Anaesthesia Critical Care & Pain Medicine最新文献

{"title":"Remimazolam for anesthesia in cardiac and noncardiac surgery. A narrative literature review and synthesis","authors":"Jacopo D’Andria Ursoleo ,&nbsp;Alice Bottussi ,&nbsp;Gabor Erdoes ,&nbsp;Jiapeng Huang ,&nbsp;Fabrizio Monaco","doi":"10.1016/j.accpm.2025.101555","DOIUrl":"10.1016/j.accpm.2025.101555","url":null,"abstract":"<div><div>Despite decades of advancements in anesthetic techniques, a novel hypnotic agent combining rapid onset and offset, hemodynamic stability, and predictable effects has remained elusive. The recent approval of remimazolam, a short-acting benzodiazepine, represents a potential breakthrough in fulfilling these criteria. Since its first approval, growing evidence highlights its benefits, including superior hemodynamic stability, rapid emergence from anesthesia, and minimal respiratory depression compared to widely used agents such as propofol. These attributes have been demonstrated across various surgical contexts and patient populations. However, existing studies have limitations that challenge the generalizability of such findings. This review evaluates the literature on remimazolam in both the cardiac and noncardiac perioperative surgical contexts. A systematic search of PubMed/MEDLINE, EMBASE, and Google Scholar databases identified studies published from 2020 to 2024, with an emphasis on randomized controlled trials and observational studies. By analyzing the limitations inherent in the retrieved studies, we aimed to provide practicing anesthesiologists with an overview of remimazolam’s potential benefits and inherent challenges, while identifying current knowledge gaps that warrant future research.</div></div>","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":"44 4","pages":"Article 101555"},"PeriodicalIF":3.7,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144183216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mortality of cancer patients with septic shock: A nation-based cohort analysis of 77,888 patients","authors":"Antoine Bianchi ,&nbsp;Yann Brousse ,&nbsp;Ines Lakbar ,&nbsp;Vanessa Pauly ,&nbsp;Veronica Orleans ,&nbsp;Guillaume Fond ,&nbsp;Gary Duclos ,&nbsp;Laurent Zieleskiewicz ,&nbsp;Djamel Mokart ,&nbsp;Laurent Boyer ,&nbsp;Marc Leone","doi":"10.1016/j.accpm.2025.101557","DOIUrl":"10.1016/j.accpm.2025.101557","url":null,"abstract":"<div><h3>Background</h3><div>Septic shock and cancer occur routinely in intensive care unit patients. Our aim was to use the French national hospitalization database to overcome the limitations of the small cohorts used in previous studies that examined the 90-day mortality rate of patients with septic shock and either solid or hematological cancers.</div></div><div><h3>Methods</h3><div>We performed a retrospective cohort study using data from the French national hospitalization database regarding adult patients with septic shock from 2017 to 2018. The primary outcomes were the hospital mortality rate at 90 days in patients with solid cancer and hematological cancer. Secondary outcomes were the risk factors associated with mortality in our cohort. Associations between 90-day mortality and cancer have been estimated by multivariable analysis.</div></div><div><h3>Results</h3><div>Septic shock was found in 77,888 patients, including 19,329 patients with solid cancer, 6,498 with hematological cancer, and 52,061 noncancer patients. The 90-day mortality rate was 44.3 %, 53.7%, and 59.1% for noncancer patients, solid cancer patients and hematological cancer patients, respectively. An association was found between 90-day mortality and solid cancer (adjusted hazard ratio 1.55 [1.51–1.59]) or hematological cancer (1.59 [1.53–1.65]) as compared with noncancer patients. Risk factors for 90-day mortality included both hematological and solid cancers.</div></div><div><h3>Conclusions</h3><div>In septic shock patients, solid cancer and hematological cancer were associated with increased 90-day mortality compared with noncancer patients. Future investigations are required to assess the interplay between cancer and septic shock.</div></div><div><h3>Registration</h3><div>National Commission for Data Protection (CNIL) under number F20220318151239</div></div>","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":"44 5","pages":"Article 101557"},"PeriodicalIF":3.7,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Temporal stability of inflammatory subphenotypes of acute respiratory distress syndrome: 28-day insights from the ICAR trial","authors":"Laurent Renard Triché ,&nbsp;Maxime Fosset ,&nbsp;Matthieu Jabaudon ,&nbsp;Emmanuel Futier ,&nbsp;Bruno Lucas ,&nbsp;Claire Latroche ,&nbsp;Béla-Simon Paschold ,&nbsp;Elias Baedorf-Kassis ,&nbsp;Tarek Sharshar ,&nbsp;Maximilian S Schaefer ,&nbsp;Boris Jung ,&nbsp;Aurélien Mazeraud ,&nbsp;Joris Pensier","doi":"10.1016/j.accpm.2025.101559","DOIUrl":"10.1016/j.accpm.2025.101559","url":null,"abstract":"<div><h3>Background</h3><div>International guidelines have emphasized the necessity of evaluating the temporal stability of acute respiratory distress syndrome (ARDS) subphenotypes. This study aimed to assess the temporal stability of subphenotypes of ARDS over 28 days.</div></div><div><h3>Methods</h3><div>A reanalysis of a randomized trial was conducted, including patients with COVID-19-related moderate-to-severe ARDS across 43 centers. A K-means clustering was conducted to identify subphenotypes at 7-day intervals from inclusion to day 28. A Bayesian discrete-time Markov model was constructed to assess the temporal stability of subphenotypes.</div></div><div><h3>Results</h3><div>Two subphenotypes were identified among 146 patients. At inclusion, 121 (83%) patients were in the hypoinflammatory subphenotype and 25 (17%) in the hyperinflammatory subphenotype. The hyperinflammatory subphenotype was associated with higher rates of organ failure, higher plasma levels of cytokines, chemokines, adhesion molecules, and proangiogenic factors, and lower endothelial stability than the hypoinflammatory subphenotype. The hyperinflammatory subphenotype was associated with higher 28-day mortality (13/25, 52% <em>vs.</em> 30/121, 25%, <em>p</em> = 0.001) and fewer ventilatory-free-days through day 28 (<em>p</em> &lt; 0.01) than the hypoinflammatory subphenotype. In the Bayesian Markov model, over 7-day intervals, patients in the hypoinflammatory subphenotype had a higher probability of remaining hypoinflammatory (70%) or being extubated (17%) than of progressing to the hyperinflammatory subphenotype (7%). Inversely, patients in the hyperinflammatory subphenotype had a higher probability of remaining in the hyperinflammatory subphenotype (52%) or dying (23%) than of transitioning to the hypoinflammatory subphenotype (20%) or being extubated (5%).</div></div><div><h3>Conclusions</h3><div>Inflammatory subphenotypes were stable in COVID-19-related ARDS, with few transitions over 28 days. Monitoring these subphenotypes could be valuable for assessing patient trajectories and treatment responses.</div></div>","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":"44 5","pages":"Article 101559"},"PeriodicalIF":3.7,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ROBotic-assisted Early Mobilization in ventilated surgical critically ill patients (ROBEM-I)—A randomized, controlled, outcome-assessor-blinded pilot study","authors":"Marco Lorenz ,&nbsp;Nadine Langer ,&nbsp;Philipp Kloss ,&nbsp;Mathilde Maechler ,&nbsp;Annika Bald ,&nbsp;Linus Warner ,&nbsp;Kristina Fuest ,&nbsp;Björn Weiß ,&nbsp;Stefan J. Schaller","doi":"10.1016/j.accpm.2025.101549","DOIUrl":"10.1016/j.accpm.2025.101549","url":null,"abstract":"<div><h3>Background</h3><div>A shortage of human resources is a key barrier to the early mobilization of mechanically ventilated ICU patients. Recent advancements in robotic mobilization systems offer promising solutions to this challenge.</div></div><div><h3>Objective(s)</h3><div>This study assessed the operability of an AI-assisted robotic mobilization system by a single healthcare provider, along with its safety, feasibility, and potential benefits for mechanically ventilated surgical ICU patients.</div></div><div><h3>Design</h3><div>Randomized controlled pilot study.</div></div><div><h3>Setting</h3><div>Five surgical ICUs at Charité – Universitätsmedizin Berlin, Germany, November 2020 to September 2022.</div></div><div><h3>Patients</h3><div>Twenty critically ill patients requiring &gt;24 h of mechanical ventilation.</div></div><div><h3>Intervention(s)</h3><div>Twice-daily robotic-assisted mobilization sessions ≥ 20 min over five days, compared to the control group receiving standard care.</div></div><div><h3>Main outcome measures</h3><div>Number of mobilization sessions conducted by a single person.</div></div><div><h3>Results</h3><div>In the robotic-assisted group, no mobility sessions were conducted by a single person (0%) <em>vs.</em> 26 (96%) in the control group (<em>p</em> &lt; 0.001). Significant secondary outcomes included a mobilization duration of 41 min/day [IQR 36–47] in the intervention group <em>vs.</em> 19 min/day [IQR 13–21] in the control group (<em>p</em> &lt; 0.001) and higher mobilization frequency, with two units/day [IQR 2−2] in the intervention group <em>vs.</em> 0.9 units/day [IQR 0.7–1.0] in the control group (<em>p</em> &lt; 0.001). Interleukin-6 levels decreased significantly by −4.65 pg/mL [IQR −13.00–3.83] in the intervention group <em>vs.</em> an increase of 3.70 pg/ml [IQR −1.30–28.88] in the control group (<em>p</em> = 0.049).</div></div><div><h3>Conclusions</h3><div>Robotic-assisted mobilization in mechanically ventilated critically ill patients did not reduce required healthcare providers but increased the duration and frequency, and significantly reduced IL-6 levels compared to the standard group.</div></div><div><h3>Trial registration</h3><div><span><span>ClinicalTrials.gov</span><svg><path></path></svg></span>, registration number <span><span>NCT04423796</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":"44 4","pages":"Article 101549"},"PeriodicalIF":3.7,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perioperative ventilation support, what clinicians and searchers must know","authors":"Joris Pensier ,&nbsp;Manuel A. Guerrero ,&nbsp;Joana Berger-Estilita ,&nbsp;Laura Borgstedt ,&nbsp;Ahmed Mohamed Sabri Zaher ,&nbsp;Samir Jaber ,&nbsp;Audrey De Jong","doi":"10.1016/j.accpm.2025.101554","DOIUrl":"10.1016/j.accpm.2025.101554","url":null,"abstract":"<div><div>Postoperative pulmonary complications (PPC) affect over 10% of surgical patients, especially after abdominal, thoracic, or cardiac surgery. Understanding PPC’s pathophysiology and risk factors provides an effective framework for prevention strategies. Significant alterations of the respiratory function occur in all patients undergoing major surgery, especially if the surgical site is close to the diaphragm. The main changes observed are a reduction in lung volumes, with the development of restrictive patterns of respiratory mechanics, atelectasis, and diaphragmatic dysfunction. Hypoxemia often develops in patients after major surgery and may lead to acute respiratory failure (ARF). Postoperative ARF may require reintubation, which has been associated with mortality and healthcare-associated pneumonia. The Peri-Operative Positive Pressure (P.O.P) Ventilation concept includes multiple interventions ranging from positive pressure pre-oxygenation to intraoperative lung protective ventilation and tailored postoperative noninvasive respiratory support. Such strategies aim to mitigate the onset of ARF and prevent a reduction in lung volumes. Despite the inevitability of respiratory function alterations after surgery and anesthesia, perioperative interventions can significantly reduce complications. Positive pressure pre-oxygenation enhances the safety of the intubation procedure and prevents the decrease in lung volumes. Intraoperative lung-protective ventilation associating low to moderate tidal volumes based on predicted body weight, positive end-expiratory pressure, and careful recruitment maneuvers have been effective in decreasing PPC. The respective roles of noninvasive ventilation (NIV) and high-flow nasal oxygenation (HFNO) in preventing PPC remain to be clarified. Their efficacy in preventing the onset of ARF may depend on the ability to identify high-risk patients and tailor interventions accordingly. Current evidence supports curative NIV as the gold standard to treat postoperative ARF in comparison to conventional oxygen therapy or HFNO. As the understanding of the complex interplay between major surgery and respiratory function evolves, so must approaches to tailoring perioperative ventilation support.</div></div>","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":"44 5","pages":"Article 101554"},"PeriodicalIF":3.7,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robot-assisted mobilization in the ICU — Opportunities and challenges","authors":"Zhigang Zhang,&nbsp;Sébastien Tanaka ,&nbsp;Aurélien Mazeraud","doi":"10.1016/j.accpm.2025.101548","DOIUrl":"10.1016/j.accpm.2025.101548","url":null,"abstract":"","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":"44 4","pages":"Article 101548"},"PeriodicalIF":3.7,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative pulmonary complications in emergency abdominal surgery. A prospective international cohort study","authors":"Carlos Ferrando-Ortolá","doi":"10.1016/j.accpm.2025.101560","DOIUrl":"10.1016/j.accpm.2025.101560","url":null,"abstract":"<div><h3>Background</h3><div>Emergency abdominal surgery is a high-risk procedure often performed on high-risk patients. The incidence of Postoperative pulmonary complications (PPCs) in emergency abdominal surgery is not well established yet. Several factors, such as the ventilatory approach, may be associated with PPCs but data on patients undergoing emergency abdominal surgery is scarce. The primary aim of the study was to describe the incidence of PPCs during the first 7 postoperative days.</div></div><div><h3>Methods</h3><div>Prospective international cohort study including all consecutive patients &gt; 18 y/o undergoing emergency abdominal surgery. From April to June 2023 each hospital selected a single 7-day period for the recruitment with a 7-day follow-up. The PPCs included the following international standard definitions for the primary outcome: acute respiratory failure; pneumothorax; weaning failure; acute respiratory distress syndrome; pulmonary infection; atelectasis; pleural effusion; bronchospasm; aspiration pneumonitis; pulmonary thromboembolism; and pulmonary edema.</div></div><div><h3>Results</h3><div>45 hospitals from 5 geographical areas participated in the study with 507 patients included in the final analysis. A total of 114 (22.5%) patients developed PPCs and 38 (7.5%) developed severe PPCs. The multivariate analysis showed that the independent risk factors for PPCs were: high ARISCAT score (Odds Ratio: 2.67; 95%CI 1.06–6.86), laparotomy (OR: 2.29; 95%CI 1.06–5.01), and postoperative positive air-test (OR: 2.05; 95%CI 1.02–4.24). Conversely, neuromuscular block reversal was associated with a reduced risk of PPCs (OR: 0.36; 95%CI 0.16−0.82).</div></div><div><h3>Conclusion</h3><div>Incidence of PPCs in patients undergoing emergency abdominal surgery is significant. Among the modifiable risk factors, a lack of neuromuscular block reversal and postoperative positive air test were associated with the increased incidence of PPCs.</div></div>","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":"44 5","pages":"Article 101560"},"PeriodicalIF":3.7,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of a web app-based music intervention on pain during wound closure in the emergency department: The EMERGENCE randomized controlled trial","authors":"Marie Charron ,&nbsp;Matthieu Daniel ,&nbsp;Bertrand Guihard ,&nbsp;Erick Gokalsing ,&nbsp;Lucie Fauré ,&nbsp;Léa Bruneau ,&nbsp;Kim Dinh","doi":"10.1016/j.accpm.2025.101545","DOIUrl":"10.1016/j.accpm.2025.101545","url":null,"abstract":"<div><h3>Background</h3><div>Wound suturing in emergency departments is a potentially stressful and painful experience for patients. Web app-based music intervention is known as an effective adjuvant treatment for the management of physical pain and anxiety in various medical fields. Only two studies have assessed the effectiveness of music listening on pain and anxiety during wound suturing. However, they found conflicting results and did not evaluate the point of view of healthcare professionals. This article details a prospective, randomized, open-label, multicenter study to evaluate the effect of a web app-based music intervention on pain and anxiety during sutures in the emergency room.</div></div><div><h3>Methods</h3><div>This was an interventional prospective, randomized, open-label, multi-center trial. The primary outcome is the comparison of maximal pain Visual Analogue Scale (VAS) with or without web app-based music intervention (application Music Care®) during the wound closure.</div></div><div><h3>Results</h3><div>Between June 2022 and February 2023, 170 patients were included. There was no significant difference between the two groups regarding the pain during suturing in this population. The mean pain VAS was 2.1 ± 2.7 cm (cm) in the music group <em>versus</em> 2.6 ± 2.6 cm in the control group (<em>p</em> <em>=</em> 0.197). However, the music group showed significantly lower values of respiratory rate (<em>p</em> = 0.002) and anxiety score (<em>p</em> = 0.042). Finally, satisfaction scores were significantly improved in the music group for the patient (<em>p</em> <em>=</em> 0.0002) and the physician (<em>p</em> &lt; 0.0001).</div></div><div><h3>Conclusion</h3><div>In this population, which demonstrated an average light maximal pain intensity, we showed no significant difference regarding the pain intensity during wound suturing. However, it does suggest that web app-based music intervention could reduce peri-procedural anxiety, but the robustness of this finding is not demonstrated yet. Nevertheless, it highlights the need for additional studies on this subject to identify its role in the optimal management of procedural pain and the improvement of the patient and practitioner experience.</div></div><div><h3>Trial Registration</h3><div>ClinicalTrials.gov n° NCT05388591 (<span><span>https://clinicaltrials.gov/study/NCT05388591?term=NCT05388591&amp;rank=1</span><svg><path></path></svg></span>).</div></div>","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":"44 4","pages":"Article 101545"},"PeriodicalIF":3.7,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144133334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pain intensity after robotic-assisted urological surgery: the PAIROU study an international prospective cohort study","authors":"Pauline Rouxel ,&nbsp;Emilien Rayon ,&nbsp;Anne-Sophie Bellocq ,&nbsp;Morgan le Guen ,&nbsp;Julien Fessler ,&nbsp;Cédric Cirenei ,&nbsp;Raïko Blondonnet ,&nbsp;Emmanuel Parfait ,&nbsp;Ana-Gabriela Patrubani ,&nbsp;Andersen Ramorasata ,&nbsp;Aurélie Gouel ,&nbsp;Nicolas Brogly ,&nbsp;Guillaume Devoldere ,&nbsp;Mélanie Dupont ,&nbsp;Elodie Gaultier ,&nbsp;Martin Dupuis ,&nbsp;Pierre Bouzat ,&nbsp;Mathilde Cattenoz ,&nbsp;Sophie Prieur ,&nbsp;Philippe Cuvillon ,&nbsp;Helene Beloeil","doi":"10.1016/j.accpm.2025.101546","DOIUrl":"10.1016/j.accpm.2025.101546","url":null,"abstract":"<div><h3>Objective</h3><div>Despite improvements in perioperative pain management protocols, severe postoperative pain is still a burden for many patients. To improve the prevention and treatment of postoperative pain, it must be accurately assessed for each procedure type. However, there is little data available assessing the pain levels after robot-assisted urological surgeries. This cohort study aimed to estimate the pain scores that can be expected after various types of robotic-assisted urologic procedures.</div></div><div><h3>Methods</h3><div>This was a prospective, multicentre, observational trial in 44 centers in Europe that included patients scheduled for robotic-assisted urological surgery. The primary outcome was pain scores on the first day after surgery assessed using the numeric rating scale (NRS). Secondary outcomes included pain score on the second day after surgery, morphine equivalent consumption in mg 48 h after the surgery, postoperative nausea and vomiting (PONV), and surgical complications.</div></div><div><h3>Results</h3><div>A total of 965 patients were recruited between November 2022 and June 2023. Median pain score on postoperative day 1 was 2 at rest (IQR, 0–4) (n = 963) and 3 with movement (IQR, 1–5) (n = 921). Morphine equivalent consumption 48 h after the surgery was 4 mg (IQR 0−20 mg). PONV was experienced by 16 % of the patients (153/963).</div></div><div><h3>Conclusion</h3><div>This large cohort study demonstrates that patients experience low pain scores and require low opioids after robotic-assisted urological surgery when commonly used multimodal analgesia protocols are administered.</div></div><div><h3>Trial registration</h3><div>clinicaltrials.gov No. NCT05575284.</div></div>","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":"44 4","pages":"Article 101546"},"PeriodicalIF":3.7,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144133343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New challenges for research and science: What is at stake?","authors":"Lionel Bouvet ,&nbsp;Audrey De Jong ,&nbsp;Dan Benhamou ,&nbsp;Jean-Michel Constantin ,&nbsp;Antoine Roquilly","doi":"10.1016/j.accpm.2025.101552","DOIUrl":"10.1016/j.accpm.2025.101552","url":null,"abstract":"","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":"44 4","pages":"Article 101552"},"PeriodicalIF":3.7,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144102564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}