Trends in Anaesthesia and Critical Care最新文献

{"title":"Optimising peak inspiratory pressures during induction of Anaesthesia: Comparing gastric inflation with 15 and 20 cm H2O during facemask ventilation using ultrasonography","authors":"Shreyash Agrawal,&nbsp;Neerja Banerjee,&nbsp;Aanchal Kakkar","doi":"10.1016/j.tacc.2025.101575","DOIUrl":"10.1016/j.tacc.2025.101575","url":null,"abstract":"<div><h3>Introduction</h3><div>Pulmonary aspiration of gastric contents is a major cause of mortality related to general anaesthesia. This study examines the effects of lower peak inspiratory pressures (15 cmH₂O) on gastric inflation (GI) and ventilation adequacy compared to the current accepted cutoff of 20 cmH₂O.</div></div><div><h3>Methods</h3><div>In this comparative, randomised study, patients were allocated to two groups, P15 and P20, defined by the peak inspiratory pressures during 3 min of pressure-controlled facemask ventilation (FMV). Anaesthesia was induced using propofol and fentanyl, along with neuromuscular blockade using vecuronium. Using ultrasonography, the cross-sectional area (CSA) of the gastric antrum was measured, and arterial blood gas samples were taken at baseline and the end of 3 min of FMV. The left paratracheal oesophagus on-air entry (LPEOAE) was also visualised during the FMV using ultrasonography.</div></div><div><h3>Result</h3><div>Sixty patients were analysed. The authors registered statistically significant inflation in both groups after 3 min of FMV (p &lt; 0.001). However, at the end of FMV, it was significantly greater in the P20 (p = 0.009). Arterial blood gas analysis revealed adequate oxygenation and ventilation in both groups. LPEOAE was significantly higher in the P20 group (p = 0.039). No significant changes in hemodynamics were seen in the two groups.</div></div><div><h3>Conclusion</h3><div>Lower inspiratory pressures of 15 cmH₂0 resulted in a reduced gastric inflation while providing adequate ventilation and oxygenation during the induction of anaesthesia in paralysed, non-obese patients.</div></div>","PeriodicalId":44534,"journal":{"name":"Trends in Anaesthesia and Critical Care","volume":"63 ","pages":"Article 101575"},"PeriodicalIF":1.4,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144633066","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":"Charting the inflammatory response after Total Knee Arthroplasty","authors":"Rohan Magoon ,&nbsp;Nitin Choudhary","doi":"10.1016/j.tacc.2025.101574","DOIUrl":"10.1016/j.tacc.2025.101574","url":null,"abstract":"","PeriodicalId":44534,"journal":{"name":"Trends in Anaesthesia and Critical Care","volume":"63 ","pages":"Article 101574"},"PeriodicalIF":1.4,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144557298","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 role of ECMO in acute intrapartum or postpartum events during cesarean section: A scoping review","authors":"Kamal Kumar,&nbsp;Sofía Zhang-Jiang,&nbsp;Malcolm Howard,&nbsp;Sonny Cheng,&nbsp;Cheng Lin","doi":"10.1016/j.tacc.2025.101573","DOIUrl":"10.1016/j.tacc.2025.101573","url":null,"abstract":"<div><h3>Background</h3><div>Peripartum obstetric emergencies, such as amniotic fluid embolism, massive hemorrhage or peripartum cardiomyopathy, can result in hemodynamic collapse and multi-organ failure. Extracorporeal membrane oxygenation (ECMO) offers temporary cardiopulmonary support by facilitating gas exchange and circulatory support in above situations. This review aims to evaluate the role and outcomes of ECMO use during acute intrapartum or early postpartum hemodynamic instability in patients undergoing Caesarean section.</div></div><div><h3>Methods</h3><div>A comprehensive literature search was conducted using PubMed, Embase, Medline, and Cochrane Central databases to identify relevant studies published up to January 2025. Inclusion criteria encompassed case reports and case series describing the use of ECMO in obstetric patients experiencing hemodynamic collapse during or within 24 h of Caesarean section. Exclusion criteria included non-obstetric patients, ECMO initiated beyond the early postpartum period, and studies without outcome data. A total of 18 publications reporting on 20 individual patients were included.</div></div><div><h3>Results</h3><div>Amniotic fluid embolism was the most frequently reported indication for ECMO use. The mean duration of ECMO support was 4.2 days. Twelve patients required mechanical ventilation for a mean of 15.3 days. Maternal survival was high, with only one reported death. Ten patients experienced uneventful recoveries. Among the survivors, four reported neurological sequelae, such as weakness and neurocognitive dysfunction.</div></div><div><h3>Conclusion</h3><div>Our results suggest that extracorporeal membrane oxygenation use in the obstetric population for hemodynamic collapse during or immediately following Caesarean section is associated with good maternal survival to discharge. Despite the severity of presentation, maternal survival to hospital discharge was favorable. Further prospective studies are needed to better define patient selection, timing, and long-term outcomes in this population.</div></div>","PeriodicalId":44534,"journal":{"name":"Trends in Anaesthesia and Critical Care","volume":"63 ","pages":"Article 101573"},"PeriodicalIF":1.4,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144522059","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":"Dual forced-air warming improves intra-operative temperature management in lumbar spine surgeries","authors":"Hsin-Yi Wang ,&nbsp;Yu-Cheng Yao ,&nbsp;Po-Hsin Chou ,&nbsp;Chien-Kun Ting ,&nbsp;Jing-Yang Liou","doi":"10.1016/j.tacc.2025.101572","DOIUrl":"10.1016/j.tacc.2025.101572","url":null,"abstract":"<div><h3>Purpose</h3><div>The efficacy of dual versus single forced-air warming (FAW) devices in lumbar spine surgeries has not been evaluated. We hypothesized that dual FAW devices can rewarm the patient faster, which results in better intra-operative temperature management.</div></div><div><h3>Methods</h3><div>Propensity score matching of two cohorts was performed. The FAW1 group received standard anesthetic care with the single FAW device and the FAW2 group used dual FAW devices. The time–temperature integral was calculated to evaluate the temperature exposure. The primary outcomes included intra-operative minimal temperature, final temperature and the integral of the hypothermic and rewarm periods (to 36 °C). The risk factors were analyzed as secondary outcomes.</div></div><div><h3>Results</h3><div>The FAW1 and FAW2 groups showed similar average lowest temperature. However, the time–temperature integral in the FAW2 group was significantly lower than that in the FAW1 group. The FAW2 group had a faster average rewarming time than the FAW1 group by 51.7 min. The FAW2 group had a higher number of patients achieving normothermia at the end of surgery than the FAW1 group (87.7 % vs. 60 %). Blood loss was associated with hypothermia in the FAW1 group.</div></div><div><h3>Conclusions</h3><div>Dual FAW devices are beneficial for intra-operative temperature management in lumbar spine surgeries. Further, they can be easily implemented. Patients who used dual FAW devices had a less exposure to mild hypothermia (&lt;35 °C) and a faster rewarming time to &gt;36 °C. Hence, there was a higher proportion of patients with normothermia at the end of surgery.</div></div><div><h3>Clinical trial number</h3><div>not applicable.</div></div>","PeriodicalId":44534,"journal":{"name":"Trends in Anaesthesia and Critical Care","volume":"63 ","pages":"Article 101572"},"PeriodicalIF":1.4,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144471492","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":"Superimposed high-frequency jet ventilation vs. pressure-controlled ventilation in endobronchial ultrasound-guided transbronchial needle aspiration: A randomised controlled trial","authors":"Manman Liu ,&nbsp;Zhen Yang ,&nbsp;Biling Wu ,&nbsp;Jie Liu ,&nbsp;Yimei Lin ,&nbsp;Juanlan Liu ,&nbsp;Wanxia Xiong ,&nbsp;Chao Liang","doi":"10.1016/j.tacc.2025.101571","DOIUrl":"10.1016/j.tacc.2025.101571","url":null,"abstract":"<div><h3>Background</h3><div>Ventilation management during endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is challenging because of shared airway use and the risks of hypoxaemia and hypercapnia. This study compared the safety and efficacy of superimposed high-frequency jet ventilation (SHFJV) and pressure-controlled ventilation (PCV) using a supraglottic airway (SGA) under general anaesthesia.</div></div><div><h3>Methods</h3><div>Patients undergoing EBUS-TBNA were randomly assigned to receive either SHFJV or PCV. The primary outcomes was perioperative changes in oxygenation index (OI). Secondary outcomes included intraoperative hypoxaemia and hypercapnia, perioperative changes pressure of carbon dioxide (PaCO₂), haemodynamic stability, intraoperative and postoperative adverse events (AEs), and SGA ventilation quality.</div></div><div><h3>Results</h3><div>All 88 patients (28.4 % female; median age, 62 years) were analysed. Overall, 44 participants were randomised to SHFJV, and 44 participants were randomised to PCV. Post-hoc analysis showed that the SHFJV group had significantly greater improvement in OI at the end of surgery (mean difference (MD) = 78.52, 95 % confidence interval (CI), 30.35 to 126.68), <em>P</em> = 0.039) and a significant decrease in PaCO₂ after 19 min (MD = −8.23, 95 % CI = −12.68 to −3.77, <em>P</em> = 0.001). Intraoperative and postoperative adverse events were similar between the groups, and no significant differences were observed in intraoperative hypoxaemia or hypercapnia. The SHFJV group had fewer cases of poor SGA ventilation quality (4.5 %) than the PCV group (20 %), demonstrating superior SGA ventilation quality (<em>P</em> = 0.024).</div></div><div><h3>Conclusions</h3><div>SHFJV significantly improved OI compared with PCV while maintaining comparable safety profiles during EBUS-TBNA. These findings underscore the SHFJV as a promising ventilation strategy, particularly for patients requiring improved oxygenation during complex airway interventions.</div></div><div><h3>Registration</h3><div>Chinese Clinical Trial Registry; Registration number: ChiCTR2300071799; <u>URL:</u> <span><span>https://www.chictr.org.cn/showproj.html?proj=197551</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":44534,"journal":{"name":"Trends in Anaesthesia and Critical Care","volume":"63 ","pages":"Article 101571"},"PeriodicalIF":1.4,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144296904","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":"Quantifying the effect of succinylcholine on vocal cord opening using electromyographic single twitch for facilitated mask ventilation: a prospective observational study","authors":"Sarah J. Werner ,&nbsp;Adrian I. Georgevici ,&nbsp;Thomas P. Weber ,&nbsp;Mitja Klutzny ,&nbsp;Stefanie Dencks ,&nbsp;Nico Oblisz ,&nbsp;Philipp Gude ,&nbsp;Jennifer Herzog-Niescery","doi":"10.1016/j.tacc.2025.101564","DOIUrl":"10.1016/j.tacc.2025.101564","url":null,"abstract":"<div><h3>Background</h3><div>Neuromuscular blocking drugs open the vocal cords and facilitate mask ventilation but may impede the return to spontaneous breathing. Current German S1 airway management guidelines recommend short-acting neuromuscular blocking drugs such as succinylcholine for at-risk patients without defining doses or methods to monitor vocal cord opening. This study investigates the relationship between electromyography-based single twitch response amplitude and vocal cord opening. Secondary endpoint was the quantification of succinylcholine's neuromuscular blocking effect after administration of 0.1 and 0.9 mg kg⁻¹ IBW.</div></div><div><h3>Methods</h3><div>Thirty patients aged ≥18 years scheduled for surgery with tracheal intubation using succinylcholine were enrolled. Induction of anaesthesia included remifentanil and propofol. The depth of anaesthesia was measured with an electroencephalogram monitor. The baseline neuromuscular block was determined electromyographically with single twitch stimulation of the ulnar nerve at the abductor digiti minimi muscle. The vocal cord area was videorecorded to determine baseline conditions. Then, the patient received 0.1 mg kg⁻¹ IBW succinylcholine and additional 0.9 mg kg⁻¹ IBW after 2 min. After 4 min the trachea was intubated.</div></div><div><h3>Results</h3><div>Pearson's correlation coefficient between the variables of the primary endpoint was −0.54 ± 0.09 (<em>P</em> &lt; 0.001). The non-linear regression including interactions with a sedation-depth-index estimated accurately the vocal cord opening (R² 68.3 %, <em>P</em> &lt; 0.001). Succinylcholine 0.1 mg kg⁻¹ opened the vocal cords 78 % (IQR 65–86 %).</div></div><div><h3>Conclusions</h3><div>After succinylcholine administration, the electromyographic single twitch stimulation combined with sedation-depth monitoring reliable estimates vocal cord aperture. The considerable vocal cord opening achieved after 0.1 mg kg⁻¹ succinylcholine supports using lower doses for assuring mask ventilation.</div></div><div><h3>Clinical trial registration</h3><div>DRKS00021433.</div></div>","PeriodicalId":44534,"journal":{"name":"Trends in Anaesthesia and Critical Care","volume":"62 ","pages":"Article 101564"},"PeriodicalIF":1.4,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144166754","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":"A National Advanced Airway Management (NAAM) programme in Romania under the framework of a European curriculum for Simulation-Based Education and Training (SBET) in anaesthesiology","authors":"Claudiu Bârsac ,&nbsp;Alina Petricā ,&nbsp;Dorel Sāndesc ,&nbsp;Diana Lungeanu ,&nbsp;Şerban Bubenek ,&nbsp;Marc Lazarovici ,&nbsp;Doris Østergaard ,&nbsp;Cosmin Bălan ,&nbsp;Janos Szederjesi ,&nbsp;Anca Irina Ristescu ,&nbsp;Horațiu Nicolae Vasian ,&nbsp;Crina L. Burlacu","doi":"10.1016/j.tacc.2025.101563","DOIUrl":"10.1016/j.tacc.2025.101563","url":null,"abstract":"<div><h3>Background</h3><div>The Romanian Society of Anaesthesia and Intensive Care (SRATI) in collaboration with the European Society of Anaesthesiology and Intensive Care (ESAIC) and the Society for Simulation in Europe (SESAM) have identified a need for advanced airway management training aligned to international guidelines. The aims of this study are to describe the planning, development, conduction and implementation of a National Advanced Airway Management (NAAM) course in Romania; and, to evaluate the NAAM content, methodology, and achievement of learning objectives, as perceived by the residents.</div></div><div><h3>Methods</h3><div>The NAAM project followed a four-step approach: 1. Target needs analysis; 2. Train-the-Trainer (TTT); 3. Integration in residents’ training; 4. Evaluation by the participating residents. Between February 2023 and April 2024, 400 residents from five simulation centres attended the course, out of which 186 provided anonymous feedback on the course design and methodology, and reported pre- and post-course confidence scores.</div></div><div><h3>Results</h3><div>NAAM significantly improved residents’ self-perceived confidence in managing difficult airways (more than 1 point increase on a 5-point Likert scale, with Wilcoxon signed−rank test p &lt; 0.001 for each self-assessed skill). Participants also reported high satisfaction scores with the eight skills stations and simulation sessions, with a median (inter-quartile range) of 5 (4–5) points for each session.</div></div><div><h3>Conclusion</h3><div>The NAAM programme has successfully enhanced the Romanian anaesthesiology training. It may serve as a model for implementing national SBET programmes in other European countries, addressing similar airway management and/or other gaps in anaesthesiology training.</div></div><div><h3>Trial registration</h3><div>Not applicable.</div></div>","PeriodicalId":44534,"journal":{"name":"Trends in Anaesthesia and Critical Care","volume":"62 ","pages":"Article 101563"},"PeriodicalIF":1.4,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144166755","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":"Liver transplantation outcomes following the implementation of a standardized ICU enhanced recovery protocol in liver transplant recipients - A single center study","authors":"Santhalakshmi Angappan ,&nbsp;Chase Wehrle ,&nbsp;Giuseppe D'Amico ,&nbsp;Cristiano Quintini ,&nbsp;Madiha Syed ,&nbsp;Faith Factora ,&nbsp;James Rowbottom ,&nbsp;Christan Bury ,&nbsp;Nowak Diane ,&nbsp;David Jury ,&nbsp;Koji Hashimoto ,&nbsp;Federico Aucejo ,&nbsp;Silvia Perez-Protto","doi":"10.1016/j.tacc.2025.101561","DOIUrl":"10.1016/j.tacc.2025.101561","url":null,"abstract":"","PeriodicalId":44534,"journal":{"name":"Trends in Anaesthesia and Critical Care","volume":"62 ","pages":"Article 101561"},"PeriodicalIF":1.4,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144084477","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":"Mechanical ventilation in Mounier-Kuhn syndrome: Hybrid-HFJV for dead space ventilation challenge","authors":"Mehmet Murat Sayın ,&nbsp;Fatma Kavak Akelma ,&nbsp;Ceyda Özhan Çaparlar ,&nbsp;İbrahim Kuzu ,&nbsp;Burak Nalbant ,&nbsp;Jülide Ergil","doi":"10.1016/j.tacc.2025.101562","DOIUrl":"10.1016/j.tacc.2025.101562","url":null,"abstract":"","PeriodicalId":44534,"journal":{"name":"Trends in Anaesthesia and Critical Care","volume":"62 ","pages":"Article 101562"},"PeriodicalIF":1.4,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143934842","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":"Modulation of postoperative inflammatory response in total knee arthroplasty: Impact of iPACK block on neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios in a randomized controlled trial","authors":"Tomasz Reysner ,&nbsp;Grzegorz Kowalski ,&nbsp;Aleksander Mularski ,&nbsp;Monika Grochowicka ,&nbsp;Przemysław Daroszewski ,&nbsp;Malgorzata Reysner","doi":"10.1016/j.tacc.2025.101551","DOIUrl":"10.1016/j.tacc.2025.101551","url":null,"abstract":"<div><h3>Background</h3><div>The neutrophil-to-lymphocyte ratio (NLR) is a marker of systemic inflammation and surgical stress. This randomized controlled trial (RCT) evaluated the effect of the infiltration between the popliteal artery and the capsule of the knee (iPACK) block with ropivacaine on postoperative NLR and analgesic outcomes in total knee arthroplasty (TKA) under spinal anesthesia.</div></div><div><h3>Methods</h3><div>Sixty TKA patients were randomized to receive either a sham block (control, n = 30) or an iPACK block with 20 mL of 0.2 % ropivacaine (n = 30). The primary outcome was NLR at 12 h postoperatively. Secondary outcomes included NLR at 24 and 48 h, platelet-to-lymphocyte ratio (PLR), opioid consumption, time to first rescue analgesia, and numeric rating scale (NRS) pain scores at multiple postoperative time points.</div></div><div><h3>Results</h3><div>The iPACK group had significantly lower NLR at 12 h (16.87 ± 4.41 vs. 23.95 ± 8.03, <em>p</em> &lt; 0.0001), 24 h (2.27 ± 0.83 vs. 4.22 ± 0.59, <em>p</em> &lt; 0.0001), and 48 h (1.80 ± 0.78 vs. 2.81 ± 1.16, <em>p</em> = 0.0002). PLR was lower at all time points (<em>p</em> &lt; 0.0001), opioid use was reduced (4.6 ± 1.0 mg/kg vs. 14.2 ± 1.9 mg/kg, <em>p</em> &lt; 0.0001), and time to first rescue analgesia was prolonged (7.0 ± 1.6 vs. 3.6 ± 0.7 h, <em>p</em> &lt; 0.0001). NRS scores were significantly lower up to 24 h (<em>p</em> &lt; 0.0001), with the greatest difference at 12 h (−1.8 ± 0.2, 95 % CI -2.1 to −1.4, <em>p</em> &lt; 0.0001).</div></div><div><h3>Conclusions</h3><div>The iPACK block with 0.2 % ropivacaine significantly reduces postoperative inflammation, improves pain control, and decreases opioid consumption in TKA. These findings support its inclusion in multimodal analgesia protocols to enhance recovery and reduce systemic inflammation.</div></div><div><h3>Trial registration</h3><div>Registered at <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> (<span><span>NCT06304298</span><svg><path></path></svg></span>)</div></div>","PeriodicalId":44534,"journal":{"name":"Trends in Anaesthesia and Critical Care","volume":"62 ","pages":"Article 101551"},"PeriodicalIF":1.4,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143894821","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}