Turkish journal of anaesthesiology and reanimation最新文献

{"title":"Anaesthesiologists Under Strain: Burnout and Its Associated Factors in a Conflict-affected Context, a Cross-sectional Study.","authors":"Vanda Yazbeck Karam, Zeina Akiki, Wael Salame, Georges Assaf, Carole Serhal, Samantha Succar, Rony Al Nawwar, Sandra Elias, Jessy Abou Nader, Charbel Gerges, Micheline Boukhalil, Hanane Barakat","doi":"10.4274/TJAR.2026.262471","DOIUrl":"https://doi.org/10.4274/TJAR.2026.262471","url":null,"abstract":"<p><strong>Objective: </strong>Anaesthesiologists are particularly vulnerable to burnout due to extended working hours, high-pressure situations, limited patient interactions, multiple responsibilities, and inherent tensions in relationships with surgeons and administrators. The study aimed to explore burnout levels and the factors associated with them among anaesthesiologists in a conflict-affected setting.</p><p><strong>Methods: </strong>A cross-sectional study was carried out between May 2024 and August 2025 using a voluntary, anonymous, and electronic survey. The Copenhagen Burnout Inventory, demographics, and practice environment questions were included. Statistical analyses were conducted to identify factors associated with personal, work-related, and client-related burnout. A significance threshold of 0.05 was applied.</p><p><strong>Results: </strong>Among the 82 anaesthesiologists, 57% experienced personal burnout, 51% experienced work-related burnout, and 28% experienced client-related burnout. Positive and significant associations were observed between working longer hours and personal burnout (adjusted ß [95% confidence interval (CI)]=15.6 (0.88; 30.3); <i>P</i>=0.04) and work-related burnout [adjusted ß (95% CI)=17.7 (3.68; 31.7); <i>P</i>=0.01], as well as between covering five or more night shifts per month and client-related burnout [adjusted ß (95% CI)=15.3 (3.86; 26.7); <i>P</i>=0.009].</p><p><strong>Conclusion: </strong>The findings reveal concerning levels of burnout among anaesthesiologists in conflict-affected regions, which is particularly important given the ongoing regional conflict and limited conflict-specific data, and highlight the potential role of modifiable predictors and associated factors. Targeted interventions are essential to support anaesthesiologists' well-being and ensure the effective functioning of healthcare institutions in such settings. Future studies with larger, randomly selected samples are warranted to further explore this issue.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Structured Preoperative Counseling on Anaesthesia Preference in Elective Cesarean Delivery: A Prospective Study.","authors":"Seval Kılbasanlı, Osman Aydın, Bülent Çakmak","doi":"10.4274/TJAR.2026.262616","DOIUrl":"https://doi.org/10.4274/TJAR.2026.262616","url":null,"abstract":"<p><strong>Objective: </strong>To assess changes in anaesthesia preference before and after structured preoperative counseling and to identify factors associated with anaesthesia preference among women scheduled for elective cesarean delivery.</p><p><strong>Methods: </strong>This prospective, single-center, single-arm, pre-post observational study included 200 pregnant women classified as the American Society of Anesthesiologists physical status II. Data were collected using a structured questionnaire assessing demographic characteristics, obstetric history, previous anaesthesia experience, level of knowledge, and anaesthesia preference, both before and after counseling. Statistical analyses were performed using SPSS version 22.0, and a <i>P</i> value < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>At baseline, 53% of patients preferred spinal anaesthesia and 47% preferred general anaesthesia. Following counseling, the preference for spinal anaesthesia increased to 88.5% (<i>P</i> < 0.001). Increasing age was associated with a decreased likelihood of choosing spinal anaesthesia [odds ratio (OR)=0.94, 95% confidence interval (CI): 0.89-0.99], whereas higher education (OR=1.78, 95% CI: 1.05-3.02), prior knowledge (OR=1.65, 95% CI: 1.02-2.68), and previous spinal anaesthesia experience (OR=2.95, 95% CI: 1.65-5.28) were identified as independent predictors of spinal anaesthesia preference. No significant association was found between smoking and anaesthesia preference, or between comorbidities and anaesthesia preference. The postoperative satisfaction rate with the anaesthesia was 91.5%.</p><p><strong>Conclusion: </strong>Following structured preoperative counseling, the preference for neuraxial anaesthesia increased among women scheduled for elective cesarean delivery. These findings suggest that standardized patient education may be a useful component of preoperative anaesthesia assessment.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149220880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Postoperative Analgesic Efficacy Between Opioid-free Anaesthesia Using Intravenous Magnesium, Lidocaine, and Erector Spinae Plane Block, and Opioid-based Anaesthesia in Laparoscopic Abdominal Surgeries: A Randomised Controlled Trial.","authors":"Jerfiha Vj, Ezhilrajan Vaithiyalingam, Pradeesh Johny","doi":"10.4274/TJAR.2026.241747","DOIUrl":"https://doi.org/10.4274/TJAR.2026.241747","url":null,"abstract":"<p><strong>Objective: </strong>Opioid-based anaesthesia is a standard practice in laparoscopic surgeries. However, it is associated with adverse effects that can limit its use. To address these issues, opioid-free anaesthesia has been introduced as an alternative. This study aims to compare the analgesic efficacy of opioid-free anaesthesia, incorporating magnesium, lidocaine, and an erector spinae plane block (ESPB), with traditional opioid-based anaesthesia during laparoscopic procedures.</p><p><strong>Methods: </strong>Seventy patients aged 18-60 years undergoing laparoscopic surgery were randomly divided into two groups of 35 each. Opioid-free group received opioid-free anaesthesia, which included an intravenous (IV) bolus of 2 g magnesium, a continuous lidocaine infusion at 1.5 mg kg^-1 hr^-1, and a bilateral ESPB with 25 mL of 0.25% bupivacaine. Opioid-based group received opioid-based anaesthesia with an IV dose of 2 μg kg^-1 fentanyl. Postoperative pain and the need for rescue analgesia were assessed for 24 h. Perioperative haemodynamic parameters were recorded, and the incidence of postoperative complications, including sedation, nausea, vomiting, and shivering, was monitored for 24 h.</p><p><strong>Results: </strong>Pain scores were significantly lower in the opioid-free group compared to the opioid-based group at 0 h (<i>P</i> < 0.001), 2 h (<i>P</i> < 0.001), and 4 h (<i>P</i>=0.005) postoperatively. The opioid-based group required rescue analgesia more frequently (<i>P</i> < 0.001). Additionally, the incidence of postoperative complications was significantly lower in the opioid-free group than in the opioid-based group (<i>P</i> < 0.001). Haemodynamic parameters were similar between the two groups.</p><p><strong>Conclusion: </strong>Opioid-free anaesthesia provides superior postoperative analgesia and reduces the incidence of postoperative complications compared with opioid-based anaesthesia for laparoscopic surgery.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149196725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hybrid Airway Management for Neuromonitoring-guided Selective Phrenic Nerve Surgery in Intractable Hiccups: A Case Report.","authors":"Bekir Suat Kürkçüoğlu, Sinan Ünsal, Bahar Uslu Bayhan, Tuğçe Gazioğlu Kişi, Onur Bayrakçı","doi":"10.4274/TJAR.2026.262496","DOIUrl":"https://doi.org/10.4274/TJAR.2026.262496","url":null,"abstract":"<p><p>Intractable hiccups are rare but debilitating, and may cause sleep disturbances, nutritional impairment, exhaustion, and a severe deterioration in quality of life. When pharmacological and interventional treatments fail, selected surgical procedures targeting the phrenic nerve may be considered. We report the anaesthetic management of a 32-year-old woman with idiopathic intractable hiccups who underwent right-sided selective phrenic nerve surgery guided by thoracoscopic neuromonitoring. Because thoracoscopic exposure and intraoperative neuromonitoring were required simultaneously, a hybrid airway strategy combining an electromyography endotracheal tube with a bronchial blocker was used. The patient was positioned in the left lateral decubitus position, and the bronchial blocker was placed in the right main bronchus under fiberoptic bronchoscopic guidance. One-lung ventilation was maintained for 35 minutes with FiO₂ of 0.70 to 0.80, tidal volume of 5-6 mL kg^-1, respiratory rate of 18 min^-1, and PEEP of 5 cmH₂O; the arterial blood gas analysis at 25 minutes showed pH 7.38, PaCO₂ 41 mmHg, and PaO₂ 92 mmHg. Sugammadex was administered intraoperatively to restore diaphragmatic motor responses required for branch-specific neuromonitoring. The medial and anterolateral branches of the right phrenic nerve exhibited abnormal electrophysiological responses and were treated with selective bipolar ablation and clipping. Postoperatively, the patient remained on room air, reported no intraoperative recall, and showed no clinically relevant diaphragmatic dysfunction on clinical and functional assessment. This case illustrates that established anaesthetic techniques can be carefully adapted to meet the competing requirements of lung isolation, anaesthetic depth control, and neuromonitoring in selected patients undergoing phrenic nerve surgery for intractable hiccups.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149196766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in the Use of Neuraxial vs. General Anaesthesia for Transurethral Resection of the Prostate.","authors":"Roman Gorchs, Vaidya Parthasarathy, Evan Burchfiel, Nitin Prabakaran, Ali Khalifa","doi":"10.4274/TJAR.2026.262690","DOIUrl":"https://doi.org/10.4274/TJAR.2026.262690","url":null,"abstract":"<p><strong>Objective: </strong>Historically, neuraxial anaesthesia (NA) was preferred for transurethral resection of the prostate (TURP) to allow monitoring for TURP syndrome, but modern surgical techniques have largely eliminated this risk. We aimed to characterise trends in anaesthesia utilisation for TURP over a 15-year period and to identify patient factors associated with anaesthetic technique selection.</p><p><strong>Methods: </strong>We performed a retrospective cohort study of patients undergoing primary TURP using the ACS-NSQIP database (2009-2023). Multivariable logistic regression identified predictors of the use of general anaesthesia (GA) versus NA. Subgroup analyses examined trends by patient health status and age.</p><p><strong>Results: </strong>Of 73,214 patients identified, GA utilisation increased significantly from 69.9% in 2009 to 88.8% in 2023 (<i>P</i> < 0.001). In multivariable analysis, each successive year was associated with a 15% increase in the odds of receiving GA [odds ratio (OR) 1.15, 95% confidence interval (CI) 1.14-1.15]. Black patients (OR 1.65, 95% CI 1.47-1.87) had higher odds of GA than white patients, and hispanic patients (OR 1.51, 95% CI 1.38-1.64) had higher odds of GA than non-hispanic patients. Conversely, older age, chronic obstructive pulmonary disease (OR 0.77, 95% CI 0.71-0.84), and diabetes (OR 0.88, 95% CI 0.84-0.93) were associated with decreased GA use. The shift towards GA was significantly more pronounced among medically complex patients (American Society of Anesthesiologists 3-4) than among less medically complex patients (<i>P</i>=0.005).</p><p><strong>Conclusion: </strong>The anaesthetic management of TURP has evolved over the last 15 years, and GA has further solidified its status as the dominant modality. This evolution likely reflects the diminished risk of TURP syndrome, allowing practice to be driven by airway control and efficiency rather than by historical safety constraints.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149196830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"One-Lung Ventilation for Neonatal Pneumonectomy in a Hydropic Premature Infant: Fiberoptic-guided Left Mainstem Intubation.","authors":"Zeliha Bozkurt, Büşra G Erol, Nezir Yılmaz","doi":"10.4274/TJAR.2026.262718","DOIUrl":"https://doi.org/10.4274/TJAR.2026.262718","url":null,"abstract":"<p><p>Congenital cystic adenomatoid malformation (CCAM) is a rare lung anomaly that can cause severe respiratory distress and hydrops fetalis. One-lung ventilation (OLV) in neonates poses extreme anatomical challenges due to the lack of appropriately sized double-lumen tubes or bronchial blockers. A male neonate (2500 g, 30 weeks' gestation) presented with hydrops fetalis and a massive right-sided thoracic CCAM. Due to progressive respiratory failure and hemodynamic instability, an emergency right pneumonectomy was scheduled on postnatal day 3. To achieve OLV, a 3.5-mm cuffed endotracheal tube (with the cuff left deflated) was advanced into the left main bronchus under fiberoptic bronchoscopy (FOB) guidance. Removal of the tube adaptor facilitated rapid, pragmatic placement while minimizing interruptions to ventilation during apneic oxygenation. Pressure-controlled lung-protective ventilation was maintained. Transient desaturation episodes during mediastinal manipulation were successfully managed. The 3-hour procedure was completed without intraoperative complications. In premature neonates in whom commercial lung-isolation devices are impractical, FOB-guided selective mainstem bronchial intubation is a rapid, feasible, and effective strategy for OLV. Individualized airway planning and FOB guidance are instrumental in ensuring accurate placement and maintaining oxygenation.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149196812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low-Angle Paramedian Approach versus Midline Approach for Remote Access Epidural Blood Patch: A Case Report.","authors":"Argun Pire, Can Eyigör, Burcu Özalp, Meltem Uyar","doi":"10.4274/TJAR.2026.262615","DOIUrl":"https://doi.org/10.4274/TJAR.2026.262615","url":null,"abstract":"<p><p>While mid-thoracic CSF leaks (T7-T8) require targeted epidural blood patches, direct thoracic puncture carries a significant risk of spinal cord injury due to the narrow epidural space. To mitigate this risk, a safety-oriented remote-access strategy from the T12-L1 level, with cranial advancement of the catheter, was employed to prevent direct thoracic spinal cord injury. We present a 46-year-old male with a T7-T8 leak in whom a standard midline approach failed due to poor catheter steerability. By adopting a low-angle (<30°) paramedian approach, we achieved precise ipsilateral catheter positioning; this technical modification provides optimized vector alignment and a tangential epidural trajectory for unilateral thoracic leaks. This technical modification may improve maneuverability and safety for unilateral thoracic leaks, compared to standard midline techniques, and appears to facilitate an optimized tangential trajectory in this case.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149196718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Harnessing the Power of Education for a Low-carbon Future in Anaesthesia: A Narrative Review.","authors":"Baxter Smelzer, Gabriel Chang, Shubha Srinivasareddy","doi":"10.4274/TJAR.2026.262416","DOIUrl":"https://doi.org/10.4274/TJAR.2026.262416","url":null,"abstract":"<p><p>Climate change poses a significant threat to public health, with the healthcare sector being a major contributor to greenhouse gas emissions. Anaesthesia and the operating room are notable contributors within this sector, particularly because of volatile inhalation gases such as desflurane and nitrous oxide. Therefore, improving sustainability in anaesthesia is a clinical and ethical imperative. This review examines recent advances in leveraging education to promote low-carbon anaesthesia practices. We summarize evidence on how various educational interventions and formats can reduce the carbon footprint of anaesthesia and discuss implementation strategies, challenges, and future directions. Many studies demonstrate that educational programs reduce the use of high global warming potential anaesthetic agents. Programs vary widely in scope, ranging from single-session lectures and surveys to multi-year sustainability task forces and formal policy changes, some of which have resulted in up to a 90% reduction in volatile agent emissions. Combining multiple techniques (such as lectures, posters, and vaporizer labeling) has been associated with substantial reductions in volatile agent emissions and with improved organizational readiness for sustainability initiatives. These education-driven shifts toward environmentally friendly approaches, such as low-flow techniques, total intravenous anaesthesia, and regional anaesthesia, have proven effective, cutting costs, maintaining patient safety, and reducing carbon emissions. Educational initiatives represent a practical and cost‑efficient strategy to reduce carbon emissions in anaesthesia practice and in healthcare. By integrating environmental stewardship into anaesthesia training and policy, anaesthesiologists can lead the transition of healthcare to low-carbon care.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149196701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Analgesia Nociception Index is More Strongly Associated with Anxiety Than with Pain in Conscious Male Patients Undergoing Hernia Repair Under Combined Spinal-epidural Anaesthesia.","authors":"Songyi Guo, Hong Wen, Lina Yang","doi":"10.4274/TJAR.2026.262544","DOIUrl":"https://doi.org/10.4274/TJAR.2026.262544","url":null,"abstract":"<p><strong>Objective: </strong>The Analgesia Nociception Index (ANI), derived from heart rate variability, is a non-invasive marker of the nociception- analgesia balance. Its validity and validity in conscious are uncertain because activity may also psychological factors, particularly anxiety. This exploratory study examined the among ANI, pain, and anxiety in male patients undergoing hernia repair with combined spinal-epidural anaesthesia (CSEA).</p><p><strong>Methods: </strong>Twenty-four male patients with American Society of Anesthesiologists physical status I-II undergoing hernia repair under CSEA were enrolled. Self-reported visual analogue scale for Anxiety (VAS-A), pain (VAS), and continuously recorded ANI were assessed at four procedural stages: lateral positioning (T1), local anaesthetic infiltration (T2), epidural puncture (T3), and two minutes post-puncture (T4). Within-patient (primary), patient-level, and observation-level correlations were and the two within-patient correlations involving ANI were formally compared.</p><p><strong>Results: </strong>At the within-patient level, ANI correlated negatively with anxiety (r=-0.794, <i>P</i> < 0.001) and with pain (r=-0.515, <i>P</i> < 0.001); the ANI-stronger than the ANI-pain correlation. The association between ANI and anxiety was significantly stronger than that between ANI and pain (Hotelling-Williams t=4.10, <i>P</i> < 0.001). The patient-level ANI--pain analysis was clearly underpowered (post-hoc power ≈ 0.18).</p><p><strong>Conclusion: </strong>Clinicians should therefore avoid interpreting a low ANI value as evidence of inadequate analgesia alone and should consider concurrent assessment of both pain and anxiety. These findings should be regarded as hypothesis-generating and require confirmation in larger, sex-balanced, multicentre studies. Trial registration: ClinicalTrials.gov (NCT05053633), registered 22 September 2021.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149196850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regional Anaesthesia Techniques in Liver and Kidney Transplantation: A Narrative Review in Donors and Recipients.","authors":"Alessandro De Cassai, Burhan Dost, Serkan Tulgar, Bahadır Çiftçi, Sandeep Diwan, Yavuz Gürkan","doi":"10.4274/TJAR.2026.262509","DOIUrl":"10.4274/TJAR.2026.262509","url":null,"abstract":"<p><p>Advances in surgical techniques and perioperative care have driven increasing interest in regional anaesthesia as part of multimodal analgesia strategies. In liver and kidney transplantation, however, the adoption of regional techniques remains limited due to concerns regarding altered coagulation, cardiovascular instability, and graft perfusion. This narrative review aims to synthesize current evidence on the feasibility, safety, and clinical utility of neuraxial and fascial plane blocks in both transplant recipients and living donors. A narrative review of the literature was conducted, focusing on regional anaesthesia techniques used in transplantation. The review integrates anatomical considerations, sources of postoperative pain, patient-specific comorbidities, and clinical evidence related to neuraxial anaesthesia and ultrasound-guided fascial plane blocks, including erector spinae plane block, quadratus lumborum block, transversus abdominis plane block, modified thoracoabdominal nerve block, external oblique intercostal block, and emerging techniques. Neuraxial anaesthesia can provide effective analgesia in carefully selected transplant patients, particularly in living donors, but its use is constrained by dynamic coagulation abnormalities and hemodynamic instability, especially in recipients. Fascial plane blocks offer a favorable risk-benefit profile, providing effective somatic and, in some cases, visceral analgesia while preserving hemodynamic stability and minimizing bleeding risk. Evidence supports their opioid-sparing effects and feasibility across a range of transplant procedures. Regional anaesthesia represents a valuable component of multimodal analgesia in liver and kidney transplantation when tailored to surgical incision patterns, sources of pain, and patient-specific physiological considerations. Fascial plane blocks, in particular, appear well suited to transplant populations and may facilitate enhanced recovery while maintaining graft-protective priorities.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":"54 4","pages":"236-247"},"PeriodicalIF":1.2,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13529075/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851502","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}