Anesthesiology and Perioperative Science最新文献

{"title":"Microbial PAMPs-PRR driven neuroimmune signaling in the development of post-infectious persistent pain","authors":"Ying Hong,&nbsp;Gang Wang,&nbsp;Mengmeng Zhou,&nbsp;Yan Xu,&nbsp;Hanbing Wang,&nbsp;Mao Ye,&nbsp;Xiao Xiao,&nbsp;Li Zhou,&nbsp;Guochang Hu,&nbsp;Chunling Jiang","doi":"10.1007/s44254-026-00199-6","DOIUrl":"10.1007/s44254-026-00199-6","url":null,"abstract":"<div><p>Post-infectious persistent pain (PIPP) is a common long-term outcome of infection, but the link between transient infection and persistent pain remains unclear. Traditional explanations, such as tissue injury, residual inflammation, and nerve damage, do not fully explain pain persistence after pathogen clearance. This review proposes that signaling between pathogen-associated molecular patterns and pattern recognition receptors (PAMP–PRR) is a key mechanistic bridge from acute infection to persistent pain. Microbial ligands from bacterial, viral, fungal, and parasitic pathogens activate PRRs in immune cells, sensory neurons, glia, and epithelial cells, triggering shared neuroimmune programs that include inflammatory amplification, neuron–immune crosstalk, glial activation, and sensitization of peripheral and central pain pathways. Persistent microbial products, viral latency, repeated antigen exposure, and trained immunity may maintain these circuits and promote a shift from PAMP-driven responses to damage-associated molecular pattern (DAMP)-mediated sterile neuroinflammation. These observations reframe PIPP as a dynamic neuroimmune disorder and support biomarker-informed, stage-specific therapies aimed at restoring neuroimmune homeostasis while preserving host defense.</p><h3>Graphical Abstract</h3>\u0000<div><figure><div><div><picture><source><img></source></picture></div></div></figure></div></div>","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"4 1","pages":""},"PeriodicalIF":7.5,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-026-00199-6.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149234658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recent perspectives regarding dexmedetomidine: highlights from anesthesiology and perioperative science","authors":"Xian Zou,&nbsp;Cheng Zhou,&nbsp;Donghang Zhang","doi":"10.1007/s44254-026-00198-7","DOIUrl":"10.1007/s44254-026-00198-7","url":null,"abstract":"","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"4 1","pages":""},"PeriodicalIF":7.5,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-026-00198-7.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149133375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing sepsis research and critical care: from predictive analytics to novel therapeutics","authors":"Yan Cui,&nbsp;Keliang Xie","doi":"10.1007/s44254-026-00197-8","DOIUrl":"10.1007/s44254-026-00197-8","url":null,"abstract":"","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"4 1","pages":""},"PeriodicalIF":7.5,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-026-00197-8.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149132969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Large language models in perioperative anesthesia: a risk-based roadmap for safe clinical adoption","authors":"Zhimin Tan,&nbsp;Qiyu He,&nbsp;Qian Li,&nbsp;Xiaoqiang Li","doi":"10.1007/s44254-026-00196-9","DOIUrl":"10.1007/s44254-026-00196-9","url":null,"abstract":"","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"4 1","pages":""},"PeriodicalIF":7.5,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-026-00196-9.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149034566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of electroacupuncture on postoperative delirium in older patients undergoing major surgery: a prospective, multicenter, randomized sham-controlled trial","authors":"Jia Shi,&nbsp;Zengping Huang,&nbsp;Hong Li,&nbsp;Shidong Zhang,&nbsp;Qun Lin,&nbsp;Pengjiu Feng,&nbsp;Qingling Qi,&nbsp;Ju Gao,&nbsp;Yuhai He,&nbsp;Yifan Gao,&nbsp;Zengxiu Zhao,&nbsp;Shiling He,&nbsp;Zhigang Zhao,&nbsp;Xue Han,&nbsp;Yuzhen Li,&nbsp;Shasha Liu,&nbsp;Jie Fan,&nbsp;Jianbo Yu","doi":"10.1007/s44254-026-00191-0","DOIUrl":"10.1007/s44254-026-00191-0","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Purpose&lt;/h3&gt;&lt;p&gt;Postoperative delirium (POD) is a common complication in older patients undergoing major surgery and is associated with prolonged hospitalization, delayed recovery, and increased mortality. This study evaluated whether perioperative electroacupuncture (EA) reduces the incidence of POD in older surgical patients.&lt;/p&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;p&gt;This multicenter, participant- and outcome assessor-blinded, randomized, sham-controlled trial included 878 patients aged 65–90 years who underwent major surgery at eight hospitals in China between September 2018 and October 2022. Participants were randomly assigned in a 1:1 ratio to receive EA or sham electroacupuncture (SEA). The EA group received stimulation at Baihui, Yintang, bilateral Shenmen and bilateral Neiguan acupoints using alternating frequencies of 2 and 100 Hz, beginning 30 min before induction of anesthesia and continuing until the end of surgery. The SEA group received sham needling at nonacupoints approximately 20 mm from the corresponding acupoints, without electrical stimulation. The primary outcome was the incidence of POD during postoperative days 1–5. Secondary outcomes included postoperative pain, subjective sleep quality, lengths of intensive care unit and hospital stay, cognitive function and quality of life at 30 days, and adverse events.&lt;/p&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;p&gt;POD occurred in 53 of 439 patients (12.1%) in the EA group and 77 of 439 patients (17.5%) in the SEA group. In the primary unadjusted between-group analysis, EA was associated with a lower incidence of POD than SEA, with an absolute risk difference of −5.5 percentage points (95% CI, −10.2 to −0.8), a relative risk of 0.69 (95% CI, 0.50–0.95), and an odds ratio of 0.65 (95% CI, 0.44–0.94; &lt;i&gt;P&lt;/i&gt; = &lt;i&gt;0.023&lt;/i&gt;). Analyses adjusted for baseline covariates and study center, as well as the available-case analysis, produced similar estimates. However, the estimated effect was attenuated when all indeterminate outcomes were classified as POD and was no longer evident under an extreme worst-case assumption for the EA group. After adjustment for multiple comparisons, no significant between-group differences were observed in intensive care unit or hospital length of stay, postoperative Acute Physiology and Chronic Health Evaluation II scores, modified Telephone Interview for Cognitive Status scores, or World Health Organization Quality of Life–BREF scores. In repeated-measures analyses, the EA group had slightly lower pain scores at 2 h and on postoperative days 1 and 2 and lower subjective sleep scores on the day of surgery and the first postoperative morning. Adverse events were infrequent and occurred at similar frequencies in the two groups.&lt;/p&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;p&gt;Among older patients undergoing major surgery, the EA group had a modestly lower incidence of POD than the SEA group, without an increase in adverse events. However, the result was sensitive to the handling of indeterminate POD assessments. The observe","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"4 1","pages":""},"PeriodicalIF":7.5,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-026-00191-0.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149034848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond the gate: supraspinal pathways for touch-induced analgesia","authors":"Hao-Di Tang,&nbsp;Hong-Bin Wang,&nbsp;Ruotian Jiang","doi":"10.1007/s44254-026-00195-w","DOIUrl":"10.1007/s44254-026-00195-w","url":null,"abstract":"","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"4 1","pages":""},"PeriodicalIF":7.5,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-026-00195-w.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149034849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oxygenation and perfusion in large vessel occlusion stroke: rethinking periprocedural management in the endovascular era","authors":"Ozan Akça,&nbsp;Jonathan Gomez","doi":"10.1007/s44254-026-00194-x","DOIUrl":"10.1007/s44254-026-00194-x","url":null,"abstract":"","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"4 1","pages":""},"PeriodicalIF":7.5,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-026-00194-x.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149034916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The endpoint is tissue perfusion: moving beyond the fluids-versus-vasopressors debate","authors":"Wissam Maroun","doi":"10.1007/s44254-026-00193-y","DOIUrl":"10.1007/s44254-026-00193-y","url":null,"abstract":"","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"4 1","pages":""},"PeriodicalIF":7.5,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-026-00193-y.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148986302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on: The efficacy of transcutaneous electricalstimulation of the Xi and Yuan acupoints on postoperative pain after endoscopic nasalsurgery: a randomized controlled trial","authors":"Xintong Zou,&nbsp;Suwen Hu,&nbsp;Yun Dong","doi":"10.1007/s44254-026-00192-z","DOIUrl":"10.1007/s44254-026-00192-z","url":null,"abstract":"","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"4 1","pages":""},"PeriodicalIF":7.5,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-026-00192-z.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148986303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intraoperative blood pressure management strategies and postoperative outcomes in patients undergoing noncardiac surgery: a systematic review and meta-analysis","authors":"Zhi-Xuan Zhang,&nbsp;Yang Han,&nbsp;Chan Chen,&nbsp;Tong-Xin Li,&nbsp;Qi-Rong Sun,&nbsp;Hui-Jia Zhuang,&nbsp;Hai Yu","doi":"10.1007/s44254-026-00188-9","DOIUrl":"10.1007/s44254-026-00188-9","url":null,"abstract":"<div><h3>Background</h3><p>Current recommendations for intraoperative blood pressure management suggest maintaining mean arterial pressure (MAP) at ≥ 60–65 mmHg to avoid hypotension. However, controversy remains regarding whether higher or individualized MAP targets improve clinically important outcomes in surgical patients. We aimed to determine whether intensive intraoperative blood pressure management, defined as higher fixed or individualized MAP targets, reduces major postoperative morbidity compared with standard management (MAP ≥ 60–65 mmHg).</p><h3>Methods</h3><p>We systematically searched PubMed, Embase, the Cochrane Library, and Web of Science for randomized controlled trials (RCTs) comparing intensive and standard intraoperative blood pressure management in adults undergoing noncardiac surgery. The primary outcomes were postoperative myocardial injury, postoperative delirium (POD), and acute kidney injury (AKI). Secondary outcomes included postoperative mortality, stroke, heart failure, acute respiratory distress syndrome (ARDS), pneumonia, intensive care unit (ICU) admission, surgical site infection (SSI), and hospital length of stay (LOS). Data were pooled using a random-effects model with the Hartung–Knapp adjustment. Risk ratios (RR) were calculated for dichotomous outcomes, and mean differences (MD) were calculated for continuous outcomes. Trial sequential analysis (TSA) was performed to control for random error and assess the conclusiveness of the available evidence.</p><h3>Results</h3><p>Eighteen RCTs involving 16,573 patients were included. Compared with standard management, intensive management was associated with lower risks of POD (10 studies; RR = 0.72, 95% CI [0.55, 0.93]; <i>P</i> = 0.019; moderate-certainty evidence) and SSI (5 studies; RR = 0.64, 95% CI [0.53, 0.76]; <i>P</i> = 0.002; moderate-certainty evidence). However, no significant between-group differences were observed in postoperative myocardial injury (9 studies; RR = 1.02, 95% CI [0.92, 1.13]), AKI (13 studies; RR = 0.92, 95% CI [0.79, 1.06]), or mortality (13 studies; RR = 0.99, 95% CI [0.83, 1.17]). TSA supported a beneficial effect of intensive management on POD, and indicated that a clinically meaningful benefit of the prespecified magnitude was unlikely for myocardial injury and AKI. No significant between-group differences were observed in postoperative stroke, pneumonia, heart failure, ICU admission, or hospital LOS.</p><h3>Conclusions</h3><p>In this systematic review and meta-analysis, intensive intraoperative blood pressure management may reduce the risks of POD and SSI in adults undergoing noncardiac surgery. However, it was not associated with significant differences in postoperative myocardial injury, AKI or mortality.</p><h3>Protocol registration</h3><p>PROSPERO: CRD420261323873.</p></div>","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"4 1","pages":""},"PeriodicalIF":7.5,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-026-00188-9.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148986233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}