BMC Anesthesiology最新文献

{"title":"Efficiency and safety of double-lumen bronchial tube and bronchial blocker for one-lung ventilation in patients with thoracic surgery: a meta-analysis.","authors":"Yuchen Wu, Yatao Liu, Han Ruan, Zhigang Zhang, Junfen Yang, Ning Li, Guoqiang Wang, Xin Wang","doi":"10.1186/s12871-025-03144-5","DOIUrl":"10.1186/s12871-025-03144-5","url":null,"abstract":"<p><strong>Objectives: </strong>To compare the efficiency and safety of double-lumen bronchial tube (DLBT) and bronchial blocker (BB) for one-lung ventilation (OLV) in patients with thoracic surgery.</p><p><strong>Methods: </strong>A systematic search was conducted across Chinese databases and English databases from the inception of the databases until December 31, 2024. Two researchers independently screened the literature and extracted data. A meta-analysis was then performed using Review Manager 5 and Stata 18.0 software. The quality of the studies was assessed using the Cochrane bias risk assessment tool, and a summary of findings (SoF) table was generated using GRADEprofiler Version 3.6.1.</p><p><strong>Results: </strong>A total of 39 RCTs were included, comprising 1360 patients in the BB group and 1349 patients in the DLBT group. The excellent rate of lung collapse quality in the BB group was 0.94 times that in the DLBT group [I² = 32%, P = 0.07, fixed-effects; RR = 0.94; 95% CI (0.90, 0.99); P = 0.01]. There was no significant difference in intubation time [I² = 97%, P < 0.00001; SMD = -0.51; 95% CI (-1.17, 0.14); P = 0.12], the success rate of first-attempt intubation [I² = 79%, P < 0.00001; RR = 1.04; 95% CI (0.93, 1.15); P = 0.51] or in the incidence of malposition[I² = 50%, P = 0.01; RR = 1.36; 95% CI (0.95, 1.96); P = 0.10)] between the two groups. However, there was a significant difference in positioning time, with the BB group showing shorter positioning times compared to the DLBT group [I² = 98%, P < 0.00001; SMD = -0.85; 95% CI (-1.50, -0.21); P = 0.004]. Compared to the DLBT group, the BB group was associated with a reduced incidence of hoarseness, sore throat, tracheal mucosal injury, hypoxemia, and pneumonia.</p><p><strong>Conclusion: </strong>The DLBT group demonstrated certain advantages in terms of lung collapse time and quality of lung collapse. However, BB demonstrate significantly shorter positioning time compared to DLBT, and it is also associated with lower risks of multiple complications, including hoarseness, sore throat, tracheal injury, hypoxemia, and pneumonia, highlighting its safety advantage in postoperative care.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"281"},"PeriodicalIF":2.3,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12125885/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191506","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":"Analysis of the feasibility of a low-anticoagulation strategy in patients undergoing post-cardiotomy extracorporeal membrane oxygenation: a retrospective cohort study.","authors":"Yan Wang, Liangshan Wang, Hongfu Fu, Jin Li, Chenglong Li, Shuai Zhang, Xing Hao, Hong Wang, Zhongtao Du, Xiaotong Hou","doi":"10.1186/s12871-025-03153-4","DOIUrl":"10.1186/s12871-025-03153-4","url":null,"abstract":"<p><strong>Background: </strong>Extracorporeal membrane oxygenation (ECMO) is increasingly used in patients after cardiac surgery; however, anticoagulation management has consistently been challenging. This study aimed to explore the feasibility of a low-anticoagulation strategy for post-cardiotomy ECMO (PC-ECMO).</p><p><strong>Methods: </strong>A retrospective comparison was performed between two anticoagulation targets in adult patients undergoing veno-arterial ECMO after cardiac surgery at the Beijing Anzhen Hospital (Beijing, China) between January 2018 and November 2023. The low-anticoagulation (LAC) strategy group consisted of patients with an activated partial thromboplastin time (APTT) ratio of 1-1.5, whereas the conventional anticoagulation (CAC) strategy group included those with an APTT ratio of 1.5-2.5. The primary outcome was thrombotic complications associated with ECMO. Secondary outcomes included bleeding events, pulmonary infection, need for renal replacement therapy, in-hospital mortality rate, ECMO support duration, hours of mechanical ventilation, anticoagulation fraction, length of hospitalization, and transfusion volume(s).</p><p><strong>Results: </strong>The study included data from 203 patients, who were divided into two groups: LAC (n = 108 [53.2%]) and CAC (n = 95 [46.8%]). Propensity score matching was used to balance confounding variables. A total of 43 patient pairs were successfully matched, and no significant difference was observed in thrombotic complications between the LAC and CAC groups (30.2% versus [vs.] 25.3%, respectively; p = 0.810). Meanwhile, no significant differences were observed in secondary outcomes and subgroups within the matched cohort, except for ECMO support time, which was shorter in the LAC group (119.6 h vs. 146.0 h; p = 0.015).</p><p><strong>Conclusion: </strong>The low-anticoagulation strategy was feasible for PC-ECMO support.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"275"},"PeriodicalIF":2.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12123780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186576","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":"Ivabradine use in critical care: a systematic review and metanalysis of cardiogenic and septic shock patients.","authors":"Lorenzo Antonino Calabrò, Marco Pasetto, Sabino Scolletta, Filippo Annoni, Zoe Demailly, Katarina Halenarova, Katia Donadello, Fabio Silvio Taccone","doi":"10.1186/s12871-025-03121-y","DOIUrl":"10.1186/s12871-025-03121-y","url":null,"abstract":"<p><strong>Introduction: </strong>In patients with acute illness, compensatory tachycardia initially serves to maintain adequate cardiac output, oxygen delivery and tissue oxygenation but may persist despite appropriate fluid and vasopressor resuscitation or may be secondary to inotropic therapy. Sustained tachycardia is a predictor of adverse outcomes in critical illness. Ivabradine, a highly selective inhibitor of the sinoatrial node's pacemaker current (I_f or \"funny\" current), mitigates tachycardia by modulating diastolic depolarization slope without affecting contractility.</p><p><strong>Aim: </strong>To report the existing evidence on the use of ivabradine in critically ill patients and assess its effect on rate control.</p><p><strong>Methods: </strong>A systematic literature search was performed up to May 2024 in the MEDLINE/PubMed®, Cochrane Controlled Clinical Trial register, EMBASE® and Scopus® databases. The search included: P- only original studies conducted in humans admitted to the Intensive Care Unit (ICU); I - when ivabradine administration was tested; C - in presence or absence of a control group; O - for any outcome; S - including case reports, randomized and observational trials, published in English in peer-reviewed journals.</p><p><strong>Results: </strong>After the first screening, 39 studies were assessed for eligibility on a total of 682 records identified. Among those, 29 were excluded; 10 studies (4 randomized controlled trial, 5 case report/series, 1 prospective observational), including a total of 243 patients, were included in the qualitative analysis, 6 studies were included in the quantitative analysis. The use of ivabradine resulted in a pooled mean heart rate reduction of 18.70 [12.70-24.80] bpm (p < 0.01) without a significant decrease in cardiac index (p = 0.59). A significant reduction of noradrenaline dose was reported in one study (-0.134 mcg/kg/min; 95% CI -0.172 to -0.012; p = 0.027). In addition, the combination of dobutamine with ivabradine has been reported to optimize dobutamine inotropic action, while mitigating its positive chronotropic effects, resulting in a more efficient cardiac cycle and improved hemodynamics.</p><p><strong>Conclusions: </strong>Ivabradine may be a useful alternative to beta-blocker in the management of inappropriate sinus tachycardia. Yet, evidence is limited and inconsistent. Larger randomized trials are needed to investigate the potential benefits or hazards of ivabradine use on hemodynamics and long-term outcomes.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"276"},"PeriodicalIF":2.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12125779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186577","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 the effects of two different local anesthetics used in spinal anesthesia on peripheral and central temperature change: a randomized controlled trial.","authors":"Azra Ozanbarcı, Hatice Kılınç, Bünyamin Muslu, Safinaz Karabayırlı, Seyfi Kartal, Güler Eraslan Doğanay, Melek Doğancı, Abdullah Kahraman, Oral Mentes, Yasemin Dayıca","doi":"10.1186/s12871-025-03148-1","DOIUrl":"10.1186/s12871-025-03148-1","url":null,"abstract":"<p><strong>Objective: </strong>In this study, we aimed to compare the effects of two different local anesthetics with different baricity used in spinal anesthesia on thermoregulation.</p><p><strong>Materials and methods: </strong>Our study was conducted on forty full-term pregnant women scheduled for elective cesarean sections under spinal anesthesia. At an operating room temperature of twenty-four degrees Celsius, peripheral body temperature was measured using temperature probes attached to the lower medial parts of the same side's lower and upper extremities, and central body temperature was measured with a tympanic thermometer. Isobaric levobupivacaine and hyperbaric bupivacaine were used in spinal anesthesia applications. After spinal anesthesia, tympanic temperature, arm and leg temperatures, mean arterial pressure, heart rate, and oxygen saturation were measured and recorded at baseline, the first, third, and fifth minutes, and every five minutes thereafter until the end of surgery.</p><p><strong>Results: </strong>In the bupivacaine group, a decrease in tympanic temperature was observed at the third minute and an increase in leg skin temperature at the fifth minute compared to baseline values. In the levobupivacaine group, a decrease in tympanic temperature was observed at the fifth minute, and an increase in leg skin temperature was observed at the third minute. In both groups, within-group comparisons showed a continued decrease in tympanic temperature and increase in leg temperature at all subsequent time points compared to baseline. No statistically significant difference was observed in arm skin temperatures within groups in either group.</p><p><strong>Conclusion: </strong>We observed that the effects of hyperbaric bupivacaine and isobaric levobupivacaine used in spinal anesthesia on thermoregulation were similar.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"271"},"PeriodicalIF":2.3,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12121188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180707","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 non-intubated and intubated video-assisted thoracoscopic surgery for perioperative complications-a systematic review and meta-analysis.","authors":"Diaofeng Zhang, Jie Wu, Yihan Yang, Ruifang Pu, Zixiao Liu, Yun Li, Wei Deng, Jiale Wang, Bo Hou, Zengcai Ge, Jiao Gao, Jiangang Li, Liming Cheng","doi":"10.1186/s12871-025-03154-3","DOIUrl":"10.1186/s12871-025-03154-3","url":null,"abstract":"<p><strong>Background: </strong>Non-intubated video-assisted thoracic surgery (NIVATS) avoids lung injury and intubation-related complications from mechanical ventilation, but the intraoperative safety and postoperative recovery quality of NIVATS remain controversial. Consequently, we systematically assessed the viability and safety of non-intubated video-assisted thoracic surgery (NIVATS) in comparison to intubated video-assisted thoracic surgery (IVATS). These findings provide evidence for optimizing anesthetic and surgical decision-making.</p><p><strong>Methods: </strong>PubMed, Web of Science, Embase, Cochrane Library, OVID, and Google Scholar were queried from their establishment until October 2024. We included eligible studies that compared non-intubated anesthesia with intubated anesthesia for video-assisted thoracoscopic surgery for thoracic conditions. Following the evaluation of bias risk in these randomized controlled trials (RCTs), a meta-analysis was conducted using Review Manager (Manager 5.4).</p><p><strong>Results: </strong>Nineteen randomized controlled trials were incorporated into the study. NIVATS demonstrated a reduced length of hospital stay, feeding time, and chest-tube dwell time compared to intubated methods. IVATS groups, hypoxemia exhibited a reduced incidence, but perioperative cough and perioperative arrhythmias revealed no statistically significant differences between IVATS and NIVATS groups. The NIVATS groups exhibited a significantly reduced risk compared to the IVATS groups for postoperative pulmonary complications (PPCs), postoperative nausea and vomiting (PONV), and sore throat.</p><p><strong>Conclusions: </strong>NIVATS avoid complications associated with intubation and are able to accelerate patient recovery to a certain extent. Although NIVATS carries intraoperative safety risks, careful patient selection can mitigate these risks.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"272"},"PeriodicalIF":2.3,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12121218/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of anesthesia type on postoperative pain and outcomes in primary hip and knee arthroplasty: a retrospective register analysis.","authors":"Keno Sponheuer, Diana Becker-Rux, Stephan Scheike, Lukas Barsch, Christina Pempe, Christian Pfrepper, Andreas Roth, Robert Werdehausen","doi":"10.1186/s12871-025-03127-6","DOIUrl":"10.1186/s12871-025-03127-6","url":null,"abstract":"<p><strong>Background: </strong>This study explores the effects of single-sided spinal versus general anesthesia on patients undergoing hip and knee arthroplasty within a fast-track surgery environment. Although many studies suggest better outcomes with neuraxial anesthesia in lower extremity joint replacement, its benefits in fast-track surgery remain unclear.</p><p><strong>Methods: </strong>A retrospective analysis was performed on data derived from 283 patients. We focused on patients who had undergone primary, elective, and unilateral endoprosthetic fast-track hip or knee joint replacement surgeries between May 15, 2019, and November 30, 2020. The primary objective was to ascertain the correlation between the type of anesthesia and several postoperative parameters, including pain intensity, analgesia requirements, incidence of postoperative nausea and vomiting, perioperative process times, and hospital length of stay, based on the collected data.</p><p><strong>Results: </strong>Our findings indicated no difference in pain intensity and patient satisfaction between the general (n = 195) and single-sided spinal anesthesia (n = 61) groups at the first postoperative day. However, a notable difference was observed in the recovery room, with patients under spinal anesthesia requiring significantly less piritramide than those after general anesthesia. Both groups had a similar incidence of postoperative nausea and length of hospital stay.</p><p><strong>Conclusions: </strong>When analyzed retrospectively, the type of anesthesia applied is not associated with an increased risk of postoperative pain, postoperative nausea and vomiting, or prolonged hospital stay. Overall, neither anesthesia method outperforms the other concerning patient satisfaction, emphasizing the importance of patient preference and individual risk factors in the decision-making process.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"274"},"PeriodicalIF":2.3,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12124000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180716","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 propofol combined with remimazolam besylate on blood pressure during general anesthesia induction in patients undergoing gynecological laparoscopic surgery: single-centre randomized controlled trial.","authors":"Xinmin Zhao, Haigen Xu, Shuping Wang, Yuanyuan Chen, Shuyu Yue","doi":"10.1186/s12871-025-03156-1","DOIUrl":"10.1186/s12871-025-03156-1","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Hypotension often occurs during intraoperative anesthesia induction in gynecological laparoscopic surgery. Remimazolam is reportedly associated with lesser intraoperative hypotension than propofol. This trial was conducted to evaluate the effect of propofol combined with remimazolam besylate on post-induction hypotension (PIH) in patients undergoing gynecological laparoscopic surgery.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;All enrolled patients were randomly assigned to receive propofol (Group P), remimazolam besylate plus propofol (Group PR), or remimazolam besylate (Group R). Patients in group P received 2.0 mg/kg propofol, Sufentanil 0.4 μg/kg, and rocuronium bromide 0.8 mg/kg; Patients in group PR received remimazolam besylate 0.2 mg/kg, propofol 1.0 mg/kg, Sufentanil 0.4 μg/kg, and rocuronium bromide 0.8 mg/kg; Patients in group R received remimazolam besylate 0.4 mg/kg, Sufentanil 0.4 μg/kg, and rocuronium bromide 0.8 mg/kg; the anesthesia was maintained with propofol 4-10 mg/kg/h and remifentanil 0.1-0.3 μg/kg/min. The primary outcome was the incidence of hypotension after anesthesia induction. Hypotension was defined as a mean arterial pressure (MAP) reduced 30% or more from the baseline MAP value or MAP &lt; 65 mmHg. Blood pressure was recorded five times during anesthesia. Time points T0, T1, T2, T3 and T4, were base line, before tracheal intubation, 1 min after tracheal intubation, 5 min after intubation, and immediately after surgical skin incision, respectively. The secondary outcomes were heart rate and bispectral index (BIS). Heart rate and BIS were measured from T0 to T4.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;One hundred sixty-nine patients were included in this study. A total of 30 patients in the three groups developed hypotension after anesthesia induction, among which the incidence of PIH induced in group P was 31.6% (18/57), the incidence of PIH induced in group PR was 14.3% (8/56), and the incidence of PIH induced group R 7.1% (4/56), and there was a statistical difference in the incidence of PIH between the three groups (χ2 = 12.24, p = 0.0022). The heart rates in group R (70.53 ± 13.36 bpm, 88.48 ± 13.53 bpm, and 72.68 ± 13.42 bpm) were significantly higher than that in group P (63.68 ± 10.76 bpm, 80.25 ± 12.50 bpm, and 66.35 ± 11.56 bpm) at T1, T2 and T4 (p &lt; 0.05, respectively). The heart rate in group R (88.48 ± 13.53 bpm) was significantly higher than that in group PR (80.00 ± 13.42 bpm) at T2 (p &lt; 0.05). There was no statistically significant difference between group PR and group P (p &gt; 0.05). BIS was significantly higher in group R than that in group P and in group PR at T3 and T4 (p &lt; 0.05, respectively). There was no statistically significant difference between group PR and group P (p &gt; 0.05).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Both Propofol plus remimazolam besylate and remimazolam besylate alone can reduce PIH, but propofol plus remimazolam besylate smooths the heart rate after general anesthesia","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"273"},"PeriodicalIF":2.3,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12121196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180097","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":"Bridging the gap between scientists and clinicians: addressing collaboration challenges in clinical AI integration.","authors":"Mia Gisselbaek, Joana Berger-Estilita, Arnout Devos, Pierre Luigi Ingrassia, Peter Dieckmann, Sarah Saxena","doi":"10.1186/s12871-025-03130-x","DOIUrl":"10.1186/s12871-025-03130-x","url":null,"abstract":"<p><p>This article explores challenges for bridging the gap between scientists and healthcare professionals in artifical intelligence (AI) integration. It highlights barriers, the role of interdisciplinary research centers, and the importance of diversity, equity, and inclusion. Collaboration, education, and ethical AI development are essential for optimizing AI's impact in perioperative medicine.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"269"},"PeriodicalIF":2.3,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12105364/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149296","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 analgesic efficacy of erector spinae plane block at different levels in laparoscopic cholecystectomies: a randomized controlled trial.","authors":"Serpil Şehirlioğlu, Ümran Yaman, Ayfer Kaya Gök, Ülkü Aygen Türkmen, Döndü Genç Moralar, Muhammed Özdemir","doi":"10.1186/s12871-025-03138-3","DOIUrl":"10.1186/s12871-025-03138-3","url":null,"abstract":"<p><strong>Background: </strong>Erector Spinae Plane Block (ESPB) is employed as a component of multimodal analgesia in laparoscopic cholecystectomy (LC) procedures. The objective of this study is to assess the impact of ESPB performed at different levels during LC operations on postoperative pain scores and opioid consumption.</p><p><strong>Methods: </strong>A total of 103 patients undergoing LC were divided into three groups: Group Th7 (ESPB administered at the 7th thoracic vertebra level), Group Th9 (ESPB administered at the 9th thoracic vertebra level), and the control group. Patients were evaluated at 30 min, 1, 4, 8, 12, and 24 h postoperatively. Morphine consumption within the first 24 h postoperatively, resting and dynamic Numeric Rating Scale (NRS) scores, and complication rates were assessed.</p><p><strong>Results: </strong>When comparing morphine consumption among the groups, it was observed that patients who received ESP blocks had significantly lower morphine consumption at 1, 4, 8, 12, and 24 h compared to the control group. However, no significant difference was found between Group Th7 and Group Th9. In Group Th7 and Group Th9, the resting NRS scores at 30 min, 1, 4, and 24 h, as well as all dynamic NRS scores except at the 8th hour, were significantly lower compared to the control group. However, there was no significant difference between Group Th7 and Group Th9.</p><p><strong>Conclusion: </strong>In LC surgeries, ESPB administered at the Th7 and Th9 levels exhibited similar analgesic efficacy. ESPB applied at the Th7 and Th9 levels can be utilized as part of multimodal analgesia.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"270"},"PeriodicalIF":2.3,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12107835/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149300","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":"Hemodynamic control during cardiopulmonary bypass and the incidence of postoperative delirium- a post hoc analysis.","authors":"Helena Claesson-Lingehall, Birgitta Olofsson, Yngve Gustafson, Alexander Wahba, Micael Appelblad, Staffan Svenmarker","doi":"10.1186/s12871-025-03141-8","DOIUrl":"10.1186/s12871-025-03141-8","url":null,"abstract":"<p><strong>Background: </strong>Delirium is a common neurological complication after cardiac surgery. The purpose of the present study was to analyze the association between hemodynamic fluctuations during cardiopulmonary bypass (CPB) and the incidence of postoperative delirium (POD) in patients undergoing cardiac surgery with CPB.</p><p><strong>Methods: </strong>This post hoc analysis included one-hundred-ninety-five (n = 195) patients aged ≥ 65 years of whom seventy (n = 70) patients developed POD. Intraoperative hemodynamic variables specifically related to the conduct of CPB were digitally recorded at 1-minute intervals. Variables outside the presumed safe boundaries for mean arterial pressure (MAP), systemic perfusion flow index- L/min/BSA (QBSA_I), systemic venous oxygen saturation (S_VO₂) and arterial oxygen delivery- ml/min/BSA (DO₂) were defined and analyzed with reference to indices of area under the curve (AUC) and the relative proportion of registrations related to POD. POD was diagnosed according to DSM-5 criteria based on a test battery performed preoperatively and repeated twice postoperatively. Statistical tests used to verify observations outside the predefined norm included the Mann-Whitney U test and the chi-squared test.</p><p><strong>Results: </strong>Markers of hemodynamic control during CPB showed significant associations with POD. Both DO₂ (P = 0.02) and QBSA_I (P < 0.001) identified POD patients outside the predefined upper and lower safety limits. S_VO₂ values > 84% (P < 0.001) werealso associated with the development of POD. The number of S_VO₂ registrations below the lower safety limit was negligible, why statistical analysis seemed not useful. No association between MAP and POD registrations was identified.</p><p><strong>Conclusions: </strong>This study revealed a clear association between markers of hemodynamic control and POD. These associations were most pronounced for DO₂ and QBSA_I. The detected association between high S_VO₂ and POD warrants further insight.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"267"},"PeriodicalIF":2.3,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12105260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149327","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}