Anesthesia & Analgesia最新文献

{"title":"Educating Anesthesiology Residents and Their Support Persons to Improve Understanding and Increase Wellness: A Multisite Study.","authors":"Susan M Martinelli,Thanh N Tran,Courtney L Canter,Di Hu,Robert S Isaak,Farzana Afroze,Teresa A Mulaikal,Beth Ladlie,Ankit Jain,Chelsea Willie,David L Stahl,Tekuila R Carter,Lara Zisblatt,Amie L Hoefnagel,Julie M Marshall,Stephen Collins,Ryan J Keneally,Timothy W Martin,Fei Chen","doi":"10.1213/ane.0000000000008030","DOIUrl":"https://doi.org/10.1213/ane.0000000000008030","url":null,"abstract":"BACKGROUNDBurnout remains prevalent among anesthesiology residents. Contributing workplace factors include limited control over scheduling, unpredictable hours, critical patient care needs, and other residency challenges. The Family Anesthesia Experience (FAX) is a program designed to educate residents and their support persons on wellness and residency demands. The focus of this multisite study was to evaluate the impact of FAX on first year clinical anesthesiology (CA1, ie, PGY2s) residents' wellness.METHODSThis was a prospective evaluation study involving 15 US anesthesiology residency programs, 13 of which completed FAX. CA1 wellness was evaluated through surveys assessing perceived stress as the primary outcome, with exploratory outcomes including burnout, depression, psychological wellness, and social support. Additionally, changes in support persons' understanding and knowledge of residency demands were tracked over time. The study included a historical control group of 302 CA1s (2019-2021) who did not participate in FAX, and an intervention group of 88 CA1s that participated in FAX (2021-2022). Statistical analyses compared changes in metrics between groups using linear mixed models and generalized linear models.RESULTSSignificant reductions in perceived stress were observed in the intervention group at 6 months post-FAX (mean change = -2.14, 95% CI, -3.95 to -0.34; P =.021, effect size = 0.58) relative to the control group, but there was no sustained difference at 12 months. Compared to the control support persons, intervention support persons reported increased understanding of residency demands, with significant improvements at 6 (mean change = 2.80, 95% CI, 1.12-4.48; P =.001, effect size = 0.77) and 12 (mean change = 2.59, 95% CI, 0.12-5.05; P =.039, effect size = 0.71) months. Improvement in support persons' understanding did not predict changes in CA1 wellness outcomes. First generation physician residents reported lower family support at baseline but showed significant improvements in family support at 6 months (mean change = 3.05 points; 95% CI, 0.25-5.84; P =.033; effect size = 1.23) compared to their non first generation peers.CONCLUSIONSFAX participation was associated with reduced perceived stress in residents up to 6 months post-intervention. First generation physicians experienced greater improvements in perceived family support compared to their non first generation peers. Our findings suggest that resident wellness may be enhanced by engaging both residents and their support persons in an educational wellness program that outlines the professional expectations and demands of anesthesiology residency training.","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147648971","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":"Presurgery Physical Performance and AI-Driven Mortality Risk Prediction in Colorectal Cancer Surgery: An Observational Study.","authors":"Philip W Steenfos,Ilze Ose,Andreas W Rosen,Søren T Skou,Ismail Gögenur","doi":"10.1213/ane.0000000000008056","DOIUrl":"https://doi.org/10.1213/ane.0000000000008056","url":null,"abstract":"","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"113 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147636037","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":"Tutorial on Analyzing Paired Longitudinal Data With Serial Correlation and Making Comparisons Between Groups, With Examples for Opioid Consumption and Quality of Life.","authors":"Franklin Dexter,Rashmi N Mueller,Karsten Bartels","doi":"10.1213/ane.0000000000008064","DOIUrl":"https://doi.org/10.1213/ane.0000000000008064","url":null,"abstract":"","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147636038","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 Functional Near-Infrared Spectroscopy Be Used for Objective Pain Assessment and Anesthetic Depth Monitoring?","authors":"Daniel Nguyen,Guido Musch","doi":"10.1213/ane.0000000000008039","DOIUrl":"https://doi.org/10.1213/ane.0000000000008039","url":null,"abstract":"","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"54 2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147636040","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":"Trending Ability and Accuracy of Minimally Invasive Pulse Wave Analysis Devices: A Systematic Review and Meta-Analysis.","authors":"Borja Barrachina,Cristina Vinuesa,Ibai Iriarte,Ania Albinarrate","doi":"10.1213/ane.0000000000008008","DOIUrl":"https://doi.org/10.1213/ane.0000000000008008","url":null,"abstract":"BACKGROUNDMinimally invasive pulse wave analysis devices are widely used for perioperative hemodynamic monitoring, but their accuracy and ability to track changes in cardiac output remain controversial. Previous reviews mainly addressed accuracy, whereas trending ability has been reported inconsistently.METHODSWe conducted a systematic review and meta-analysis of studies comparing minimally invasive pulse wave analysis devices with reference techniques. Methodological quality was assessed through a predefined fitness appraisal (simultaneity, homoscedasticity, absence of systematic trend, independence). Random-effects models (metafor, R 4.3.2) were used with log and logit transformations as appropriate. We included 50 studies; 49 provided accuracy/precision data and all 50 provided trending ability data, yielding 69 and 70 lines of analysis, respectively. Subgroup analyses were performed by device, clinical setting, and conflict of interest.RESULTSAcross all devices and settings, pooled bias was 0.09 L/min (95% confidence interval [CI], -0.05 to 0.23) and pooled percentage error was 48.3% (unweighted mean 49.0%, 95% CI, 45.8-52.2). Global trending analyses showed pooled four-quadrant concordance of 72.6% (95% CI, 67.9-77.4) and polar plot ±30° agreement of 63.2% (95% CI, 54.9-71.5). Heterogeneity was extreme (I2 >95% throughout). Subgroup analyses showed lower percentage error in intensive care unit (ICU) (≈42%) than in noncardiac surgery (≈55%) and more favorable results in studies with declared conflict of interest (≈44% vs 51%, P < .05). MostCare and Argos achieved four-quadrant concordance >90% and polar agreement close to accepted thresholds, but these estimates were based on few studies. Sensitivity analyses restricted to high-quality datasets yielded results very similar to the overall estimates.CONCLUSIONSMinimally invasive pulse wave analysis devices do not achieve sufficient accuracy or trending ability to be interchangeable with reference techniques. Extreme heterogeneity persists across devices, clinical settings, and methodological quality. Differences associated with conflicts of interest and between ICU and noncardiac surgery populations suggest that performance is context-dependent and influenced by study sponsorship. Taken together with recent evidence and new methodological standards for cardiac output validation, our findings underscore the need for more transparent algorithms, rigorous reporting of trending ability, and standardized validation frameworks before these technologies can be considered reliable for guiding hemodynamic management.","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"63 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147625879","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":"Effect of Local Anesthetic Solution at Different Temperatures for Epidural Labor Analgesia on Intrapartum Fever: A Randomized Clinical Trial.","authors":"Hai-Chao Wei,Ying Cao,Xiao-Yang Wu,Meng-Meng Cai,Jia-Feng Sun,Wei-Chun Tang,Bo-Xiang Du","doi":"10.1213/ane.0000000000008041","DOIUrl":"https://doi.org/10.1213/ane.0000000000008041","url":null,"abstract":"BACKGROUNDWhether heating local anesthetic solutions to core body temperature (37°C) for epidural labor analgesia reduces intrapartum fever incidence remains undefined in the current literature.METHODSThis double-blind randomized controlled trial (RCT) enrolled 220 nulliparous parturients (18-35 years, American Society of Anesthesiologists [ASA] physical status II, term singleton pregnancy). Participants were randomized to receive epidural labor analgesia with 0.075% ropivacaine + 0.5 µg/mL sufentanil at 37°C (warmed group) or 22°C (room-temperature group). Epidurals were placed at L3-L4 with a test dose of 3 mL of 1.5% lidocaine at room temperature, followed by programmed bolus epidural analgesia (initial 10 mL, 10 mL/h) and patient-controlled epidural analgesia (PCEA) 5 mL (30-minute lockout). Tympanic temperature was measured every 30 minutes from epidural initiation to delivery, defining intrapartum fever as ≥38°C. The primary outcome was fever incidence, on which the power analysis was based, and also maximum temperature and shivering. Secondary outcomes comprised analgesia onset, block level, labor durations, neonatal Apgar scores, umbilical cord blood pH and BE, and maternal adverse events.RESULTSA total of 220 parturients were included (warmed group, n = 110; room-temperature group, n = 110). The warmed group had a lower intrapartum fever incidence (15.5% [17/110] vs 30.9% [34/110], relative risk [RR] 0.5 [95% confidence interval {CI}, 0.298-0.840]; P = .007); however, the reduction of 49.8% did not reach the preset clinically meaningful difference of 60% reduction proposed in the power analysis. The maximum body temperature was also lower in the warmed group: median (interquartile range [IQR]) 37.4 (IQR, 37.2-37.7) °C vs 37.6 (IQR, 37.3-38.0) °C, median difference -0.2 (95% CI, -0.3 to -0.1) °C (P = .006). Shivering incidence was not different between groups (10.9% [12/110] vs 14.5% [16/110]; P = .418). No statistically significant differences were observed between groups in any of the secondary outcomes assessed, including block characteristics, local anesthetic consumption, labor duration, neonatal outcomes, and maternal adverse events.CONCLUSIONAlthough we found a 50% reduction in the incidence of temperature rise using warmed (37°C) local anesthetics for epidural labor analgesia, this did not reach our preset threshold of 60% reduction.","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"52 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147625902","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":"Enduring Barriers to Delivery of Safe Anesthesia in Rural Afghanistan: Report From a Kandahar Training Program.","authors":"Mohammad Sharif Oria,Mohammad Monir Kamran,Shafiqullah Shafaq,Julia L Weinkauf","doi":"10.1213/ane.0000000000008058","DOIUrl":"https://doi.org/10.1213/ane.0000000000008058","url":null,"abstract":"","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"42 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147625876","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":"Scientific Integrity in an Age of Scale, Speed, and Synthesis.","authors":"James P Rathmell","doi":"10.1213/ane.0000000000008040","DOIUrl":"https://doi.org/10.1213/ane.0000000000008040","url":null,"abstract":"","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147585565","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 Business of Anesthesiology: Private Equity's Growing Influence on the Workforce.","authors":"Victor F A Almeida,Travis Tsai,John Ha,Manoela Dantas,Eliana F R Duraes,Luis E Tollinche","doi":"10.1213/ane.0000000000008009","DOIUrl":"https://doi.org/10.1213/ane.0000000000008009","url":null,"abstract":"","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147585564","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":"Observation of Movement to Command in a Single Patient in a Cohort Undergoing Intended General Anesthesia With Remimazolam in the Absence of Neuromuscular Blockade.","authors":"Takuya Shiraishi,Musashi Yahagi,Manami Yawata,Yamato Tamakawa,Shunsuke Murata,Kanaru Suzuki,Yuichi Yaguchi,Jungo Kato","doi":"10.1213/ane.0000000000008061","DOIUrl":"https://doi.org/10.1213/ane.0000000000008061","url":null,"abstract":"","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"99 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147585569","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}