Anesthesiology and Perioperative Science最新文献

{"title":"Characterizing preoperative domain-specific performance on the Montreal Cognitive Assessment and exploring its associations with adverse outcomes","authors":"Ellene Yan, Yasmin Alhamdah, Aparna Saripella, Eric Cheuk, Sazzadul Islam, David He, Keera N. Fishman, Leif Erik Lovblom, Maria Carmela Tartaglia, David F. Tang-Wai, Jean Wong, Frances Chung","doi":"10.1007/s44254-026-00181-2","DOIUrl":"10.1007/s44254-026-00181-2","url":null,"abstract":"<div><h3>Purpose</h3><p>The Montreal Cognitive Assessment (MoCA) is a validated screening tool for cognitive impairment (CI) in surgical populations that assesses multiple cognitive domains. The primary objective of this report was to characterize preoperative domain-specific performance on the MoCA in older surgical patients. The secondary objectives were to explore preoperative characteristics and adverse outcomes associated with poorer domain-specific performance.</p><h3>Methods</h3><p>This was a post hoc analysis of the Detection of Cognitive Impairment (Detect CI) study. The MoCA was administered preoperatively to assess seven cognitive domains: executive/visuospatial function, naming, attention, language, abstraction, delayed recall, and orientation. It was scored out of 30, with higher education-adjusted MoCA scores indicating better cognitive performance and scores <span>(le)</span> 25 classifying probable CI. Adverse outcomes were collected in 382 participants at 30 days and 379 participants at 90 days postoperatively.</p><h3>Results</h3><p>The 382 participants (median age, 73 years [IQR, 68, 77]; 58% female) had a mean MoCA score of 25.9 <span>(pm)</span> 2.8, with 35% screening positive for CI. Participants with probable CI performed significantly poorer across all seven cognitive domains (executive/visuospatial function, naming, attention, language, abstraction, delayed recall, and orientation) than those without CI. Having <span>(le)</span> 12 years of education was associated with poorer executive/visuospatial function, naming, language, abstraction, and delayed recall. Of all cognitive domains, exploratory analyses showed that only orientation was associated with 30-day adverse outcomes after adjusting for age, sex, education level, and/or American Society of Anesthesiologists status and within-domain multiplicity. Each one-point decrease in orientation score was associated with a longer length of stay (β = 0.5, 95% confidence interval [95% CI] 0.2–0.8; <i>P </i><span>(=)</span> 0.012) and higher adjusted odds of postoperative delirium (adjusted odds ratio [aOR] = 11.4, 95% CI 2.6–46.8; <i>P </i><span>(=)</span> 0.004), complications (aOR = 3.1, 95% CI 1.3–8.9; <i>P </i><span>(=)</span> 0.035), non-home discharge (aOR = 4.1, 95% CI 1.5–11.4; <i>P </i><span>(=)</span> 0.014), and composite adverse outcomes (aOR = 5.6, 95% CI 1.9–23.9; <i>P </i><span>(=)</span> 0.014). Orientation remained associated with postoperative delirium after adjusting for multiplicity both within and across MoCA domains (aOR = 11.4, 95% CI 2.6–46.8; <i>P </i><span>(=)</span> 0.031).</p><h3>Conclusions</h3><p>This analysis characterized preoperative domain-specific performance on the MoCA in older adults, with participants screening positive for CI exhibiting poorer performance across all cognitive domains. Exploratory findings suggested that orientation difficulties may be associated with early adverse outcomes, with postoperative delirium showing the most r","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"4 1","pages":""},"PeriodicalIF":7.5,"publicationDate":"2026-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-026-00181-2.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148281205","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 glymphatic system in chronic pain: putative mechanisms and prospective therapeutic strategies","authors":"Haiyi Zhang,&nbsp;Xin Li,&nbsp;Xingji You,&nbsp;Jingxiang Wu","doi":"10.1007/s44254-026-00180-3","DOIUrl":"10.1007/s44254-026-00180-3","url":null,"abstract":"<div><p>Chronic pain represents a widespread and substantial clinical burden, yet existing therapeutic approaches frequently yield suboptimal outcomes, partly due to an incomplete understanding of its underlying pathogenic mechanisms. The glymphatic system, a brain-wide network involved in cerebrospinal fluid circulation and metabolic waste clearance, has been observed to exhibit progressive dysfunction during the development and maintenance of chronic pain. The relationship between chronic pain and glymphatic dysfunction appears multifaceted and complex. This perspective review systematically synthesizes emerging evidence to summarize the potential bidirectional interplay between glymphatic dysfunction and chronic pain pathogenesis, with an emphasis on glymphatic dysfunction as a plausible contributing mediator across diverse pain conditions. We specifically address how neuroinflammation-associated glymphatic dysfunction may contribute to the progression of chronic pain, and conversely, how persistent pain may further amplify neuroinflammation, thereby potentially establishing a self-sustaining vicious cycle. Furthermore, we outline rationales for putative clinical interventions targeting this pathological cascade, with the goal of providing conceptual insights for the development of novel therapeutic strategies for chronic pain. Collectively, this review advances current understanding of the potential links between chronic pain and glymphatic dysfunction and presents an alternative conceptual framework for the future management of chronic pain.</p><h3>Graphic Abstract</h3>\u0000<div><figure><div><div><picture><source><img></source></picture><span>The alternative text for this image may have been generated using AI.</span></div></div></figure></div></div>","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"4 1","pages":""},"PeriodicalIF":7.5,"publicationDate":"2026-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-026-00180-3.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148281206","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":"Central venous oxygen saturation vs. oxygen extraction ratio in septic shock resuscitation: Which metric is more informative?","authors":"Athanasios Chalkias,&nbsp;Konstantina Katsifa,&nbsp;Stavroula Amanetopoulou,&nbsp;Aikaterini Nodarou,&nbsp;Petros Lampropoulos,&nbsp;Ioannis Thiveos,&nbsp;Konstantinos Sakellaridis,&nbsp;Varvara Grammatikopoulou,&nbsp;Athanasios Prekates,&nbsp;Paraskevi Tselioti","doi":"10.1007/s44254-026-00177-y","DOIUrl":"10.1007/s44254-026-00177-y","url":null,"abstract":"<div><p>Septic shock is a life-threatening syndrome characterized by profound circulatory dysfunction and disordered cellular metabolism, necessitating precise physiologic monitoring to guide resuscitation. In this context, sepsis-induced hemodynamic derangements range from early vasoplegia and hyperdynamic circulation to later-stage myocardial depression and microcirculatory failure. These dynamic changes create a heterogeneous perfusion landscape that challenges traditional approaches to oxygen transport assessment. Central venous oxygen saturation (ScvO₂) has long been used as a surrogate marker of cardiac output and global tissue oxygenation; however, in sepsis, impaired cellular oxygen utilization may result in paradoxically normal or elevated ScvO₂ despite ongoing tissue hypoxia. In contrast, the oxygen extraction ratio (O₂ER) offers a more integrative assessment of oxygen transport by reflecting the balance between oxygen delivery and consumption. Unlike ScvO₂, O₂ER may remain informative in the presence of microcirculatory and mitochondrial dysfunction and may demonstrate greater sensitivity to changes in oxygen delivery, based on physiological reasoning and observational data. Accordingly, O₂ER may provide complementary physiological insight in complex shock states, although this approach has not been validated in randomized interventional trials. This narrative review synthesizes foundational and contemporary evidence to propose a physiologically grounded framework for oxygen transport monitoring, delineating the strengths, limitations, and clinical utility of ScvO₂, O₂ER, and metabolic markers in guiding resuscitation strategies for patients with septic shock. </p></div>","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-026-00177-y.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148009287","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":"Efficacy of internal intercostal membrane-origin block versus thoracic paravertebral block for postoperative analgesia after video-assisted thoracoscopic surgery: a randomized controlled trial","authors":"Jun-Jie Ye,&nbsp;Qing Lin,&nbsp;Zhen-Jun Fang,&nbsp;Li Chen,&nbsp;Ying Yu,&nbsp;Lin-Fang Zhang,&nbsp;Jin-Hua Chen,&nbsp;Bin Zheng,&nbsp;Shu-Chen Chen,&nbsp;Wei-Feng Yu,&nbsp;Jie Tian,&nbsp;Zhong-Meng Lai","doi":"10.1007/s44254-026-00175-0","DOIUrl":"10.1007/s44254-026-00175-0","url":null,"abstract":"<div><h3>Background</h3><p>This study aims to compare the internal intercostal membrane-origin block (IIMOB) with the thoracic paravertebral block (TPVB), analyzing the postoperative analgesic efficacy and safety in patients undergoing video-assisted thoracoscopic surgery (VATS).</p><h3>Methods</h3><p>A total of 236 patients were enrolled. Patients undergoing uniport VATS were randomized to uniport TPVB (UP) or uniport IIMOB (UI) (<i>n</i> = 54 each), and those undergoing multiport VATS were randomized to multiport TPVB (MP) or multiport IIMOB (MI) (<i>n</i> = 54 each). Postoperatively, patients in UP and MP groups received TPVB, while those in UI and MI groups received IIMOB. Additional VATS patients were randomly divided into two groups (<i>n</i> = 10 each), methylene blue TPVB (BP) and methylene blue IIMOB (BI) groups, to assess injectate spread. The primary outcome was postoperative analgesic efficacy, quantified as the area under the curve (AUC) of Numerical Rating Scale (NRS) scores at rest and during coughing from 3 to 48 h after surgery.</p><h3>Results</h3><p>Compared with TPVB, IIMOB was associated with lower postoperative NRS-AUC values at rest and during coughing (all <i>P</i> &lt; 0.05), reduced sufentanil consumption within 48 h, delayed first pump use, and smaller increases in plasma levels of perioperative inflammatory and neuroendocrine stress biomarkers at 24 h post operation. Additionally, patients received IIMOB experienced fewer incidences of back pain, hypotension, vascular injury, and block failure. There was no significant difference in the methylene blue diffusion gaps between the BI and BP groups. However, the BP group had a larger blue-dyed area in the ventral region of spinal column and higher 90-min dye color change rate compared with the BI group.</p><h3>Conclusion</h3><p>These findings revealed that IIMOB provided superior analgesia with fewer adverse events than TPVB after VATS.</p><h3>Clinical trial registration</h3><p>Chinese Clinical Trial Registry, ChiCTR2400082500. Registered on 29 March 2024, http://www.chictr.org.cn/ChiCTR2400082500.</p></div>","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-026-00175-0.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148009383","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":"Intrathecal hydromorphone for postoperative pain management in gastrectomy: a dose-finding and randomized controlled study","authors":"Lin Ding,&nbsp;Yu Leng,&nbsp;Hongxin Liu,&nbsp;Xiaojuan Jiang,&nbsp;Jun Ma,&nbsp;Zhichao Gong,&nbsp;Chengyu Li,&nbsp;Cheng Zhou,&nbsp;Qian Li","doi":"10.1007/s44254-026-00174-1","DOIUrl":"10.1007/s44254-026-00174-1","url":null,"abstract":"<div><h3>Background</h3><p>Single-dose intrathecal hydromorphone or transversus abdominis plane (TAP) block has garnered growing interest as components of multimodal analgesia for gastrectomy. However, the spinal mechanisms of intrathecal hydromorphone and its optimal dosing remain unclear. This study aimed to confirm the spinal mechanism of intrathecal hydromorphone using animal models, precisely determine its 95% effective dose (ED₉₅) in clinical settings, and compare its analgesic efficacy with TAP block.</p><h3>Methods</h3><p>In a rat model of acute pain, we determined the dose–response relationship of intrathecal hydromorphone. Clinically, the ED₉₅ of hydromorphone for patients undergoing gastrectomy was identified through a double-blind, biased-coin sequential trial involving 51 patients aged 18 years or older who were classified as ASA I-III. In subsequent randomized controlled trial (RCT), 96 gastrectomy patients were randomly assigned to receive either intrathecal hydromorphone at its ED₉₅ dose or a four-point TAP block (15 mL of 0.2% ropivacaine per point). The primary outcomes were ED₉₅ and cumulative pain intensity during mobilization within 24 postoperative hours.</p><h3>Results</h3><p>Animal studies demonstrated that intrathecal hydromorphone produces dose-dependent antinociceptive effects primarily mediated by spinal μ-receptors. Clinically, the calculated ED₉₅ for intrathecal hydromorphone in gastrectomy was 131.67 μg (95% CI 113.19–150 μg). Based on these findings, we selected 150 μg (the upper limit of the 95% CI) as the intervention dose for the subsequent RCT to ensure analgesic coverage in at least 95% of patients. In this RCT, 89 patients completed the modified intention-to-treat analysis. Patients in the intrathecal hydromorphone group reported significantly lower cumulative pain intensity (65.0 [48.0–89.0] cm·h) compared to the TAP block group (93.0 [64.0–131.0] cm·h; <i>P</i> = 0.001). Furthermore, rescue opioid consumption was reduced at both 24 and 48 h postoperatively in the intrathecal hydromorphone group (<i>P</i> &lt; 0.05). Trajectory analysis showed that the TAP group had a higher incidence of inadequate early pain control, while the intrathecal group maintained better initial analgesia but demonstrated mild rebound pain after 24 h. Recovery profiles and adverse events were comparable between groups.</p><h3>Conclusion</h3><p>Intrathecal hydromorphone exerts dose-dependent antinociceptive effects through spinal μ-receptor mechanisms. At a dose of 150 μg (upper 95% CI of the ED₉₅) for gastrectomy, intrathecal hydromorphone provides superior postoperative analgesia compared to TAP block, with reduced opioid consumption.</p><h3>Trial registration</h3><p>ChiCTR2300069163 Part I for the dose-finding trial on March 8, 2023; ChiCTR2300073827 for the randomized controlled trial on July 21, 2023. (http://www.chictr.org.cn).</p></div>","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-026-00174-1.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148009010","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: effect of synchronized intermittent mandatory versus manual assistance ventilation during anesthetic emergence on postoperative atelectasis in patients undergoing laparoscopic abdominal surgery: a randomized controlled trial","authors":"Xintong Zou,&nbsp;Suwen Hu,&nbsp;Liangrong Wang","doi":"10.1007/s44254-026-00178-x","DOIUrl":"10.1007/s44254-026-00178-x","url":null,"abstract":"","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-026-00178-x.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148009009","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":"Preoperative and intraoperative EEG alpha power in relation to postoperative delirium: a systematic review and meta-analysis","authors":"Rong Wang,&nbsp;Wen Ouyang,&nbsp;Jia Chen,&nbsp;Guiping Jiang,&nbsp;Xing Liu","doi":"10.1007/s44254-026-00171-4","DOIUrl":"10.1007/s44254-026-00171-4","url":null,"abstract":"<div><h3>Background</h3><p>Perioperative electroencephalogram (EEG) alpha power has been proposed as a marker of brain vulnerability and a candidate biomarker for postoperative delirium (POD). However, reported associations between preoperative or intraoperative EEG alpha power and POD remain inconsistent.</p><h3>Methods</h3><p>We performed a PRISMA-guided systematic review and meta-analysis of observational studies in adults (≥ 18 years) undergoing non-neurological surgery that reported resting-state preoperative or intraoperative EEG alpha power and POD assessed with validated tools. PubMed, Ovid MEDLINE, Embase, Web of Science, and the Cochrane Library were searched to December 26, 2025. Standardized mean differences (<i>Hedges's g</i>) between groups of POD and without POD were pooled using random-effects models.</p><h3>Results</h3><p>Twelve studies (1637 patients) met inclusion criteria. Intraoperative EEG alpha power was lower in patients who developed POD compared to those without POD (<i>g</i> = −0.57, 95% CI [−0.92, −0.22], <i>P</i> = 0.006). Sensitivity analyses further supported the robustness of this association—after excluding a cardiac cohort with cognitive impairment, heterogeneity decreased (<i>I</i>^<i>2</i> reduced from 85.3% to 57.1%) and the result remained robust in an extended analysis (<i>I</i>^<i>2</i> = 0, <i>g</i> = −0.44). In contrast, preoperative alpha power showed substantial heterogeneity. Sensitivity analyses identified baseline cognition as an essential source of variability, and after adjustment, a significant association between higher preoperative alpha power and POD was observed (<i>I</i>^<i>2</i> = 0, <i>g</i> = 0.27, <i>P</i> = 0.037).</p><h3>Conclusions</h3><p>Lower intraoperative alpha power was consistently associated with subsequent POD across diverse surgical populations, supporting its potential as a marker of intraoperative cerebral vulnerability. In contrast, associations between preoperative alpha power and POD were variable and were influenced by baseline cognitive status. Further studies incorporating cognition alongside more standardized perioperative EEG are needed.</p><h3>Protocol registration</h3><p>Registered at PROSPERO on February 10, 2025 (CRD42024599991).</p></div>","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-026-00171-4.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147937855","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 protocol: a critical analysis of global ERAC guidelines, metrics, and the imperative for contextual implementation—a narrative review","authors":"Weijia Du,&nbsp;Yingcai Song,&nbsp;Xiaozhe Qian,&nbsp;Zhiqiang Liu","doi":"10.1007/s44254-026-00170-5","DOIUrl":"10.1007/s44254-026-00170-5","url":null,"abstract":"<div><p>Enhanced Recovery After Cesarean (ERAC) protocols represent a significant advance in standardizing perioperative care to improve maternal outcomes. This narrative review synthesizes current evidence through a critical lens, arguing that the translation of ERAC principles into equitable, global practice is hindered by a predominant focus on high-resource contexts and a lack of integration with local cultural paradigms of postpartum recovery. We conducted a targeted literature search to identify major international ERAC guidelines and patient-reported outcome measures (PROMs). We then propose and apply an analytical \"Framework for Contextualized ERAC Implementation\" to evaluate this literature. Our analysis reveals that while guidelines from societies like Enhanced Recovery After Surgery (ERAS), Society for Obstetric Anesthesia and Perinatology (SOAP), and National Institute for Health and Care Excellence (NICE) provide robust evidence-based recommendations, their development processes and implicit assumptions often limit direct applicability worldwide. Similarly, PROMs like Obstetric Quality of Recovery (ObsQoR) and Stanford Obstetric Recovery Checklist (STORK), though validated, may not capture recovery domains prioritized in diverse cultural settings, such as those influenced by traditions like zuo yuezi (a traditional period of postpartum confinement and rest in Chinese culture). Successful implementation depends on moving beyond direct translation of protocols to active adaptation across two spectra: resource stratification (from low to high) and cultural integration (from translation to adaptation). Future efforts must prioritize the co-design of tiered, resource-sensitive protocols and the development of culturally competent metrics to ensure ERAC fulfills its promise of optimized, patient-centered recovery for all postpartum individuals.</p></div>","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-026-00170-5.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147738544","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":"Weighted average chloride concentration of intraoperative fluids and acute kidney injury: a non-linear association and the \"two-hit\" vulnerability","authors":"Shunyu Yao,&nbsp;Qunhui Liu,&nbsp;Chaoliang Tang","doi":"10.1007/s44254-026-00173-2","DOIUrl":"10.1007/s44254-026-00173-2","url":null,"abstract":"","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-026-00173-2.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147737940","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":"Long non-coding RNAs as key modulators in neuropathic pain: mechanistic pathways and novel therapeutic opportunities","authors":"Lingling Guo,&nbsp;Guangwei Sun,&nbsp;Lu Li,&nbsp;Guang Han","doi":"10.1007/s44254-026-00172-3","DOIUrl":"10.1007/s44254-026-00172-3","url":null,"abstract":"<div><p>Neuropathic pain (NP) is a chronic pain syndrome caused by a lesion or disease of the somatosensory nervous system. It is characterized by complex clinical manifestations and limited therapeutic efficacy, markedly impairing quality of life. Traditional analgesics often show variable effectiveness, and are associated with significant adverse effects. To address these challenges in pain research, long non-coding RNAs (lncRNAs) have attracted interest due to their key roles in gene transcription, epigenetic regulation, and cellular signaling networks. LncRNAs can modulate multiple structures related to pain, including peripheral nerves, the spinal cord, and higher central nervous system regions, by regulating neuronal excitability, ion channel function, neuroinflammatory responses, glial cell activation, and synaptic plasticity. Notably, they may also participate in central mechanisms underlying the comorbidity of pain and emotional disorders. Nascent intervention strategies targeting lncRNAs, such as antisense oligonucleotides, RNA interference, gene editing, small molecule modulators, and lncRNA replacement therapy, are increasingly demonstrating therapeutic potential. However, constraints on potential clinical translation include limited species conservation of lncRNAs, high tissue and cell specificity, and challenges in delivery efficiency and long-term safety. LncRNAs provide novel molecular insights into NP mechanisms and offer significant opportunities for the development of precise analgesic strategies. Future studies should focus on cross-species validation, targeted delivery system optimization, and integrative mechanistic analyses, to advance clinical translation of lncRNA-based interventions.</p><h3>Graphical Abstract</h3>\u0000<div><figure><div><div><picture><source><img></source></picture><span>The alternative text for this image may have been generated using AI.</span></div></div></figure></div></div>","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-026-00172-3.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147738331","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}