Pub Date : 2026-04-01Epub Date: 2025-05-30DOI: 10.1213/ANE.0000000000007546
James S Huntley
{"title":"Walking a Few Steps Alongside.","authors":"James S Huntley","doi":"10.1213/ANE.0000000000007546","DOIUrl":"10.1213/ANE.0000000000007546","url":null,"abstract":"","PeriodicalId":7784,"journal":{"name":"Anesthesia and analgesia","volume":" ","pages":"828"},"PeriodicalIF":3.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-04-01Epub Date: 2025-12-30DOI: 10.1213/ANE.0000000000007920
Niraja Rajan, Girish P Joshi
{"title":"Music for Perioperative Anxiety: A Low-Risk, High-Value Intervention.","authors":"Niraja Rajan, Girish P Joshi","doi":"10.1213/ANE.0000000000007920","DOIUrl":"10.1213/ANE.0000000000007920","url":null,"abstract":"","PeriodicalId":7784,"journal":{"name":"Anesthesia and analgesia","volume":" ","pages":"621-623"},"PeriodicalIF":3.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145861466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-04-01Epub Date: 2025-11-07DOI: 10.1213/ANE.0000000000007780
Annella M Fernandez, Phillip S Adams, Marc A Sherwin, Lauren K Licatino, Elizabeth A Ungerman
{"title":"Season and Depression Scores Among Anesthesiology Residents: A Multicenter, Longitudinal Survey Study.","authors":"Annella M Fernandez, Phillip S Adams, Marc A Sherwin, Lauren K Licatino, Elizabeth A Ungerman","doi":"10.1213/ANE.0000000000007780","DOIUrl":"10.1213/ANE.0000000000007780","url":null,"abstract":"","PeriodicalId":7784,"journal":{"name":"Anesthesia and analgesia","volume":" ","pages":"816-818"},"PeriodicalIF":3.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145457439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-04-01Epub Date: 2025-12-30DOI: 10.1213/ANE.0000000000007921
Girish P Joshi
{"title":"Clarifying the Guidelines and Decoding the Enigma: Strategies for Anesthetic Management of Patients on Glucagon-Like Peptide-1 Receptor Agonists.","authors":"Girish P Joshi","doi":"10.1213/ANE.0000000000007921","DOIUrl":"10.1213/ANE.0000000000007921","url":null,"abstract":"","PeriodicalId":7784,"journal":{"name":"Anesthesia and analgesia","volume":" ","pages":"635-638"},"PeriodicalIF":3.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145861362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-04-01Epub Date: 2025-11-24DOI: 10.1213/ANE.0000000000007806
Britta S von Ungern-Sternberg, Aine Sommerfield
{"title":"Enhancing Anesthesia Research: The Imperative of Consumer Engagement Into Clinical Research.","authors":"Britta S von Ungern-Sternberg, Aine Sommerfield","doi":"10.1213/ANE.0000000000007806","DOIUrl":"10.1213/ANE.0000000000007806","url":null,"abstract":"","PeriodicalId":7784,"journal":{"name":"Anesthesia and analgesia","volume":" ","pages":"685-690"},"PeriodicalIF":3.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145755120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-04-01Epub Date: 2026-02-10DOI: 10.1213/ANE.0000000000007879
Emily Methangkool, Vance G Nielsen
{"title":"DOACs, Andexanet, Pump Clots-Oh My! A Joint Consensus Statement for Safe Management of Patients on DOACs Requiring Cardiac Surgery.","authors":"Emily Methangkool, Vance G Nielsen","doi":"10.1213/ANE.0000000000007879","DOIUrl":"10.1213/ANE.0000000000007879","url":null,"abstract":"","PeriodicalId":7784,"journal":{"name":"Anesthesia and analgesia","volume":" ","pages":"664-667"},"PeriodicalIF":3.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146155917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-04-01Epub Date: 2025-08-29DOI: 10.1213/ANE.0000000000007718
Matthias Lucas, Ralf Stoll, Kai-Uwe Döbel, Achim Spenner, Kevin M Trentino, Kevin Murray, Petra Seeber
<p><strong>Background: </strong>Patients admitted to HELIOS Klinikum in Gotha and Erfurt, Germany, received one of 3 models of care. Nontransfusable patients received transfusion-free blood management, whereas transfusable patients received either patient blood management (PBM) or no PBM. Few studies have compared outcomes in patients undergoing these models of care within 1 hospital network. Our primary aim was to compare adult nontransfusable patients undergoing major surgery to transfusable patients. Our secondary aim was to compare transfusable patients receiving PBM strategies to those receiving no PBM.</p><p><strong>Methods: </strong>A retrospective cohort study of 25,979 major adult noncardiac surgical admissions to 2 German hospitals between 2008 and 2020. We applied propensity score methods to multivariable regression models adjusting for age, sex, admission hemoglobin, comorbidities, surgical procedure group, surgical complexity, and admission year. Outcomes included in-hospital mortality, surgical site complications, renal complications, respiratory complications, acute myocardial infarction (AMI), readmissions within 30 days, length of stay, estimated blood loss, transfusion rate, and transfusion reactions.</p><p><strong>Results: </strong>Patients receiving transfusion-free blood management had lower mortality (odds ratio [OR] 0.33, 95% confidence interval [CI], 0.26-0.42; P < .001), renal complications (OR 0.40, 95% CI, 0.34-0.48; P < .001), respiratory complications (OR 0.43, 95% CI, 0.37-0.49; P < .001), readmissions (OR 0.54, 95% CI, 0.48-0.60; P < .001), and shorter hospital stay (risk ratio [RR] 0.91, 95% CI, 0.90-0.93; P < .001) compared to transfusable patients. There were no AMI complications in the transfusion-free group compared to 0.3% (n = 78) in the transfusable group. Surgical site complications were not significantly different between groups (OR 0.94, 95% CI, 0.86-1.02; P = .140). In our secondary analysis of transfusable patients, PBM was associated with lower mortality (OR 0.79, 95% CI, 0.66-0.95; P = .012), surgical site complications (OR 0.62, 95% CI, 0.57-0.69, P < .001), renal complications (OR 0.76, 95% CI, 0.65-0.88; P < .001), respiratory complications (OR 0.68, 95% CI, 0.60-0.78; P < .001), and shorter hospital stay when compared to no PBM (RR 0.86, 95% CI, 0.85-0.87; P < .001). Hospital readmissions were higher in the PBM group (OR 1.28, 95% CI, 1.18-1.40; P < .001). The proportion of patients receiving a red cell transfusion, units transfused per patient, and estimated blood loss were lower in the PBM group when compared to no PBM. There were no transfusion complications coded in the PBM or no PBM groups.</p><p><strong>Conclusions: </strong>Our primary and secondary analyses demonstrate addressing anemia and minimizing or avoiding transfusion is associated with improved outcomes. The results of the study highlight the important role transfusion-free care and PBM have in improving outcomes for patients under
背景：德国哥达和埃尔福特HELIOS Klinikum医院收治的患者接受三种治疗模式之一。不可输血的患者接受无输血血液管理，而可输血的患者接受患者血液管理（PBM）或不接受PBM。很少有研究比较在同一家医院网络中接受这些护理模式的患者的结果。我们的主要目的是比较接受大手术的成人不可输血患者和可输血患者。我们的次要目的是比较接受PBM策略的输血患者和未接受PBM的输血患者。方法：对2008年至2020年间在德国2家医院接受非心脏手术的25,979名主要成人患者进行回顾性队列研究。我们将倾向评分方法应用于多变量回归模型，调整年龄、性别、入院血红蛋白、合并症、手术组、手术复杂性和入院年份。结果包括住院死亡率、手术部位并发症、肾脏并发症、呼吸系统并发症、急性心肌梗死（AMI）、30天内再入院、住院时间、估计失血量、输血率和输血反应。结果：与可输血患者相比，接受免输血管理的患者死亡率（优势比[OR] 0.33, 95%可信区间[CI]， 0.26-0.42, P < 0.001）、肾脏并发症（优势比[OR] 0.40, 95% CI, 0.34-0.48, P < 0.001）、呼吸系统并发症（优势比[OR] 0.43, 95% CI, 0.37-0.49, P < 0.001）、再入院率（优势比[OR] 0.54, 95% CI, 0.48-0.60, P < 0.001）和住院时间（风险比[RR] 0.91, 95% CI, 0.90-0.93, P < 0.001）较低。无输血组无AMI并发症，可输血组为0.3% （n = 78）。手术部位并发症组间差异无统计学意义（OR 0.94, 95% CI, 0.86-1.02; P = 0.140）。在我们对可输血患者的二次分析中，PBM与较低的死亡率（OR 0.79, 95% CI, 0.66-0.95, P = 0.012）、手术部位并发症（OR 0.62, 95% CI, 0.57-0.69, P < 0.001）、肾脏并发症（OR 0.76, 95% CI, 0.65-0.88, P < 0.001）、呼吸并发症（OR 0.68, 95% CI, 0.60-0.78, P < 0.001）以及与无PBM相比较短的住院时间（RR 0.86, 95% CI, 0.85-0.87, P < 0.001）相关。PBM组再入院率较高（OR 1.28, 95% CI, 1.18-1.40; P < 0.001）。与无PBM组相比，PBM组接受红细胞输血的患者比例、每位患者输血单位数和估计失血量均较低。在PBM组或没有PBM组中没有编码的输血并发症。结论：我们的主要和次要分析表明，解决贫血和尽量减少或避免输血与改善预后相关。研究结果强调了无输血护理和PBM在改善大手术患者预后方面的重要作用。
{"title":"Outcomes of Nontransfusable and Transfusable Patients After Major Noncardiac Surgery: A Retrospective Cohort Study.","authors":"Matthias Lucas, Ralf Stoll, Kai-Uwe Döbel, Achim Spenner, Kevin M Trentino, Kevin Murray, Petra Seeber","doi":"10.1213/ANE.0000000000007718","DOIUrl":"10.1213/ANE.0000000000007718","url":null,"abstract":"<p><strong>Background: </strong>Patients admitted to HELIOS Klinikum in Gotha and Erfurt, Germany, received one of 3 models of care. Nontransfusable patients received transfusion-free blood management, whereas transfusable patients received either patient blood management (PBM) or no PBM. Few studies have compared outcomes in patients undergoing these models of care within 1 hospital network. Our primary aim was to compare adult nontransfusable patients undergoing major surgery to transfusable patients. Our secondary aim was to compare transfusable patients receiving PBM strategies to those receiving no PBM.</p><p><strong>Methods: </strong>A retrospective cohort study of 25,979 major adult noncardiac surgical admissions to 2 German hospitals between 2008 and 2020. We applied propensity score methods to multivariable regression models adjusting for age, sex, admission hemoglobin, comorbidities, surgical procedure group, surgical complexity, and admission year. Outcomes included in-hospital mortality, surgical site complications, renal complications, respiratory complications, acute myocardial infarction (AMI), readmissions within 30 days, length of stay, estimated blood loss, transfusion rate, and transfusion reactions.</p><p><strong>Results: </strong>Patients receiving transfusion-free blood management had lower mortality (odds ratio [OR] 0.33, 95% confidence interval [CI], 0.26-0.42; P < .001), renal complications (OR 0.40, 95% CI, 0.34-0.48; P < .001), respiratory complications (OR 0.43, 95% CI, 0.37-0.49; P < .001), readmissions (OR 0.54, 95% CI, 0.48-0.60; P < .001), and shorter hospital stay (risk ratio [RR] 0.91, 95% CI, 0.90-0.93; P < .001) compared to transfusable patients. There were no AMI complications in the transfusion-free group compared to 0.3% (n = 78) in the transfusable group. Surgical site complications were not significantly different between groups (OR 0.94, 95% CI, 0.86-1.02; P = .140). In our secondary analysis of transfusable patients, PBM was associated with lower mortality (OR 0.79, 95% CI, 0.66-0.95; P = .012), surgical site complications (OR 0.62, 95% CI, 0.57-0.69, P < .001), renal complications (OR 0.76, 95% CI, 0.65-0.88; P < .001), respiratory complications (OR 0.68, 95% CI, 0.60-0.78; P < .001), and shorter hospital stay when compared to no PBM (RR 0.86, 95% CI, 0.85-0.87; P < .001). Hospital readmissions were higher in the PBM group (OR 1.28, 95% CI, 1.18-1.40; P < .001). The proportion of patients receiving a red cell transfusion, units transfused per patient, and estimated blood loss were lower in the PBM group when compared to no PBM. There were no transfusion complications coded in the PBM or no PBM groups.</p><p><strong>Conclusions: </strong>Our primary and secondary analyses demonstrate addressing anemia and minimizing or avoiding transfusion is associated with improved outcomes. The results of the study highlight the important role transfusion-free care and PBM have in improving outcomes for patients under","PeriodicalId":7784,"journal":{"name":"Anesthesia and analgesia","volume":" ","pages":"653-663"},"PeriodicalIF":3.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12959601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-04-01Epub Date: 2026-01-29DOI: 10.1213/ANE.0000000000007868
Ashley N Budd, Miklos D Kertai, Moritz C Wyler von Ballmoos, Jacob Raphael, Kamrouz Ghadimi, Jerrold H Levy, Linda J Shore-Lesserson, Michael A Mazzeffi, Roman M Sniecinski, Kenichi A Tanaka, Daniel Bolliger, Mohamed Abdalla, Kelly G Ural, Patrick A Upchurch, Olga Rozental, Caroline B Hunter, Adam R Seibert, John C Klick, David Carroll, Katie Lobner, Nadia B Hensley
The Society of Cardiovascular Anesthesiologists (SCA) along with the Society of Thoracic Surgeons (STS) sought to improve the care of adult patients undergoing cardiac surgery who are taking direct oral anticoagulants (DOACs), such as factor Xa and direct thrombin inhibitors. To fulfill this, a systematic review of the literature on cessation of DOACs before cardiac surgery, options for monitoring DOACs, the need for bridging, reversal agents, and resuming the medications after surgery was performed. Additionally, an expert consensus around the management of these patients was completed. Summary statements were created using evidence and expert consensus to guide care of patients in each of these domains, with the ultimate goal to enhance patient safety and outcomes.
{"title":"Management of Direct Oral Anticoagulants in Adult Patients Undergoing Cardiac Surgery: A Joint Consensus Statement by the Society of Cardiovascular Anesthesiologists and the Society of Thoracic Surgeons.","authors":"Ashley N Budd, Miklos D Kertai, Moritz C Wyler von Ballmoos, Jacob Raphael, Kamrouz Ghadimi, Jerrold H Levy, Linda J Shore-Lesserson, Michael A Mazzeffi, Roman M Sniecinski, Kenichi A Tanaka, Daniel Bolliger, Mohamed Abdalla, Kelly G Ural, Patrick A Upchurch, Olga Rozental, Caroline B Hunter, Adam R Seibert, John C Klick, David Carroll, Katie Lobner, Nadia B Hensley","doi":"10.1213/ANE.0000000000007868","DOIUrl":"10.1213/ANE.0000000000007868","url":null,"abstract":"<p><p>The Society of Cardiovascular Anesthesiologists (SCA) along with the Society of Thoracic Surgeons (STS) sought to improve the care of adult patients undergoing cardiac surgery who are taking direct oral anticoagulants (DOACs), such as factor Xa and direct thrombin inhibitors. To fulfill this, a systematic review of the literature on cessation of DOACs before cardiac surgery, options for monitoring DOACs, the need for bridging, reversal agents, and resuming the medications after surgery was performed. Additionally, an expert consensus around the management of these patients was completed. Summary statements were created using evidence and expert consensus to guide care of patients in each of these domains, with the ultimate goal to enhance patient safety and outcomes.</p>","PeriodicalId":7784,"journal":{"name":"Anesthesia and analgesia","volume":" ","pages":"668-681"},"PeriodicalIF":3.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146083939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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