Anesthesia & Analgesia最新文献

{"title":"Anaphylaxis Induced by Rocuronium, Sugammadex, or Rocuronium-Sugammadex Complex: Summary of Published Cases.","authors":"Bin Gao,Yang Liu,Yun-Tai Yao","doi":"10.1213/ane.0000000000008024","DOIUrl":"https://doi.org/10.1213/ane.0000000000008024","url":null,"abstract":"","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147483696","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 Value of the Aperiodic Exponent of the Intraoperative Electroencephalogram for Predicting Postoperative Delirium in Elderly Patients.","authors":"Martin Soehle,Jan Menzenbach,Katharina Riedel,Mark Coburn,Marcus Thudium","doi":"10.1213/ane.0000000000008013","DOIUrl":"https://doi.org/10.1213/ane.0000000000008013","url":null,"abstract":"BACKGROUNDPostoperative delirium (POD) is a frequent and serious complication after surgery. Parameters of the electroencephalogram (EEG), such as the Bispectral Index and the occurrence of burst suppression, have been associated with POD. We analyzed the predictive properties of periodic and aperiodic parameters of the EEG power spectrum.METHODSIn a secondary post-hoc analysis of a prospective observational study, patients with an age of at least 60 years undergoing major cardiac or non-cardiac surgery were analyzed. The frontal intraoperative raw EEG was recorded by a BIS monitor and offline analyzed with the FOOOF toolbox, revealing the periodic and aperiodic parameters of the power spectrum. Patients were screened for POD and divided in a 2:1 ratio into a training and a validation cohort. Predictors of POD were identified by uni- and multivariable logistic regression.RESULTSThirty-two out of the 120 training group patients developed POD. These showed a significantly longer median duration of surgery (286 [interquartile range {IQR} 236-391] vs 223 [127-331] min, P = .005), lower median BIS (40.4 [IQR 38.1-43.4] vs 42.7 [39.5-46.0], P = .038), and a higher mean aperiodic exponent (2.09 ± 0.19 vs 1.99 ± 0.17, P = .017). Duration of surgery (odds ratio [OR] = 1.01; 95% confidence interval [CI], 1.00-1.01, P = .005), peak center frequency (OR = 0.79; CI, 0.62-0.97, P = .039) and aperiodic exponent (OR = 23.2; CI, 2.1-318.2, P = .013) were predictors of POD according to univariable logistic regression. At a cutoff of 1.967, the aperiodic exponent had a sensitivity of 0.813 and a specificity of 0.478 for the prediction of POD. A low duration of time spent in burst suppression was observed in both patients with POD (67 [6-363] s) and without POD (173 [4-641] s, P = .30), and cumulative burst suppression time was not a predictor of POD. In a stepwise regression model, age, duration of surgery, peak power, and the aperiodic exponent were associated with POD (AUROC = 0.80 (CI, 0.71-0.89, P < .001). The predictive model was confirmed in the validation group (n = 60) with an AUROC = 0.77 (CI, 0.65-0.90, P = .001).CONCLUSIONSA higher aperiodic exponent, for example, a less complex EEG signal, is associated with a greater POD risk, especially in combination with known POD predictors such as age and duration of surgery.","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"192 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147495162","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":"GLP-1 Agonists: More Answers, More Questions.","authors":"","doi":"10.1213/ane.0000000000007994","DOIUrl":"https://doi.org/10.1213/ane.0000000000007994","url":null,"abstract":"","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"33 1","pages":"639"},"PeriodicalIF":0.0,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147446992","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":"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}