21), and low (≤ 14) risk groups. The patient-related predictors were a GA < 35 weeks (OR [95% CI]: 2.31 [1.13, 4.71], score of 8), height < 150 cm (2.21 [1.11, 4.38], score of 8), and post-pregnancy body mass index > 27.5 kg/m² (2.68 [1.33, 5.41], score of 10). The anesthesia-related predictors were a hyperbaric bupivacaine dose > 11 mg (2.56 [1.34, 4.87], score of 9) and induction by a first-year resident (1.48 [1.05, 2.09], score of 4). The surgery-related predictors were previous cesarean delivery in labor (1.83 [1.2, 2.78], score of 6) and elective cesarean delivery (2.53 [1.57, 4.07], score of 9) compared to indication by cephalopelvic disproportion. The incidence of intraoperative hypotension was significantly higher in the high-block group than in the control group (46% vs. 25%, p < 0.001).</p><p><strong>Conclusion: </strong>The combination of patient- and anesthesia-related predictors played an important role in the intermediate- and high-risk groups for high sensory spinal block. Addressing the modifiable risk factors-a GA < 35 weeks, an optimal dose of bupivacaine, and the experience level of the spinal block performer-could minimize the risk of high spinal block during cesarean delivery.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"24 1","pages":"406"},"PeriodicalIF":2.3,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11552125/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142614502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of remimazolam tosilate in anesthesia for short otolaryngology surgery.","authors":"Wen Cheng, Yi Cheng, Hongying He, Dandan Zhou, Jing Wang, Yi Zhang, Zhao Wang","doi":"10.1186/s12871-024-02790-5","DOIUrl":"10.1186/s12871-024-02790-5","url":null,"abstract":"<p><strong>Background: </strong>Remimazolam tosilate represents the novel ultrashort-acting benzodiazepine drug. This work focused on exploring whether remimazolam tosilate was effective and safe in anesthesia for short otolaryngology surgery in adults, and optimize its medication regimen, thus providing a theoretical basis for its widespread clinical application.</p><p><strong>Methods: </strong>The present unicentric, double-blind, randomized controlled study enrolled altogether 85 otolaryngology surgery patients aged 18-60 years, and they were divided as remimazolam (RM, 42 cases) or midazolam (MD, 43 cases) group. Efficacy outcomes included successful sedation time, sedation effect (Modified Observer's Assessment of Alertness/Sedation (MOAA/S) score), bispectral index values (BIS), and postoperative recovery. The safety outcomes were patient vital signs at each time point (before induction (T0), 2 min and 5 min after trial drug treatment (T1 and T2 separately), during successful intubation (T3), at the end of surgery (T4), during extubation (T5), and at the time of exiting the room (T6)), any adverse reactions (AEs) during perioperative period, and patient satisfaction with anesthesia experience.</p><p><strong>Results: </strong>Demographics were not significantly different in both groups (P > 0.05). RM group had significantly decreased successful sedation time relative to MD group (P < 0.05), while increased successful sedation rate (100%) relative to MD group (90.70%, P = 0.116). RM group showed decreased MOAA/S score and BIS value compared with MD group at T1 and T2 (P < 0.05). The spontaneous respiration recovery time and extubation time were not significantly different in both groups (P > 0.05), but RM group exhibited decreased discharge time compared with MD group (P < 0.05). Compared with MD group, the RM group had lower blood pressure (BP) at T3 (P < 0.05); whereas higher heart rate (HR) and respiration rate (RR) at T1 and T2 (P < 0.05). Difference in AEs was not of statistical significance. Finally, RM group exhibited the increased satisfaction of anesthesia experience compared with MD group (P < 0.05).</p><p><strong>Conclusion: </strong>Remimazolam tosilate is effective on anesthesia for short otolaryngology surgery. Remimazolam shows the rapid onset, stable circulation, fast postoperative recovery, no increase in perioperative AEs, and high satisfaction with anesthesia experience compared with midazolam.</p><p><strong>Trial registration: </strong>https://www.chictr.org.cn/ (ChiCTR2200067123) on 27/12/2022. This study was consistent with CONSORT guidelines.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"24 1","pages":"407"},"PeriodicalIF":2.3,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11552106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142614384","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":"Comparative efficacy of ciprofol and propofol in reducing respiratory depression during ERCP anesthesia: a randomized controlled trial.","authors":"Juanhong Wang, Rui Wang, Xiaofang Ma, Wenjing Zhu, Baoping Zhang, Yuhu Ma, Yatao Liu","doi":"10.1186/s12871-024-02791-4","DOIUrl":"10.1186/s12871-024-02791-4","url":null,"abstract":"<p><strong>Background: </strong>Propofol is one of the important drug causes of respiratory depression in endoscopic retrograde cholangiopancreatography (ERCP) anesthesia. This study aims to clarify whether Ciprofol in ERCP anesthesia reduces the respiratory depression rate.</p><p><strong>Methods: </strong>In this randomized controlled trial performed at the Surgical Endoscopy Center, the First Hospital of Lanzhou University between Jun 01, 2022 and Feb 20, 2024, patients undergoing ERCP anesthesia were randomly assigned into ciprofol (study group) or propofol (control group). Primary outcomes included respiratory depression rate during anesthesia, and secondary outcomes included body movement and hypoxemia, awakening time, mean arterial pressure and heart rate changes at key points during surgery.</p><p><strong>Results: </strong>20 of the 306 patients had respiratory depression (6.5%). The frequency of respiratory depression was 3.3% in the group C and 9.8% in the group P, with a difference of 6.5% between the two groups (P = 0.035). Ciprofol anesthesia decreased the hyoxemia, injection pain, and circulation and heart rate fluctuations. Multivariable logistic regression analyses showed that Propofol (OR 1.970; 95% CI, 1.121-3.461, P = 0.018), mallampati classification>II (OR 1.594; 95% CI, 1.129-2.249, P = 0.008), and fasting time>10.5 h (OR 3.184; 95% CI, 1.531-6.621, P = 0.002) were independent risk factors for incidence of respiratory depression in ERCP anesthesia.</p><p><strong>Conclusions: </strong>For patients undergoing anesthesia for ERCP, Ciprofol, compared to Propofol, has been shown to effectively reduce the incidence of intraoperative respiratory depression, thereby enhancing the safety of the anesthesia process.</p><p><strong>Trial registration: </strong>This study was registered in the Chinese Clinical Trial Registry on 15/01/2022 (ChiCTR2200055629).</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"24 1","pages":"404"},"PeriodicalIF":2.3,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11546404/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142615119","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 bougie-guided cricothyrotomy and traditional cricothyrotomy techniques in an obese 3D-printed surgical airway manikin: a randomized controlled study.","authors":"Secdegül Coşkun Yaş, Emel Altıntaş, Ayfer Keleş, Ahmet Demircan","doi":"10.1186/s12871-024-02800-6","DOIUrl":"10.1186/s12871-024-02800-6","url":null,"abstract":"<p><strong>Background: </strong>Obesity is one of the conditions that may require invasive airway management. The effectiveness of invasive airway techniques in obesity is not fully understood, and there is no routinely recommended technique. This study aimed to compare the first attempt success rate, procedure time, and difficulty of traditional surgical cricothyrotomy and bougie-guided cricothyrotomy on a 3D-printed surgical airway manikin made obese using simple techniques.</p><p><strong>Methods: </strong>The study was designed as a prospective randomized controlled study. The obese simulation was created with a 3D-printed surgical airway manikin and sponge layers. Bougie-guided cricothyrotomy and traditional cricothyrotomy techniques were taught to emergency residents, and they were asked to practice the technique on the designed manikin. The duration of the procedure for both techniques, the number of attempts, the success rate, and the difficulty scores of the techniques were recorded.</p><p><strong>Results: </strong>A total of 24 residents were included in the study. As the first technique, 13 residents used bougie-guided cricothyrotomy. A total of 23 (95.8%) were successful with both techniques. In the traditional surgical cricothyrotomy, 7 (31.8%) residents were successful on the first attempt, while in the bougie-guided cricothyrotomy, 15 (68.2%) residents were successful on the first attempt (p = 0.020). In residents with less than 2 years of seniority, the mean difficulty score of the bougie-guided cricothyrotomy was lower (p = 0.024).</p><p><strong>Conclusions: </strong>The success rate of the bougie-guided cricothyrotomy in the first attempt was higher than that of the traditional surgical technique. There was no statistically significant difference between the overall success rates and procedure times of both methods. The level of difficulty of the bougie-guided cricothyrotomy was found to be easier, especially for residents with less than two years of seniority.</p><p><strong>Presentations: </strong>The manuscript has been presented 9th EurAsian Congress on Emergency Medicine (oral presentation) at the 9-12 November, 2023, Antalya, Turkey, and won the best oral abstract award at this congress.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"24 1","pages":"403"},"PeriodicalIF":2.3,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11546524/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142615120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of dexmedetomidine on thiol/disulphide homeostasis in coronary artery bypass surgery: a randomized controlled trial.","authors":"Yusuf Ozguner, Savaş Altınsoy, Gökçen Kültüroğlu, Dilek Unal, Julide Ergil, Salim Neşelioğlu, Özcan Erel","doi":"10.1186/s12871-024-02794-1","DOIUrl":"10.1186/s12871-024-02794-1","url":null,"abstract":"<p><strong>Background: </strong>Thiol-disulfide homeostasis (TDH) plays a pivotal role in various physiological mechanisms, including antioxidant defence, detoxification, apoptosis, regulation of enzyme activities and cellular signal transduction. TDH can be used as a biomarker to detect oxidative stress (OS) levels and ischemia status in the tissues. Coronary artery bypass grafting (CABG) surgery is a procedure associated with high oxidative stress. Dexmedetomidine, an alpha-2 agonist anaesthetic agent, has antioxidant effects. In this study, the effects of dexmedetomidine on oxidative stress in CABG surgery were investigated.</p><p><strong>Methods: </strong>Patients who underwent on-pump CABG surgery were divided into two groups: those receiving dexmedetomidine (Group D) and those not receiving dexmedetomidine (Group C). From anesthesia induction to the end of surgery, patients in Group D received intravenous infusions of 0.05-0.2 mcg/kg/min remifentanil and 0.2-0.7 mcg/kg/h dexmedetomidine. Patients in Group C received intravenous infusion of 0.05-0.2 mcg/kg/min remifentanil. Blood samples were collected from the patients 30 min before induction of anesthesia (T1), 30 min after removal of the aortic cross-clamp (T2), and at the end of the surgery (T3). Thiol-disulfide homeostasis (TDH) was assessed using a novel method. A novel automated method enables the determination of native thiols, total thiols and disulfides levels in plasma, allowing the calculation of their respective ratios.</p><p><strong>Results: </strong>In patients receiving dexmedetomidine, lower postoperative levels of disulfide, disulfide/native thiol, and disulfide/total thiol, along with higher native thiol/total thiol, were observed compared to the control group. (p < 0.05) Postoperative native thiol and total thiol levels were similar for both groups. (p > 0.05) CONCLUSIONS: In our study, through dynamic thiol-disulfide measurements, we found that levels of oxidative stress (OS) were lower in patients who received dexmedetomidine. We believe that the positive effects of dexmedetomidine on OS could be beneficial in CABG surgery. Furthermore, we anticipate that with further studies conducted in larger patient cohorts, the clinical utilization of dexmedetomidine will become more widespread.</p><p><strong>Trial registration number: </strong>NCT05895331 / 06.07.2023.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"24 1","pages":"402"},"PeriodicalIF":2.3,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11542366/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603153","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}