Anesthesia & Analgesia最新文献

{"title":"Therapy for the Soul: Music Intervention.","authors":"","doi":"10.1213/ane.0000000000007993","DOIUrl":"https://doi.org/10.1213/ane.0000000000007993","url":null,"abstract":"","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"14 1","pages":"624"},"PeriodicalIF":0.0,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147446993","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":"Call to Action: The Hidden Role of Anesthesiologists in the Opioid Epidemic.","authors":"Nancy M Boulos,Amy Zhou,Eileen K Nguyen,Alexandre Joosten","doi":"10.1213/ane.0000000000008021","DOIUrl":"https://doi.org/10.1213/ane.0000000000008021","url":null,"abstract":"","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147446995","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":"Contextualizing AI Evaluation in Anesthesiology: Interpreting Predictive Modeling and Reinforcement Learning Metrics Across Clinical Use Cases-An Expert Statement From the Society of Technology in Anesthesia.","authors":"Oliver Cafferty,Sean D Jeffries,Zheyan Tu,Eric D Pelletier,Avinash Sinha,Thomas M Hemmerling, ","doi":"10.1213/ane.0000000000007992","DOIUrl":"https://doi.org/10.1213/ane.0000000000007992","url":null,"abstract":"","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147446996","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":"Postoperative Urinary Retention After Reversal of Neuromuscular Block by Neostigmine versus Sugammadex in Patients Undergoing Laparoscopic Cholecystectomy: A Randomized Controlled Trial.","authors":"Callie E Diesch,Margaret X Vo,Kevin Salinas,Kaylee N Grant,Grant H Flindt,Shweta G Mohapatra,Aiden Berry,Matthew W Oh,Joy L Chen,Irina Gasanova,Tiffany Moon","doi":"10.1213/ane.0000000000008000","DOIUrl":"https://doi.org/10.1213/ane.0000000000008000","url":null,"abstract":"BACKGROUNDIn an era of fast-track surgery and enhanced recovery protocols, postoperative urinary retention (POUR) remains a common barrier to same-day discharge, contributing to prolonged PACU stays, patient discomfort, and unplanned admissions. Although sugammadex has been associated with a reduced incidence of POUR, no prospective, randomized studies have compared neostigmine and sugammadex for neuromuscular blockade reversal in laparoscopic cholecystectomy. The objective of this study was to determine the incidence of postoperative urinary retention after the reversal of rocuronium-induced neuromuscular blockade with neostigmine versus sugammadex in patients undergoing laparoscopic cholecystectomy.METHODSA total of 235 patients undergoing laparoscopic cholecystectomy were enrolled. Anesthesia was induced with rocuronium 0.6 mg/kg (ideal body weight, IBW) to facilitate intubation, and moderate neuromuscular blockade was maintained intraoperatively with 0.15 mg/kg (IBW) doses. At the end of surgery, patients received either sugammadex 2 mg/kg (total body weight, TBW) or neostigmine 50 to 70 µg/kg (IBW) with glycopyrrolate 8 to 10 µg/kg (IBW) for reversal. Bladder volumes were assessed via ultrasound before and after attempted voiding. Postoperative urinary retention (POUR) was defined as (1) inability to void with bladder volume ≥ 300 mL, (2) post-void residual ≥ 200 mL, or (3) need for catheterization. The incidence of POUR was recorded as the primary end point.RESULTSThe incidence of POUR was significantly lower with sugammadex compared with neostigmine, difference of 12.8% (95% CI of the difference 4% to 22%, P < .001). There were no major adverse events in either group.CONCLUSIONSIn patients undergoing laparoscopic cholecystectomy, neuromuscular blockade with rocuronium followed by reversal with sugammadex provides a significant reduction in postoperative urinary retention when compared to reversal with neostigmine, without any major adverse effects.","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147359061","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":"Perspective on Pediatric Anesthesia Patient Safety Past to Future.","authors":"C Dean Kurth,Elizabeth B Malinzak,Megha K Kanjia","doi":"10.1213/ane.0000000000007996","DOIUrl":"https://doi.org/10.1213/ane.0000000000007996","url":null,"abstract":"","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147359064","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":"Private Equity and Anesthesia Systems: Balancing Market Efficiency With Clinical Continuity.","authors":"Mikhail Chernov","doi":"10.1213/ane.0000000000008010","DOIUrl":"https://doi.org/10.1213/ane.0000000000008010","url":null,"abstract":"","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"283 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147359062","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":"High-Flow Nasal Oxygen and the Risk of Gastric Insufflation: A Systematic Review and Meta-Analysis Supplemented by Narrative Synthesis.","authors":"Venkatesan Thiruvenkatarajan,Jellsingh Jeyadoss,Philip Harford,Minsu Kim,Ashok Kumar Jayaraj","doi":"10.1213/ane.0000000000008005","DOIUrl":"https://doi.org/10.1213/ane.0000000000008005","url":null,"abstract":"High-flow nasal oxygen (HFNO) generates positive airway pressure, raising concerns about gastric insufflation and aspiration risk. Although most studies report minimal or no gastric distension, some suggest significant changes. This systematic review and meta-analysis applied the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework to evaluate the effect of HFNO on gastric insufflation and related markers across clinical settings. We searched Medline, Embase, Emcare, and CINAHL through August 2025 for studies reporting qualitative or quantitative markers of gastric insufflation during HFNO use, including comet-tail artifacts, antral cross-sectional area, and gastric volume. Eligible designs included randomized trials, observational and volunteer studies, and case reports. Methodological quality was evaluated using the Mixed Methods Appraisal Tool, and certainty of evidence was rated with GRADE. Meta-analysis was performed for outcomes reported in two or more studies. Six randomized trials, five observational studies, two volunteer studies, one case series, and two case reports were included. Observational studies primarily assessed outcomes before and after HFNO intervention. Pooled analysis of four randomized controlled trials (RCTs; n = 375) showed HFNO significantly reduced gastric insufflation compared with face-mask ventilation during elective peri-intubation (risk ratios [RR] = 0.32; 95% confidence interval [CI], 0.19-0.52; P < .00001; I2 = 0%), rated moderate-certainty. For antral cross-sectional area, pooled analysis of three RCTs (n = 318) found no significant difference between HFNO and face-mask ventilation (MD -0.33 cm2; 95% CI, -0.72 to 0.05; P = .09; I2 = 74%), rated moderate-certainty. Observational studies assessing pre- and post-HFNO changes showed no significant increase in antral cross-sectional area (MD 0.08 cm2; 95% CI, -0.29 to 0.45; P = .67; I2 = 0%) and no significant change in gastric liquid volume (MD -0.01 ml/kg; 95% CI, -0.07 to 0.06; P = .80; I2 = 0%), both rated low certainty. Nonpooled data suggested possible increases in critically ill patients, but the evidence was of very low certainty. A single study assessing microaspiration found HFNO reduced gastroesophageal reflux and prevented microaspiration compared with face-mask ventilation. No clinically significant aspiration events were reported across studies. Moderate-certainty evidence supports HFNO as safe regarding gastric insufflation and antral cross-sectional area in most elective and procedural contexts. Low-certainty evidence suggests no increase in gastric volume. Caution is warranted due to limited, low-to-very-low-certainty evidence at higher flow rates and among critically ill patients. Larger multicenter trials and robust observational studies are necessary to confirm safety in these settings.","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"87 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147359063","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":"Benchmarking Large Language Model Performance in Perioperative Crisis Responses.","authors":"Nathan C Hurley,Rachel Corbitt,Sam Fallahian,Sarah Saenz,Aaron S Hess,Kristopher M Schroeder","doi":"10.1213/ane.0000000000007924","DOIUrl":"https://doi.org/10.1213/ane.0000000000007924","url":null,"abstract":"","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147359239","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":"Prospective Study of Postoperative Respiratory Depression Metrics After Cesarean Delivery Among Women Receiving Intrathecal Morphine.","authors":"Adam Lustig,Brendan Carvalho,Shimon Haim,Nan Guo,Chaim Greenberger,Dana Karol,Boris Aptekman,Carolyn F Weiniger","doi":"10.1213/ane.0000000000007908","DOIUrl":"https://doi.org/10.1213/ane.0000000000007908","url":null,"abstract":"BACKGROUNDThe Society for Obstetric Anesthesia and Perinatology (SOAP) recommends monitoring for respiratory depression after cesarean delivery according to intrathecal morphine (ITM) dose. The aim of the study was to compare respiratory metrics after ITM administration, to determine evidence for the SOAP recommendations.METHODSProspective observational cohort study design. Following institutional review board approval, women undergoing non-emergency cesarean delivery with spinal anesthesia in a single center were enrolled. Women were offered 50 µg, 150 µg or transversus abdominis plane (TAP) block without ITM, for postoperative analgesia. Respiratory monitoring, continuous acoustic respiratory rate (RR) and pulse oximetry oxygen saturation (SpO2) monitor Masimo Radius-7, was used after surgery up to 12 hours postoperatively. The primary outcome was bradypnea, number of women with RR ≤ 8 breaths per minute according to dose.RESULTSAmong 80 recruits, 33 (41%) chose 50 µg, 46 (57%) chose 150 µg, and one chose TAP block. Bradypnea events were detected 564 times among 27 (81.8%) women receiving 50 µg and 529 times among 40 (87.0%) women receiving 150 µg. Median [interquartile range (IQR)] duration of bradypnea per patient was 1.58 [1.15-2.42] in 50 µg group and 1.09 [0.83-1.70] in 150 µg group, P < .001. The event rate of bradypnea was 1.89 (95% confidence intervals [CIs], 1.73-2.05) events per person-hour among women receiving 50 µg versus 1.23 (95% CI, 1.12-1.34) events per person-hour among women receiving 150 µg, P = .624. Most, 62% of bradypnea occurred by 6 hours, and 86% of events by 12 hours. Apnea and hypoxemia event rates were similar, but hypoxemia duration was significantly prolonged after 150 µg, median 48 [IQR, 36-90] versus 56 sec [IQR, 40-106]; P = .001. Nursing assessments done per institutional protocol did not identify any respiratory events. No woman required oxygen or naloxone administration.CONCLUSIONWe found no statistically significant differences in RR comparing 50 and 150 µg ITM, using continuous monitoring. Although the 150 µg group experienced a higher incidence of hypoxemia events, these were not clinically significant.","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147359433","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 Amisulpride Inclusion in a Postoperative Nausea and Vomiting Protocol: A Retrospective Pre-Post Analysis.","authors":"Kristie Kim,Melissa Assel,Joanna Serafin,Kara M Barnett,Andrew Vickers,Hanae K Tokita","doi":"10.1213/ane.0000000000008020","DOIUrl":"https://doi.org/10.1213/ane.0000000000008020","url":null,"abstract":"","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"248 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147329507","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}