Pub Date : 2025-10-24DOI: 10.1213/ane.0000000000007785
Mark Vernon,Benjamin Rapsas,Lisa C Krishnamurthy,Venkatagiri Krishnamurthy,Jennifer Stevens,Anna Woodbury
{"title":"Percutaneous Electrical Nerve Field Stimulation and White Matter Integrity in a Randomized Trial of Veterans With Fibromyalgia.","authors":"Mark Vernon,Benjamin Rapsas,Lisa C Krishnamurthy,Venkatagiri Krishnamurthy,Jennifer Stevens,Anna Woodbury","doi":"10.1213/ane.0000000000007785","DOIUrl":"https://doi.org/10.1213/ane.0000000000007785","url":null,"abstract":"","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"105 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145351643","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 : 2025-10-20DOI: 10.1213/ane.0000000000007796
{"title":"Passing the BASIC Exam: The Influence of Demographics.","authors":"","doi":"10.1213/ane.0000000000007796","DOIUrl":"https://doi.org/10.1213/ane.0000000000007796","url":null,"abstract":"","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"53 1","pages":"987"},"PeriodicalIF":0.0,"publicationDate":"2025-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145331762","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 : 2025-10-20DOI: 10.1213/ane.0000000000007775
Csaba Szabo
{"title":"Exposing the Reproducibility Crisis and Scientific Misconduct: Evolution of Learning From Published Books.","authors":"Csaba Szabo","doi":"10.1213/ane.0000000000007775","DOIUrl":"https://doi.org/10.1213/ane.0000000000007775","url":null,"abstract":"","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"134 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145331761","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 : 2025-10-20DOI: 10.1213/ane.0000000000007748
Chenxuan Zhou,Shiu-Yi Emily Chen
{"title":"The Role of Propofol-Based Total Intravenous Anesthesia and Regional Anesthesia in Cancer Surgery.","authors":"Chenxuan Zhou,Shiu-Yi Emily Chen","doi":"10.1213/ane.0000000000007748","DOIUrl":"https://doi.org/10.1213/ane.0000000000007748","url":null,"abstract":"","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"72 1","pages":"e89-e90"},"PeriodicalIF":0.0,"publicationDate":"2025-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145331763","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 : 2025-10-17DOI: 10.1213/ane.0000000000007781
Silvia De Rosa,Denise Battaglini,Sergio Lassola,Stefano Zago,Fiorenza Ferrari,Stefano Checcacci Carboni,
{"title":"Ambispective Study on the Efficacy of the Spritztube for Airway Management in Elective Surgery.","authors":"Silvia De Rosa,Denise Battaglini,Sergio Lassola,Stefano Zago,Fiorenza Ferrari,Stefano Checcacci Carboni, ","doi":"10.1213/ane.0000000000007781","DOIUrl":"https://doi.org/10.1213/ane.0000000000007781","url":null,"abstract":"","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145311373","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 : 2025-10-17DOI: 10.1213/ane.0000000000007789
Peter Nagele,Mohammad A Helwani,Eslam Samaha,Andreas Koköfer,Frank Brown,Theodore Karrison,Brian F Gage,Jamie C Brown-Shpigel,Daniel S Rubin
{"title":"A Combined Intravenous and Oral Metoprolol Regimen to Reduce Perioperative Myocardial Injury: The ORION Trial.","authors":"Peter Nagele,Mohammad A Helwani,Eslam Samaha,Andreas Koköfer,Frank Brown,Theodore Karrison,Brian F Gage,Jamie C Brown-Shpigel,Daniel S Rubin","doi":"10.1213/ane.0000000000007789","DOIUrl":"https://doi.org/10.1213/ane.0000000000007789","url":null,"abstract":"","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145311372","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}
BACKGROUNDPatients on venoarterial extracorporeal membrane oxygenation (VA-ECMO) are frequently managed with varying degrees of hyperoxia. Existing data suggest that higher levels of Pao2 correlate with worsened outcome in patients receiving ECMO support. We hypothesized that higher levels of Pao2 during VA-ECMO support would correlate with an increased risk of acute brain injury (ABI) in critically ill patients with cardiogenic shock (CS). To test our hypothesis, we performed a retrospective review of patients receiving VA-ECMO for CS at a tertiary medical center.METHODSData from patients who received ECMO support for CS between January 2017 and January 2024 were retrospectively collected from Beijing Anzhen Hospital, Capital Medical University. Patients were categorized into 4 groups based on their Pao2 values after 24 hours of ECMO: normoxia (Pao2 60-149 mm Hg), mild hyperoxia (Pao2 150-199 mm Hg), moderate hyperoxia (Pao2 200-299 mm Hg), and severe hyperoxia (Pao2 ≥300 mm Hg). ABI was categorized as ischemic stroke (IS) + intracranial hemorrhage (ICH), hypoxic-ischemic brain injury (HIBI), and neurological examination abnormalities (NEA). The rate of ABI and in-hospital mortality was evaluated using univariate and multivariable logistic regression analyses.RESULTSAmong 481 CS patients supported by VA-ECMO, 164 (34.1%) experienced ABI, with subtypes including IS + ICH (n = 73, 44.5%), HIBI (n = 25, 5.20%), and NEA (n = 66, 13.7%). The multivariable logistic regression for composite ABI at 4 hours post-ECMO revealed a dose-dependent association with hyperoxia severity: mild (odds ratio [OR], 2.33; 95% confidence interval [CI], 1.10-4.96), moderate (OR, 4.16; 95% CI, 2.16-8.02), and severe hyperoxia (OR, 6.10; 95% CI, 3.33-11.2). This dose-response pattern persisted at 24 hours (mild: OR, 3.44 and 95% CI, 1.88-6.29; moderate: OR, 3.28 and 95% CI, 1.80-5.97; severe: OR, 4.78 and 95% CI, 2.14-11.2). Severe hyperoxia (OR, 2.46; 95% CI, 1.25-4.84) was identified as an independent predictor of in-hospital mortality.CONCLUSIONSHyperoxia (Pao2 ≥150 mm Hg) at both 4 and 24 hours post-ECMO initiation was significantly associated with ABI, while severe hyperoxia (Pao2 ≥300 mm Hg) at 24 hours correlated with in-hospital mortality.
背景：静脉动脉体外膜氧合（VA-ECMO）治疗的患者经常出现不同程度的高氧。现有数据表明，在接受ECMO支持的患者中，较高水平的Pao2与预后恶化相关。我们假设VA-ECMO支持期间较高水平的Pao2与心源性休克（CS）危重患者急性脑损伤（ABI）风险增加相关。为了验证我们的假设，我们对在三级医疗中心接受VA-ECMO治疗CS的患者进行了回顾性研究。方法回顾性收集首都医科大学附属北京安贞医院2017年1月至2024年1月间接受ECMO支持的CS患者资料。根据24小时ECMO后Pao2值将患者分为4组：常氧组（Pao2 60-149 mm Hg）、轻度高氧组（Pao2 150-199 mm Hg）、中度高氧组（Pao2 200-299 mm Hg）、重度高氧组（Pao2≥300 mm Hg）。ABI分为缺血性脑卒中(IS) +颅内出血（ICH）、缺氧缺血性脑损伤（HIBI）和神经系统检查异常（NEA）。采用单变量和多变量logistic回归分析评估ABI率和住院死亡率。结果481例经VA-ECMO支持的CS患者中，有164例（34.1%）发生ABI，其亚型包括IS + ICH （n = 73, 44.5%）、HIBI （n = 25, 5.20%）和NEA （n = 66, 13.7%）。ecmo后4小时复合ABI的多变量logistic回归显示与高氧严重程度存在剂量依赖性关联：轻度（优势比[OR]， 2.33； 95%可信区间[CI]， 1.10-4.96）、中度（优势比[OR]， 4.16; 95% CI, 2.16-8.02）和重度高氧（优势比，6.10;95% CI, 3.33-11.2）。这种剂量-反应模式持续24小时（轻度：OR， 3.44和95% CI， 1.88-6.29；中度：OR， 3.28和95% CI， 1.80-5.97；重度：OR， 4.78和95% CI， 2.14-11.2）。重度高氧（OR, 2.46; 95% CI, 1.25-4.84）被确定为院内死亡率的独立预测因子。结论ecmo启动后4和24小时缺氧（Pao2≥150 mm Hg）与ABI显著相关，24小时重度高氧（Pao2≥300 mm Hg）与院内死亡率相关。
{"title":"Early Exposure to Arterial Hyperoxia During Extracorporeal Membrane Oxygenator Support and Acute Brain Injury and Mortality in Patients With Cardiogenic Shock.","authors":"Yuyao Yang,Liangshan Wang,Chenglong Li,Hong Wang,Xing Hao,Zhongtao Du,Xiaotong Hou","doi":"10.1213/ane.0000000000007782","DOIUrl":"https://doi.org/10.1213/ane.0000000000007782","url":null,"abstract":"BACKGROUNDPatients on venoarterial extracorporeal membrane oxygenation (VA-ECMO) are frequently managed with varying degrees of hyperoxia. Existing data suggest that higher levels of Pao2 correlate with worsened outcome in patients receiving ECMO support. We hypothesized that higher levels of Pao2 during VA-ECMO support would correlate with an increased risk of acute brain injury (ABI) in critically ill patients with cardiogenic shock (CS). To test our hypothesis, we performed a retrospective review of patients receiving VA-ECMO for CS at a tertiary medical center.METHODSData from patients who received ECMO support for CS between January 2017 and January 2024 were retrospectively collected from Beijing Anzhen Hospital, Capital Medical University. Patients were categorized into 4 groups based on their Pao2 values after 24 hours of ECMO: normoxia (Pao2 60-149 mm Hg), mild hyperoxia (Pao2 150-199 mm Hg), moderate hyperoxia (Pao2 200-299 mm Hg), and severe hyperoxia (Pao2 ≥300 mm Hg). ABI was categorized as ischemic stroke (IS) + intracranial hemorrhage (ICH), hypoxic-ischemic brain injury (HIBI), and neurological examination abnormalities (NEA). The rate of ABI and in-hospital mortality was evaluated using univariate and multivariable logistic regression analyses.RESULTSAmong 481 CS patients supported by VA-ECMO, 164 (34.1%) experienced ABI, with subtypes including IS + ICH (n = 73, 44.5%), HIBI (n = 25, 5.20%), and NEA (n = 66, 13.7%). The multivariable logistic regression for composite ABI at 4 hours post-ECMO revealed a dose-dependent association with hyperoxia severity: mild (odds ratio [OR], 2.33; 95% confidence interval [CI], 1.10-4.96), moderate (OR, 4.16; 95% CI, 2.16-8.02), and severe hyperoxia (OR, 6.10; 95% CI, 3.33-11.2). This dose-response pattern persisted at 24 hours (mild: OR, 3.44 and 95% CI, 1.88-6.29; moderate: OR, 3.28 and 95% CI, 1.80-5.97; severe: OR, 4.78 and 95% CI, 2.14-11.2). Severe hyperoxia (OR, 2.46; 95% CI, 1.25-4.84) was identified as an independent predictor of in-hospital mortality.CONCLUSIONSHyperoxia (Pao2 ≥150 mm Hg) at both 4 and 24 hours post-ECMO initiation was significantly associated with ABI, while severe hyperoxia (Pao2 ≥300 mm Hg) at 24 hours correlated with in-hospital mortality.","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"69 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145305707","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 : 2025-10-07DOI: 10.1213/ane.0000000000007679
Tina Ramishvili,Karuna Wongtangman,Michael E Kiyatkin,Felix Borngaesser,Annika Bald,Ling Zhang,Maira I Rudolph,Stephen J Lorenzen,Ibraheem M Karaye,Olubukola O Nafiu,Matthias Eikermann,Jonathan D Leff
BACKGROUNDDexmedetomidine is commonly used for sedation after cardiac surgery, but its role in facilitating weaning from mechanical ventilation remains unclear, with the existing evidence yielding inconsistent findings. In this study, we hypothesized that dexmedetomidine administration is associated with a prolonged duration of mechanical ventilation after cardiac surgery.METHODSWe conducted a retrospective cohort study of adult patients who underwent nonemergent cardiac surgery under cardiopulmonary bypass at Montefiore Medical Center, Bronx, New York, between May 2016 and June 2021. The primary exposure was the use of dexmedetomidine infusion compared to no dexmedetomidine infusion. The secondary exposure was the average, total sedative dose patients received during mechanical ventilation. The sedative dose was categorized into low and high exposure groups for analysis. Adjusted differences between groups were calculated using geometric means to enhance the interpretability of the findings.RESULTSData from 2191 cases were analyzed, including 1455 (66.4%) patients who underwent coronary artery bypass graft surgeries (CABG), 521 (23.8%) valve surgeries, and 215 (9.8%) combined CABG and valve surgeries. The median (interquartile range) duration of mechanical ventilation was 406 (297-837) minutes. Dexmedetomidine infusion was associated with a longer duration of mechanical ventilation (adjusted absolute difference [ADadj] 42 minutes; 95% confidence interval [CI], 11-75; adjusted model estimates [MEadj] 1.1; 95% CI, 1.0-1.2; P = .007) compared with no dexmedetomidine administration. High sedative dose, compared to low sedative dose, was independently associated with prolonged mechanical ventilation (ADadj 71 minutes; 95% CI, 42-101; MEadj 1.2; 95% CI, 1.1-1.2; P < .001). Furthermore, the sedative dose significantly modified the association between dexmedetomidine use and ventilation duration (P for interaction <.001). Among patients with a high sedative dose, dexmedetomidine was associated with shorter mechanical ventilation (ADadj -233 minutes; 95% CI, -324 to -125; MEadj 0.7; 95% CI, 0.6-0.8; P < .001).CONCLUSIONSDexmedetomidine use, and a high sedative dose during mechanical ventilation were independently associated with prolonged mechanical ventilation after cardiac surgery. Among patients with a high sedative dose, dexmedetomidine was associated with shorter mechanical ventilation duration.
{"title":"Association Between Dexmedetomidine Use and Duration of Invasive Mechanical Ventilation After Cardiac Surgery: A Hospital Registry Study.","authors":"Tina Ramishvili,Karuna Wongtangman,Michael E Kiyatkin,Felix Borngaesser,Annika Bald,Ling Zhang,Maira I Rudolph,Stephen J Lorenzen,Ibraheem M Karaye,Olubukola O Nafiu,Matthias Eikermann,Jonathan D Leff","doi":"10.1213/ane.0000000000007679","DOIUrl":"https://doi.org/10.1213/ane.0000000000007679","url":null,"abstract":"BACKGROUNDDexmedetomidine is commonly used for sedation after cardiac surgery, but its role in facilitating weaning from mechanical ventilation remains unclear, with the existing evidence yielding inconsistent findings. In this study, we hypothesized that dexmedetomidine administration is associated with a prolonged duration of mechanical ventilation after cardiac surgery.METHODSWe conducted a retrospective cohort study of adult patients who underwent nonemergent cardiac surgery under cardiopulmonary bypass at Montefiore Medical Center, Bronx, New York, between May 2016 and June 2021. The primary exposure was the use of dexmedetomidine infusion compared to no dexmedetomidine infusion. The secondary exposure was the average, total sedative dose patients received during mechanical ventilation. The sedative dose was categorized into low and high exposure groups for analysis. Adjusted differences between groups were calculated using geometric means to enhance the interpretability of the findings.RESULTSData from 2191 cases were analyzed, including 1455 (66.4%) patients who underwent coronary artery bypass graft surgeries (CABG), 521 (23.8%) valve surgeries, and 215 (9.8%) combined CABG and valve surgeries. The median (interquartile range) duration of mechanical ventilation was 406 (297-837) minutes. Dexmedetomidine infusion was associated with a longer duration of mechanical ventilation (adjusted absolute difference [ADadj] 42 minutes; 95% confidence interval [CI], 11-75; adjusted model estimates [MEadj] 1.1; 95% CI, 1.0-1.2; P = .007) compared with no dexmedetomidine administration. High sedative dose, compared to low sedative dose, was independently associated with prolonged mechanical ventilation (ADadj 71 minutes; 95% CI, 42-101; MEadj 1.2; 95% CI, 1.1-1.2; P < .001). Furthermore, the sedative dose significantly modified the association between dexmedetomidine use and ventilation duration (P for interaction <.001). Among patients with a high sedative dose, dexmedetomidine was associated with shorter mechanical ventilation (ADadj -233 minutes; 95% CI, -324 to -125; MEadj 0.7; 95% CI, 0.6-0.8; P < .001).CONCLUSIONSDexmedetomidine use, and a high sedative dose during mechanical ventilation were independently associated with prolonged mechanical ventilation after cardiac surgery. Among patients with a high sedative dose, dexmedetomidine was associated with shorter mechanical ventilation duration.","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"348 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240971","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}
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