Background: Pressure-controlled ventilation volume-guaranteed (PCV-VG) is being increasingly used for ventilation during general anesthesia. Carbon dioxide (CO₂) pneumoperitoneum in the Trendelenburg position is routinely used during robot-assisted laparoscopic gynecologic surgery. Here, we hypothesized that PCV-VG would reduce peak inspiratory pressure (Ppeak), compared to volume-controlled ventilation (VCV) and pressure-controlled ventilation (PCV).

High intraoperative inspired oxygen concentration is applied to prevent desaturation during induction and recovery of anesthesia. However, high oxygen concentration may lead to postoperative pulmonary complications. The purpose of this study is to compare the postoperative pulmonary parameters according to intraoperative inspired oxygen fraction in patients undergoing general anesthesia. We identified all randomized controlled trials investigating postoperative differences in arterial gas exchange according to intraoperative fraction of inspired oxygen (FiO₂). A total of 10 randomized controlled trials were included, and 787 patients were analyzed. Postoperative PaO₂ was lower in the high FiO₂ group compared with the low FiO₂ group (mean difference (MD) −4.97 mmHg, 95% CI −8.21 to −1.72, p = 0.003). Postoperative alveolar-arterial oxygen gradient (AaDO₂) was higher (MD 3.42 mmHg, 95% CI 0.95 to 5.89, p = 0.007) and the extent of atelectasis was more severe (MD 2.04%, 95% CI 0.14 to 3.94, p = 0.04) in high intraoperative FiO₂ group compared with low FiO₂ group. However, postoperative SpO₂ was comparable between the two groups. The results of this meta-analysis suggest that high inspired oxygen fraction during anesthesia may impair postoperative pulmonary parameters. Cautious approach in intraoperative inspired oxygen fraction is required for patients susceptible to postoperative pulmonary complications.

Objectives: This clinical trial is registered at ClinicalTrials.gov. (NCT02476981) This randomized, prospective double-blind study compared remifentanil with dexmedetomidine for monitored anaesthesia care during minimally invasive corrections of vertebral compression fractures (vertebroplasty or kyphoplasty). Methods: Patients > 65 years of age with American Society of Anesthesiologists (ASA) classification I–III, scheduled for vertebroplasty or kyphoplasty under monitored anaesthesia care, received remifentanil (i.v. infusion 1–5 µg/kg/h) or dexmedetomidine (loading dose 0.3–0.4 µg/kg followed by i.v. infusion 0.2–1 µg/kg/h) to maintain observer's assessment of alertness/sedation (OAA/S) scale <4 during the procedure. Results: There were no statistically significant differences in demographic data between the remifentanil ( n = 37) and dexmedetomidine groups ( n = 38). Patients on dexmedetomidine experienced lower mean arterial pressure (MAP) and heart rate (HR), and higher SpO₂ values, than patients on remifentanil. Compared with dexmedetomidine, remifentanil produced more respiratory depression, oxygen desaturation, and reduced the need for additional intraoperative opioids. There were no significant between-group differences in terms of recovery time, investigators’ satisfaction scores, or patients’ overall pain experiences. Conclusions: During monitored anaesthesia care, dexmedetomidine provides less respiratory depression, lower MAP and HR, but also less analgesic effect than remifentanil in elderly patients undergoing vertebroplasty or kyphoplasty.

Background and Objective: Obesity is associated with difficult or failed intubation attempts, making general anesthesia challenging for anesthesiologists to perform. The purpose of this study was to evaluate and compare the efficacy of a McCoy laryngoscope and a C-MAC D-blade video laryngoscope for intubation in obese patients with a body mass index (BMI) ≥ 35 kg/m². Methods: In total, 104 patients were randomly assigned to be intubated with a McCoy (McCoy group) or C-MAC D-blade video laryngoscope (C-MAC group). The primary outcome was intubation time. The secondary outcomes were vocal cord exposure time, vocal cord passage time, proportion of successful intubation, mask ventilation scale, intubation difficulty scale (IDS), percentage of glottis opening (POGO) score, and hemodynamic variables. Results: Although the intubation time did not significantly differ, the C-MAC group showed shorter vocal cord exposure times and a higher rate of successful vocal cord exposure within 5 s. The IDS value was significantly lower in the C-MAC group than in the McCoy group. The proportion of patients who required an increase in lifting force during laryngoscopy was higher in the McCoy group than in the C-MAC group, which may explain the difference in MAP between the groups. Conclusions: Both the McCoy laryngoscope and the C-MAC D-blade video laryngoscope were useful during the intubation of obese patients. The C-MAC D-blade video laryngoscope might be more useful for obese patients in terms of hemodynamic stability.