Effect of general anesthesia on postoperative pulmonary embolism

The influence of anesthesia type and duration on the occurrence of pulmonary embolism (PE) after surgery remains controversial. This study investigates the association between anesthesia type and duration with postoperative PE. A retrospective cohort of adult patients undergoing surgery from May 2020 to August 2024 at large-scale general hospitals was analyzed. Multivariable logistic regression models were employed to adjust for potential confounders, and sensitivity analyses (using overlap weighting and array approach) were performed to validate the findings. A total of 178,052 patients were included in the analysis, of whom 91 developed PE after surgery. The median duration of general anesthesia (GA) was 1.72 h, with an interquartile range (IQR) of 1.17–2.52 h. The median duration of regional anesthesia was 1.54 h, with an IQR of 1.20–2.03 h. Anesthesia type and the duration of regional anesthesia were not associated with PE occurrence (adjusted odds ratio [aOR] [95% confidence interval, CI], 1.148 [0.671–2.098], p = 0.631), (aOR [95% CI], 1.117 [0.498–1.557], p = 0.738). The rates of PE consistently increased with GA prolongation (aOR [95% CI], 1.308 [1.176–1.432], p p Our study demonstrates that prolonged GA, particularly > 3 h, significantly increases the risk of PE.

麻醉方式与麻醉时长对术后肺栓塞（pulmonary embolism, PE）的发生风险尚存争议。本研究旨在探讨麻醉方式、麻醉时长与术后肺栓塞之间的关联。本研究纳入2020年5月至2024年8月于大型综合医院接受手术的成年患者，开展回顾性队列分析，采用多变量logistic回归模型校正潜在混杂因素，并通过重叠加权法与数组法实施敏感性分析以验证研究结论。本研究共纳入178052例患者，其中91例术后发生肺栓塞。全身麻醉（general anesthesia, GA）中位时长为1.72小时，四分位间距（interquartile range, IQR）为1.17~2.52小时；区域麻醉中位时长为1.54小时，四分位间距为1.20~2.03小时。麻醉方式与区域麻醉时长均与肺栓塞发生无显著关联（校正比值比[adjusted odds ratio, aOR]（95%置信区间[confidence interval, CI]）：1.148[0.671~2.098]，P=0.631；aOR(95%CI)：1.117[0.498~1.557]，P=0.738）。随着全身麻醉时长延长，术后肺栓塞发生率持续升高（aOR[95%CI]：1.308[1.176~1.432]，原文此处P值疑似存在笔误）。本研究结果表明，全身麻醉时长延长（尤其是超过3小时）可显著增加术后肺栓塞发生风险。