{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T23:24:15Z","timestamp":1784935455668,"version":"3.55.0"},"reference-count":24,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T00:00:00Z","timestamp":1760659200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T00:00:00Z","timestamp":1760659200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Anesthesiol"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Given propofol\u2019s antioxidant and anti\u2011inflammatory properties compared with volatile\/inhalational agents, we aimed to evaluate the association between anesthetic technique and both in\u2011hospital mortality and postoperative complications following spinal surgery.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>In this retrospective, population\u2011based cohort study, we used South Korea\u2019s National Health Insurance Service database to identify adult patients (\u2265\u200918 years) who underwent spinal surgery between January 1, 2016 and December 31, 2021. Primary outcomes were in\u2011hospital mortality and postoperative complications. Propensity score (PS) matching (1:1) was employed to balance baseline characteristics between the total intravenous anesthesia (TIVA) and volatile\/inhalational anesthesia (INH) groups.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Among 708,387 patients, 264,728 (37.4%) received TIVA and 443,659 (62.6%) received INH. After PS matching, 460,654 patients remained (230,327 per group). In the PS\u2011matched cohort, TIVA was associated with significantly lower odds of in\u2011hospital mortality (OR 0.85; 95% CI 0.80\u20130.89; <jats:italic>P<\/jats:italic>\u2009=\u20090.004) and postoperative complications (11.8% vs. 14.2%; OR 0.81; 95% CI 0.80\u20130.82; <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) compared with INH. In the full cohort, multivariable logistic regression confirmed these findings: TIVA remained linked to reduced in\u2011hospital mortality (OR 0.74; 95% CI 0.63\u20130.87; <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) and fewer postoperative complications (OR 0.71; 95% CI 0.70\u20130.73; <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>In this nationwide cohort, propofol\u2011based TIVA was associated with lower in\u2011hospital mortality and fewer postoperative complications than volatile\/inhalational anesthesia in adult spinal surgery patients. Prospective trials are warranted to confirm these findings.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Trial registration<\/jats:title>\n            <jats:p>: Not applicable.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s12871-025-03385-4","type":"journal-article","created":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T10:45:10Z","timestamp":1760697910000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Propofol TIVA vs. inhalational anesthesia for spine surgery: in\u2011hospital mortality and postoperative complications in a nationwide Korean cohort"],"prefix":"10.1186","volume":"25","author":[{"given":"Tak Kyu","family":"Oh","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saeyeon","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"In-Ae","family":"Song","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,10,17]]},"reference":[{"key":"3385_CR1","doi-asserted-by":"publisher","first-page":"415","DOI":"10.1016\/j.wneu.2019.06.181","volume":"130","author":"N Dietz","year":"2019","unstructured":"Dietz N, Sharma M, Adams S, Alhourani A, Ugiliweneza B, Wang D, Nu\u00f1o M, Drazin D, Boakye M. 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Informed consent was waived by IRB of Seoul National University Bundang Hospital due to the retrospective and anonymized nature of the data analysis. The study was conducted in accordance with the Helsinki Declaration of 1975 (revised in 2008).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"508"}}