Anesthesiology
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Geographic Disparities in Opioid Prescribing Patterns for Toothache Pain in the United States
A national study reveals significant state-level and urban-rural variations in opioid prescribing following toothache diagnoses, with 15 states exceeding the national average and rural areas showing slightly lower prescription rates.
RAI Outperforms mFI-5 in Predicting Post-UPPP Complications: A Frailty Stratification Breakthrough
The Risk Analysis Index (RAI) significantly outperforms the modified frailty index-5 (mFI-5) in predicting mortality and major complications after uvulopalatopharyngoplasty, supporting its adoption for preoperative risk assessment in sleep
Remimazolam Besylate Matches Propofol for Short-Term ICU Sedation: The SHOSREB Trial
The SHOSREB trial demonstrates that remimazolam besylate is non-inferior to propofol for short-term light sedation in mechanically ventilated ICU patients, with both agents achieving 97.5% successful sedation rates and comparable time withi
The Hidden Driver of Chronic Pain: How Macrophages Fuel Neuropathic Symptoms
Researchers using human stem cell models have discovered that macrophages actively amplify the electrical signals of damaged nerves, driving the spontaneous pain characteristic of neuropathy, offering a new target for non-opioid pain relief
Wearable TEAS Outperforms Metoclopramide in Managing Moderate to Severe Postoperative Nausea and Vomiting
A randomized clinical trial demonstrates that wearable Transcutaneous Electrical Acupoint Stimulation (TEAS) provides superior 2-hour remission and significantly lower 24-hour relapse rates compared to intravenous metoclopramide for moderat
Neuro-Immune Crosstalk: Macrophages Directly Amplify Spontaneous Activity in Damaged Human Sensory Neurons
A groundbreaking human iPSC-derived co-culture study reveals that macrophages respond to neuronal injury by adopting a pro-algesic state, directly intensifying spontaneous neuronal firing—a key driver of chronic neuropathic pain and a novel
Epidural Anesthesia Outperforms IV Remifentanil in External Cephalic Version: Results from a Large-Scale Cohort Study
A large prospective cohort study reveals that epidural anesthesia significantly increases the success rate of external cephalic version (70.0%) and subsequent vaginal delivery (72.2%) compared to intravenous remifentanil, despite a higher i
Precision Medicine Fails to Improve Postoperative Pain: Insights from the CYP2D6-Guided Opioid Trial
A randomized clinical trial demonstrates that while CYP2D6 genotyping significantly shifts opioid prescribing patterns for poor and intermediate metabolizers, it does not improve pain control or reduce opioid consumption within the context
High-Risk Surgery Significantly Impairs Restorative Sleep: A Wearable Technology Analysis
This cohort study demonstrates that postoperative sleep architecture is differentially disrupted based on surgical risk. High-risk procedures cause prolonged deficits in REM and deep sleep, which are associated with increased complications,
Wearable TEAS Device Outperforms Metoclopramide for Moderate to Severe Postoperative Nausea and Vomiting
A randomized clinical trial demonstrates that wearable transcutaneous electrical acupoint stimulation (TEAS) provides superior symptom relief and significantly lower relapse rates compared to intravenous metoclopramide in managing moderate
Optimizing the Surgical Field: Diltiazem and Esmolol Excel in Controlled Hypotension for Endoscopic Sinus Surgery
This systematic review and network meta-analysis of 52 randomized trials evaluates pharmacological agents for controlled hypotension in ESS, identifying diltiazem, esmolol, and dexmedetomidine as the most effective for reducing intraoperati
Preemptive Magnesium Sulfate Infusion Significantly Stabilizes Hemodynamics During Pheochromocytoma Resection
A randomized, double-blind trial confirms that preemptive magnesium sulfate reduces intraoperative hemodynamic instability by nearly 50% in patients undergoing pheochromocytoma and paraganglioma resection, providing a safe and effective adj
Combined Fascial Plane Blocks Fail to Superiorize Paravertebral Block in Mastectomy: Results from a 1,507-Patient Cluster-Randomized Trial
A large-scale cluster-randomized trial involving 1,507 patients demonstrated that adding PECS I blocks to paravertebral or serratus anterior plane blocks does not reduce postoperative opioid use or improve recovery compared to paravertebral
Risk-Stratified Proactive Blood Pressure Management Fails to Improve Long-Term Functional Recovery After Noncardiac Surgery: Insights from the PRETREAT Trial
The PRETREAT randomized clinical trial demonstrates that proactive, risk-stratified intraoperative blood pressure targets do not reduce six-month functional disability compared to standard care in noncardiac surgery patients, suggesting tha
40-Hz Light Stimulation Significantly Reduces Emergence Delirium in Children Following Sevoflurane Anesthesia
A randomized clinical trial published in JAMA Pediatrics demonstrates that 40-Hz light stimulation via VR glasses significantly lowers the incidence of emergence delirium in pediatric patients, providing a novel, nonpharmacologic approach t
High PEEP and Recruitment Manoeuvres Fail to Reduce Pulmonary Complications in One-Lung Ventilation: Insights from the PROTHOR Trial
The international PROTHOR trial reveals that using higher PEEP and recruitment manoeuvres during one-lung ventilation does not decrease postoperative pulmonary complications compared to a lower PEEP strategy, while notably increasing intrao
Perioperative Dexmedetomidine Fails to Reduce Major Complications After Cardiac Surgery: Results from the DOCS Trial
The DOCS trial, a multi-center randomized controlled study, found that perioperative dexmedetomidine infusion did not significantly reduce in-hospital mortality or major complications in adults undergoing cardiac surgery with cardiopulmonar
Norepinephrine at Extubation: Challenging the Hemodynamic Safety Paradigm in Critically Ill Patients with Obesity
A multicenter validation study confirms that low-dose norepinephrine at the time of extubation does not increase reintubation rates in patients with obesity, offering clinicians greater flexibility in weaning strategies for hemodynamically
Individualized Driving Pressure-Guided PEEP Fails to Reduce Pulmonary Complications in Open Abdominal Surgery: Results from the DESIGNATION Trial
The DESIGNATION trial demonstrates that driving pressure-guided high PEEP with recruitment maneuvers does not reduce postoperative pulmonary complications compared to standard low PEEP in patients undergoing open abdominal surgery, while si
The Paradox of Personalized PEEP: Why Driving Pressure-Guided Ventilation Failed to Improve Outcomes in Emergency Surgery
This article evaluates the IMPROVE-2 trial and a recent meta-analysis on driving pressure-guided PEEP. Despite physiological improvements in lung compliance, individualized PEEP failed to reduce postoperative respiratory failure in emergenc
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