Anesthesia & Analgesia最新文献

{"title":"The One Big Beautiful Bill Will Cause One Big Bad Mess: Unintended Consequences During the Opioid Crisis.","authors":"Naileshni Singh,Charley Yan,Chinar Sanghvi,Scott Pritzlaff","doi":"10.1213/ane.0000000000007776","DOIUrl":"https://doi.org/10.1213/ane.0000000000007776","url":null,"abstract":"","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"61 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145127218","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":"Perceptions of Admissions Metrics Among Anesthesiologist Assistant Program Directors: A Cross-Sectional Survey.","authors":"Gaurav P Patel,Jennifer M Stever,Katherine S Monroe","doi":"10.1213/ane.0000000000007772","DOIUrl":"https://doi.org/10.1213/ane.0000000000007772","url":null,"abstract":"","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145127215","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":"Bridging the Gap: Are Medical Student Anesthesiology Clerkship Characteristics Associated With Anesthesiology Match Rates?","authors":"Harrison D Pravder,Juliana Veira,Xiwen Zhao,Hung-Mo Lin,Viji Kurup","doi":"10.1213/ane.0000000000007747","DOIUrl":"https://doi.org/10.1213/ane.0000000000007747","url":null,"abstract":"","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"156 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145127217","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":"Less Is More for Bleeding Management Algorithms in Cardiac Surgery: A Network Meta-Analysis and Meta-Regression of Randomized Studies.","authors":"Alessandro Barbaria,Ekaterina Baryshnikova,Martina Anguissola,Giovanna Landi,Tommaso Aloisio,Stefano Casalino,Marco Ranucci","doi":"10.1213/ane.0000000000007714","DOIUrl":"https://doi.org/10.1213/ane.0000000000007714","url":null,"abstract":"BACKGROUNDMajor bleeding after cardiac surgery is still a relatively common complication, requiring red blood cell (RBC) transfusions and use of procoagulants. The existing guidelines recommend a bleeding management based on viscoelastic tests and bleeding management algorithms (BMA). However, there are different BMAs with different trigger values prompting the use of different procoagulants; consequently, based on these trigger values, a BMA can be more or less liberal in the use of drugs and blood derivates aimed to control bleeding. At present, no studies have investigated the effectiveness of liberal versus restrictive BMAs in limiting the risk of RBC transfusion.METHODSIn this study, we performed 2 network meta-analyses and a meta-regression of randomized and nonrandomized (before and after) studies where a BMA was applied. Based on the trigger values prompting the use of procoagulants (fresh frozen plasma, platelet concentrate, fibrinogen concentrate, prothrombin complex concentrate, recombinant activated factors), we have adjudicated the various BMAs to a restrictive or liberal group, and we compared the effectiveness of restrictive versus liberal BMAs in limiting RBC transfusions. Additionally, the consumption of procoagulants was compared between the 2 groups.RESULTSBoth restrictive and liberal BMAs were superior to conventional strategies in limiting RBC transfusions (rate and units). Restrictive BMAs were more effective than liberal BMAs in terms of RBC units transfused (mean difference -0.43 units, 95% confidence interval [CI], -0.80 to -0.07, P = .020). The RBC transfusion rate was tested after correction for potential confounders (complexity of surgery and hematocrit trigger for RBC transfusion) with a meta-regression RBC transfusion rate was significantly lower in restrictive versus liberal BMAs (odds ratio 0.728, 95% CI 0.569-0.932, P = .012). The use of any kind of procoagulants was significantly (P = .001) lower in restrictive versus liberal BMAs.CONCLUSIONSOverall, viscoelastic test-based BMAs are superior to conventional strategies in limiting RBC transfusions in the presence of major bleeding; however, a restrictive strategy of procoagulant administration is superior to a liberal strategy in terms of RBC transfusion containment. Liberal BMAs are associated with a significantly higher use of procoagulants without any benefit in terms of RBC transfusions; therefore, in terms of cost/benefit ratio, restrictive BMAs should be preferred.","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145077792","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":"Postcesarean Analgesia: Statistically Insignificant versus Noninferior.","authors":"Raghuraman M Sethuraman,KalaiSelvi Vairavan Subbammal","doi":"10.1213/ane.0000000000007767","DOIUrl":"https://doi.org/10.1213/ane.0000000000007767","url":null,"abstract":"","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071809","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":"Genome-Wide DNA Methylation Profiles of Long-Term Cognitive Decline after Delirium in Intensive Care Unit Patients.","authors":"Yoshitaka Nishizawa,Takehiko Yamanashi,Summer S Qureshi,Tomoteru Seki,Kyosuke Yamanishi,Tsuyoshi Nishiguchi,Tetsufumi Kanazawa,Masaaki Iwata,Christopher G Hughes,Pratik Pandharipande,Gen Shinozaki","doi":"10.1213/ane.0000000000007749","DOIUrl":"https://doi.org/10.1213/ane.0000000000007749","url":null,"abstract":"BACKGROUNDTo date, no studies have reported on the differences in genome-wide DNA methylation (DNAm) profiles between delirium patients with and without long-term cognitive decline (LTCD). This study aimed to identify epigenetic markers associated with LTCD after delirium using blood samples from intensive care unit (ICU) patients.METHODSBlood DNA samples from 104 patients (86 delirium patients and 18 nondelirium patients) were analyzed using the Illumina EPIC array genome-wide platform. We investigated the differences in DNAm related to the presence or absence of LTCD among delirium patients, nondelirium patients, and the entire cohort. Enrichment analyses were conducted using gene ontology (GO) and Kyoto Encyclopedia of Genes and Genome terminology (KEGG).RESULTSAmong the 20 top hits of differentially methylated cytosine-phosphate-guanine (CpG) sites associated with LTCD in patients with delirium, CpG located within the major histocompatibility complex (MHC) region on chromosome 6 (cg11103845) was significantly associated after false discovery rate (FDR) correction (FDR-adjusted P = .034). Enrichment analysis revealed immune-related pathways associated with LTCD. Although not statistically significant, MHC class II-related pathways, such as \"MHC class II receptor activity\" and \"MHC class II protein complex assembly,\" were also ranked among the top hits.CONCLUSIONSThis genome-wide DNAm analysis focused on LTCD after delirium highlights differentiating epigenetic signals related to MHC class II and immune processes. These findings provide initial evidence that epigenetic processes may play a crucial role in the pathophysiological mechanisms underlying LTCD after delirium.","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071810","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":"Propofol Versus Dexmedetomidine Effects on PND and Sleep: Potential Patient Population Effects.","authors":"Zhenfeng Gao,Lin Chen,Dan Zhao","doi":"10.1213/ane.0000000000007765","DOIUrl":"https://doi.org/10.1213/ane.0000000000007765","url":null,"abstract":"","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"50 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071811","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":"Autonomous Artificial Intelligence Performance in Anesthesiology Simulation: GPT-4o in Anesthesia simSTAT.","authors":"Manabu Yoshimura,Yasuhiro Morimoto","doi":"10.1213/ane.0000000000007769","DOIUrl":"https://doi.org/10.1213/ane.0000000000007769","url":null,"abstract":"","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"64 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071814","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":"Should Not Anesthesia Research Involve Anesthesiologists? Consequences of the Decline in Academic Anesthesia and Possible Solutions.","authors":"James Peyton,Britta S von Ungern-Sternberg,Clyde Matava","doi":"10.1213/ane.0000000000007752","DOIUrl":"https://doi.org/10.1213/ane.0000000000007752","url":null,"abstract":"","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071854","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":"Phonomyography: A New Perspective in Perioperative Monitoring of Neuromuscular Blockade?","authors":"Cyrus Motamed,Migena Demiri,Nora Colegrave","doi":"10.1213/ane.0000000000007761","DOIUrl":"https://doi.org/10.1213/ane.0000000000007761","url":null,"abstract":"","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"80 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145077793","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}