Anesthesiology Research and Practice最新文献

{"title":"Hemodynamic Response to Laryngoscopy and Endotracheal Intubation With Conventional Macintosh Laryngoscope Versus C-MAC Video Laryngoscope in Patients Undergoing Elective Coronary Artery Bypass Grafting: A Randomized Controlled Trial.","authors":"Sehrish Khan, Malika Hameed, Waleed Razi Khan, Muhammad Saad Yousuf, Khalid Samad","doi":"10.1155/anrp/2771364","DOIUrl":"10.1155/anrp/2771364","url":null,"abstract":"<p><strong>Background: </strong>Laryngoscopy and endotracheal intubation evoke significant hemodynamic responses, particularly in patients undergoing coronary artery bypass grafting (CABG) who have compromised cardiac reserves. This study aimed to compare the hemodynamic effects of the C-MAC video laryngoscope (VL) with those of the conventional Macintosh laryngoscope (MC) in patients undergoing elective CABG.</p><p><strong>Methods: </strong>This randomized controlled trial included 86 patients scheduled for elective CABG, who were randomly assigned to intubation with either the MC group or the C-MAC VL group. Hemodynamic parameters, including heart rate, systolic, diastolic, and mean arterial pressures, were recorded at five time points (prelaryngoscopy baseline to 10 min postintubation). Secondary outcomes included the intubation success rate, duration of laryngoscopy and intubation, glottic visualization, and complications.</p><p><strong>Results: </strong>Two-way repeated measures ANOVA revealed no significant group effect or group-by-time interaction for any hemodynamic variable (all <i>p</i> > 0.05), confirming equivalent hemodynamic profiles across all time points. A significant time effect was observed for all variables (all <i>p</i> < 0.001). First-attempt intubation success was 88.4% (VL) versus 74.4% (MC) (<i>p</i> = 0.166). The C-MAC provided significantly better glottic visualization (modified CL grade, <i>p</i> < 0.001). No major complications occurred in either group.</p><p><strong>Conclusion: </strong>In patients undergoing CABG, C-MAC VL and conventional MC result in similar hemodynamic responses. The choice of laryngoscope may be guided by airway considerations and operator experience rather than anticipated cardiovascular effects. <b>Trial Registration:</b> Clinicaltrials.gov_identifier: NCT04433884.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":"2026 ","pages":"2771364"},"PeriodicalIF":1.5,"publicationDate":"2026-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13275988/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148293206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound-Guided Pectoral Nerve Block for Cardiac Implantable Electronic Device Implantation: A Prospective Randomized Controlled Trial of Postprocedural Analgesic Benefit in an Asian Population.","authors":"Tian Zheng, Yuxuan Zhong, Lifeng Zhang, Xiaoshu Cheng, Jianxin Hu, Xiao Huang, Biming Zhan","doi":"10.1155/anrp/8742805","DOIUrl":"10.1155/anrp/8742805","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Pain after cardiac implantable electronic device (CIED) implantation remains clinically relevant and may increase postoperative analgesic requirements. Ultrasound-guided pectoral nerve block has shown benefit in anterior chest wall procedures, but evidence during CIED implantation, particularly in Asian populations with relatively lower body mass index (BMI), remains limited. This study aimed to evaluate the efficacy and safety of ultrasound-guided pectoral nerve block for postoperative analgesia during CIED implantation and to explore clinical factors associated with rescue analgesic use.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In this prospective randomized controlled trial, 660 patients undergoing CIED implantation were randomly assigned to a pectoral nerve block group or a standard-care group, with 330 patients in each group. Postoperative pain intensity was assessed using the numeric rating scale (NRS) at 1, 2, 4, 24, and 48 h after the procedure. Longitudinal NRS trajectories were analyzed using a linear mixed-effects model for repeated measures. Rescue analgesic use, length of hospital stay, and adverse events were compared between groups. Univariable and multivariable logistic regression analyses were performed as exploratory analyses to identify factors associated with rescue analgesic requirement.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Procedural characteristics were comparable between groups, including procedure type, device type, procedure duration, and implant laterality. Longitudinal analysis demonstrated significantly lower postoperative NRS scores over time in the pectoral nerve block group. Pain scores were consistently lower in the block group than in the control group at 1 h (0.87 ± 0.51 vs. 2.50 ± 0.78), 2 h (1.33 ± 0.55 vs. 4.37 ± 0.89), 4 h (2.00 ± 0.83 vs. 4.37 ± 0.93), 24 h (2.27 ± 0.91 vs. 4.57 ± 0.90), and 48 h (2.03 ± 0.67 vs. 3.67 ± 0.99) (all &lt;i&gt;p&lt;/i&gt; &lt; 0.001). The proportion of patients requiring rescue analgesics was significantly lower in the pectoral nerve block group than in the control group (7.58% vs. 16.67%, &lt;i&gt;p&lt;/i&gt; = 0.001). Length of hospital stay and adverse event rates were comparable between groups. In exploratory multivariable analysis, higher BMI and higher glycated hemoglobin were independently associated with greater rescue analgesic use, whereas pectoral nerve block was independently associated with a lower likelihood of rescue analgesic requirement.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Ultrasound-guided pectoral nerve block significantly improved postoperative analgesia and reduced rescue analgesic use in patients undergoing CIED implantation without increasing adverse events. These findings support its use as an effective perioperative analgesic strategy in an Asian cohort with a relatively lower BMI profile and suggest that BMI-related variation in analgesic requirement may remain clinically relevant even in such populations. &lt;b&gt;Trial Registration:&lt;/b&gt; ClinicalTrials.gov; identifi","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":"2026 ","pages":"8742805"},"PeriodicalIF":1.5,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13238265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148197072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to \"MIF-Mediated NLRP3 Inflammasome-Dependent Pyroptosis in Spinal Neurons and Microglial Polarization Facilitate Neuropathic Pain Progression\".","authors":"","doi":"10.1155/anrp/9818954","DOIUrl":"https://doi.org/10.1155/anrp/9818954","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1155/anrp/6624776.].</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":"2026 ","pages":"9818954"},"PeriodicalIF":1.3,"publicationDate":"2026-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13202602/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148040818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound-Guided Airway Nerve Blocks vs. Lidocaine Topical Anesthesia Using Video-Assisted Laryngoscopy in Suspected Difficult Intubation for Patients Undergoing Bariatric Surgery: A Randomized Clinical Trial.","authors":"Reham M Hashim, Mohamed S M Zaki, David B N Elagiby, Islam A A Taher","doi":"10.1155/anrp/2054379","DOIUrl":"10.1155/anrp/2054379","url":null,"abstract":"<p><strong>Introduction: </strong>Anesthetic complications related to difficult airways in obese patients are very common, necessitating the need for an ideal method of awake intubation, either airway block anesthesia or topical anesthesia.</p><p><strong>The aim of this work: </strong>To compare topical airway anesthesia with airway nerve block for ease of awake intubation, with the C-MAC video laryngoscope device employed in difficult intubation anticipated in patients undergoing bariatric surgery. Ease of intubation has been assessed by comparing gag reflex, cough reflex, patient comfort, and other factors.</p><p><strong>Patients and methods: </strong>This study has been conducted on 80 obese patients undergoing bariatric surgery, where 40 patients received airway nerve block Group LA and 40 patients received topical anesthesia by the method of spray as you go for anesthetizing the airway using 10% lidocaine spray Group <i>T</i>, in addition to conscious sedation before video-assisted laryngoscopy.</p><p><strong>Result: </strong>Group LA showed better airway conditions with decreased cough and gag reflexes, and more patients were intubated at the first attempt than in Group <i>T</i>. Intubation time and need for a rescue airway were less in Group LA. Patient comfort and experience, by recall absence and lower Visual Analog Scale (VAS) scores, were better for Group LA in comparison with Group <i>T</i>. Adverse events in terms of heart rate (HR), elevated mean blood pressure (MAP), and desaturation episodes were more common in Group <i>T</i>.</p><p><strong>Conclusion: </strong>This study concluded that ultrasound-guided airway nerve blocks provided shorter intubation time, significantly superior airway conditions, and more stable hemodynamic and oxygenation profiles compared to topical lidocaine spray, with fewer airway-related complications, reduced need for rescue interventions, and higher overall comfort with no recall of the procedure. <b>Trial Registration:</b> ClinicalTrials.gov identifier: NCT07069686.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":"2026 ","pages":"2054379"},"PeriodicalIF":1.5,"publicationDate":"2026-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13195441/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148013112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound-Guided Erector Spinae Plane Block Versus Transversus Abdominis Plane Block for Postoperative Analgesia in Adult Patients Undergoing Laparoscopic Appendectomy.","authors":"Eman Abdelnaby Mohamed Soliman, Mohsen Abdelgani Basyoni, Amira Fathy Hafni Soliman, Mohamed Abdelmawla Saleh, Engy Sami Attia Sami","doi":"10.1155/anrp/6654154","DOIUrl":"10.1155/anrp/6654154","url":null,"abstract":"<p><strong>Background: </strong>Effective postoperative analgesia is essential after laparoscopic appendectomy. This randomized, double-blind controlled study compared the analgesic efficacy of ultrasound-guided erector spinae plane block (ESP) and the transversus abdominis plane block (TAP).</p><p><strong>Methods: </strong>This randomized, double-blind controlled study included 72 adult patients undergoing laparoscopic appendectomy. The primary outcome was the 24 h postoperative Numerical Rating Scale (NRS) pain score. Secondary outcomes included time to first rescue analgesia, total 24 h pethidine consumption, intraoperative fentanyl requirements, and adverse events. Patients were randomized to receive either an ultrasound-guided erector spinae plane block or a transversus abdominis plane block.</p><p><strong>Results: </strong>The erector spinae plane block group demonstrated significantly lower postoperative pain scores (mean difference -0.8 to -1.4), longer time to first rescue analgesia (mean difference 1.6 hours; 95% CI: 1.2-2.0), and reduced 24-hour pethidine consumption (mean difference -43.1 mg; 95% CI: -54.0 to -32.1). No major complications occurred.</p><p><strong>Conclusion: </strong>The erector spinae plane block provides superior postoperative analgesia after laparoscopic appendectomy and supports its inclusion in multimodal analgesic pathways. <b>Trial Registration:</b> ClinicalTrials.gov: NCT06220513.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":"2026 ","pages":"6654154"},"PeriodicalIF":1.5,"publicationDate":"2026-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13195795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148013165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Efficacy of Ultrasound-Guided Quadratus Lumborum Block Versus Alternative Fascial Plane Blocks for Postoperative Analgesia Following Hysterectomy: A Systematic Review and Meta-Analysis.","authors":"Priyanka Dwivedi, Tejas K Patel, Vijeta Bajpai, Chanchal Goyal, Ankita Kabi, Santosh Kumar Sharma, Hari Shanker Joshi, Pratibha Singh","doi":"10.1155/anrp/5760922","DOIUrl":"10.1155/anrp/5760922","url":null,"abstract":"<p><strong>Objective: </strong>The primary aim was to compare the efficacy of the quadratus lumborum (QL) block with alternative fascial plane blocks for postoperative analgesia following hysterectomy, while secondary aims were to compare total 24-h analgesic consumption, postoperative pain scores at different time intervals, and the incidence of postoperative nausea and vomiting (PONV) between the QL block and comparator groups.</p><p><strong>Methods: </strong>Electronic databases were systematically searched for studies that compared bilateral ultrasound-guided single-injection QL block to no block or other fascial plane blocks in hysterectomy surgeries. The QL block was compared with other fascial plane blocks, including transversus abdominis plane (TAP), oblique subcostal TAP (OSTAP), erector spinae plane (ESP), and combined TAP with ilioinguinal/iliohypogastric nerve block. The methodological quality of the included studies was assessed using the RoB 2.0 risk-of-bias tool. All outcomes were pooled using the Mantel-Haenszel method and random-effect model.</p><p><strong>Results: </strong>After screening 946 relevant articles, 15 RCTs were included in this meta-analysis. The QL block significantly prolonged the time to first rescue analgesic request compared to the TAP block in the abdominal hysterectomy subgroup (MD 244.77 [95% CI: 191.98 to 297.56], <i>I</i> ² = 89%; GRADE evidence-\"high\") and the laparoscopic hysterectomy subgroup (MD 443.15 [95% CI: 56.37 to 829.93], <i>I</i> ² = 98%; GRADE evidence-\"high\"). Regarding the 24-h total analgesic requirement, the QL block significantly reduced its consumption than the TAP block in both the abdominal (MD -2.64 [95% CI: -4.19 to -1.09], <i>I</i> ² = 93%; GRADE evidence-\"moderate\") and the laparoscopic hysterectomy subgroup (MD -6.65 [95% CI: -7.39 to -5.91], <i>I</i> ² = NA due to <i>n</i> = 1; GRADE evidence-\"moderate\"). The risk of PONV did not differ significantly between the QL block and placebo in abdominal hysterectomy (RR 2.48 [95% CI: 0.50 to -12.35], <i>I</i> ² = 0%; GRADE evidence: \"moderate\") and laparoscopic hysterectomy arm (RR 0.78 [95% CI: 0.50 to -1.22], <i>I</i> ² = 44%; GRADE evidence: \"moderate\"). The QL block did not show significant difference in risk of PONV than the TAP block across both the abdominal (RR 0.59 [95% CI: 0.25 to 1.40], <i>I</i> ² = 0%; GRADE evidence: \"moderate\") and laparoscopic hysterectomy subgroups (RR 0.86 [95% CI: 0.30 to 2.45], <i>I</i> ² = 0%; GRADE evidence: \"moderate\").</p><p><strong>Conclusion: </strong>The QL block provides superior postoperative analgesia compared with the TAP block in patients undergoing abdominal and laparoscopic hysterectomy.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":"2026 ","pages":"5760922"},"PeriodicalIF":1.5,"publicationDate":"2026-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13181214/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147969701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Study of the Effect of Continuous Caudal Epidural With General Anesthesia Versus General Anesthesia on Intraoperative and Postoperative Analgesic Requirements for Lumbar Fixation.","authors":"Paula Michael El-Komos Samaan, Esraa Abdellatif Mohamed Shawky, Mahmoud Abd El-Aziz Ahmed Ghallab, Ahmed Mohamed El-Sayed El-Hennawy, Omar Mohamed Zafer Mohamed","doi":"10.1155/anrp/1582655","DOIUrl":"10.1155/anrp/1582655","url":null,"abstract":"<p><strong>Study design: </strong>The study was an interventional, randomized, prospective comparative clinical trial on 60 patients scheduled for lumbar fixation surgery.</p><p><strong>Study aim: </strong>The study goal was to justify the effectiveness of combined continuous caudal epidural with general anesthesia compared to general anesthesia alone as analgesia for lumbar fixation patients.</p><p><strong>Overview of literature: </strong>Pain control during the intraoperative and postoperative period for spine surgeries is crucial. Much literature had proved that caudal analgesia is an acceptable alternative approach for intraoperative and postoperative analgesia.Methods: 60 patients were equally allocated to two groups: Group A (Study group) and Group B (Control group). For Group A patients', general anesthesia induction was followed by fluoroscopic-guided caudal epidural catheter insertion. Thirty patients of Group B received general anesthesia only. Various parameters were assessed, including postoperative pain and hemodynamic parameters, time to rescue analgesia, estimated blood loss, surgeon satisfaction with the surgical field, total intraoperative and postoperative narcotics, and common postoperative complications of caudal epidural.</p><p><strong>Results: </strong>The intraoperative heart rate and mean blood pressure showed significant differences. Group A showed a significantly lower intraoperative fentanyl dose. Group A patients had nonsignificant lower blood loss and higher surgeon satisfaction with the surgical field. Postoperative numeric pain scale was significantly lower in the study group. Study group had significant less frequent postoperative morphine need and significant lower total 6-h morphine dose. The rate of requesting the morphine first rescue dose was significantly later and lower in the study group. There was a significant less frequent sedation, in addition to a significant less frequent nausea and vomiting in the study group.</p><p><strong>Conclusions: </strong>Combined continuous caudal epidural with general anesthesia had lower intraoperative fentanyl dose and postoperative morphine dose, with overall lower opioid requirements and better pain control. <b>Trial Registration:</b> Clinical trial.gov.identifier; NCT06929611.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":"2026 ","pages":"1582655"},"PeriodicalIF":1.5,"publicationDate":"2026-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13173366/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147961910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the Effects of Intranasal and Oral Midazolam Premedication on Sedation and Separation From Parents for Pediatric Patients.","authors":"Dilek Metin Yamac, Nedret Erguven, Ecder Ozenc","doi":"10.1155/anrp/4837750","DOIUrl":"10.1155/anrp/4837750","url":null,"abstract":"<p><strong>Aim: </strong>The aim of this study is to compare the effect of intranasal and oral midazolam administered for premedication to children of preschool age on hemodynamic parameters, sedation, and separation from parents.</p><p><strong>Method: </strong>A prospective, randomized, single-blind design was adopted, including 60 children aged 2-6 years scheduled for elective surgery under general anesthesia. Participants were randomly assigned into two equal groups using a sealed-envelope randomization technique (Group O, <i>n</i> = 30, 0.5 mg/kg oral midazolam; Group N, <i>n</i> = 30, 0.25 mg/kg intranasal midazolam). The study drug was administered 20 min prior to induction of anesthesia. Vital signs and sedation score levels were recorded every 5 min. At the end of the 20th minute, the separation from parents score was assessed and recorded. Assessments were completed by an anesthesiologist who did not know the method of administration for premedication.</p><p><strong>Results: </strong>There were no statistically significant differences between the two groups in terms of mean age, sex, height, and weight. In Group N, 11/30 (36%) of patients had different types of nasal irritation identified. In both groups, sedation score values examined in the 10th minute were significantly high compared to the initial values. No statistical significance was observed for the other values. There was no statistically significant difference observed for the mean separation from parents scores in Group N and Group O examined in the 20th minute (<i>p</i> > 0.05).</p><p><strong>Conclusion: </strong>In our study, 0.25 mg/kg intranasal midazolam and 0.5 mg/kg oral midazolam, administered to children from 2 to 6 years for premedication, were effective methods, with no significant differences between the two kinds of administration in terms of sedation or separation from parents. Due to the nasal irritation emerging in patients with nasal administration, oral midazolam was evaluated as a more preferable method. <b>Trial Registration:</b> ClinicalTrials.gov: NCT07021755.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":"2026 ","pages":"4837750"},"PeriodicalIF":1.5,"publicationDate":"2026-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13168865/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147939799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pericapsular Nerve Group Block Versus Fascia Iliaca Compartment Block for Hip Arthroplasty: An Updated Meta-Analysis of Randomized Controlled Trials With Trial Sequential Analysis.","authors":"Luigi La Via, Fabio Raciti, Giovanni Guarneri, Ornella Rosa, Francesco Vasile, Francesco Perna, Marco Sapienza, Carmelo Calvagna, Gianluca Testa, Vito Pavone","doi":"10.1155/anrp/5550599","DOIUrl":"10.1155/anrp/5550599","url":null,"abstract":"<p><strong>Purpose: </strong>Regional anesthesia techniques are crucial for optimizing pain management after hip arthroplasty. The pericapsular nerve group (PENG) block represents a novel approach targeting specific neural structures for hip joint innervation.</p><p><strong>Objective: </strong>To evaluate the efficacy of PENG block compared to suprainguinal fascia iliaca compartment block (S-FICB) in adult patients undergoing hip arthroplasty, focusing on postoperative opioid consumption, pain scores, and mobilization time.</p><p><strong>Methods: </strong>We conducted a systematic review following PRISMA guidelines, searching PubMed and Scopus databases through October 2025. Only randomized controlled trials comparing PENG block with S-FICB were included. Risk of bias was assessed using the revised Cochrane tool. Meta-analysis employed random effects modeling, with evidence strength evaluated using GRADE methodology.</p><p><strong>Results: </strong>Five randomized controlled trials (824 patients) were included. PENG block significantly reduced 24-h opioid consumption compared to S-FICB (MD -3.85 mg, 95% CI -6.61 to -1.09, <i>p</i> = 0.006, <i>I</i> ² = 87%), improved pain scores (MD -0.74, 95% CI -1.28 to -0.19, <i>p</i> = 0.008, <i>I</i> ² = 74%), and shortened time to mobilization (MD -6.94 h, 95% CI -8.96 to -4.93, <i>p</i> < 0.00001, <i>I</i> ² = 0%). Trial sequential analysis demonstrated robust evidence for mobilization time, with qualified support for analgesic outcomes due to incomplete information size and heterogeneity. Evidence certainty was high for mobilization time and moderate for opioid consumption and pain scores.</p><p><strong>Conclusions: </strong>PENG block provides statistically significant reductions in opioid consumption and pain scores, with robust and clinically meaningful earlier mobilization compared to S-FICB in patients undergoing hip arthroplasty. These findings support incorporating PENG block into multimodal enhanced recovery pathways, though heterogeneity in analgesic outcomes warrants cautious interpretation.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":"2026 ","pages":"5550599"},"PeriodicalIF":1.5,"publicationDate":"2026-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13165277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147925633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Regional Anesthesia vs. General Anesthesia Technique on Perioperative Outcomes in Geriatric Patients With Hip Fracture: Narrative Review.","authors":"Hong Tao, Shuguang Yang, Wei Mei","doi":"10.1155/anrp/8083966","DOIUrl":"10.1155/anrp/8083966","url":null,"abstract":"<p><p>The rising incidence of hip fractures in aging populations necessitates optimized perioperative management to mitigate complications. This narrative review evaluates the impact of regional anesthesia (RA) and analgesia techniques compared to general anesthesia (GA) on perioperative outcomes in geriatric patients undergoing hip fracture surgery. Current evidence reveals no consistent mortality benefit for RA over GA. Multicenter trials such as REGAIN and RAGA found no significant difference in 30- to 60-day survival. Similarly, spinal anesthesia does not show a clear superior advantage over GA on postoperative delirium (POD) in geriatric hip fracture patients. For pneumonia and other major complications, current evidence remains inconclusive, with more well-designed studies needed in the future. Peripheral nerve blocks (PNBs), including femoral block, fascia iliaca compartment block, and pericapsular nerve group blocks, demonstrate superior perioperative analgesia by reducing opioid consumption and early pain scores. However, evidence on PNBs' effects on mortality or major complications remains limited. Overall, RA and GA exhibit comparable mortality outcomes, while PNBs enhance pain management but require further high-quality trials to assess long-term benefits. Current data highlight the need for individualized anesthesia strategies and robust RCTs to clarify optimal practices in high-risk geriatric populations.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":"2026 ","pages":"8083966"},"PeriodicalIF":1.5,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13154770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147866439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}