AnesthesiologyPub Date : 2026-10-01Epub Date: 2026-09-08DOI: 10.1097/ALN.0000000000006271
Kara M Barnett, Kelly Lebak
{"title":"When Multimodal Analgesia Succeeds, Do Regional Blocks Still Have Value?","authors":"Kara M Barnett, Kelly Lebak","doi":"10.1097/ALN.0000000000006271","DOIUrl":"10.1097/ALN.0000000000006271","url":null,"abstract":"","PeriodicalId":7970,"journal":{"name":"Anesthesiology","volume":"145 4","pages":"818-820"},"PeriodicalIF":9.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148918123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
AnesthesiologyPub Date : 2026-10-01Epub Date: 2026-09-08DOI: 10.1097/ALN.0000000000006249
Matthias Thoma
{"title":"Reassessing Local Anesthetic and Adjuvant Mixtures: Comment.","authors":"Matthias Thoma","doi":"10.1097/ALN.0000000000006249","DOIUrl":"10.1097/ALN.0000000000006249","url":null,"abstract":"","PeriodicalId":7970,"journal":{"name":"Anesthesiology","volume":"145 4","pages":"1075-1076"},"PeriodicalIF":9.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148918094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
AnesthesiologyPub Date : 2026-10-01Epub Date: 2026-06-10DOI: 10.1097/ALN.0000000000006200
Anita M Jegarl, Mitchell Martin, Nicholas R Cormier, Anthony Tanella, Dillon Schafer, Xiwen Zhao, Nadeera Dawlagala, Theo Yonn-Brown, Amanda Girod, Hung-Mo Lin, Adriana G Ramirez, Courtney E Gibson, Jennifer B Ogilvie, Jaime B Hyman
{"title":"Superficial Cervical Plexus Block and Quality of Recovery after Thyroidectomy: A Randomized Clinical Trial.","authors":"Anita M Jegarl, Mitchell Martin, Nicholas R Cormier, Anthony Tanella, Dillon Schafer, Xiwen Zhao, Nadeera Dawlagala, Theo Yonn-Brown, Amanda Girod, Hung-Mo Lin, Adriana G Ramirez, Courtney E Gibson, Jennifer B Ogilvie, Jaime B Hyman","doi":"10.1097/ALN.0000000000006200","DOIUrl":"10.1097/ALN.0000000000006200","url":null,"abstract":"<p><strong>Background: </strong>Whether adding a bilateral superficial cervical plexus block to a thyroidectomy enhanced recovery pathway improves postoperative quality of recovery remains uncertain.</p><p><strong>Methods: </strong>In a single-center prospective, randomized, double-blind, placebo-controlled trial in adults undergoing thyroidectomy with general anesthesia, participants were randomized to bilateral superficial cervical plexus blocks with 0.25% bupivacaine or saline. All participants received multimodal analgesia with dexamethasone, acetaminophen, nonsteroidal anti-inflammatory drugs, and incisional local anesthetic. The primary outcome was quality of recovery, measured by the QoR-40 survey, on postoperative day 1. Secondary outcomes included the need for rescue opioid, total opioid consumption, nausea, vomiting, antiemetic administration, length of stay in the postanesthesia care unit (PACU), and opioid use on postoperative day 1.</p><p><strong>Results: </strong>A total of 160 participants were randomized to receive a superficial cervical plexus block with bupivacaine 0.25% (n = 78) or saline (n = 82). On postoperative day 1, mean QoR-40 scores were 174 (95% CI, 170 to 178) for bupivacaine and 173 (95% CI, 169 to 177) for saline. The adjusted mean difference between bupivacaine versus saline was 0.91 (95% CI, -3.57 to 5.40; P = 0.688). There were no significant between-group differences in the need for opioids in the PACU or on postoperative day 1, nausea, vomiting, or PACU length of stay. However, the total amount of opioid administered in the PACU was lower in the bupivacaine group (median [interquartile range], 0 [0 to 8]) compared with the saline group (2 [0 to 20]; Hodges-Lehmann location shift, 0 morphine milligram equivalents; 95% CI, -4 to 0; P = 0.017), and fewer participants in the bupivacaine group received rescue antiemetics (3 [3.8%] vs . 13 [16%]; difference, -12%; 95% CI, -22% to -1.8%; P = 0.011).</p><p><strong>Conclusions: </strong>Bilateral superficial cervical plexus blocks did not improve quality of recovery after thyroidectomy when added to a multimodal analgesic regimen including dexamethasone, acetaminophen, nonsteroidal anti-inflammatory drugs, and incisional local anesthetic but were associated with lower total PACU opioid consumption.</p>","PeriodicalId":7970,"journal":{"name":"Anesthesiology","volume":" ","pages":"918-926"},"PeriodicalIF":9.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148216003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
AnesthesiologyPub Date : 2026-10-01Epub Date: 2026-08-17DOI: 10.1097/ALN.0000000000006230
Alex S Evers
{"title":"Holger K. Eltzschig, M.D., Ph.D., Recipient of the 2026 Award for Excellence in Research.","authors":"Alex S Evers","doi":"10.1097/ALN.0000000000006230","DOIUrl":"https://doi.org/10.1097/ALN.0000000000006230","url":null,"abstract":"","PeriodicalId":7970,"journal":{"name":"Anesthesiology","volume":"145 4","pages":"842-844"},"PeriodicalIF":9.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148944128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
AnesthesiologyPub Date : 2026-10-01Epub Date: 2026-05-13DOI: 10.1097/ALN.0000000000006149
Johannes Spaeth, Malte Trost, Bernd Flamm, Christin Wenzel, Stefan Schumann
{"title":"Anesthesia Workstation Performance in Pediatric Ventilation: Part 1. Precision of Ventilation.","authors":"Johannes Spaeth, Malte Trost, Bernd Flamm, Christin Wenzel, Stefan Schumann","doi":"10.1097/ALN.0000000000006149","DOIUrl":"10.1097/ALN.0000000000006149","url":null,"abstract":"<p><strong>Background: </strong>Mechanical ventilation of children sets the highest demands on the performance of anesthesia workstations. Different ventilator technologies are available, each representing unique pneumatic characteristics. The hypothesis of this study was that precision of delivered ventilation parameters depends on the ventilator type.</p><p><strong>Methods: </strong>Six modern anesthesia workstations (GE HealthCare Carestation 650; Mindray Bio-Medical Electronics Co. Ltd. Wato EX-65 Pro and A9; Dräger Medical Atlan A350 and Perseus A500; and Getinge Flow-c) were tested in physical models simulating the respiratory systems of a preterm baby, a neonate, an infant, and a toddler. Volume-controlled and pressure-controlled ventilation were investigated with and without airway leakage. Delivered tidal volume, peak inspiratory pressure, positive end-expiratory pressure, and inspiratory to expiratory ratio were compared to the set values. The data are presented descriptively; a difference greater than or equal to 10% between the delivered and set values was considered clinically relevant.</p><p><strong>Results: </strong>Deviations of the delivered volume from the set tidal volume during volume-controlled ventilation ranged between -19.5 ± 0.6% and +35.1 ± 3.0% in the preterm baby model but decreased with increasing tidal volume. Positive end-expiratory pressure and peak inspiratory pressure during pressure-controlled ventilation did not differ relevantly from the set values in any device or lung model. Expiratory ratios varied widely in most devices, leading to relevant differences in tidal volume during pressure-controlled ventilation. With leakage, tidal volume was, on average, 7% lower during volume-controlled ventilation but 2% lower during pressure-controlled ventilation.</p><p><strong>Conclusions: </strong>Precision of ventilation with modern anesthesia workstations varies depending on the ventilator type, ventilation mode, and set parameters. Pressure-controlled ventilation is advantageous in the six workstations tested considering the good agreement between the applied and the set parameters and leakage compensation. The results imply precision superiority of pressure-controlled ventilation over volume-controlled ventilation in preterm babies and neonates, independent from the ventilator technology in use.</p>","PeriodicalId":7970,"journal":{"name":"Anesthesiology","volume":" ","pages":"942-953"},"PeriodicalIF":9.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147925688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
AnesthesiologyPub Date : 2026-10-01Epub Date: 2026-07-29DOI: 10.1097/ALN.0000000000006206
Xiangyi Kong, Yan Zhang, Longfei Wang, Penghui Wei
{"title":"Unexpected Failure of Bronchial Blocker Placement Due to an Undiagnosed Tracheal Bronchus.","authors":"Xiangyi Kong, Yan Zhang, Longfei Wang, Penghui Wei","doi":"10.1097/ALN.0000000000006206","DOIUrl":"10.1097/ALN.0000000000006206","url":null,"abstract":"","PeriodicalId":7970,"journal":{"name":"Anesthesiology","volume":" ","pages":"1006-1007"},"PeriodicalIF":9.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148597997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
AnesthesiologyPub Date : 2026-10-01Epub Date: 2026-08-18DOI: 10.1097/ALN.0000000000006228
Nikolay O Kamenshchikov, Mark A Tyo, Igor V Kravchenko, Elena A Churilina, Maxim S Kozulin, Yuri K Podoksenov, Chong Lei
{"title":"Nitric Oxide and Kidney Injury after Heart Surgery: Comment.","authors":"Nikolay O Kamenshchikov, Mark A Tyo, Igor V Kravchenko, Elena A Churilina, Maxim S Kozulin, Yuri K Podoksenov, Chong Lei","doi":"10.1097/ALN.0000000000006228","DOIUrl":"10.1097/ALN.0000000000006228","url":null,"abstract":"","PeriodicalId":7970,"journal":{"name":"Anesthesiology","volume":" ","pages":"1064-1065"},"PeriodicalIF":9.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}