Anesthesia and pain medicine最新文献

{"title":"Perioperative risks of glucagon-like peptide-1 receptor agonists and their implications in airway management using supraglottic airway devices.","authors":"Chung-Sik Oh, Soomin Lee, Boohwi Hong","doi":"10.17085/apm.26589","DOIUrl":"10.17085/apm.26589","url":null,"abstract":"<p><p>Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are widely used for managing diabetes and obesity. The increasing prevalence of these conditions has necessitated new considerations in perioperative care. By delaying gastric emptying, these agents may challenge the traditional fasting-based assumptions of gastric emptiness before anesthesia. Residual gastric contents may persist despite adherence to standard fasting guidelines. Yet, a corresponding increase in aspiration-related complications has not been consistently observed. The clinical implications of this discrepancy remain a matter of ongoing discussion. These uncertainties have implications for airway management, particularly the use of supraglottic airway devices (SGAs), which are commonly used for elective anesthesia under the assumption of a low aspiration risk. In patients treated with GLP-1 RAs, airway decisions may require individualized risk assessment rather than reliance on fasting duration alone. This narrative review aimed to synthesize current evidence regarding the effects of GLP-1 RAs on gastric physiology and aspiration risk, and discuss their potential implications for SGAs in perioperative practice.</p>","PeriodicalId":101360,"journal":{"name":"Anesthesia and pain medicine","volume":"21 2","pages":"181-193"},"PeriodicalIF":3.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13175902/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147944573","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":"Postoperative delirium: from bundles to precision prevention.","authors":"Min-Yu Kim, Jeongmin Kim, Bon-Nyeo Koo","doi":"10.17085/apm.25494","DOIUrl":"10.17085/apm.25494","url":null,"abstract":"<p><p>Perioperative brain health, encompassing postoperative delirium (POD) and longer-lasting cognitive decline, has become a major priority for patient safety and quality of recovery in older surgical patients. The 2018 unified nomenclature introduced perioperative neurocognitive disorders as an umbrella term spanning pre-existing neurocognitive disorder, POD, delayed neurocognitive recovery, and postoperative neurocognitive disorder. The incidence of POD varies widely, reflecting differences in age, baseline cognition, surgical type, and ascertainment; however, its clinical footprint is consistently substantial, with increased mortality, longer hospitalization, and downstream cognitive deterioration. Electroencephalography (EEG)-guided anesthesia trials have yielded mixed results, favoring its integration with hemodynamic optimization and medication stewardship. Screening uptake remains < 10% in many settings, limiting the ability to provide scalable and equitable brain care. Current prevention standards prioritize multicomponent, non-pharmacological bundles such as mobilization, reorientation/cognitive stimulation, sleep promotion, sensory optimization, hydration, nutrition, oxygen delivery, and prompt management of precipitating factors. Nonetheless, translation to \"precision prevention\" is constrained by three gaps: low implementation of recommended screening pathways, heterogeneity and limited transportability of prognostic models, and an under-operationalized vulnerability domain in which frailty and malnutrition lack standardized tools, cut-offs, and linked interventions. Biomarkers and perioperative physiology including EEG suppression patterns and individualized perfusion targets are biologically coherent adjuncts for risk refinement; however, current evidence supports their use as additive stratifiers within bundles rather than stand-alone gatekeepers. Next-generation perioperative brain health studies should standardize vulnerability phenotyping, integrate evidence-based selective monitoring and biomarker-informed refinement, and embed these elements into scalable workflows that convert guidelines into practical bedside actions.</p>","PeriodicalId":101360,"journal":{"name":"Anesthesia and pain medicine","volume":"21 2","pages":"171-180"},"PeriodicalIF":3.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13175899/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147944588","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":"Changes in postoperative pneumonia incidence after the pandemic: a retrospective observational study using a common data model.","authors":"Dong Hyuck Kim, Hyungseok Seo, Yoonkyung Lee, Il Seok Kim, Minsoo Kim, Youn Hee Lim, Jung Eun Kim, Soo Il Choi, Seokyoung Song, Byung Gun Lim, Moonki Park, Bon Sung Koo, Jae Hwa Yoo, Da Hyung Kim, Jong Bum Choi, Hyungtae Kim, Cheolhyeong Lee, Seung Hee Yoo, Ho Kyung Yu, Chan Noh, Dong-Kyu Lee, Sang Gyu Kwak","doi":"10.17085/apm.25411","DOIUrl":"10.17085/apm.25411","url":null,"abstract":"<p><strong>Background: </strong>The coronavirus disease 2019 (COVID-19) pandemic has profoundly influenced surgical practice and perioperative care, but its impact on postoperative pneumonia incidence remains unclear.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using the Observational Medical Outcomes Partnership-Common Data Model databases from 17 Korean hospitals. Based on the inpatient surgery date, patients were classified into prepandemic (January 2018-December 2019) and postpandemic groups (January 2020-December 2021). Postoperative pneumonia was identified within 30 days after surgery. Logistic regression analysis assessed the independent effects of the pandemic, age, anesthetic technique, and their interaction.</p><p><strong>Results: </strong>The overall incidence of postoperative pneumonia per 10,000 persons changed slightly from 12.38 prepandemic to 12.99 postpandemic (+4.94%). Younger patients (< 70 years) demonstrated decreased incidence (8.47→7.97, -5.81%), whereas older patients (≥ 70 years) demonstrated increased incidence (28.97→31.97, +10.36%). Considerable interhospital variation was observed, with some hospitals reporting increases exceeding 100%, while others reporting declines exceeding 80%. Overall postoperative pneumonia risk was similar between the pre- and postpandemic periods (odds ratio [OR], 0.893; 95% confidence interval [CI], 0.787-1.015). Older age (≥ 70 years) was strongly associated with higher risk (OR, 2.816; 95% CI, 2.383-3.328), and a significant postpandemic×age interaction indicated that older patients were disproportionately affected (OR, 1.385; 95% CI, 1.145-1.675).</p><p><strong>Conclusions: </strong>The COVID-19 pandemic did not substantially change the overall incidence of postoperative pneumonia, although variations existed across hospitals and age groups. Older age remained the strongest risk factor. Further studies are warranted to clarify the underlying causes and optimize perioperative infection control.</p>","PeriodicalId":101360,"journal":{"name":"Anesthesia and pain medicine","volume":"21 2","pages":"258-266"},"PeriodicalIF":3.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13175909/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147944616","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":"Driving pressure guided ventilation in robot-assisted laparoscopic surgery with steep Trendelenburg position: a randomized controlled study.","authors":"Sooah Cho, Bo Rim Kim, Sang-Youn Park, Soo-Hyuk Yoon, Jae-Hyon Bahk, Susie Yoon","doi":"10.17085/apm.25337","DOIUrl":"10.17085/apm.25337","url":null,"abstract":"<p><strong>Background: </strong>Robot-assisted laparoscopic prostatectomy (RALP) with pneumoperitoneum and steep Trendelenburg positioning impairs ventilation and increases the risk of postoperative pulmonary complications (PPCs). Although positive end-expiratory pressure (PEEP) may reduce atelectasis, the optimal levels remain unclear. This study evaluated the effects of driving pressure (DP)-guided PEEP titration during RALP.</p><p><strong>Methods: </strong>This single-center, randomized controlled trial enrolled adults undergoing RALP (American Society of Anesthesiologists < 3, without pulmonary disease) for either DP minimization-guided individualized PEEP (DP group) or fixed 5 cmH2O PEEP (control). DP was calculated as plateau pressure minus PEEP, with individualized PEEP determined using decremental titration. Atelectasis was quantified using modified lung ultrasound (LUS) score, incorporating B-lines and consolidations. Primary outcome was LUS score at end-Trendelenburg. Secondary outcomes included oxygenation and PPCs.</p><p><strong>Results: </strong>Of 101 assessed, 63 completed analysis. The DP group (n=31) received higher individualized PEEP (median 8.0 cmH2O) during Trendelenburg than controls (5.0 cmH2O, n=32). In the DP group, mean DP was lower during Trendelenburg (19.0 ± 3.4 vs. 21.3 ± 4.7 cmH2O, P=0.035) and LUS score was significantly lower at the end-Trendelenburg (median [1Q, 3Q]: 9.0 [8.0, 11.5] vs. 11.0 [9.0, 13.0]; median difference, -2.0 [95% CI, -3.0 to 0.0]; P=0.032) and recovery (9.0 vs. 13.5, P<0.001). Intraoperative PaO2 during Trendelenburg was higher in the DP group (154.6 ± 33.1 vs. 133.3 ± 34.7 mmHg, P=0.015). PPCs and hospital stay were comparable between groups.</p><p><strong>Conclusions: </strong>DP-guided PEEP titration during RALP reduced lung de-aeration burden assessed by modified LUS score, though benefits did not translate to reduced PPCs.</p>","PeriodicalId":101360,"journal":{"name":"Anesthesia and pain medicine","volume":"21 2","pages":"223-234"},"PeriodicalIF":3.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13175901/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147944529","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":"Response to: Comments on \"Effects of immediate extubation in the operating room on long-term outcomes in living donor liver transplantation: a retrospective cohort study\".","authors":"Jung-Pil Yoon, Ji-Uk Yoon, Hye-Jin Kim, Seyeon Park, Yeong Min Yoo, Hong-Sik Shon, Da Eun Lee, Eun-Jung Kim, Hee Young Kim","doi":"10.17085/apm.26537","DOIUrl":"10.17085/apm.26537","url":null,"abstract":"","PeriodicalId":101360,"journal":{"name":"Anesthesia and pain medicine","volume":"21 2","pages":"269-271"},"PeriodicalIF":3.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13175907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147944599","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":"Assessment of changes in lung aeration and diaphragmatic function using ultrasonography in laparoscopic abdominal surgery: a prospective observational study.","authors":"Divya Sethi, Stuti Prajapati, Garima Garg","doi":"10.17085/apm.25248","DOIUrl":"10.17085/apm.25248","url":null,"abstract":"<p><strong>Background: </strong>A few studies investigating the perioperative use of lung ultrasound (LUS) have shown loss of lung aeration with decline in diaphragmatic function after general anesthesia. We aimed to measure changes in lung aeration and diaphragmatic functions using LUS in patients undergoing elective laparoscopic cholecystectomy.</p><p><strong>Methods: </strong>Forty patients of American Society of Anesthesiologists I/II undergoing elective laparoscopic cholecystectomy under general anesthesia were enrolled. For all patients, LUS examination was performed at 5 time points: preoperative room, after intubation, after deflation of pneumoperitoneum, 30 min after extubation, and 24 h post-extubation. The aeration loss was assessed using the modified LUS score. The diaphragmatic excursion was also evaluated preoperatively, and at 30 min and 24 h post-extubation.</p><p><strong>Results: </strong>A progressive increase in modified LUS score was seen after intubation, after deflation of pneumoperitoneum, 30 min postoperative, after extubation and 24 h post-extubation at postoperative anesthesia care unit (PACU) as compared to preoperative room (P < 0.0001). The maximum modified LUS score was observed postoperatively after 30 min: 8 (5, 10) and 24 h post-extubation in PACU: 8 (4.25, 11.0). No significant change in the diaphragmatic excursion or respiratory complications was observed.</p><p><strong>Conclusions: </strong>Our study found a progressive loss of lung aeration after the induction of general anesthesia in laparoscopic cholecystectomy, extending up to the 24-h perioperative period. However, diaphragmatic excursion remained unchanged. The study also suggests that LUS is a valuable tool for detecting perioperative atelectasis and quantifying the aeration loss.</p>","PeriodicalId":101360,"journal":{"name":"Anesthesia and pain medicine","volume":" ","pages":"235-241"},"PeriodicalIF":3.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13175898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147794036","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":"Current recommendations for preventing residual neuromuscular blockade.","authors":"Jeong Eun Lee, Hoon Jung","doi":"10.17085/apm.26556","DOIUrl":"10.17085/apm.26556","url":null,"abstract":"<p><p>The use of neuromuscular blocking agents (NMBAs) offers several advantages during surgery under general anesthesia because they help secure the surgical field and facilitate appropriate mechanical ventilation. Eliminating postoperative residual neuromuscular blockade (rNMB) remains a major challenge for anesthesiologists. Despite the use of intermediate-acting NMBAs and sugammadex, the incidence of rNMB still remains close to 50%. Although it is relatively easy to distinguish rNMB from a serious adverse reaction in healthy patients in the postanesthesia care unit, the effects of anesthesia make it much more difficult to rule out rNMB in critically ill patients. Although there were no comprehensive guidelines for NMBA management for decades, the most crucial step is now no longer the assessment of blockade depth based on subjective clinical tests or qualitative neuromuscular monitoring (NMM), but rather the appropriate use of NMBAs and reversal agents, and extubation guided by objective, quantitative monitoring. Accordingly, the American Society of Anesthesiologists, the European Society of Anaesthesiology and Intensive Care have published practical guidelines for preventing rNMB over the past five years, recommending appropriate use of NMBAs and reversal agents and the incorporation of quantitative NMM as standard monitoring whenever NMBAs are used. Furthermore, with recent advances in electromyography and the increasing availability of NMM, education on its proper use is essential.</p>","PeriodicalId":101360,"journal":{"name":"Anesthesia and pain medicine","volume":"21 2","pages":"162-170"},"PeriodicalIF":3.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13175903/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147944534","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":"Comparison of multimodal analgesia including intermediate cervical plexus block versus local infiltration analgesia after carotid endarterectomy: a randomized observer-blinded trial.","authors":"Jisun Choi, Yang-Jin Park, RyungA Kang, Shin-Seok Yang, Yu Jeong Bang, Ji-Hye Kwon, Woo Seog Sim, Duk Kyung Kim, Jong Hwan Lee, Justin Sangwook Ko","doi":"10.17085/apm.25380","DOIUrl":"10.17085/apm.25380","url":null,"abstract":"<p><strong>Background: </strong>Effective perioperative analgesia is essential to prevent abrupt changes in cerebral blood flow following carotid endarterectomy (CEA). We aimed to evaluate whether multimodal analgesia, including intermediate cervical plexus block (CPB), reduces 24 h postoperative opioid consumption compared with local infiltration.</p><p><strong>Methods: </strong>This randomized, observer-blinded study included 40 patients undergoing CEA. Patients were randomly allocated to either the multimodal group (multimodal analgesia with intermediate CPB, n = 20) or the control group (local infiltration, n = 20). The primary outcome was 24 h intravenous (IV) opioid conversion to IV morphine equivalents. Secondary outcomes included pain scores at rest and during motion, time to first opioid use, hypertension incidence, antihypertensive use, postoperative nausea/vomiting, satisfaction with pain management, quality of first-night sleep, Korean version of the Quality of Recovery-15 (QoR-15K) scores, complications, cerebral hyperperfusion syndrome, and intraoperative analgesia nociception index values.</p><p><strong>Results: </strong>In the intention-to-treat analysis, 24 h postoperative opioid consumption was 13.3 (6.7, 20.0) mg and 10.0 (6.7, 13.3) mg in the control and multimodal groups, respectively, with no significant difference (P = 0.191). The multimodal group had significantly lower immediate postoperative pain at rest (P < 0.001) and during movement (P < 0.001), as well as longer time to first opioid use (P = 0.047) and higher QoR-15K scores (P = 0.004). No significant differences were observed in the other parameters.</p><p><strong>Conclusions: </strong>Multimodal analgesia with intermediate CPB did not reduce 24 h opioid consumption after CEA. However, it was associated with better early postoperative pain control and recovery scores.</p>","PeriodicalId":101360,"journal":{"name":"Anesthesia and pain medicine","volume":"21 2","pages":"242-251"},"PeriodicalIF":3.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13175900/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147944558","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":"Updated pediatric cardiopulmonary resuscitation: a comprehensive review of the 2025 guidelines.","authors":"Jeong Eun Lee, Mihui Kim, Eun Kyung Choi, Jiyong Yeom, Jinyoung Oh, Sung-Hye Byun, Dong Gun Lim, Hoon Jung","doi":"10.17085/apm.26581","DOIUrl":"10.17085/apm.26581","url":null,"abstract":"<p><p>Pediatric cardiac arrest differs fundamentally from adult arrest in its etiology, physiology, and clinical course. In children, most events arise from progressive respiratory failure or circulatory compromise rather than primary cardiac causes. The 2025 American Heart Association pediatric cardiopulmonary resuscitation (CPR) guidelines provide an updated, evidence-based framework that reflects these distinctions. This review summarizes key revisions across basic life support, advanced life support, and post-cardiac arrest care (PCAC), and outlines practical considerations for clinical implementation. Major updates include refined chest compression techniques for infants, earlier administration of epinephrine for non-shockable rhythms, revised management of foreign-body airway obstruction, and clearer guidance on the use and limitations of end-tidal carbon dioxide monitoring. The guidelines also emphasize targeted hemodynamic management, including maintaining diastolic pressures ≥ 25 mmHg in infants and ≥ 30 mmHg in children during CPR, and sustaining systolic and mean arterial pressures above the age-specific 10th percentile after return of spontaneous circulation. Temperature management prioritizes the strict avoidance of hyperthermia, with the optional use of structured temperature control protocols. The unified Chain of Survival-comprising (1) recognition and emergency activation, (2) high-quality CPR, (3) defibrillation, (4) advanced resuscitation, (5) PCAC, and (6) recovery and survivorship-serves as an integrated framework linking early recognition of arrest to long-term rehabilitation. Implementation of these recommendations requires coordinated teamwork, system-level preparedness, and age-appropriate clinical decision-making. Applied within this framework, the 2025 pediatric CPR guidelines have the potential to improve survival and neurological outcomes in infants and children experiencing cardiac arrest.</p>","PeriodicalId":101360,"journal":{"name":"Anesthesia and pain medicine","volume":"21 2","pages":"150-161"},"PeriodicalIF":3.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13175904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147944099","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 impact of a topical spray of lidocaine 10% on maternal satisfaction prior to spinal needle insertion for cesarean delivery in North India: a prospective, randomized, double-blind, placebo-controlled trial.","authors":"Swati Singh, Harsh Harsh, Annu Choudhary, Rajat Kumar, Vikash Kumar","doi":"10.17085/apm.25275","DOIUrl":"10.17085/apm.25275","url":null,"abstract":"<p><strong>Background: </strong>Maternal satisfaction with anesthesia services is crucial, and an important factor affecting it is spinal needle pain. This study was designed to ascertain the effects of a topical spray of 10% lidocaine on spinal needle prick pain and its correlation with maternal satisfaction.</p><p><strong>Methods: </strong>One hundred ten patients receiving subarachnoid blockade prior to cesarean delivery were randomly allocated to two groups: group LIDO (2 puffs of topical 10% lidocaine spray) and group NS (2 puffs of normal saline spray) given 120 s prior to lumbar puncture, and finally data from 99 patients was analyzed. The primary outcome was maternal satisfaction score (1-5) at the end of surgery, and secondary outcomes were numeric rating scale (NRS) pain score during spinal needle puncture, physical response to pain (observer-assessed score, 0-4).</p><p><strong>Results: </strong>Maternal satisfaction did not differ significantly between the two groups (mean rank 50.76 vs. 49.26; median [1Q, 3Q]: 4 [4, 5] vs. 4 [4, 5], P = 0.767). Although both the NRS score and the physical response to spinal needle prick were significantly lower in the LIDO group compared to placebo (P < 0.001 for both), maternal satisfaction remained comparable between the groups.</p><p><strong>Conclusions: </strong>Topical 10% lidocaine spray is a feasible, economic, and effective intervention to alleviate pain during spinal needle prick in pregnant women. However, addressing spinal needle prick pain alone cannot improve maternal satisfaction and requires a multidimensional approach.</p>","PeriodicalId":101360,"journal":{"name":"Anesthesia and pain medicine","volume":"21 2","pages":"194-202"},"PeriodicalIF":3.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13175906/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147944622","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}