Vida Naderi Boldaji, Ali Reza Safarpour, Mohammad Ali Sahmeddini
{"title":"A systematic review on predictors of postreperfusion hyperkalemia during liver transplantation.","authors":"Vida Naderi Boldaji, Ali Reza Safarpour, Mohammad Ali Sahmeddini","doi":"10.1186/s12871-025-03234-4","DOIUrl":"10.1186/s12871-025-03234-4","url":null,"abstract":"<p><strong>Background: </strong>Liver transplantation (LT) is a well-known efficacious treatment for life-threatening liver diseases. This complicated surgery is significantly associated with morbidity and mortality. Hyperkalemia (a condition where the blood potassium level is ≥ 5 mEq/L) is a serious complication that occurs at all times during liver transplantation, but it happens more frequently within 5 min after reperfusion. Rapid changes in serum potassium levels have led anesthesiologists to predict the development of hyperkalemia and try to adjust blood potassium levels before reperfusion.</p><p><strong>Method: </strong>A systematic literature search was conducted in Web of Science, Scopus, Science Direct, and PubMed from January 1, 1990, to June 2023 for the published records on the recipients and donor-related characteristics known to contribute to the development of hyperkalemia after reperfusion during liver transplantation.</p><p><strong>Results: </strong>Higher baseline potassium, number and storage time of transfused RBC, administration of angiotensin receptor blockers, sodium bicarbonate, or bolus catecholamines, just before reperfusion, metabolic acidosis, low cardiac output, the use of venovenous bypass, lower intraoperative urine output, anesthesia time, and serum Albumin level, elevated effluent K levels, transplantation from an elderly donor, living-related donor, and donor with prolonged hospital stay known as risk factors of the occurrence of PRHK.</p><p><strong>Conclusion: </strong>In this study, we reviewed all donor-and recipient-related factors contributing to postreperfusion hyperkalemia during liver transplantation. We suggest more meticulous research on pathophysiological mechanisms and predisposing factors of PRHK caused by ECD liver transplantation.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"444"},"PeriodicalIF":2.6,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12403395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943287","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}
Manuel Sollmann, Lena Marie Bode, Sebastian Krämer, Martin Lacher, Sarah Dorothea Müller, Salome Breidenbach, Franziska Greul, Peter Zimmermann, Tobias Piegeler
{"title":"Superior recovery and efficiency with laryngeal mask airway compared to endotracheal intubation in minimally invasive repair of pectus excavatum: a retrospective analysis.","authors":"Manuel Sollmann, Lena Marie Bode, Sebastian Krämer, Martin Lacher, Sarah Dorothea Müller, Salome Breidenbach, Franziska Greul, Peter Zimmermann, Tobias Piegeler","doi":"10.1186/s12871-025-03320-7","DOIUrl":"10.1186/s12871-025-03320-7","url":null,"abstract":"<p><strong>Background: </strong>Minimally invasive repair is the standard treatment for patients with pectus excavatum. Recent data suggest that using a laryngeal mask airway during thoracic surgery might offer advantages over endotracheal intubation, such as faster recovery from surgery, shorter anesthesia times and fewer complications. The aim of this study was to evaluate the safety and potential benefits of laryngeal mask airway use in minimally invasive pectus excavatum repair.</p><p><strong>Methods: </strong>Retrospective analysis of electronic anesthesia protocols and records of patients who underwent pectus excavatum repair at a large academic center between 2019 and 2024. Perioperative data, complications, and procedural times were evaluated. Patients who had their airways secured with endotracheal intubation were compared to those who were ventilated using a laryngeal mask.</p><p><strong>Results: </strong>Data of 48 patients were analyzed (n = 32 with endotracheal intubation, n = 16 for laryngeal mask). The use of a laryngeal mask significantly shortened anesthesia induction time (4.0 vs. 7.5 min, p = 0.002), recovery time (9.1 vs. 19.0 min, p = 0.002) and emergence time (7.0 vs. 17.0 min, p < 0.001). Patients in the laryngeal mask group also had a significantly reduced need for postoperative oxygen supplementation (6.3 vs. 36.8%, p = 0.008). There were fewer anesthesiologic complications when a laryngeal mask was used, although this difference did not reach statistical significance (6.3 vs. 18.5%, p = 0.65). Hospital (6 vs. 5.5 days, p = 0.81) and ICU length of stay (21.73 vs. 23.84 h, p = 0.31), surgical complications (18.8 vs. 15.6%, p = 0.79) and incision-suture time (90.3 vs. 89.7 min, p = 0.92) were comparable in both groups.</p><p><strong>Conclusions: </strong>The use of a laryngeal mask in minimally invasive pectus excavatum repair is safe and effective. Its advantages- reduced respiratory complications and shorter anesthesia-related times-support its use as an alternative airway device for this procedure for medical as well as for economic reasons.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"438"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12400620/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943313","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":"Ultrasonography evaluation of the inferior vena cava collapsibility index and the superior vena cava distensibility index for predicting hypotension during general anesthesia in atrial fibrillation patients: a prospective observational study.","authors":"Xiaomei Li, Guangsui Yang, Suwen Hao, Changhua Zhu, Haijian Liu, Jiang Zhu","doi":"10.1186/s12871-025-03295-5","DOIUrl":"10.1186/s12871-025-03295-5","url":null,"abstract":"<p><strong>Background: </strong>Atrial fibrillation (AF) is a prevalent arrhythmia, the ineffective contraction of the atria leads to a decrease in effective cardiac output. AF patients are prone to hypotension during anesthesia, especially in the early stages of general anesthesia. We explored whether the inferior vena cava collapsibility index (IVCCI) or the superior vena cava distensibility index (SVCDI) could predict the occurrence of post-induction hypotension (PIH) and early intraoperative hypotension (eIOH) in AF patients.</p><p><strong>Methods: </strong>A total of 77 AF patients undergoing left atrial appendage occlusion under general anesthesia were included in this study. The inferior vena cava was measured before induction and the superior vena cava after induction. The main outcome was the ultrasound measurements of IVCCI and SVCDI in AF patients and their association with hypotension during general anesthesia. Hypotension was classified as the mean arterial pressure (MAP) below 60 mmHg or more than 20% below the baseline level. The correlation between IVCCI, SVCDI and the percentage decrease in MAP was assessed. Receiver operating characteristic (ROC) curves of IVCCI, SVCDI were separately generated to predict PIH and eIOH. Logistic regression was employed to validate the risk factors for PIH and eIOH in AF patients.</p><p><strong>Results: </strong>AF patients who developed PIH had a significantly higher IVCCI (P < 0.001) and developed eIOH had a significantly higher SVCDI (P < 0.001). ROC curve analysis showed that IVCCI had an accuracy of 85% to predict PIH at a cut-off point more than 34.1% (P < 0.001). SVCDI had an accuracy of 86% to predict eIOH at a cut-off point more than 17.8% (P < 0.001). After adjusting for confounding variables, IVCCI was an independent predictor of PIH (P < 0.001), while SVCDI was an independent predictor of eIOH (P < 0.001).</p><p><strong>Conclusion: </strong>Preoperative IVCCI > 34.1% indicates a non-invasive predictor of PIH in AF patients; SVCDI > 17.8% suggest a reliable predictor of eIOH in AF patients.</p><p><strong>Trial registration: </strong>This trial was registered on June 27, 2023 at the China Clinical Trial Center (http://www.chictr.org.cn; No. ChiCTR2300072846).</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"440"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12403413/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943297","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}
Mohammad Fouad Algyar, Ahmed Anas Zahra, Ahmed Samir Elshikhali, Essam Ahmed Abdelhameed, Dalia Ahmed El Hefny, Saad Ahmed Moharam, Mohammed Said ElSharkawy, Omar Sayed Farghaly, Mohammed Awad Ahmed
{"title":"Analgesic efficacy of different volumes in erector spinae plane block in patients undergoing single level lumbar spine fixation: a non-inferiority randomized trial.","authors":"Mohammad Fouad Algyar, Ahmed Anas Zahra, Ahmed Samir Elshikhali, Essam Ahmed Abdelhameed, Dalia Ahmed El Hefny, Saad Ahmed Moharam, Mohammed Said ElSharkawy, Omar Sayed Farghaly, Mohammed Awad Ahmed","doi":"10.1186/s12871-025-03247-z","DOIUrl":"10.1186/s12871-025-03247-z","url":null,"abstract":"<p><strong>Background: </strong>Using a lower volume (LVs) of local anaesthetic (LA) reduces the risk of toxicity, side effects, and cost. Our study assessed whether the lower LA volumes (10 or 15 ml) have the same analgesic efficacy as 20 ml of erector spinae plane block (ESPB) in single-level lumbar spine fixation.</p><p><strong>Methods: </strong>Our non-inferiority, randomised, double-blind trial recruited sixty cases scheduled for single-level lumbar spine fixation. All cases had bilateral ultrasound-guided (USG) ESPB before the surgery by bupivacaine 0.25% and were randomised into three groups according to the volume used: 10 ml for the E10 group, 15 ml for the E15 group, and 20 ml for the E20 group. The primary outcome was total morphine consumption. The secondary outcomes were pain scores, time of first analgesic, side effects, and patient satisfaction.</p><p><strong>Results: </strong>There was a non-inferior positive analgesic effect in terms of intraoperative fentanyl consumption, time till first rescue analgesia (P = 0.862), postoperative morphine within the first 24 and 48 h, and pain score in groups E10 and E15 compared to group E20 (P > 0.05). Patients who required intraoperative fentanyl were 4 (20%) in group E10, 2 (10%) in group E15, and 1 (5%) in group E20 (P = 0.322). Postoperative morphine within the first 24 h was 3.6 ± 1.23 mg in group E10, 3.3 ± 0.92 mg in group E15, 3.3 ± 0.92 mg in group E20 (P = 0.575), and at 48 h was 6.8 ± 1.65 mg in group E10, 6.2 ± 1.81 mg in group E15, 5.6 ± 1.76 mg in group E20 (P = 0.103). Intraoperative hemodynamic measurements, ambulation time, patient satisfaction, and complications were comparable among the three groups (P > 0.05).</p><p><strong>Conclusions: </strong>Preoperative ESPB is an effective analgesic technique for single-level lumbar spine fixation, with LVs proving non-inferior to higher volumes in clinical outcomes while potentially minimizing toxicity and side effects.</p><p><strong>Trial registration: </strong>Registration at clinical trial gov. (ID: NCT05892887). The date of the first registration submission was (2023-05-10), and the study started on 2023-06-01.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"439"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12400640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943310","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":"\"I had a knot in my heart\": unusual complication after implantation of a Swan-Ganz catheter.","authors":"Zulfugar T Taghiyev, Andreas Böning","doi":"10.1186/s12871-025-03317-2","DOIUrl":"10.1186/s12871-025-03317-2","url":null,"abstract":"<p><strong>Background: </strong>The implantation of a Swan-Ganz catheter for invasive hemodynamic monitoring is an established measure after cardiac surgery. A rare but serious complication is the formation of a knot in the heart, which can be diagnostically challenging. We report on a patient who developed left heart failure postoperatively after quadruple bypass surgery combined with aortic valve replacement and in whom a knot formed inadvertently during monitoring using a Swan-Ganz catheter.</p><p><strong>Case presentation: </strong>An 82-year-old female underwent combined quadruple coronary artery bypass grafting and aortic valve replacement for severe coronary and valvular heart disease. Postoperatively, she experienced acute left ventricular dysfunction, necessitating mechanical circulatory support with an Impella device. A Swan-Ganz catheter was placed through the internal jugular vein for accurate hemodynamic monitoring. After placement, unexpected catheter immobility raised suspicion of an intracardiac knot. Initial transthoracic echocardiography did not clearly visualize the lesion; however, subsequent chest radiography and jugular vein ultrasound confirmed catheter-associated intracardiac knot formation. Considering the heightened risk for cardiac injury and thromboembolic events, interdisciplinary consensus recommended bedside surgical extraction. The catheter and associated knot were successfully removed via transcutaneous vascular incision without complications. Inspection revealed knot formation proximal to the catheter thermistor, while the balloon remained intact and functional.</p><p><strong>Conclusion: </strong>Intracardiac knot formation associated with Swan-Ganz catheter placement is rare but presents significant risks. Timely interdisciplinary assessment, multimodal imaging, and surgical extraction under controlled conditions effectively mitigate potential complications, enabling safe catheter removal and favorable patient outcomes.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"441"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12403380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943213","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}
Essamedin M Negm, Mohammed A Younus, Ahmed A Morsy, Sahar M S El Gammal, Mona A El-Harrisi, Fayrouz A Abdel Sameaa, Rawan A M Rashad, Tamer S Elserafy, Ahmed M Gouda
{"title":"Opioid-sparing multimodal analgesia for post-craniotomy pain: a randomized, double-blind, placebo-controlled trial.","authors":"Essamedin M Negm, Mohammed A Younus, Ahmed A Morsy, Sahar M S El Gammal, Mona A El-Harrisi, Fayrouz A Abdel Sameaa, Rawan A M Rashad, Tamer S Elserafy, Ahmed M Gouda","doi":"10.1186/s12871-025-03306-5","DOIUrl":"https://doi.org/10.1186/s12871-025-03306-5","url":null,"abstract":"","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"437"},"PeriodicalIF":2.6,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12395639/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943262","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":"Balancing thrombosis and hemorrhage: anticoagulation-free VA-ECMO with a multidisciplinary strategy for cerebellar hemorrhage complicated by takotsubo syndrome.","authors":"Xianli Chen, Yalan Qin, Wenqi Huang, Youhua Wang","doi":"10.1186/s12871-025-03312-7","DOIUrl":"https://doi.org/10.1186/s12871-025-03312-7","url":null,"abstract":"","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"436"},"PeriodicalIF":2.6,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12395905/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943369","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}
Shereen E Abd Ellatif, Asmaa M Galal Eldin, Ehab Sabry Ali, Heba M Fathi
{"title":"Ultrasound-guided modified versus conventional serratus anterior plane block as a preemptive analgesic for unilateral video-assisted thoracoscopic surgery.","authors":"Shereen E Abd Ellatif, Asmaa M Galal Eldin, Ehab Sabry Ali, Heba M Fathi","doi":"10.1186/s12871-025-03314-5","DOIUrl":"https://doi.org/10.1186/s12871-025-03314-5","url":null,"abstract":"<p><strong>Purpose: </strong>Various approaches to serratus anterior plane (SAP) block have been discussed in the literature. The present study aimed to compare the analgesic efficacy and postoperative pulmonary function recovery of modified serratus anterior plane block (MSAP) and conventional serratus anterior plane block (CSAP) in patients undergoing video-assisted thoracoscopic surgery (VATS).</p><p><strong>Methods: </strong>A total of 99 patients who underwent thoracoscopic surgery were randomly divided into three equal groups: a control group (C group) that received no block, a CSAP group that received preoperative conventional serratus anterior plane block, and an MSAP group that received preoperative modified serratus anterior plane block. The primary outcome was the first 24-hour tramadol consumption. The secondary outcomes were first-time-to-rescue analgesia, postoperative visual analogue score (VAS), postoperative respiratory function, and perioperative hemodynamics.</p><p><strong>Results: </strong>The lowest tramadol consumption and longest time to first rescue analgesia were observed in the MSAP group. The postoperative VAS score at 2, 4, and 6 h was significantly greater in the control group, but it was comparable between the two block groups. At 8 h, the VAS score was the lowest in the MSAP group. At 12, 16, and 24 h, the VAS scores were comparable among the three groups. The MSAP group presented the best respiratory function during the first postoperative 8 h. Heart rate and mean arterial blood pressure were similar in both block groups but were greater in the control group during the intraoperative period.</p><p><strong>Conclusion: </strong>The modified serratus anterior plane block is more efficient than the conventional serratus anterior plane block at reducing opioid consumption, prolonging rescue analgesic time, and improving pulmonary function recovery in patients undergoing video-assisted thoracoscopic surgery.</p><p><strong>Trial registration: </strong>This clinical trial was approved by the Zagazig University Institutional Review Board (IRB #10060/30-10-2022), was first submitted to clinical trials.gov on 1/12/2022 and was subsequently registered retrospectively on 22/12/2022 (NCT05661253). The first research participant was enrolled on 2/12/2022.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"435"},"PeriodicalIF":2.6,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12395965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943282","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}
Xinlei Lu, Siyue Li, Ye Xuan, Mengting Shen, Weiping Lei, Yaqin Huang, Yibin Tao, Yuan Cheng, Jianliang Sun
{"title":"Effects of sufentanil combined with remifentanil on hemodynamics during induction and postoperative recovery quality in preschool children undergoing tonsillectomy and adenoidectomy.","authors":"Xinlei Lu, Siyue Li, Ye Xuan, Mengting Shen, Weiping Lei, Yaqin Huang, Yibin Tao, Yuan Cheng, Jianliang Sun","doi":"10.1186/s12871-025-03315-4","DOIUrl":"https://doi.org/10.1186/s12871-025-03315-4","url":null,"abstract":"","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"431"},"PeriodicalIF":2.6,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12395757/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144942881","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":"Comparing the efficacy of combining ketorolac and Paracetamol (Acetaminophen) with Paracetamol alone on postoperative pain after laminectomy. A double-blinded randomized clinical trial.","authors":"Shaho Shoja, Khaled Rahmani, Nasrin Soufizadeh, Shapour Shoja","doi":"10.1186/s12871-025-03335-0","DOIUrl":"https://doi.org/10.1186/s12871-025-03335-0","url":null,"abstract":"<p><strong>Background: </strong>Postoperative pain management has driven a shift toward non-opioid analgesics. Combining Paracetamol (Acetaminophen) and Ketorolac, a multimodal analgesic approach shows potential. However, evidence on the synergistic effects of these combinations remains limited, particularly for laminectomy.</p><p><strong>Methods: </strong>This randomized, double-blinded controlled trial was conducted between March 2023 and December 2024. Eligible patients were adults undergoing laminectomy who met the inclusion and exclusion criteria. Participants were randomized to receive either conventional Paracetamol (1000 mg) with or without Ketorolac (30 mg) every 6 h for 24 h. Primary outcomes included postoperative morphine consumption and pain intensity measured by the Visual Analogue Scale (VAS). Secondary outcomes included hemodynamic changes and the incidence of postoperative nausea and vomiting (PONV).</p><p><strong>Results: </strong>A total of 90 patients completed the study, with comparable baseline demographics between groups. The intervention group required significantly less morphine (0.35 ± 0.95 mg) compared to the control group (1.33 ± 3.03 mg) in the first 24 h post-surgery (p = 0.02). Pain intensity decreased over time in both groups, with no significant differences observed in VAS scores. Hemodynamic parameters were more stable in the intervention group, with lower systolic and diastolic blood pressures over time; however, some results were not statistically significant. The incidence of PONV was similar between groups.</p><p><strong>Conclusions: </strong>While the combination therapy demonstrated trends toward improved hemodynamic stability, some parameters, such as DBP and MAP, did not reach statistical significance, warranting further exploration. Further research is recommended to validate the broader applicability of this combination in various surgical contexts.</p><p><strong>Trial registration: </strong>The study was registered at irct.behdasht.gov.ir/trial/66,286 (IRCT20221010056140N1, registration date: 01/28/2023).</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"432"},"PeriodicalIF":2.6,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12395926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943348","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}