Brazilian Journal of Anesthesiology最新文献

{"title":"Effectiveness and safety of antifibrinolytic agents in off-pump coronary artery bypass grafting: a systematic review and meta-analysis","authors":"João Lucas W.C. Marchesani ,&nbsp;Matheus H. Leite e Silva ,&nbsp;Matheus S. Thomaz ,&nbsp;Davi B. Wolff ,&nbsp;Emerson C.L. Almeida ,&nbsp;Michelle D.S.S. Costa","doi":"10.1016/j.bjane.2026.844731","DOIUrl":"10.1016/j.bjane.2026.844731","url":null,"abstract":"<div><h3>Background</h3><div>Coronary Artery Bypass Grafting (CABG) is the most widely used cardiac intervention and can be accomplished without an extracorporeal circulation off-pump. The benefits of antifibrinolytics in off-pump CABG have yet to be demonstrated.</div></div><div><h3>Methods</h3><div>Randomized Controlled Trials (RCTs) and observational studies comparing the use of antifibrinolytic agents (tranexamic acid, aprotinin, and epsilon-aminocaproic) versus controls in patients undergoing off-pump CABG were searched in the PubMed, Embase, and Cochrane databases. Outcomes included thromboembolic events, in-hospital mortality, overall mortality, bleeding, Intensive Care Unit (ICU) length of stay, and blood product transfusions. Meta-analyses were conducted using the Inverse Variance method under a random-effects model, with p &lt; 0.05 considered statistically significant.</div></div><div><h3>Results</h3><div>Of the 23,149 patients in 20 RCTs and seven observational studies, 51% received antifibrinolytic agents (tranexamic acid or aprotinin). Observational and randomized designs were analyzed separately in primary subgroup analyses. Significant reduction was found for overall mortality (RR = 0.72; [95% CI 0.54–0.95]) in the RCT subgroup. Red-blood-cell transfusion requirements were reduced (RR = 0.65; [95% CI 0.53, 0.78]) as well as Platelets (RR = 0.59; [95% CI 0.41, 0.84]) and fresh-frozen-plasma (RR = 0.39; [95% CI 0.36, 0.42]) transfusion requirement. The RCT subgroup showed a reduction in thromboembolic events (RR = 0.55; [95% CI 0.39, 0.79]).</div></div><div><h3>Conclusions</h3><div>In <em>off-pump</em> CABG, antifibrinolytics reduced the need for blood transfusion while reducing thromboembolic events and overall mortality in RCT subgroups, while pooled analyses combining RCTs and observational studies did not demonstrate significant reductions.</div></div><div><h3>Prospero Link</h3><div><span><span>https://www.crd.york.ac.uk/PROSPERO/view/CRD42024545640</span><svg><path></path></svg></span></div></div>","PeriodicalId":32356,"journal":{"name":"Brazilian Journal of Anesthesiology","volume":"76 2","pages":"Article 844731"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146055240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on: “Comparison of automatic versus constant CPAP in elderly patients after major abdominal surgery: a randomized noninferiority trial”","authors":"Raghuraman M. Sethuraman,&nbsp;Annu Theagrajan,&nbsp;Akash Babu","doi":"10.1016/j.bjane.2026.844744","DOIUrl":"10.1016/j.bjane.2026.844744","url":null,"abstract":"","PeriodicalId":32356,"journal":{"name":"Brazilian Journal of Anesthesiology","volume":"76 2","pages":"Article 844744"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147373312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to the Letter to the Editor regarding “Lateral versus posterior quadratus lumborum block in children undergoing open orchiopexy: a double-blind randomized clinical trial”","authors":"Ozgecan P. Zanbak Mutlu,&nbsp;Pinar Kendigelen,&nbsp;Ayse C. Tutuncu","doi":"10.1016/j.bjane.2025.844718","DOIUrl":"10.1016/j.bjane.2025.844718","url":null,"abstract":"","PeriodicalId":32356,"journal":{"name":"Brazilian Journal of Anesthesiology","volume":"76 2","pages":"Article 844718"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145709127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Working together for perioperative excellence in pediatric perioperative research","authors":"Britta S. von Ungern-Sternberg ,&nbsp;Aine Sommerfield","doi":"10.1016/j.bjane.2026.844736","DOIUrl":"10.1016/j.bjane.2026.844736","url":null,"abstract":"","PeriodicalId":32356,"journal":{"name":"Brazilian Journal of Anesthesiology","volume":"76 2","pages":"Article 844736"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146138019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Moving toward a standardized regional anesthesia approach in clavicle surgery","authors":"Martin Julian Schaefer,&nbsp;Martin Zoremba","doi":"10.1016/j.bjane.2025.844711","DOIUrl":"10.1016/j.bjane.2025.844711","url":null,"abstract":"","PeriodicalId":32356,"journal":{"name":"Brazilian Journal of Anesthesiology","volume":"76 1","pages":"Article 844711"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145552141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between troponin and NT-proBNP levels, cytokines, and clinical outcomes in early sepsis response: a cohort study","authors":"Wagner Nedel ,&nbsp;Luis Valmor Portela","doi":"10.1016/j.bjane.2025.844712","DOIUrl":"10.1016/j.bjane.2025.844712","url":null,"abstract":"","PeriodicalId":32356,"journal":{"name":"Brazilian Journal of Anesthesiology","volume":"76 1","pages":"Article 844712"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145544056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Therapeutic misconceptions: the protective role of the perioperative team","authors":"Britta S. von Ungern-Sternberg ,&nbsp;Aine Sommerfield","doi":"10.1016/j.bjane.2025.844720","DOIUrl":"10.1016/j.bjane.2025.844720","url":null,"abstract":"","PeriodicalId":32356,"journal":{"name":"Brazilian Journal of Anesthesiology","volume":"76 1","pages":"Article 844720"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145846915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative effectiveness of TAP block, EOIP block, and standard care for postoperative analgesia in renal transplantation: a retrospective study","authors":"Karam Azem ,&nbsp;Roussana Aranbitski ,&nbsp;Safo Awad ,&nbsp;Omer Shpack ,&nbsp;Alexander Peres ,&nbsp;Rotem Argov ,&nbsp;Omer Kaplan ,&nbsp;Anatoliy Artyukh ,&nbsp;Andrey Khinchuk ,&nbsp;Michael Yohay Stav ,&nbsp;Philip Heesen ,&nbsp;Sharon Orbach-Zinger ,&nbsp;Eviatar Nesher ,&nbsp;Shai Fein","doi":"10.1016/j.bjane.2025.844692","DOIUrl":"10.1016/j.bjane.2025.844692","url":null,"abstract":"<div><h3>Background</h3><div>Effective pain management following renal transplantation is crucial. While various regional analgesic techniques have been studied, the optimal approach remains unclear. We compared the additive value of Transversus Abdominis Plane (TAP) and External Oblique Intercostal Plane (EOIP) blocks to Standard Care (SC) on postoperative pain and opioid consumption.</div></div><div><h3>Methods</h3><div>This retrospective study included 237 renal transplant recipients (127 SC, 75 TAP, 35 EOIP) between January 2023 and December 2024. Multivariable regression analysis assessed the association of block type on postoperative pain and opioid consumption.</div></div><div><h3>Results</h3><div>TAP block was associated with significantly lower pain scores than SC during the first eight postoperative hours (5.0 vs. 7.0, <em>p</em> &lt; 0.001). Pre-incision TAP block demonstrated the most significant reduction in both pain scores (β = -2.21, 95% CI -3.38 to -1.05, <em>p</em> &lt; 0.001) and opioid consumption (β = -13.56, 95% CI: -21.59 to -5.52, <em>p</em> = 0.001). EOIP block showed no significant advantages over SC and was associated with higher opioid consumption compared to TAP block.</div></div><div><h3>Conclusion</h3><div>Pain predominantly manifested in the first eight postoperative hours. TAP block, particularly when administered pre-incision, was associated with superior pain control compared to SC or EOIP block. Living donor recipients experienced significantly higher pain scores regardless of technique, warranting further investigation.</div></div>","PeriodicalId":32356,"journal":{"name":"Brazilian Journal of Anesthesiology","volume":"76 1","pages":"Article 844692"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145623830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility of early rapid sequence induction and intubation training and the role of a cognitive aid on-demand reader in medical students: lessons from a pilot randomized study","authors":"Getúlio Rodrigues de Oliveira Filho,&nbsp;Miguel Angelo Fabrin,&nbsp;Victor Medeiros Benincá,&nbsp;Ian Novy Quadri,&nbsp;Gabriel Resun Gomes da Silva","doi":"10.1016/j.bjane.2025.844701","DOIUrl":"10.1016/j.bjane.2025.844701","url":null,"abstract":"","PeriodicalId":32356,"journal":{"name":"Brazilian Journal of Anesthesiology","volume":"76 1","pages":"Article 844701"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145433237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation between impostor phenomenon and burnout syndrome in medical residents: a single-center study","authors":"Cristina González Ramírez,&nbsp;Rocío Pérez Bocanegra,&nbsp;Carlos Armando Sánchez-Navarro","doi":"10.1016/j.bjane.2025.844688","DOIUrl":"10.1016/j.bjane.2025.844688","url":null,"abstract":"","PeriodicalId":32356,"journal":{"name":"Brazilian Journal of Anesthesiology","volume":"76 1","pages":"Article 844688"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145314166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}