Background: When performing spinal anesthesia for cesarean section, it is important to determine the appropriate anesthetic dose as well as to predict the level of spinal anesthesia. In this study, it was hypothesized that some anthropometric measurements may be related to maximum sensory block and hemodynamic changes. Objectives: The aim of this study are to find maternal anthropometric values that are correlate with the level of spinal anesthesia. Methods: Maternal anthropometric measurements, including height, weight, supine and standing abdominal circumference (AC), and hip circumference, were recorded before spinal anesthesia for cesarean section. Spinal anesthesia was induced by administering 8 mg of 0.5% hyperbaric bupivacaine and 20 μg of fentanyl at the L3-L4 interspace. The level of sensory block was determined using pin-prick at 1, 5, 10, and 15 minutes after spinal anesthesia. The sensory block level and hemodynamic adverse events were analyzed in relationship to anthropometric measurements. Results: The supine AC/height ratios significantly correlate with the maximal sensory block level at 5, 10, and 15 minutes after the injection of spinal anesthetic (P = 0.001, P < 0.001 and P < 0.001, respectively). Further, there were significant correlations between body mass index (BMI) and sensory block level at every assessment (P = 0.041, P = 0.002, P = 0.001 and P < 0.001, respectively). When comparing the groups with and without hypotension, BMI, weight, and supine AC/height ratio were found to be significantly higher in the group with hypotension (P = 0.002, P = 0.004 and P = 0.006, respectively). Conclusions: We conclude that BMI and AC/height ratio correlate with the sensory block level of spinal anesthesia for cesarean section.

Background and Objectives: Evidence regarding the prevalence of neuropathic pain in patients with cervical radicular pain is limited. This study aimed to investigate the prevalence of neuropathic pain components in patients with cervical radicular pain using established screening tools and identify the relationship between neuropathic pain components and clinical factors. Materials and Methods: Data from 103 patients (aged ≥ 20 years) with cervical radicular pain who visited our pain clinic were analyzed retrospectively. Demographic characteristics, history of neck surgery, pain intensity using numeric rating score, dominant pain site, duration of symptoms, and neck disability index were assessed. The prevalence of neuropathic pain components was defined according to the Douleur Neuropathique 4 questions and painDETECT questionnaire tools. Patient characteristics were compared using the chi-square test or Fisher’s exact test for categorical variables and the independent t-test or Mann–Whitney U test for continuous variables. The correlation between neck disability index and other variables was analyzed using Pearson’s correlation coefficient. Results: Of the 103 patients, 29 (28.1%) had neuropathic pain components. The neck disability index was significantly higher (p < 0.001) for patients in the neuropathic pain group (23.79 ± 6.35) than that in the non- neuropathic pain group (18.43 ± 7.68). The Douleur Neuropathique 4 questions (r = 0.221, p < 0.025) and painDETECT questionnaire (r = 0.368, p < 0.001) scores positively correlated with the neck disability index score. Conclusions: The prevalence of neuropathic pain components in patients with cervical radicular pain was low. The patients in our study showed a strong correlation between functional deterioration and their neuropathic pain screening score. This study may be useful in understanding the characteristics of cervical radicular pain.

Background: Antihypertensive medications taken before surgery are associated with increased intraoperative hypotension, and patient positioning can further influence hemodynamics during surgery. However, the combined effects of antihypertensive medication use and patient positioning on intraoperative hypotension during spine surgery have not been clearly established. Objectives: This study aimed to investigate the incidence of hypotension in patients undergoing spine surgery according to surgical position, antihypertensive drug use, and patient characteristics through a retrospective analysis of medical records. Methods: This retrospective study analyzed 4,973 patients who had undergone spine surgery. Demographic data, medical history, antihypertensive medication use before surgery, and anesthetic information, including blood pressure during surgery, were collected from electronic medical records (EMRs). The incidence of hypotension according to surgical positioning (supine vs. prone) and antihypertensive medication use was investigated. Results: The incidence of intraoperative hypotension was higher in patients positioned prone (supine: 19.06% vs. prone: 24.91%) and among those taking more antihypertensive medications (no medication: 19.49%; one medication: 25.18%; two or more medications: 32.97%). Logistic regression indicated that patients with a history of hypertension undergoing surgery in the prone position had a significantly greater risk of hypotension [odds ratio (OR) = 1.407] and severe hypotension (OR = 1.940) compared with those with no history of hypertension undergoing surgery in the supine position. Older age, longer anesthesia duration, cervical surgical site, and the use of multiple antihypertensive agents were associated with an increased risk of intraoperative hypotension. In particular, taking two or more antihypertensive drugs (OR = 1.601) and undergoing surgery in the prone position (OR = 1.505) were independent predictors of hypotension and severe hypotension during spine surgery. Conclusions: Preoperative use of two or more antihypertensive medications increases the risk of intraoperative hypotension, and spine surgery in the prone position increases the risk of severe hypotension.

Purpose: Anesthesiology has evolved from a discipline focused primarily on ensuring intraoperative survival to one that promotes recovery, minimizes complications, and improves long-term outcomes. Drug choice is central to this shift, as it directly affects both immediate and long-term patient results. This review summarizes current evidence on anesthetic drug selection and its clinical implications.Current concepts: Enhanced recovery after surgery (ERAS) emphasizes opioid-sparing strategies and multimodal analgesia, with agents such as propofol, dexmedetomidine, and lidocaine supporting early mobilization and recovery. Sugammadex enables rapid and reliable reversal of neuromuscular blockade, reducing residual paralysis and associated respiratory complications. Remimazolam offers predictable recovery and hemodynamic stability, making it particularly valuable in older or high-risk patients. Beyond perioperative outcomes, precision anesthesia integrates factors such as frailty, sarcopenia, pharmacogenomics, and oncological considerations, suggesting that anesthetic management may influence long-term survival and quality of life.Discussion and conclusion: Anesthetic drug selection should be recognized as a key determinant of patient recovery and prognosis. Integrating ERAS principles, neuromuscular monitoring with sugammadex, and emerging agents such as remimazolam within a precision anesthesia framework can guide safer and more individualized clinical practice.

Background: Intravenous (IV) fluid therapy is essential and widely used; however, it is associated with high error rates, largely due to human factors, necessitating constant and careful monitoring by medical staff. Gravity-based systems are prone to errors, whereas electronic pumps, though more accurate, are limited by size, cost, and complexity. In this study, the impact of single-drop weight measurement and real-time light source monitoring on the accuracy of gravity-based infusion systems was evaluated.Methods: Gravity-based IV sets with IV infusion flow regulators (IIFRs) from three manufacturers were tested using 1,000 ml of 0.9% saline. The drops per min and the drop weight were recorded using a pulse oximeter, which served as a light source. The flow rates from the pulse oximeter group (PO) were compared with those from the manufacturer’s drop volume (C) and the IIFR groups. The mean absolute percentage error (MAPE) of predicted versus actual volumes was analyzed along with correlations between the residual volume and drop rate.Results: The PO group values were statistically closer to those of the actual measurements than the C and IIFR groups values (P < 0.05), demonstrating higher accuracy and lower MAPE, except at 300 ml/h when than those of the C group, independent of residual volume. The residual volume strongly correlated with the drop rate (r > 0.9).Conclusions: Real-time drop measurements using light sources combined with single-drop weight assessment improve the accuracy of these systems. Integrating pulse oximeters into IV sets may enhance clinical precision and reduce provider workload.