BMC Anesthesiology最新文献

{"title":"Development and validation of a prediction model for post-induction hypotension in elderly patients undergoing non-cardiac surgery: a prospective cohort study.","authors":"Zhen Bian, Wei Dou, Yaoyu Ying, Haijing Shi, Fuhai Ji, Jinghui Hu, Ke Peng","doi":"10.1186/s12871-025-03090-2","DOIUrl":"https://doi.org/10.1186/s12871-025-03090-2","url":null,"abstract":"<p><strong>Backgrounds: </strong>Post-induction hypotension (PIH) is prevalent in elderly surgical patients and associated with adverse outcomes; however, predicting PIH remains challenging. We aimed to develop a feasible and practical PIH prediction model for elderly patients undergoing non-cardiac surgery.</p><p><strong>Methods: </strong>In this single-center prospective cohort study, 938 elderly patients undergoing non-cardiac surgery were enrolled from December 2022 to May 2023 (n = 657 in the development cohort) and from June 2023 to August 2023 (n = 281 in the temporal validation cohort), respectively. The study outcome was the occurrence of PIH, defined as hypotension during the first 15 min after anesthesia induction or until skin incision (whichever occurred first). Predictors were determined based on LASSO and logistic regression analyses. A nomogram and a dynamic application were used for model visualization. The internal and temporal validation were performed to evaluate the discriminability, calibration and clinical utility.</p><p><strong>Results: </strong>The median age was 71 years in both cohorts. The incidence of PIH was 51.6% and 50.5% in the development and validation cohorts, respectively. Cardiac function, baseline mean arterial pressure in the ward, etomidate use, and pre-induction mean arterial pressure were determined as predictors. The PIH prediction model was visualized as a nomogram and a dynamic application. The area under the receiver operating characteristic curve was 0.680 (95% confidence interval [CI]: 0.639 to 0.720) in internal validation and 0.697 (95% CI: 0.635 to 0.759) in temporal validation. The mean absolute errors were 0.012 and 0.029 for the internal and temporal validation calibration curves, respectively. The Brier score was 0.223. The decision curve analysis indicated that the model had a gain in predicting PIH.</p><p><strong>Conclusion: </strong>A PIH prediction model with four predictors was developed and validated for elderly patients undergoing non-cardiac surgery. This model provides a foundation for future refinements to enhance its value of assisting clinical decision-making across diverse healthcare settings.</p><p><strong>Trial registration: </strong>This study was registered at the Chinese Clinical Trial Registry (ChiCTR2200066201).</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"217"},"PeriodicalIF":2.3,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12036260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143987013","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":"Strategy for effective analgesia with intravenous buprenorphine in patients with acute postoperative pain.","authors":"Mateusz Szczupak, Jacek Kobak, Maria Cimoszko-Zauliczna, Sabina Krupa-Nurcek, Anna Ingielewicz, Jolanta Wierzchowska","doi":"10.1186/s12871-025-03084-0","DOIUrl":"https://doi.org/10.1186/s12871-025-03084-0","url":null,"abstract":"<p><strong>Background: </strong>Analgesic treatment is the primary method for managing acute postoperative pain. Opioid analgesics are the main class of drugs used to treat moderate to severe pain, whether it is acute or chronic. These opioids differ in various ways, including their pharmacochemical properties, distribution and absorption rates, metabolism, and elimination pathways for the drug and its metabolites. These differences result in varying degrees of analgesic efficacy, which, in clinical practice, allows for the selection of the most effective drug that maximizes pain relief while ensuring safety. Buprenorphine is a semi-synthetic opioid with properties that are not yet fully understood. It has a wide range of applications in treating both acute and chronic pain, including non-cancer and cancer-related pain. One of the most significant clinical advantages of buprenorphine is its safety profile, which includes a ceiling effect on respiratory depression, no immunosuppressive effects, inhibition of hyperalgesia, no cumulative effects in patients with renal failure, and a low risk of constipation following its use.</p><p><strong>Aim: </strong>This study aims to analyze current reports on the use of intravenous buprenorphine as a first-line opioid analgesic for postoperative pain relief. The paper discusses the pharmacochemical properties of the drug and the mechanisms behind postoperative pain. Additionally, it presents the experiences of the pain management team at Copernicus Hospital in Gdansk regarding administering intravenous buprenorphine.</p><p><strong>Material and methods: </strong>The current literature on buprenorphine for treating moderate to severe acute pain has been reviewed, focusing on its effectiveness in managing postoperative pain following surgical procedures. Additionally, the experience of the Copernicus Hospital pain team with buprenorphine is summarized in a brief discussion.</p><p><strong>Conclusion: </strong>After reviewing current literature and recommendations, along with the experiences of the pain management team at Copernicus Hospital in Gdańsk, it can be concluded that buprenorphine is an analgesic that demonstrates a high level of efficacy and safety. When used in combination with non-opioid analgesics, buprenorphine achieves a synergistic effect, resulting in effective pain relief. This approach facilitates early patient rehabilitation and enables a swift return to normal activities, even following extensive surgical procedures.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"216"},"PeriodicalIF":2.3,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12034152/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969678","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":"Prevalence of frailty and its effect on requirement of organ support and clinical outcomes in critically ill patients: a prospective observational single center study.","authors":"Dhananjay Kumar Singh, Venkata Ganesh, Neeru Sahni, Balaji Kannamani, Vikas Saini, Laxminarayana Yaddanapudi","doi":"10.1186/s12871-025-03096-w","DOIUrl":"https://doi.org/10.1186/s12871-025-03096-w","url":null,"abstract":"<p><strong>Background: </strong>Assessing pre-hospital frailty on ICU admission can help in risk stratification. We conducted this prospective, observational study to determine the prevalence of frailty in critically ill patients based on Clinical Frailty Scale (CFS) within 24 h of admission and to study effect of frailty on requirement of organ support and clinical outcome.</p><p><strong>Methods: </strong>The study was registered in Clinical Trials Registry-India (CTRI/2021/04/032782) on 13/04/2021. After approval from IEC and written informed consent, all adult patients admitted to our ICU from April 15th, 2021 to April 14th, 2022 were included. The patients were categorized as Frail & Non-Frail, defining frailty as CFS ≥ 5, two weeks before index admission. The groups were compared for requirement of organ support (vasoactive support, mechanical ventilation, renal replacement therapy) and clinical outcomes (hospital acquired infections (HAI), hospital and ICU length of stay (LOS) and hospital, ICU and 30-day mortality).</p><p><strong>Result: </strong>Out of 358 admissions, 317 were enrolled. The demographic data were comparable except for higher family income amongst frail patients, p < 0.001. The prevalence of frailty was 24.6%. A significantly higher number of frail patients required vasoactive support (p = 0.006). Incidence of HAI in frail group was significantly higher (48.7%) as compared to non-frail group (20.9%) (p < 0.001). The median ICU LOS was 7 days [IQR, 3-7] in frail compared to 6 days [IQR,3-10] in non-frail group, p = 0.051. The median hospital LOS in frail patients was 18 days [IQR,10-32] compared to 15 days [IQR, 8.25-26] in non-frail, p = 0.005. ICU, hospital and 30-day mortality were significantly higher in frail patients, p < 0.01.</p><p><strong>Conclusion: </strong>The prevalence of frailty in ICU patients was 24.6% and a higher number of frail patients had requirement of vasopressor support and incidence of HAI. Additionally, frail patients also had longer hospital LOS and higher ICU, hospital and 30-day mortality.</p><p><strong>Trial registration: </strong>CTRI/2021/04/032782.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"215"},"PeriodicalIF":2.3,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12034203/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143978559","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":"Incidence and predictors of perioperative mortality in Ethiopia: a systematic review and meta-analysis.","authors":"Tikuneh Yetneberk, Diriba Teshome, Abebe Tiruneh, Yohannes A Dersesh, Nega Getachew, Moges Gelaw, Meseret Firde","doi":"10.1186/s12871-025-03093-z","DOIUrl":"https://doi.org/10.1186/s12871-025-03093-z","url":null,"abstract":"<p><strong>Introduction: </strong>The Lancet Commission on Global Surgery highlights perioperative mortality rate (POMR) as a key indicator of a nation's surgical system effectiveness. While POMR is often measured in high-income countries, it is less studied in low- and middle-income countries (LMICs). This study aims to assess the POMR and its predictors in Ethiopia.</p><p><strong>Methods: </strong>We conducted a thorough literature search across PubMed/MEDLINE, Embase, Web of Science, Scopus, and Google Scholar for studies from Ethiopia between 2019 and 2023 reporting POMR for various surgical procedures. Data were extracted in duplicate from eligible studies. We used random-effects meta-analysis to pool estimates of POMR and its predictors.</p><p><strong>Results: </strong>The meta-analysis revealed a POMR of 5.36%. Identified predictors of perioperative mortality in Ethiopia included older age, comorbidities, ICU admission, and an ASA physical status classification of III or higher and emergency surgeries.</p><p><strong>Conclusion: </strong>Ethiopia's perioperative mortality rate is significantly high. Improving surgical care quality and safety, along with expanding access to surgical services, is crucial for bettering surgical outcomes in the country.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"214"},"PeriodicalIF":2.3,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12034119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976887","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":"Effectiveness of ultrasound-guided versus anatomical landmark-guided percutaneous dilatational tracheostomy: a systematic review and meta-analysis.","authors":"Dan Wen, Xiuru Yang, Zhenghua Liang, Yang Hu, Simei Wang, Dan Zhang, Yao Wang, Yuqi Shen, Fenglin Yan","doi":"10.1186/s12871-025-03085-z","DOIUrl":"https://doi.org/10.1186/s12871-025-03085-z","url":null,"abstract":"<p><strong>Background: </strong>Percutaneous dilatational tracheostomy (PDT) is increasingly used in intensive care units owing to its advantages of reduced surgical trauma and fewer complications. Recently, ultrasonography has become a potentially useful tool for assisting PDT.</p><p><strong>Objective: </strong>To compare ultrasound- and landmark-guided PDT for major bleeding, first-puncture success rates, periprocedural complications, and tracheotomy procedure times.</p><p><strong>Methods: </strong>Randomized controlled trials (RCTs) or non-RCTs comparing ultrasound- and landmark-guided PDT were searched for in PubMed, Web of Science, MEDLINE, CINAHL, Cochrane Library, Wanfang Data Knowledge Service Platform, China National Knowledge Infrastructure (CNKI) and the Chinese Biomedical Literature Service System (SinoMed). The primary outcomes were major bleeding and first puncture success rate. Secondary outcomes were periprocedural complications and the tracheotomy procedure time. The meta-analysis was performed using RevMan 5.3 software.</p><p><strong>Results: </strong>This meta-analysis included five RCTs and one non-RCT, with a total of 609 patients. Compared with landmark-guided PDT, ultrasound-guided PDT can reduce the incidence of major bleeding (odds ratio [OR] = 0.35, 95% confidence interval [CI; 0.14, 0.90], P = 0.03) and improved the success rate of first puncture (OR = 4.41, 95% CI [2.54, 7.65], P < 0.000001). Additionally, ultrasound-guided PDT is associated with a lower incidence of periprocedural complications (OR = 0.35, 95% CI [0.22, 0.54], P < 0.00001). However, there was no advantage in reducing the tracheotomy procedure time between the two methods (mean difference = - 0.64, 95% CI [-4.14, 2.85], P = 0.72).</p><p><strong>Conclusion: </strong>Compared to landmark-guided PDT, ultrasound-guided PDT can reduce the incidence of major bleeding and periprocedural complications and increase the success rate of the first puncture. However, the advantage of ultrasound-guided PDT in reducing the tracheotomy procedure time is unclear.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"211"},"PeriodicalIF":2.3,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12023463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143973281","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":"Etomidate-Induced myoclonus in Sprague‒Dawley rats involves the activation of neocortical Calpain-2 and its decrement on KCC2 protein.","authors":"Yan Feng, Yong-Xiang Cheng, Xing-Hao Wang","doi":"10.1186/s12871-025-03065-3","DOIUrl":"https://doi.org/10.1186/s12871-025-03065-3","url":null,"abstract":"<p><strong>Background: </strong>Etomidate-induced myoclonus has become a pressing clinical problem with an incidence of 50-80%. The underlying mechanism involves neocortical glutamate accumulation and N-methyl-d-aspartate (NMDA) receptor activity. However, the therapeutic target remains uncertain.</p><p><strong>Methods: </strong>Adult male Sprague-Dawley (SD) rats were injected with etomidate (1.5 mg/kg), propofol (11.8 mg/kg), and lidocaine (4.0 mg/kg) plus etomidate (1.5 mg/kg), etomidate (3.8 mg/kg), etomidate (6.0 mg/kg) through the tail vein and behavioral scores of the rats were recorded within 5 min after anesthesia to establish the model of etomidate-induced myoclonus and to observe the dose dependence. The in vitro Western blot analysis of NKCC1 and KCC2 proteins and the regulatory effect of N-methyl-d-aspartate (NMDA) receptor were performed to find the potential target of etomidate-induced myoclonus or excitability. Additionally, to verify whether calpain-2 is involved in the process of regulatory effect of NMDAR on the cleavage of KCC2 protein during etomidate-induced myoclonus, muscular tension and KCC2 protein were analyzed in rats microinjected with calpain-2 inhibitor (MDL-28170) or MDL-28170 + NMDA in the neocortical motor cortex during etomidate anesthesia. Finally, MDL-28170 or vitamin E was injected intravenously before etomidate, the muscular tension, KCC2 protein and duration of loss of righting reflex (LORR) of rats were evaluated to verify the neuroprotective effect of vitamin E.</p><p><strong>Results: </strong>Etomidate significantly increased the mean behavioral score at different time points compared with the propofol and lidocaine + etomidate groups within 5 min after anesthesia; the mean behavioral score decreased at different time points with increasing dose of etomidate. 0.5 µM ( 0.73 ± 0.18 vs. 1.04 ± 0.17, n = 6, p = 0.0096) and 1 µM (0.73 ± 0.24 vs. 1.03 ± 0.14, n = 6, p = 0.0077) etomidate induced the decrement of neocortical KCC2 protein compared to the control group. NMDA activated but 2-amino-5-phosphonopentanoic acid (AP5) inhibited 0.5 and 1 µM etomidate-induced decrement of neocortical KCC2 protein. MDL-28170 microinjected into the neocortex during etomidate anesthesia not only inhibited the decrement of KCC2 protein but also blocked the muscular tension induced by etomidate alone or etomidate plus NMDA. Intravenous injection of vitamin E prevented etomidate-induced muscular tension and decrement of the KCC2 protein.</p><p><strong>Conclusion: </strong>Calpain-2 was involved in the process of etomidate-induced myoclonus and NMDAR activity by promoting the decrement of KCC2 protein and exerting the excitability. Vitamin E, as a natural antioxidant, can effectively prevent etomidate-induced myoclonus and does not affect recovery after etomidate anesthesia in rats.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"213"},"PeriodicalIF":2.3,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12023595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985919","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 comparison of McGrath MAC, AIRWAY SCOPE^®, and AceScope^® video laryngoscopes in novice healthcare providers: a randomized crossover simulation study.","authors":"Musashi Yahagi, Kyuma Omi, Yuichi Yaguchi","doi":"10.1186/s12871-025-03094-y","DOIUrl":"https://doi.org/10.1186/s12871-025-03094-y","url":null,"abstract":"<p><strong>Background: </strong>Video laryngoscopes are widely used for tracheal intubation, particularly in challenging airway scenarios. The McGrath MAC, AIRWAY SCOPE^®, and AceScope^® are popular video laryngoscopes with different design features. This study aimed to compare the effectiveness and usability of these three devices in novice healthcare providers during simulated tracheal intubation scenarios employing a manikin.</p><p><strong>Methods: </strong>Sixty novice healthcare providers, including nurses and pharmacists, were enrolled in this randomized crossover study. Participants performed tracheal intubation using the McGrath MAC, AIRWAY SCOPE, and AceScope in both normal airway and cervical spine immobilization models. Primary outcomes were intubation success rate and time to intubation. Secondary outcomes included user preferences, device ease of use, and the incidence of dental injuries.</p><p><strong>Results: </strong>The AIRWAY SCOPE demonstrated the shortest intubation time in both normal airway and cervical spine immobilization models (14.90 ± 1.76 s and 23.80 ± 2.43 s, respectively), followed by the McGrath MAC and AceScope. All devices exhibited high success rates, and there were no significant differences in perceived difficulty among the three video laryngoscopes. The incidence of dental injuries was generally comparable among the devices. However, in the cervical spine immobilization model, the AceScope demonstrated a significantly higher rate of dental injuries compared to the McGrath MAC (p < 0.05), highlighting a potential concern for clinical practice.</p><p><strong>Conclusions: </strong>The AIRWAY SCOPE was the most efficient video laryngoscope in terms of intubation time, followed by the McGrath MAC and AceScope. However, all devices showed high success rates and no significant differences in perceived difficulty. Further research is needed to validate these findings in clinical settings and investigate the impact of device-specific features on intubation outcomes and dental injury incidence.</p><p><strong>Trial registration: </strong>Registration number: jRCT1030240598 ( https://jrct.niph.go.jp/re/reports/detail/91422 ) The registration date of the clinical trial is January 8, 2025.UMIN000050394.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"212"},"PeriodicalIF":2.3,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12023392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972743","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":"Family members' experiences with intensive care unit diaries.","authors":"Vincenzo Bosco, Caterina Mercuri, Rita Nocerino, Michał Czapla, Izabella Uchmanowicz, Rocco Mazzotta, Vincenza Giordano, Silvio Simeone","doi":"10.1186/s12871-025-03083-1","DOIUrl":"https://doi.org/10.1186/s12871-025-03083-1","url":null,"abstract":"<p><strong>Background: </strong>The admission of a family member to intensive care represents an emotionally complex experience, often characterised by anxiety, stress and uncertainty. ICU diaries, compiled by nurses and family members, have been proposed as a useful tool to support caregivers' psychological well-being, improve communication and humanise the care environment. The aim of the study was to describe the content of ICU diaries filled out by family members to explore the experiences and meanings attributed to the diaries.</p><p><strong>Methods: </strong>The study used a qualitative approach based on thematic analysis of diaries completed by 16 family members of patients admitted to intensive care units. The data were coded and analysed to identify recurrent themes and to understand the emotional and psychological experience of the family members.</p><p><strong>Results: </strong>Three main themes emerged from the analysis: time, the family context (including maintaining contact with the patient, the relatives'emotions, fear of suffering, spirituality, the person at the centre of the relatives' lives and connection with the outside world) and the usefulness of the diary in understanding the care process. The diaries facilitated the continuity of the affective bond with the patient, offered a space to express emotions and improved communication with healthcare professionals.</p><p><strong>Conclusion: </strong>The results highlight the value of ICU diaries in supporting family members during the patient's admission, reducing stress and strengthening the relationship with the healthcare team. The practical implications suggest the importance of promoting the structured use of diaries to foster more empathetic and family-centred care.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"210"},"PeriodicalIF":2.3,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12023576/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963384","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 serratus posterior superior intercostal plane block on postoperative analgesia in patients undergoing breast cancer surgery: a randomized controlled trial.","authors":"Bengü G Köksal, Çağdaş Baytar, Emine Bayraktar, Hakan Balbaloğlu","doi":"10.1186/s12871-025-03092-0","DOIUrl":"10.1186/s12871-025-03092-0","url":null,"abstract":"<p><strong>Background: </strong>The serratus posterior superior intercostal plane block (SPSIPB) is a newly described truncal block. This study aimed to compare the effects of SPSIPB with conventional methods on postoperative opioid consumption and pain scores within 24 h postoperatively.</p><p><strong>Methods: </strong>This randomized controlled trial included 60 patients aged 18-65 years with an American Society of Anesthesiologists Physical Status of I-III. Patients were randomly assigned to either the SPSIPB or the control group. The primary outcome was cumulative opioid consumption within the first 24 h postoperatively. Secondary outcomes included resting and dynamic Numerical Rating Scale (NRS) pain scores, Quality of Recovery (QoR)-15 questionnaire scores, intraoperative remifentanil consumption, and the incidence of postoperative nausea and vomiting.</p><p><strong>Results: </strong>Total tramadol consumption was significantly lower in the SPSIPB group during the first 12 h and at the end of the 24th hour postoperatively compared with the control group (p < 0.05). The dynamic NRS score at 0 h postoperatively was lower in the SPSIPB group (p = 0.001), whereas no significant differences in NRS scores were observed at other time-points. The postoperative QoR-15 scores were significantly higher in the SPSIPB group compared with the control group. Furthermore, the SPSIPB group had significantly lower intraoperative remifentanil consumption (p = 0.003). Nausea and vomiting were more frequent at 12 and 24 h postoperatively in the control group compared with the SPSIPB group.</p><p><strong>Conclusions: </strong>Serratus posterior superior intercostal plane block significantly reduced opioid use, and improved recovery quality after oncoplastic breast surgery.</p><p><strong>Trial registration: </strong>NCT06225908, registered at ClinicalTrials.gov.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"209"},"PeriodicalIF":2.3,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12020093/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143974981","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":"Dexamethasone as an additive to bupivacaine in an ultrasound-guided adductor canal block for the management of persistent pain after arthroscopic reconstruction of the anterior cruciate ligament: a randomized, double-blind study.","authors":"Saeid Elsawy, Amani Abdelwahab, Yara Hamdi, Rasha Ahmed Ali Hamed","doi":"10.1186/s12871-025-02921-6","DOIUrl":"https://doi.org/10.1186/s12871-025-02921-6","url":null,"abstract":"<p><strong>Background: </strong>Pain is a protective response to noxious stimuli to prevent further damage. The surgical incision results in several events that lead to pain that outlasts its benefits. Persistent postsurgical pain (PPSP) is defined as \"pain that persists for three months after surgical intervention.</p><p><strong>Objectives: </strong>To investigate the effect of dexamethasone as an adjuvant to adductor canal block on persistent postsurgical pain after ACL reconstruction.</p><p><strong>Patients and methods: </strong>Ninety patients who underwent arthroscopic reconstruction of the anterior cruciate ligament and who completed the study were randomly allocated into two groups. Forty-five patients in each group received ultrasound-guided adductor canal block at the end of surgery. G I (Dexa group): Forty-five patients received a 20 ml mixture of 0.25% bupivacaine and 8 mg dexamethasone (2 ml). G II (control group): Patients received a 20 ml mixture of 0.25% bupivacaine and 2 ml of normal saline.</p><p><strong>Results: </strong>No significant differences in demographic data, intraoperative hemodynamics or surgery duration were detected between the two groups. The duration of postoperative analgesia was significantly longer in the dexamethasone group (10 h ± 3 vs. 6 h ± 1) than in the control group. Additionally, 24 h postoperative consumption of meperidine was significantly lower in the dexamethasone group (65 ± 23 vs. 104 ± 27) than in the control group. Postoperative VAS scores at 6 and 12 h were also lower in the dexamethasone group than in the control group. Three-month follow-up revealed a significantly lower incidence of PPSP in the dexamethasone group (20% versus 33% in the control group). Moreover, the severity of PPSP was significantly lower in the dexamethasone group than in the control group. Additionally, Codeine consumption was significantly lower in the dexamethasone group than in the control group.</p><p><strong>Conclusion: </strong>Perineural dexamethasone in ultrasound-guided adductor canal block reduced the severity of PPSP and opioid analgesia consumption in the first three months following arthroscopic reconstruction of the ACL.</p><p><strong>Clinical trial registration: </strong>The study was registered on clinical trial registration (NCT04631822) in October 2020.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"208"},"PeriodicalIF":2.3,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12020280/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143979256","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}