Brazilian journal of anesthesiology (Elsevier)最新文献

{"title":"Prolonged grief disorder in family caregivers after oncology palliative care: a cross-sectional study.","authors":"Clarissa Pires Riviere, José Osvaldo Barbosa Neto, João Batista Santos Garcia","doi":"10.1016/j.bjane.2026.844850","DOIUrl":"https://doi.org/10.1016/j.bjane.2026.844850","url":null,"abstract":"<p><strong>Background: </strong>Family caregivers may experience prolonged grief disorder (PGD) and depressive symptoms after a relative's death.</p><p><strong>Objective: </strong>To estimate PGD prevalence and identify associated factors among family caregivers of patients who died in an oncology palliative care unit.</p><p><strong>Methods: </strong>This cross-sectional study included 80 family caregivers interviewed at least six months after the patient's death. Assessments included sociodemographic and perceived support questionnaires, the PG-13 instrument, and the Beck Depression Inventory-II (BDI-II). Adjusted associations with PGD were estimated using hierarchical binary logistic regression.</p><p><strong>Results: </strong>PGD prevalence was 25.0% (20/80; 95% CI 16.0-35.9), and moderate-to-severe depressive symptoms were observed in 32.5% (26/80) of caregivers. In the final adjusted model, higher odds of PGD were associated with female patient sex (OR = 16.47, 95% CI 1.30-208.80; p = 0.031) and moderate-to-severe depressive symptoms (OR = 78.77, 95% CI 7.63-812.79; p < 0.001). Lower odds were associated with routine physical activity (OR = 0.07, 95% CI 0.01-0.84; p = 0.036) and perceived bereavement support (OR = 0.13, 95% CI 0.02-0.76; p = 0.024).</p><p><strong>Conclusion: </strong>PGD affected one quarter of caregivers and was strongly associated with depressive symptom severity. Routine physical activity and perceived bereavement support were associated with lower adjusted odds of PGD. The cross-sectional design precludes causal inference.</p>","PeriodicalId":72456,"journal":{"name":"Brazilian journal of anesthesiology (Elsevier)","volume":" ","pages":"844850"},"PeriodicalIF":1.9,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149229248","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":"Gastric volume estimation in children with cerebral palsy: which equation should be used?","authors":"Mustafa Gökhan Bayram, Dinçer Fırat Şeker","doi":"10.1016/j.bjane.2026.844841","DOIUrl":"https://doi.org/10.1016/j.bjane.2026.844841","url":null,"abstract":"","PeriodicalId":72456,"journal":{"name":"Brazilian journal of anesthesiology (Elsevier)","volume":" ","pages":"844841"},"PeriodicalIF":1.9,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149198199","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":"Intraoperative methadone in adult laparoscopic surgery: a systematic review and meta-analysis of randomized trials.","authors":"Julio S Curi, Matheus Arraes, Jasmeen Kaur, Carlos Martins, Rafael A Neves, Eduardo M Pereira, Shaun E Gruenbaum, Rafael A Lombardi","doi":"10.1016/j.bjane.2026.844848","DOIUrl":"https://doi.org/10.1016/j.bjane.2026.844848","url":null,"abstract":"<p><strong>Background: </strong>Opioids are routinely used for pain control in laparoscopic procedures. Methadone, a long-acting opioid, has unclear efficacy in this context. Therefore, we aim to compare intraoperative methadone vs. short-acting opioids or placebo for laparoscopic surgeries.</p><p><strong>Methods: </strong>We searched PubMed, Scopus, Embase, and Cochrane for eligible Randomized Controlled Trials (RCTs) up to June 2025. Outcomes were cumulative opioid use at 24-hours (primary endpoint), the incidence of respiratory depression, postoperative nausea/vomiting, and hypoxia; intraoperative propofol use; emergence time; Post-Anesthesia Care Unit (PACU) length of stay and opioid use; pain scores at 30 and 60-minutes and at 24-hours (h). We used a random-effects model, Cochrane risk-of-bias analyses, certainty-of-evidence assessment, trial sequential analyses, and minimal clinically important differences to assess clinical impact.</p><p><strong>Results: </strong>7 RCTs (591 patients) were included. Compared to short-acting opioids, methadone was significantly associated with a reduction in postoperative hypoxia (RR = 0.24; 95% CI 0.06-0.91; p = 0.03), PACU opioid use (RR = 0.69; 95% CI 0.53-0.90; p < 0.01), pain scores at 30 (MD = -1.21; 95% CI -1.91 to -0.51; p < 0.01) and at 60-minutes (MD = -0.41; 95% CI -0.80 to -0.03; p = 0.03), and cumulative opioid use at 24h (MD = -1.62; 95% CI -2.75 to -0.50; p < 0.01). There were no differences between groups in the remaining outcomes.</p><p><strong>Conclusion: </strong>Intraoperative methadone in laparoscopic procedures was associated with a statistically significant reduction in pain scores, hypoxia, and opioid requirements. However, the reduction in opioid requirements did not reach clinical significance, and most effects were small, heterogeneous, and supported by limited-certainty evidence. Evidence regarding respiratory adverse events remains limited because of the small number of trials and participants.</p>","PeriodicalId":72456,"journal":{"name":"Brazilian journal of anesthesiology (Elsevier)","volume":" ","pages":"844848"},"PeriodicalIF":1.9,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149198369","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":"Cervical spine motion during tracheal intubation with videolaryngoscopy versus macintosh laryngoscopy in adults undergoing cervical spine surgery: a randomized controlled trial.","authors":"Hieu Trung Doan, Thang Toan Nguyen, Anh Thi Hong Nguyen, Du Gia Hoang","doi":"10.1016/j.bjane.2026.844847","DOIUrl":"https://doi.org/10.1016/j.bjane.2026.844847","url":null,"abstract":"<p><strong>Background: </strong>Excessive cervical spine motion during tracheal intubation may increase neurological risk in individuals with cervical spine pathology. Videolaryngoscopy may reduce cervical motion compared with Macintosh direct laryngoscopy, but any biomechanical reduction should be distinguished from neurological protection.</p><p><strong>Methods: </strong>Adults scheduled for elective cervical spine surgery were randomized 1:1 to intubation with a ClearVue videolaryngoscope (group V) or a Macintosh laryngoscope (group M) under manual in-line stabilization. Lateral fluoroscopy was acquired immediately before laryngoscopy (G0, neutral position) and at best glottic view (G1). The prespecified primary endpoint was directly measured cumulative C0‒C5 cervical motion. Cervical spine motion (ΔG) was also calculated at C0‒C1, C1‒C2, C2‒C3, C3‒C4 and C4‒C5. ΔG was expressed in degrees (°).</p><p><strong>Results: </strong>Fifty-six patients were randomized and analyzed (28 per group). Mean (SD) ΔG at C0‒C5 was 19.71 (4.75) in group V and 26.32 (8.46) in group M (mean difference [M‒V], 6.61; 95% CI 2.91‒10.31; p < 0.001). At C0‒C1, ΔG was 2.68 (2.53) vs. 4.68 (2.42) (difference = 2.00; 95% CI 0.67‒3.33; p = 0.004). First-attempt success was 89.3% (25/28) vs. 78.6% (22/28) (p = 0.47). Among patients intubated successfully on the first attempt, intubation time was shorter in group V (21.75 ± 3.64s) than group M (31.71 ± 21.25s).</p><p><strong>Conclusion: </strong>ClearVue videolaryngoscopy reduced fluoroscopically measured upper cervical and directly measured cumulative C0‒C5 motion compared with Macintosh direct laryngoscopy. These findings should be interpreted as biomechanical surrogate outcomes, not as evidence of neurological protection.</p>","PeriodicalId":72456,"journal":{"name":"Brazilian journal of anesthesiology (Elsevier)","volume":" ","pages":"844847"},"PeriodicalIF":1.9,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149198264","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":"ESPB versus thoracic paravertebral block in pediatric nephrolithotomy: analytic population and inference after a negative superiority trial.","authors":"Swarupanjali Padhi, Prashant Ramdas Kokiwar, Janvi Patel, Ankita Kalra","doi":"10.1016/j.bjane.2026.844849","DOIUrl":"https://doi.org/10.1016/j.bjane.2026.844849","url":null,"abstract":"","PeriodicalId":72456,"journal":{"name":"Brazilian journal of anesthesiology (Elsevier)","volume":" ","pages":"844849"},"PeriodicalIF":1.9,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149198233","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":"Nitrous oxide and the environmental case in anesthesia: scale, priority, and Brazilian evidence.","authors":"Ricardo Vieira Carlos, Britta Regli von Ungern-Sternberg, Vinícius Caldeira Quintão, Paulo Sergio Mateus Marcelino Serzedo, Marcelo Luis Abramides Torres","doi":"10.1016/j.bjane.2026.844845","DOIUrl":"https://doi.org/10.1016/j.bjane.2026.844845","url":null,"abstract":"","PeriodicalId":72456,"journal":{"name":"Brazilian journal of anesthesiology (Elsevier)","volume":" ","pages":"844845"},"PeriodicalIF":1.9,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149186712","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":"Integrity and trust in anesthesiology research: recognizing and combating scientific misconduct.","authors":"André P Schmidt, Federico Bilotta, Maria José C Carmona, Liana M T A Azi","doi":"10.1016/j.bjane.2026.844843","DOIUrl":"https://doi.org/10.1016/j.bjane.2026.844843","url":null,"abstract":"","PeriodicalId":72456,"journal":{"name":"Brazilian journal of anesthesiology (Elsevier)","volume":" ","pages":"844843"},"PeriodicalIF":1.9,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170650","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 premature abandonment of thoracic epidural analgesia in the Era of video-assisted thoracoscopic surgery thoracic epidural analgesia in the VATS Era.","authors":"Gabriel Trindade Avelar, André Versiani Caldeira Rocha, Regina Bicalho Gomes de Faria, Marina Ayres Delgado","doi":"10.1016/j.bjane.2026.844846","DOIUrl":"https://doi.org/10.1016/j.bjane.2026.844846","url":null,"abstract":"","PeriodicalId":72456,"journal":{"name":"Brazilian journal of anesthesiology (Elsevier)","volume":" ","pages":"844846"},"PeriodicalIF":1.9,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170956","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 versus deep airway device removal in pediatric tonsillectomy: a systematic review and meta-analysis.","authors":"Henrique Baggio Pivetta, Alice O Almeida, Rafael L Miranda, Rafaela P Silva, Raphaela G Mendes, João M M Borges, Raquel E Saldanha, Matheus Arraes, Pablo P Sanín, Walid Alrayashi","doi":"10.1016/j.bjane.2026.844840","DOIUrl":"https://doi.org/10.1016/j.bjane.2026.844840","url":null,"abstract":"<p><strong>Background and objectives: </strong>Tonsillectomy, with or without adenoidectomy, is among the most common pediatric surgeries, associated with a high incidence of perioperative respiratory adverse events. The timing of airway device removal, during deep anesthesia or after awakening, may influence these outcomes.</p><p><strong>Methods: </strong>PubMed, Embase and CENTRAL were systematically searched for studies comparing awake and deep airway device removal in pediatric otolaryngology surgery. The primary analysis was restricted to Randomized Controlled Trials (RCTs). The primary outcome was laryngospasm; secondary outcomes included cough, oxygen desaturation and airway obstruction. Risk Ratios (RR) with 95% Confidence Intervals (95% CI) were pooled using random-effects models.</p><p><strong>Results: </strong>Seven studies (six RCTs and one observational study, the latter used only in sensitivity analyses), including 1,571 children, were analyzed. Deep airway device removal was associated with a higher risk of airway obstruction (RR = 1.82; 95% CI 1.10-3.03; p = 0.020) and a lower risk of cough (RR = 0.57; 95% CI 0.43-0.75; p < 0.001), with no evidence of a difference between the Laryngeal Mask Airway (LMA) and Endotracheal Tube (ETT) subgroups (p for subgroup differences = 0.992). Laryngospasm did not differ significantly (RR = 0.99; 95% CI 0.43-2.30; p = 0.984). Desaturation was lower with deep removal in the RCT-only analysis (RR = 0.62; 95% CI 0.44-0.88; p = 0.007).</p><p><strong>Conclusions: </strong>Deep airway device removal was associated with less coughing, with no evidence that this effect differed between LMA and ETT. Deep removal may increase airway obstruction, though sensitive to individual studies. Desaturation findings were sensitive to study design and sare not definitive.</p>","PeriodicalId":72456,"journal":{"name":"Brazilian journal of anesthesiology (Elsevier)","volume":" ","pages":"844840"},"PeriodicalIF":1.9,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149148246","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":"Electroconvulsive Therapy Anesthesia Scale (ECTAS): development and preliminary expert-based evidence of content validity.","authors":"Matheus Veras Guterres Mendes, José Osvaldo Barbosa Neto, Gabriel Magalhães Nunes Guimarães, Bruno Bacellar Palhano, Marcelly Amanda Lucena Ericeira, Julio Cesar de Oliveira Silva, João Batista Santos Garcia","doi":"10.1016/j.bjane.2026.844842","DOIUrl":"https://doi.org/10.1016/j.bjane.2026.844842","url":null,"abstract":"","PeriodicalId":72456,"journal":{"name":"Brazilian journal of anesthesiology (Elsevier)","volume":" ","pages":"844842"},"PeriodicalIF":1.9,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149148273","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}