Pub Date : 2025-12-11DOI: 10.1213/ane.0000000000007886
Hanna Kempe,Matthias Kreuzer,Gerhard Schneider,Pedro Gambús,Sérgio Vide
BACKGROUNDAdequate analgesia during general anesthesia is fundamental to minimize stress responses and optimize perioperative outcomes. Traditional monitoring based on nonspecific autonomic responses may be confounded by nonnociceptive factors. Newer nociception monitors, including the Analgesia Nociception Index (ANI) and the Nociception Level Index (NOL), offer alternative approaches, yet direct comparisons in the same patient population remain limited.METHODSIn this prospective study, 30 adult patients undergoing general anesthesia with propofol and remifentanil target-controlled infusion were monitored concurrently with ANI and NOL. Recorded values were categorized into insufficient, adequate, or excessive analgesia according to manufacturer thresholds. Agreement between monitors was evaluated. A 1-category disagreement was where monitors disagreed by one level (eg, insufficient vs adequate or adequate versus excessive). A 2-category disagreement was where they disagreed by 2 levels (eg, insufficient versus excessive).RESULTSAcross more than 38 hours of time-matched recordings, the monitors agreed in 43.7% of the monitoring time. One-category and 2-category disagreements were observed in 37.1% and 8.7% of recordings, respectively. Excessive analgesia was noted in 37.6% (ANI) and 38.1% (NOL) of surgical time. Each monitor reported "optimal analgesia" on around 31% of the time and insufficient analgesia 25% of the time.CONCLUSIONSThe modest agreement between ANI and NOL underscores discrepancies likely stemming from their different methodological approaches. These findings suggest that a multimodal strategy integrating various monitoring modalities may enhance intraoperative analgesic management.
{"title":"A Comparison of the Analgesia Nociception Index and Nociception Level Index Under General Anesthesia With Propofol and Remifentanil.","authors":"Hanna Kempe,Matthias Kreuzer,Gerhard Schneider,Pedro Gambús,Sérgio Vide","doi":"10.1213/ane.0000000000007886","DOIUrl":"https://doi.org/10.1213/ane.0000000000007886","url":null,"abstract":"BACKGROUNDAdequate analgesia during general anesthesia is fundamental to minimize stress responses and optimize perioperative outcomes. Traditional monitoring based on nonspecific autonomic responses may be confounded by nonnociceptive factors. Newer nociception monitors, including the Analgesia Nociception Index (ANI) and the Nociception Level Index (NOL), offer alternative approaches, yet direct comparisons in the same patient population remain limited.METHODSIn this prospective study, 30 adult patients undergoing general anesthesia with propofol and remifentanil target-controlled infusion were monitored concurrently with ANI and NOL. Recorded values were categorized into insufficient, adequate, or excessive analgesia according to manufacturer thresholds. Agreement between monitors was evaluated. A 1-category disagreement was where monitors disagreed by one level (eg, insufficient vs adequate or adequate versus excessive). A 2-category disagreement was where they disagreed by 2 levels (eg, insufficient versus excessive).RESULTSAcross more than 38 hours of time-matched recordings, the monitors agreed in 43.7% of the monitoring time. One-category and 2-category disagreements were observed in 37.1% and 8.7% of recordings, respectively. Excessive analgesia was noted in 37.6% (ANI) and 38.1% (NOL) of surgical time. Each monitor reported \"optimal analgesia\" on around 31% of the time and insufficient analgesia 25% of the time.CONCLUSIONSThe modest agreement between ANI and NOL underscores discrepancies likely stemming from their different methodological approaches. These findings suggest that a multimodal strategy integrating various monitoring modalities may enhance intraoperative analgesic management.","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145728514","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}
Pub Date : 2025-12-08DOI: 10.1213/ane.0000000000007867
Thomas Cooper,Bob A Rappaport,Beverley A Orser
{"title":"SmartTots and the Power of Scientific Public-Private Partnerships With the US Food and Drug Administration.","authors":"Thomas Cooper,Bob A Rappaport,Beverley A Orser","doi":"10.1213/ane.0000000000007867","DOIUrl":"https://doi.org/10.1213/ane.0000000000007867","url":null,"abstract":"","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"211 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145696692","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}
Pub Date : 2025-12-08DOI: 10.1213/ane.0000000000007843
Odmara L Barreto Chang,Amy B Wise,Anika Sinha,Katherine L Possin,Adam Boxer,Adam M Staffaroni,
{"title":"Remote Cognitive Testing for Detection of Baseline Cognitive Impairment and Prediction of Postoperative Delirium Risk: A Pilot Study.","authors":"Odmara L Barreto Chang,Amy B Wise,Anika Sinha,Katherine L Possin,Adam Boxer,Adam M Staffaroni, ","doi":"10.1213/ane.0000000000007843","DOIUrl":"https://doi.org/10.1213/ane.0000000000007843","url":null,"abstract":"","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145704376","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}
Pub Date : 2025-11-26DOI: 10.1213/ane.0000000000007815
Jetske M Stoop,Jorrit G Verhoeven,Sanne Hoeks,Johannes Jeekel,Markus Klimek
BACKGROUNDMusic intervention is effective in reducing perioperative anxiety, which occurs in a majority of hospitalized surgical patients. A calculated Number Needed to Treat (NNT) provides an intuitive means of conveying the effectiveness of an intervention that can help clinicians decide whether or not to implement said intervention. This study aimed to calculate an NNT to provide extra context to help clinicians consider the implementation of music intervention.METHODSTo calculate the NNT of music intervention for perioperative anxiety, a systematic review and meta-analysis were performed. A comprehensive literature search was conducted in Medline ALL, Embase, Web of Science Core Collection, Cochrane, CINAHL Plus, and PsycINFO from inception until April 14, 2025. Studies describing randomized controlled trials comparing the effect of perioperative music intervention on perioperative anxiety, measured with any validated tool, were included. The revised Cochrane risk-of-bias handbook was used to determine the quality of the included studies. The NNT was calculated with Furukawa's method, converting a calculated Cohen's d to an NNT.RESULTSTwenty papers were included in the review and meta-analysis. All studies used either the Visual Analog Scale for Anxiety or the 6-item State-Trait Anxiety Index. Standardized mean difference of anxiety reduction after music interventions was -0.72 (95% confidence interval [CI], -0.92 to -0.53), which equals a moderate-to-large effect size. The NNT for perioperative music intervention is 4. This indicates that 4 patients need to listen to music perioperatively, to reduce the Visual Analog Scale for Anxiety for 1 patient by 12 mm, or the State-Trait Anxiety Index by 5.7 points.CONCLUSIONSThis meta-analysis shows that a relatively low number of patients need to be treated with music intervention to reduce perioperative anxiety with an effectiveness similar to benzodiazepines.
背景音乐干预对减少围手术期焦虑是有效的，这发生在大多数住院的外科患者中。计算出的治疗所需数量（NNT）提供了一种直观的方法来传达干预措施的有效性，可以帮助临床医生决定是否实施所述干预措施。本研究旨在计算NNT以提供额外的背景，帮助临床医生考虑音乐干预的实施。方法计算音乐干预围手术期焦虑的NNT，进行系统回顾和meta分析。在Medline ALL， Embase, Web of Science Core Collection, Cochrane， CINAHL Plus和PsycINFO中进行了全面的文献检索，从成立到2025年4月14日。研究描述了随机对照试验，比较围手术期音乐干预对围手术期焦虑的影响，用任何有效的工具测量。使用修订后的Cochrane风险偏倚手册来确定纳入研究的质量。用Furukawa的方法计算NNT，将计算出的Cohen's d转换为NNT。结果共纳入文献20篇。所有的研究要么使用焦虑视觉模拟量表，要么使用六项状态-特质焦虑指数。音乐干预后焦虑减少的标准化平均差异为-0.72(95%可信区间[CI]， -0.92至-0.53)，相当于中等到较大的效应量。围手术期音乐干预的NNT为4。这表明4例患者围手术期需要听音乐，使1例患者的焦虑视觉模拟量表降低12 mm，或使状态-特质焦虑指数降低5.7分。结论：该荟萃分析显示，相对较少的患者需要通过音乐干预来减少围手术期焦虑，其效果与苯二氮卓类药物相似。
{"title":"The Number Needed to Treat for Music as a Medicine against Perioperative Anxiety: A Systematic Review and Meta-Analysis.","authors":"Jetske M Stoop,Jorrit G Verhoeven,Sanne Hoeks,Johannes Jeekel,Markus Klimek","doi":"10.1213/ane.0000000000007815","DOIUrl":"https://doi.org/10.1213/ane.0000000000007815","url":null,"abstract":"BACKGROUNDMusic intervention is effective in reducing perioperative anxiety, which occurs in a majority of hospitalized surgical patients. A calculated Number Needed to Treat (NNT) provides an intuitive means of conveying the effectiveness of an intervention that can help clinicians decide whether or not to implement said intervention. This study aimed to calculate an NNT to provide extra context to help clinicians consider the implementation of music intervention.METHODSTo calculate the NNT of music intervention for perioperative anxiety, a systematic review and meta-analysis were performed. A comprehensive literature search was conducted in Medline ALL, Embase, Web of Science Core Collection, Cochrane, CINAHL Plus, and PsycINFO from inception until April 14, 2025. Studies describing randomized controlled trials comparing the effect of perioperative music intervention on perioperative anxiety, measured with any validated tool, were included. The revised Cochrane risk-of-bias handbook was used to determine the quality of the included studies. The NNT was calculated with Furukawa's method, converting a calculated Cohen's d to an NNT.RESULTSTwenty papers were included in the review and meta-analysis. All studies used either the Visual Analog Scale for Anxiety or the 6-item State-Trait Anxiety Index. Standardized mean difference of anxiety reduction after music interventions was -0.72 (95% confidence interval [CI], -0.92 to -0.53), which equals a moderate-to-large effect size. The NNT for perioperative music intervention is 4. This indicates that 4 patients need to listen to music perioperatively, to reduce the Visual Analog Scale for Anxiety for 1 patient by 12 mm, or the State-Trait Anxiety Index by 5.7 points.CONCLUSIONSThis meta-analysis shows that a relatively low number of patients need to be treated with music intervention to reduce perioperative anxiety with an effectiveness similar to benzodiazepines.","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145599703","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}
Pub Date : 2025-11-25DOI: 10.1213/ane.0000000000007854
Jennifer A Byrne
{"title":"The Problem of Wrongly Identified and Nonverifiable Nucleotide Sequences and Cell Lines in Research Papers, or How to Study Things That May Not Exist.","authors":"Jennifer A Byrne","doi":"10.1213/ane.0000000000007854","DOIUrl":"https://doi.org/10.1213/ane.0000000000007854","url":null,"abstract":"","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145599706","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}
Pub Date : 2025-11-25DOI: 10.1213/ane.0000000000007860
Faye M Evans,Kiana Winslow,J Bradley Cousins,Yuanting Zha,Jenny Hoang,V Mark Gacii,Balavenkat Subramanian,M Dylan Bould
BACKGROUNDFor nearly 30 years, the World Federation of Societies of Anaesthesiologists (WFSA) has supported fellowship programs to develop subspecialty anesthesia leaders from low- and middle-income countries (LMICs). To date, no formal program evaluation has assessed the educational effectiveness, accountability, or impact of such interventions. This study is part of a mixed-methods evaluation and aimed to survey graduates from all WFSA-supported fellowship programs about program processes and consequences.METHODSThis survey is the second phase of an exploratory sequential mixed-methods study. All graduates from WFSA-supported fellowships from 1996 to 2024 were eligible for inclusion. Survey content was informed by Guskey's 5-level evaluation framework for evaluating training programs and findings from a prior qualitative phase. The instrument was pretested and piloted with anesthesiologists not eligible for inclusion and distributed electronically in English, Spanish, and French.RESULTSWe received 264 responses from 388 surveys distributed (response rate of 68.0%). Most respondents completed their fellowship in the past 10 years; fewer graduates were reported between 2020 and 2022 due to the coronavirus disease 2019 (COVID-19) pandemic. Over 90% of respondents reported consistent access to clinical learning, teaching, and mentorship, peer support, and financial support during their fellowships. Fewer than 5% expressed a lack of confidence in their ability to deliver subspecialty care upon returning home. However, nearly 25% reported being unable to provide clinical care to the same standard as during their fellowship, and almost one-third reported insufficient access to essential equipment required for their subspecialty practice.CONCLUSIONSWFSA-supported fellowship programs were viewed favorably by graduates across all 5 levels of Guskey's framework. The most frequently cited challenge was the transfer of skills and knowledge to home institutions, often due to contextual disparities between well-resourced training centers and under-resourced home environments. These barriers were most pronounced among fellows returning to the most resource-constrained settings. Addressing these barriers-particularly for fellows from the most under-resourced settings should be a priority for further program investment. Despite these limitations, most participants reported contributing to improved clinical service delivery-often beyond their individual practice-supporting the program's goal of developing subspeciality leadership in anesthesiology.
{"title":"Survey of World Federation of Societies of Anaesthesiologists Fellowship Graduates: Applying a Theory-Driven Framework to Assess Training Outcomes.","authors":"Faye M Evans,Kiana Winslow,J Bradley Cousins,Yuanting Zha,Jenny Hoang,V Mark Gacii,Balavenkat Subramanian,M Dylan Bould","doi":"10.1213/ane.0000000000007860","DOIUrl":"https://doi.org/10.1213/ane.0000000000007860","url":null,"abstract":"BACKGROUNDFor nearly 30 years, the World Federation of Societies of Anaesthesiologists (WFSA) has supported fellowship programs to develop subspecialty anesthesia leaders from low- and middle-income countries (LMICs). To date, no formal program evaluation has assessed the educational effectiveness, accountability, or impact of such interventions. This study is part of a mixed-methods evaluation and aimed to survey graduates from all WFSA-supported fellowship programs about program processes and consequences.METHODSThis survey is the second phase of an exploratory sequential mixed-methods study. All graduates from WFSA-supported fellowships from 1996 to 2024 were eligible for inclusion. Survey content was informed by Guskey's 5-level evaluation framework for evaluating training programs and findings from a prior qualitative phase. The instrument was pretested and piloted with anesthesiologists not eligible for inclusion and distributed electronically in English, Spanish, and French.RESULTSWe received 264 responses from 388 surveys distributed (response rate of 68.0%). Most respondents completed their fellowship in the past 10 years; fewer graduates were reported between 2020 and 2022 due to the coronavirus disease 2019 (COVID-19) pandemic. Over 90% of respondents reported consistent access to clinical learning, teaching, and mentorship, peer support, and financial support during their fellowships. Fewer than 5% expressed a lack of confidence in their ability to deliver subspecialty care upon returning home. However, nearly 25% reported being unable to provide clinical care to the same standard as during their fellowship, and almost one-third reported insufficient access to essential equipment required for their subspecialty practice.CONCLUSIONSWFSA-supported fellowship programs were viewed favorably by graduates across all 5 levels of Guskey's framework. The most frequently cited challenge was the transfer of skills and knowledge to home institutions, often due to contextual disparities between well-resourced training centers and under-resourced home environments. These barriers were most pronounced among fellows returning to the most resource-constrained settings. Addressing these barriers-particularly for fellows from the most under-resourced settings should be a priority for further program investment. Despite these limitations, most participants reported contributing to improved clinical service delivery-often beyond their individual practice-supporting the program's goal of developing subspeciality leadership in anesthesiology.","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"65 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145599954","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":"Executive Summary of the American College of Cardiology/American Heart Association Joint Committee (2024) on Clinical Practice for Cardiac Evaluation and Management of Patients Having Noncardiac Surgeries.","authors":"BobbieJean Sweitzer,Annemarie Thompson,Jeanna Blitz","doi":"10.1213/ane.0000000000007857","DOIUrl":"https://doi.org/10.1213/ane.0000000000007857","url":null,"abstract":"","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"103 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145599705","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：