BMC Anesthesiology最新文献

{"title":"Cerebral oxygenation and hemodynamic changes during ephedrine and phenylephrine administration for transient intraoperative hypotension in patients undergoing major abdominal surgery: a randomized controlled trial.","authors":"Xueyan Li, Yijun Zheng, Jun Zhang","doi":"10.1186/s12871-025-02944-z","DOIUrl":"10.1186/s12871-025-02944-z","url":null,"abstract":"<p><strong>Background: </strong>Phenylephrine and ephedrine are frequently used vasopressors for treating intraoperative hypotension. However, their impact on cerebral oxygenation and blood flow remains a subject of debate. This study aims to understand their effects on cerebral oxygen saturation and hemodynamics when used for treatment of intraoperative hypotension.</p><p><strong>Methods: </strong>The adult patients undergoing major abdominal surgery under general anesthesia were randomly assigned into ephedrine (ED) group or phenylephrine (PE) group. They received an intravenous bolus of either ephedrine or phenylephrine for treating intraoperative transient hypotension. The primary outcome was their effects on regional cerebral oxygen saturation (rScO₂). The secondary outcomes included cerebral hemodynamics middle cerebral artery velocity (MCAvm), pulsatility index (PI), and resistance index (RI), as well as systemic hemodynamics arterial blood pressure (ABP), heart rate (HR), cardiac output (CO), cardiac index (CI), stroke volume (SV) and stroke volume index (SVI). Additionally, two indices of cerebral autoregulation, mean flow index (Mx_a) and cerebral oximetry index (CO_X), were calculated in real-time via ICM + software.</p><p><strong>Results: </strong>Forty patients were included in this study. The initial results showed ephedrine increased rScO₂ (p < 0.001), while phenylephrine increased Mx_a (p < 0.02) and CO_X (p < 0.007), respectively. However, upon further linear-mix model analysis, the effects of both drugs on rScO₂ (p = 0.944), Mx_a (p = 0.093) and CO_X (p = 0.084) were found to be non-significant. Compared with the hemodynamic parameters during hypotension, the systolic blood pressure (SBP) (p < 0.001), diastolic blood pressure (DBP) (p < 0.001), mean arterial pressure (MAP) (p < 0.001), and MCAvm (p < 0.001) significantly increased after both ephedrine and phenylephrine administration. However, no significant differences were found between the two groups in terms of the changes in MAP (p = 0.549) and MCAvm (p = 0.173). And there were significant increases in CO (p < 0.001), HR (p < 0.001), and CI (p < 0.001) following ephedrine administration, while decreases in HR (p < 0.001), CO (p < 0.001), and CI (p < 0.001) after phenylephrine administration.</p><p><strong>Conclusion: </strong>In the management of intraoperative hypotension, both phenylephrine and ephedrine effectively increase MAP and MCAvm, albeit with their differential effects on CO and HR. It seems that neither vasopressor has a significant impact on cerebral oxygenation and cerebral autoregulation.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"87"},"PeriodicalIF":2.3,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11841356/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143466413","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 application of reinforced endotracheal tubes with pressure indicators in preventing postoperative airway-related complications in neurosurgical patients: a randomized controlled study.","authors":"Xiaoqin Guan, Ying Tian, Jiaqi Yang, Yingying Jiang, Xiaoqin Luo, Yu Li, Chan Chen","doi":"10.1186/s12871-025-02967-6","DOIUrl":"10.1186/s12871-025-02967-6","url":null,"abstract":"<p><strong>Background: </strong>Excessive cuff pressure can lead to complications associated with endotracheal intubation. This study aims to compare the effects of cuff inflation guided by a pressure indicator versus the tactile estimation method on postoperative airway-related complications in neurosurgical patients.</p><p><strong>Methods: </strong>This study employed a prospective, randomized, double-blind, controlled design. Blinding was implemented for the subjects and data collectors. Subjects were randomly divided into two groups. The intervention group used tracheal tubes with pressure indicators. The control group used standard reinforced tracheal tubes. The primary outcome measure was the score of tracheal mucosal injury in two groups of subjects under bronchoscopy assistance with extubation. Secondary outcome measures included: (1) the incidence of tracheal mucosal injury assessed by bronchoscopy at the time of extubation; (2) the incidence of blood-stained cuff during extubation; (3) the incidence and severity of sore throat, and the incidence of hoarseness, blood-stained sputum, and coughing at 1 h and 24 h post-extubation.</p><p><strong>Results: </strong>The intervention group demonstrated a significantly lower tracheal mucosal injury score before extubation compared to controls (1.4 ± 0.274 vs. 2.7 ± 0.335; P = 0.009). There were no significant differences in immediate post-extubation complications or short-term (1-hour) postoperative symptoms. Notably, while the majority of 24-hour post-extubation outcomes remained comparable between groups, the intervention group exhibited significantly reduced sore throat severity at this timepoint (P = 0.044).</p><p><strong>Conclusion: </strong>The use of tracheal tubes with pressure indicators to control intraoperative cuff pressure could reduce postoperative airway mucosal damage in neurosurgical patients and alleviated post-extubation pharyngeal pain after 24 h.</p><p><strong>Trial registration: </strong>ChiCTR2200065315, first registered on 02/11/2022. The study was retrospectively registered.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"90"},"PeriodicalIF":2.3,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11841299/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143466513","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 direct and indirect images and hemodynamic response of two different video laryngoscopes to tracheal intubation.","authors":"Özlem Sezen, Tahsin Şimşek, Aynur Kaynar Şimşek, Gülten Arslan, Kemal Tolga Saracoglu, Ayten Saracoglu","doi":"10.1186/s12871-025-02966-7","DOIUrl":"10.1186/s12871-025-02966-7","url":null,"abstract":"<p><strong>Aims: </strong>The aim of this study was to compare the effects of two different videolaryngoscopes (VLs) on direct (through the mouth) and indirect (screen images) laryngoscopy and to evaluate their effects on hemodynamic response.</p><p><strong>Settings and design: </strong>A total of 70 patients between the ages of 18 and 65 years with ASA I-III physical status, planned for general anesthesia, with an expected difficult airway, were included in the study. Patients were enrolled in the study between 02/ 2022 and 06/ 2022. Patients were randomly divided into two groups. McGrath video laryngoscope was used in Group MC and Hugemed video laryngoscope was used in Group H. Modified Cormack Lehane and POGO scores (Percentage of glottic opening) of all patients on direct and indirect laryngoscopy were evaluated and recorded and then orotracheal intubation was performed. Demographic data, ASA status, Mallampati classification, thyromental distances and mouth opening were recorded. Standard monitoring was applied to all patients. During intubation, endotracheal intubation time, number of attempts, intubation-related complications and sore throat were recorded. Hemodynamic parameters (mean arterial pressure, peripheral oxygen saturation values) were recorded before, after induction and after intubation.</p><p><strong>Results: </strong>There was no difference between the groups in terms of descriptive characteristics (p > 0.05). When direct and indirect POGO scores were compared in group MC, no difference was found between the patients (p > 0.05). When direct and indirect POGO scores were compared, no difference was found between patients in Group H (p > 0.05). The mean POGO VL indirect score of Group H patients was found to be significantly higher than that of Group MC (p < 0.035) Both VLs showed similar results in terms of intubation time, number of attempts and hemodynamic findings.</p><p><strong>Conclusions: </strong>McGrath and Hugemed videolaryngoscopes provide a good laryngeal view with similar Cormack Lehane scores during non-difficult endotracheal intubation and facilitate successful intubation by maintaining hemodynamic stability. It was observed that the Hugemed VL had a better indirect POGO score, but the images provided by the blades of both VLs on direct laryngoscopy allowed intubation.</p><p><strong>Clinical trials registration number: </strong>NCT06649526. Clinical trials registration date 17/10/2024 ''retrospectively registered'\".</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"86"},"PeriodicalIF":2.3,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11841296/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143466443","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":"Intravenous patient-controlled analgesia versus epidural anesthesia in the treatment of patients undergoing total hip arthroplasty: a retrospective comparative study.","authors":"Qian Wu, Xiao Jun Zhi","doi":"10.1186/s12871-025-02931-4","DOIUrl":"10.1186/s12871-025-02931-4","url":null,"abstract":"<p><strong>Background: </strong>Total hip arthroplasty is a common surgical procedure used to reduce pain and improve hip joint function in patients with advanced hip inflammation. Patient-controlled epidural analgesia is more effective in reducing postoperative anxiety. In addition, combined spinal and epidural anesthesia is associated with a lower incidence of respiratory complications like atelectasis. This retrospective comaprative study compared the post operative analgesic effect and postoperative recovery of intravenous patient-controlled analgesia and patient-controlled epidural analgesia.</p><p><strong>Methods: </strong>A total of 200 patients received hip arthroplasty from January 2018 to January 2021. The patients were divided into the study group (patient-controlled epidural analgesia group, N = 110) and the control group (intravenous patient-controlled analgesia group, N = 90). Various factors were examined, including the surgical procedure, Ramsay Sedation Scale (RSS), resting visual analogue scale (VAS), Bruggrmann comfort scale (BCS), postoperative recovery, and the prevalence of postoperative adverse reactions.</p><p><strong>Results: </strong>The study group showed statistically significant shorter operation time, respiratory recovery time, eye opening time, extubation time, and orientation recovery time, lower RSS score at 4 h, 8 h, 12 h, 24 h, and 48 h compared to the control group. Similarly, the VAS score in the study group was significantly lower at the same time points after operation. Moreover, the BCS scores in the study group were significantly higher at the same time points after operation. The study group demonstrated statistically significant higher comfort levels and shorter times for first mobilization, first bowel movement, and length of hospital stay compared to the control group. Only four cases in the study group experienced nausea and vomiting, somnolence, dizziness, and respiratory depression, while 13 cases in the control group experienced nausea and vomiting, rash, lower limb fatigue, hypotension, drowsiness, dizziness, postoperative mental disorder, and respiratory depression.</p><p><strong>Conclusion: </strong>The results reveal that patient-controlled epidural analgesia offers superior pain relief, lower side effects, better post-operative analgesic effect, and better postoperative recovery. Patient-controlled epidural analgesia shows great promising clinical application potential for anesthesia after total hip arthroplasty.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"89"},"PeriodicalIF":2.3,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11841313/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143466535","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":"Prediction of hypertensive responses associated with interscalene block, a prospective cohort study.","authors":"Mahmut Sami Tutar, Ahmet Polat, Rabia Korkmaz, İlhami Aksoy, Fatih Doğar, Ahmet Yildirim, Muhammed Halit Satici, Munise Yildiz, Betul Kozanhan","doi":"10.1186/s12871-025-02947-w","DOIUrl":"10.1186/s12871-025-02947-w","url":null,"abstract":"<p><strong>Background: </strong>The aim was the effects of interscalene block (ISB) on blood pressure, focusing on identifying anatomical and clinical predictors of hypertensive responses. The aim is to improve the safety and effectiveness of ISB, especially in patients at increased risk of adverse hemodynamic events.</p><p><strong>Methods: </strong>We conducted a prospective cohort study including patients undergoing ISB. Key measurements included carotid intima-media thickness (CIMT), neck length, anterior scalene muscle thickness, BMI, age, history of diabetes mellitus, and hypertension. Blood pressure was monitored at multiple intervals, and logistic regression was used to identify independent systolic blood pressure elevation predictors.</p><p><strong>Results: </strong>A total of 110 patients were included in the study. Reduced anterior scalene muscle thickness (OR = 0.620, 95% CI = 0.462-0.833; p = 0.002), increased CIMT (OR = 1.006, 95% CI = 1.002-1.009; p = 0.001), and history of hypertension hypertension (OR = 4.31, 95% CI = 1.173-15.85; p = 0.028), were independent predictors of blood pressure elevation during ISB (p = 0.028, p = 0.001, p = 0.002). CIMT ≥ 750 μm and anterior scalene muscle thickness ≤ 12.75 mm were identified as critical cut-off values (p < 0.001 for both).</p><p><strong>Conclusions: </strong>Preoperative evaluation of anatomical and clinical predictors, such as CIMT and anterior scalene muscle thickness, may improve patient safety, particularly for high-risk individuals during ISB. However, the moderate predictive ability of these factors suggests that they should be considered part of a comprehensive preoperative risk assessment.</p><p><strong>Trial registration: </strong>NCT06394960, date: January 25, 2024, first patient registration date: May 2, 2024.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"82"},"PeriodicalIF":2.3,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11837286/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143456913","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 nasal clips combined with nasal cannulas in preventing hypoxemia during gastrointestinal endoscopy with sedation: a randomized controlled trial.","authors":"Rui Lu, Haifei Xiang, Minshu Zhu, Yan Cao, Xiandong Shao, Guo Yu, Tao-Hsin Tung, Wenjie Du, Lingyang Chen, Jianbin Cao, Mingcang Wang","doi":"10.1186/s12871-024-02863-5","DOIUrl":"10.1186/s12871-024-02863-5","url":null,"abstract":"<p><strong>Background: </strong>Gastrointestinal endoscopy with sedation is frequently complicated by hypoxemia. Nasal cannulas have limitations in eliminating hypoxemia. We hypothesized that the combination of nasal clips and nasal cannulas would improve the inspired oxygen concentrations and prevent hypoxemia compared with the use of nasal cannulas alone.</p><p><strong>Methods: </strong>A total of 600 adult patients were randomly assigned to receive supplemental oxygen through single-lumen nasal cannulas or through the combination of nasal clips and nasal cannulas. The primary outcome was the incidence of hypoxemia. Additionally, subclinical respiratory depression and severe hypoxemia, duration of hypoxemia, lowest SpO₂ level, measures to increase oxygen saturation level, and adverse events such as cough and hiccups were compared as secondary outcomes.</p><p><strong>Results: </strong>Three hundred patients in the nasal clip group and 296 patients in the nasal cannula group were included in the intention-to-treat analysis. Nasal clips significantly decreased the incidence of hypoxemia from 25.0-17.7%(RR = 0.707, 95% CI = 0.516 to 0.967, P = 0.029). The median and interquartile range of lowest SpO₂ in the nasal clip group (96 [92 to 98]) was significantly greater than that in the nasal cannula group (95 [89 to 97]; median difference = 1.000, 95% CI = 0.000 to 2.000, P = 0.004). No significant differences were found between the two groups in subclinical respiratory depression or severe hypoxemia, duration of hypoxemia, adverse events or measures taken to increase oxygen saturation.</p><p><strong>Conclusions: </strong>The combination of nasal clips and cannulas reduces hypoxemia during gastrointestinal endoscopy with sedation, demonstrating a significant advantage over the sole use of nasal cannulas, with tolerable adverse events.</p><p><strong>Trial registration: </strong>Chinese Clinical Trial Registry (ChiCTR2200065407).</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"83"},"PeriodicalIF":2.3,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11837456/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143456713","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":"Rhabdomyolysis in intensive care unit-distinctive clinical indicators and prognosis.","authors":"Zhen Wang, Qing Wang, Jinghan Chen, Leiming Cai","doi":"10.1186/s12871-025-02964-9","DOIUrl":"10.1186/s12871-025-02964-9","url":null,"abstract":"<p><strong>Background: </strong>Rhabdomyolysis is commonly encountered in intensive care unit (ICU), yet its clinical features and prognostic indicators have not been comprehensively defined. This study aims to identify clinical characteristics and outcomes of ICU patients with rhabdomyolysis, and assess if rhabdomyolysis predicts outcomes.</p><p><strong>Methods: </strong>This retrospective study investigated patients admitted to the ICU of Shanghai Baoshan District Wusong Central Hospital from 2022 to 2023. Clinical and laboratory indices, along with discharge outcomes, were analyzed.</p><p><strong>Results: </strong>The study included 151 patients, divided into Control group (CK ≤ 1000 U/L, n = 117) and RML group (CK > 1000 U/L, n = 34) groups. The RML group showed higher proportions of male gender (76.5% vs. 56.4%, p = 0.035), infection (88.2% vs. 68.4%, p = 0.022), muscle weakness (41.2% vs. 13.7%, p = 0.035), and myoglobin > 1000 U/L (55.9% vs. 14.5%, p < 0.001), but lower incidence of malignant tumors (0% vs. 17.9%, p = 0.017). The poor outcome rate (POR, the combined rate of death and cessation of treatment) was significantly higher in the RML group (52.9% vs. 33.3%, p = 0.038). Multivariate logistic regression analysis identified male gender [OR, 1.120-7.147; p = 0.028], sepsis [OR, 1.234-10.949; p = 0.019], and mechanical ventilation [OR, 1.489-8.478; p = 0.004] as independent risk factors for poor outcome in ICU patients. Rhabdomyolysis was not an independent risk factor.</p><p><strong>Conclusions: </strong>ICU patients with rhabdomyolysis experienced a significantly higher rate of poor outcomes. Male gender, sepsis, and mechanical ventilation were identified as independent risk factors for poor outcomes, while rhabdomyolysis itself was not found to be an independent risk factor. Prospective research is needed to validate these findings in diverse ICU populations.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"84"},"PeriodicalIF":2.3,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11837707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143456877","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":"Asymptomatic giant epiglottic cyst causing an unexpectedly difficult airway: a case report.","authors":"Shunyu Han, Guoyan Yang","doi":"10.1186/s12871-025-02948-9","DOIUrl":"10.1186/s12871-025-02948-9","url":null,"abstract":"<p><strong>Background: </strong>Giant epiglottic cysts can cause throat discomfort, a sensation of foreign body presence in the throat, and respiratory distress. Furthermore, individuals without symptoms might face difficulties with airway management during anesthesia-related emergencies. In extreme situations, a tracheostomy might be required.</p><p><strong>Case presentation: </strong>A 61-year-old man, who was diagnosed with a left heel spur, decided to undergo an arthroscopic osteotomy. The process of ventilating with an anesthesia mask grew more difficult and eventually impossible following the insertion of the laryngeal mask. The giant epiglottic cyst was identified through video laryngoscopy, which also facilitated successful tracheal intubation.</p><p><strong>Conclusion: </strong>For any surgery, it is essential to conduct a comprehensive anesthesia assessment, particularly for difficult airway risks. Using video laryngoscopy promptly can enhance intubation success, and suitable ventilation tools can help in failed intubation scenarios. While new technologies can facilitate airway assessment and management, mastering techniques like FONA techniques is still essential. However, calling for help in all cases remains paramount.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"85"},"PeriodicalIF":2.3,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11837400/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143456982","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 improving sleep quality the night before surgery with zolpidem on postoperative gastrointestinal function in patients undergoing laparoscopic partial colorectal resection: a randomized, double-blind, controlled trial.","authors":"Ruijia Gao, Yu Huang, Shimeng Mao, Hongyan He, Jinliang Yao, Jiying Feng, Ying Wang","doi":"10.1186/s12871-025-02959-6","DOIUrl":"10.1186/s12871-025-02959-6","url":null,"abstract":"<p><strong>Background: </strong>Sleep is one of the basic physiological needs of human beings. Preoperative sleep disorders are associated with poor prognosis in surgical patients, and sleep disorders have been shown to be one of the risk factors for gastrointestinal dysfunction. However, there are now few studies to investigate whether improving preoperative sleep disorders can promote the recovery of postoperative gastrointestinal function. This study aimed to investigate the effects and significance of improving preoperative sleep quality with zolpidem on postoperative gastrointestinal function.</p><p><strong>Methods: </strong>In this prospective, randomized, double-blind clinical trial, 76 patients undergoing elective laparoscopic partial colorectal resection and with a Pittsburgh Sleep Quality Index (PSQI) score > 5, were randomly divided into two groups. The zolpidem group (Group Z, n = 38) was given a capsule containing 10 mg of zolpidem the night before the operation, and the control group (Group C, n = 38) was given an empty capsule the night before the operation. Follow-up visits were performed on the 1st, 3rd, and 7th postoperative days, respectively. The primary outcome of this study was the I-FEED (Intake, Feeling nauseated, Emesis, Physical Exam, and Duration of symptoms) score on the third postoperative day (POD3). Secondary outcomes included time to postoperative first flatus, first feces, and first food intake (semi-liquid diet), I-FEED scores, visual analog scores (VAS) during coughing and at rest, times of patient-controlled intravenous analgesia (PCIA) effective presses, sufentanil dosage, number of remedial analgesia in the 24-hour postoperative period, and changes in inflammatory markers (TNF-α).</p><p><strong>Results: </strong>Compared with Group C, Group Z had a lower I-FEED score on POD1 (P < 0.05) and shorter time to first flatus and first food intake (P < 0.05); there were significant differences between the two groups in VAS scores during coughing and at rest on POD1, VAS score during coughing on POD3, times of PCIA effective presses and sufentanil dosage in the 24-hour postoperative period, and patient satisfaction (P < 0.05).</p><p><strong>Conclusion: </strong>For patients with sleep disorders, the use of zolpidem to improve sleep the night before surgery is beneficial in partially improving postoperative gastrointestinal function, relieving postoperative pain, and increasing patient satisfaction.</p><p><strong>Test registration: </strong>ChiCTR2300077566 November 13, 2023.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"80"},"PeriodicalIF":2.3,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834607/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448205","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":"Toxic effects of prolonged propofol exposure on cardiac development in zebrafish larvae.","authors":"Shaojie Qian, Huizi Liu, Hanwei Wei, Jintao Liu, Xiaojun Li, Xiaopan Luo","doi":"10.1186/s12871-025-02942-1","DOIUrl":"10.1186/s12871-025-02942-1","url":null,"abstract":"<p><strong>Background: </strong>Propofol, commonly used as an intravenous anesthetic during pregnancy, can easily penetrate the placental barrier, potentially affecting fetal heart development. This study aims to investigate propofol's impact on developing zebrafish heart structure and function, and identify potential drug targets.</p><p><strong>Methods: </strong>Zebrafish embryos were exposed to different concentrations of propofol (0.5, 1, and 5 mg/L) to observe changes in zebrafish larval heart structure and function (heart rate). In vitro cell experiments were conducted to assess the effects of propofol at different concentrations on cardiomyocyte viability and migration. Transcriptomic sequencing was utilized to identify and validate potential drug targets associated with propofol-induced cardiac toxicity.</p><p><strong>Results: </strong>The results demonstrate that propofol dose-dependently reduces the hatching and survival rates of zebrafish larvae, while increasing the rate of deformities. Transgenic green fluorescent zebrafish larvae exposed to propofol exhibit enlarged cardiac cavities, and HE staining reveals thinning of the myocardial wall. Additionally, propofol-treated zebrafish larvae show a decrease in heart rate. We also assess the impact of propofol on myocardial cell function, showing decreased cell viability, reduced migration function, and increased apoptosis. Finally, transcriptome sequencing analysis and differential gene co-expression network analysis identify agxt2 as a potential target of propofol-induced cardiac toxicity.</p><p><strong>Conclusion: </strong>In conclusion, our study indicates that propofol alters the structure and function of the developing zebrafish heart, with the mitochondrial-related gene agxt2 possibly being a target of its pharmacological effects.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"81"},"PeriodicalIF":2.3,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448285","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}