Abstract
<title>Abstract</title> <p> Objective To evaluate and compare the quality and dissemination characteristics of videos related to combined spinal-epidural anesthesia (CSEA) and general anesthesia (GA) on TikTok, Douyin, and Bilibili. Methods This study employed a cross-sectional design. Data were collected on April 15–16, 2026. After screening, 428 videos were included. The modified DISCERN (mDISCERN), Global Quality Score (GQS), and Video Information Quality Index (VIQI) were used to assess video quality. Engagement metrics (likes, comments, shares, and favorites) were extracted, and uploaders were classified into medical personnel and non-medical personnel. Differences in video quality and dissemination characteristics were analyzed across platforms and between uploader types. Spearman's rank correlation coefficient was used to analyze the correlations between engagement metrics and quality scores. Results A total of 91 CSEA-related and 337 GA-related videos were included. For CSEA content, TikTok exhibited significantly higher engagement metrics, including likes (median: 4288.00 vs 43.50), favorites (median: 469.50 vs 52.00), comments (median: 97.00 vs 3.50), and shares (median: 275.00 vs 23.00), compared with Bilibili (corrected <italic>P</italic> < 0.05). In terms of quality assessment, TikTok scored significantly higher in mDISCERN, GQS, and VIQI scores (median: 2.00 vs 1.00, 3.00 vs 2.00, and 14.00 vs 12.00, respectively) than Bilibili (corrected <italic>P</italic> < 0.05). For GA-related videos, TikTok had the highest likes (1730.00). Correlation analysis revealed that VIQI scores were strongly positively correlated with all engagement metrics (Spearman's <italic>ρ</italic> > 0.720, all <italic>P</italic> < 0.001), while mDISCERN scores showed only a weak positive correlation with likes in GA videos ( <italic>ρ</italic> = 0.112, <italic>P</italic> < 0.05). Videos published by medical personnel achieved significantly higher scores in mDISCERN, GQS, and VIQI than those of non-medical personnel (Holm-adjusted <italic>P</italic> < 0.001, 0.25<| <italic>r</italic> <sub> <italic>rb</italic> </sub> |<0.66). Conclusion The quality of CSEA and GA-related videos on TikTok, Douyin, and Bilibili is generally low to moderate, with substantial inter-platform heterogeneity. Engagement is driven by audiovisual quality rather than evidence-based rigor. Medical personnel produce more reliable content. Comprehensive improvements in the reliability and quality of CSEA and GA-related online content are urgently required. </p>