Trends in Anaesthesia and Critical Care最新文献

{"title":"A sustainable alternative of scalpel cricothyroidotomy model: sheep larynx","authors":"Özge Özen , Aysun Ankay Yılbaş , Özgür Canbay","doi":"10.1016/j.tacc.2026.101638","DOIUrl":"10.1016/j.tacc.2026.101638","url":null,"abstract":"","PeriodicalId":44534,"journal":{"name":"Trends in Anaesthesia and Critical Care","volume":"67 ","pages":"Article 101638"},"PeriodicalIF":0.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146189131","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":"Seconds from collapse: Awake intubation in a fast-deforming postoperative airway","authors":"Catarina Cruz Chaves,&nbsp;José Paulo Santos Ferreira,&nbsp;Manuel Silva","doi":"10.1016/j.tacc.2026.101636","DOIUrl":"10.1016/j.tacc.2026.101636","url":null,"abstract":"<div><div>Postoperative cervical hematoma is a life-threatening cause of airway obstruction, particularly after extensive head and neck surgery. The 2025 Difficult Airway Society (DAS) guidelines highlight the need for early recognition of airway compromise, preservation of spontaneous ventilation, and prioritization of awake techniques when anatomical distortion is anticipated. We report a 55-year-old man with parotid carcinoma who underwent a 10-h elective parotidectomy with a transcoclear petrosectomy approach. He was admitted ventilated to the post-anaesthesia care unit and extubated uneventfully 20 hours later. On postoperative day 4, he developed rapidly progressive cervical swelling requiring urgent surgical re-exploration. Given the severe anatomical distortion and impending airway compromise, a multidisciplinary airway strategy was formulated, and awake flexible bronchoscopic intubation was performed under spontaneous ventilation, with ENT surgeons prepared for immediate surgical rescue. Nasal fibreoptic intubation was initially hindered by marked supraglottic oedema and distorted upper airway anatomy, but successful nasotracheal intubation was achieved on the second attempt. CT imaging confirmed a large multiloculated cervical hematoma with substantial mass effect and airway displacement. This case reinforces key DAS 2025 and ASA 2022 principles in emergency airway management and underscores the critical role of awake flexible bronchoscopic intubation in the setting of rapidly evolving postoperative airway distortion.</div></div>","PeriodicalId":44534,"journal":{"name":"Trends in Anaesthesia and Critical Care","volume":"67 ","pages":"Article 101636"},"PeriodicalIF":0.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146038372","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":"Feasibility of real-time videolaryngoscopy streaming to operating room monitors: An observational study","authors":"Tim Zehnder ,&nbsp;Paul Flückiger ,&nbsp;Julien Didier ,&nbsp;Patrick Schoettker","doi":"10.1016/j.tacc.2026.101640","DOIUrl":"10.1016/j.tacc.2026.101640","url":null,"abstract":"<div><h3>Background</h3><div>Streaming the intubation procedure performed with a videolaryngoscope (VL) to operating room monitors has been rendered possible through technical improvements. This study explored the impact of streaming McGRATH MAC+™ VL live intubations to operating room monitors on team dynamics, situational awareness and evaluated overall perceptions of the device in daily practice.</div></div><div><h3>Methods</h3><div>This cross-sectional, observational study was conducted between February and November 2025 at the Lausanne university hospital (CHUV) in Switzerland. Operating room professionals with exposure to McGRATH MAC+™ streaming completed a paper-based questionnaire assessing perceived changes in awareness, participation, communication, and device performance. Retrospective within-subject comparisons (before vs after streaming ratings) were analysed.</div></div><div><h3>Results</h3><div>We enrolled 50 participants (37 anaesthesia, 13 operative). After the introduction of VL streaming, awareness of the intubation process was perceived to have improved by the anaesthesia staff (p &lt; 0.001) and the operative staff (p = 0.005). The participants didn't perceive a significant change in their participation to the intubation with VL streaming. Secondary outcomes highlighted facilitated intra-team communication within anaesthesia teams and modestly improved inter-team coordination. No meaningful changes were reported regarding perceived intubation time or complication rates. In addition, VL was considered highly effective for training and improved operator confidence.</div></div><div><h3>Conclusions</h3><div>Streaming videolaryngoscope live intubations to operating room monitors resulted in higher retrospectively perceived situational awareness and the device was viewed as an educational asset. Selective use in difficult or teaching cases may offer a high-yield strategy for enhancing team coordination during airway management.</div></div><div><h3>Trial registration</h3><div><span><span>clinicaltrials.gov</span><svg><path></path></svg></span>: NCT06453525.</div></div>","PeriodicalId":44534,"journal":{"name":"Trends in Anaesthesia and Critical Care","volume":"67 ","pages":"Article 101640"},"PeriodicalIF":0.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146189129","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":"Virtual reality for postoperative pain relief: A narrative review","authors":"Mohamed Attia ,&nbsp;Anthony Wilson ,&nbsp;Lukas Hughes-Noehrer ,&nbsp;Sophie Collinson ,&nbsp;Steven K. Rogers ,&nbsp;Mowafak Abdelghani ,&nbsp;Brendan McGrath ,&nbsp;Frank L. Bowling ,&nbsp;Gareth Kitchen","doi":"10.1016/j.tacc.2025.101618","DOIUrl":"10.1016/j.tacc.2025.101618","url":null,"abstract":"<div><div>Effective management of postoperative pain is essential to enhance recovery, improve patient satisfaction, and reduce hospital length of stay. Virtual Reality (VR) is an emerging non-pharmacological adjunct that provides immersive distraction and has demonstrated reductions in pain scores, opioid consumption, and anxiety across surgical populations. Neuroimaging studies implicate modulation of the anterior cingulate cortex, primary and secondary somatosensory cortices, and salience networks in VR's analgesic effects. Preliminary evidence suggests VR may be beneficial in paediatric and adult perioperative care, particularly during procedures such as venipuncture, burn dressing changes, gynaecological and orthopaedic surgery, and rehabilitation.</div><div>VR appears safe, with adverse effects largely limited to cybersickness. Early health-economic analyses suggest potential cost savings via reduced opioid prescribing and length of stay, though standardisation of protocols is lacking. Limitations of current evidence include small sample sizes, heterogeneity in VR interventions, and limited long-term outcome data.</div><div>VR offers a promising opioid-sparing strategy in perioperative practice. Future research should prioritise adequately powered randomised controlled trials, economic evaluations, and determination of optimal session duration, environment design, and integration into routine perioperative care.</div></div>","PeriodicalId":44534,"journal":{"name":"Trends in Anaesthesia and Critical Care","volume":"66 ","pages":"Article 101618"},"PeriodicalIF":0.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145692656","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":"Comparative efficacy of ciprofol and propofol for sedation in patients undergoing colonoscopy: A systematic review, meta-analysis and trial sequential analysis of randomized controlled trials","authors":"Cecilio Armengol-García,&nbsp;Fidel Torres-Fabela,&nbsp;José Roberto Arreola-Martínez,&nbsp;Luis Eduardo Salinas-Ruiz,&nbsp;Cynthia López-García,&nbsp;Orlando Herrera-Barrón,&nbsp;Valeria Blandin-Alvarez","doi":"10.1016/j.tacc.2025.101610","DOIUrl":"10.1016/j.tacc.2025.101610","url":null,"abstract":"<div><h3>Background</h3><div>Colonoscopy often requires sedation to minimize discomfort. Propofol is widely used but is associated with adverse effects such as injection pain, hypotension, and apnea. Ciprofol, a novel structurally related intravenous sedative, may offer improved safety and tolerability. This meta-analysis aimed to compare the efficacy and safety of ciprofol versus propofol in patients undergoing colonoscopy procedure.</div></div><div><h3>Methods</h3><div>We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) following PRISMA guidelines. Trial sequential analysis was performed for the primary outcome to confirm robustness of the observed effect and minimize type I error risk. Eligible studies included adult patients undergoing colonoscopy randomized to receive ciprofol or propofol. Primary outcome was incidence of injection pain. Secondary outcomes included bradycardia, hypotension, apnea, respiratory depression, dizziness, colonoscopy success, induction time, procedure duration, and time to full alertness. Random-effects models were used to pool relative risks (RR) and mean differences (MD).</div></div><div><h3>Results</h3><div>Four RCTs comprising 707 patients were included (367 received ciprofol, 370 propofol). Ciprofol significantly reduced injection pain compared with propofol (RR 0.08; 95 % CI 0.01–0.50; p = 0.007). No significant differences were found in rates of bradycardia, hypotension, apnea, respiratory depression, dizziness, colonoscopy success, induction time or procedure duration. However, ciprofol was associated with a modestly longer recovery time to full alertness (MD 1.50 min; 95 % CI 0.95–2.06; p &lt; 0.01).</div></div><div><h3>Conclusion</h3><div>Ciprofol provides a clear benefit in reducing injection pain compared to propofol, while demonstrating comparable cardiorespiratory safety. The slightly longer recovery time observed with ciprofol is unlikely to be clinically significant. Further multicenter studies are warranted to confirm these findings in diverse populations.</div></div>","PeriodicalId":44534,"journal":{"name":"Trends in Anaesthesia and Critical Care","volume":"66 ","pages":"Article 101610"},"PeriodicalIF":0.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145645588","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 commentary on evaluation of renal outcomes in the critically ill","authors":"Rohan Magoon ,&nbsp;Varun Suresh","doi":"10.1016/j.tacc.2025.101620","DOIUrl":"10.1016/j.tacc.2025.101620","url":null,"abstract":"","PeriodicalId":44534,"journal":{"name":"Trends in Anaesthesia and Critical Care","volume":"66 ","pages":"Article 101620"},"PeriodicalIF":0.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145797817","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":"Reply to ‘Reflection on Recto-intercostal fascial plane block: A scoping review’","authors":"Prashant Sirohiya ,&nbsp;Ram Singh ,&nbsp;Brajesh Kumar Ratre ,&nbsp;Balbir Kumar","doi":"10.1016/j.tacc.2025.101619","DOIUrl":"10.1016/j.tacc.2025.101619","url":null,"abstract":"","PeriodicalId":44534,"journal":{"name":"Trends in Anaesthesia and Critical Care","volume":"66 ","pages":"Article 101619"},"PeriodicalIF":0.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145749761","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":"Can artificial intelligence be used to support training in videolaryngoscopy – a prospective non-randomised controlled manikin study","authors":"Moon-Moon Majumdar ,&nbsp;Sneh Vinu Shah ,&nbsp;Rajinder Singh Chaggar","doi":"10.1016/j.tacc.2025.101609","DOIUrl":"10.1016/j.tacc.2025.101609","url":null,"abstract":"<div><h3>Background</h3><div>There has been increasing interest in artificial intelligence (AI) to aid clinicians in airway management. larynGuide (aiEndoscopic, Switzerland) is a software that offers anatomy and navigation AI overlay on real-time videolaryngoscopy views. Our study aimed to evaluate whether larynGuide could improve tracheal intubation success and technique among clinicians, as well as to gather clinician opinion on its utility.</div></div><div><h3>Methods</h3><div>This was a prospective, two-group, controlled, manikin study. Participants were recruited at Northwick Park Hospital from August 2024–March 2025, and allocated into two groups: videolaryngoscopy 1) with AI or 2) without AI, to perform five intubations. Primary outcomes were whether larynGuide improves first-pass success of tracheal intubation or changes the time to successful intubation.</div></div><div><h3>Results</h3><div>45 participants were allocated to AI overlay and 39 to no AI. There were no failed intubations or oesophageal intubations. There was one failed first-pass success (1/420, incidence of 0.24 %) in an intubation with AI overlay. Time to passage of the bougie, and of the tracheal tube through the glottic opening were faster without AI (Kruskal-Wallis ANOVA p = 0.00017, p = 0.00005 respectively). There was no significant difference in supervisor-assessed intubation technique score (p = 0.30), or participants’ perception of improvement in their own technique (p = 0.52) between AI and non-AI groups. The majority of participants (83.1 %) felt that the AI was extremely, very or somewhat useful.</div></div><div><h3>Conclusions</h3><div>Although intubations with AI overlay took longer, there was no significant difference in supervisor-assessed technique or self-assessed improvement. Participants saw value in the overlay, especially for training. While AI shows potential in enhancing videolaryngoscopy training and use, further research is required to determine its safety, effectiveness, and optimal integration into practice.</div></div>","PeriodicalId":44534,"journal":{"name":"Trends in Anaesthesia and Critical Care","volume":"65 ","pages":"Article 101609"},"PeriodicalIF":0.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145568654","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":"Awake tracheal intubation through a supraglottic airway device using the Aintree® intubation catheter","authors":"Mehmet Yılmaz ,&nbsp;A. Zeynep Turan Cıvraz ,&nbsp;Ahmet Yüksek ,&nbsp;Ayten Saracoglu ,&nbsp;Kemal Tolga Saracoglu","doi":"10.1016/j.tacc.2025.101599","DOIUrl":"10.1016/j.tacc.2025.101599","url":null,"abstract":"","PeriodicalId":44534,"journal":{"name":"Trends in Anaesthesia and Critical Care","volume":"65 ","pages":"Article 101599"},"PeriodicalIF":0.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145520199","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":"Mind matters: Navigating preoperative cognitive testing in elderly population","authors":"K. Nekvindová ,&nbsp;T. Gabrhelík ,&nbsp;J. Hůsková ,&nbsp;P. Michálek","doi":"10.1016/j.tacc.2025.101598","DOIUrl":"10.1016/j.tacc.2025.101598","url":null,"abstract":"<div><h3>Background</h3><div>With more surgical procedures performed under general anesthesia in older adults, perioperative brain health has become a growing public health concern. This review is the first to synthesize cognitive screening tools specifically from the perspective of anesthesiology practice. Preoperative cognitive screening can identify individuals at risk of neurocognitive disorders, including postoperative delirium.</div></div><div><h3>Literature search</h3><div>This narrative review, based on the PCC framework, examined cognitive assessment tools used preoperatively in the elderly. A structured literature search (2020–2024) conducted exclusively in the PubMed database, following PRISMA guidelines, identified 124 studies. Of these, 31 were excluded: 25 did not evaluate cognition preoperatively, 2 lacked defined tests, 2 omitted testing before surgery, and 2 involved patients younger than the geriatric age group.</div></div><div><h3>Discussion</h3><div>The review reveals major gaps in cognitive evaluation practices for elderly patients before surgery. Although tools such as Mini-Cog, MOCA, and MMSE are commonly used, many lack validation in perioperative settings and do not fully address complex geriatric needs. Involvement of professionals outside anesthesiology underscores the fragmented nature of current approaches.</div></div><div><h3>Conclusion</h3><div>Preoperative cognitive screening is increasingly recognized as essential in perioperative care. While existing tools offer practical value, standardized and validated instruments specific to surgical contexts are urgently needed. Improved screening may reduce neurocognitive complications and enhance outcomes for elderly patients by enabling anesthesiologists to identify cognitive risk factors early and tailor perioperative management accordingly.</div></div>","PeriodicalId":44534,"journal":{"name":"Trends in Anaesthesia and Critical Care","volume":"65 ","pages":"Article 101598"},"PeriodicalIF":0.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145417837","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}