Postoperative pulmonary complications remain a leading cause of morbidity after abdominal surgery. The recent study by Gültop and Şensöz Çelik offers an important contribution: combined block and intravenous (BIV) analgesia effectively preserves postoperative diaphragm contractility compared with single-modality techniques.

Aims: This study aimed to characterize publication and citation patterns in the literature on cardiopulmonary complications and critical care in scorpion envenomation and to map its thematic and intellectual structure. Methods: The Web of Science Core Collection was searched on September 24, 2026. Records were screened against predefined eligibility criteria. Descriptive bibliometric indicators were calculated, and author-keyword co-occurrence (minimum three occurrences) and cited-reference co-citation (cited by at least 20 included records) networks were mapped using VOSviewer version 1.6.21. Results: Of 462 retrieved records, 239 published between 1982 and 2026 were included; the 2026 count was partial. The records had received 5,346 citations (median, 10; h-index, 41). Toxicon was the leading source (n = 37), and India was the most frequently represented affiliation country (n = 44). The author-keyword map, based on 162 records with author keywords, contained 28 terms in eight clusters. The co-citation map included 38 cited references in three clusters: foundational cardiovascular toxicity, myocardial injury and severity, and treatment and syntheses. Conclusion: The literature is organized around acute cardiac and pulmonary injury, pediatric envenomation, and treatment-related themes. Combined keyword and co-citation mapping provides clinicians and researchers with a structured entry point to mechanistic, severity, assessment, and treatment literature and can guide focused evidence synthesis, without estimating complication incidence or comparative treatment effectiveness.

Background/Objectives: The impact of surgical timing on perioperative outcomes remains a subject of ongoing debate. Although after-hours surgery has been associated with adverse outcomes in various surgical populations, its role in lumbar spine surgery remains unclear. This study aimed to evaluate factors associated with postoperative intensive care unit (ICU) admission in patients undergoing lumbar spine surgery. Methods: In this retrospective observational study, 460 patients who underwent lumbar spine surgery were analyzed. Patients were categorized according to the timing of surgery as in-hours or after-hours. Demographic, clinical, intraoperative, and laboratory parameters were compared between the two groups. Multivariable logistic regression analysis was performed to evaluate factors associated with postoperative ICU admission. Results: Of the 460 patients, 380 (82.6%) underwent surgery during in-hours and 80 (17.4%) after-hours. The baseline characteristics, including age, sex, and comorbidities, were comparable between the two groups. ICU admission was significantly more frequent in the after-hours group (45.0% vs. 19.5%, p < 0.001), whereas the length of hospital stay and intraoperative variables were similar between the two groups. Preoperative laboratory analysis revealed higher inflammatory markers (NLR and SII) and lower albumin levels in the after-hours group (all p < 0.05), whereas postoperative values were comparable. In the multivariable analysis, after-hours surgery remained independently associated with ICU admission (adjusted OR 4.82, 95% CI 2.15–10.78, p < 0.001). Lower preoperative albumin and higher preoperative NLR demonstrated borderline significance. Conclusions: After-hours lumbar spine surgery was associated with a significantly increased rate of ICU admission, even after adjustment for patient characteristics, surgical urgency, and clinical indications. These findings suggest that surgical timing may contribute to increased perioperative resource utilization and highlight the potential role of system-level and organizational factors in influencing perioperative outcomes.