Anesthesiology and Perioperative Science

A Springer Nature partner journal.

[Anesthesiology and Perioperative Science @journal_aps]

🚨Is ScvO₂ fooling us in septic shock?

A “normal” or high ScvO₂👀doesn’t always mean tissues are getting enough oxygen.

🔍O₂ER may reveal what ScvO₂ misses:
⬆️Earlier detection of oxygen debt
⬆️Better insight into DO₂–VO₂ balance

👉https://t.co/V3muYecDPE
#SepticShock

[Anesthesiology and Perioperative Science @journal_aps]

💥Thoracic analgesia showdown!

A new RCT shows #IIMOB beats #TPVB after #VATS:🔽pain,🔽opioids,🔽hypotension, and🔽block failure.

🧪Longer local anesthetic retention may explain its superior analgesia.

🔗https://t.co/n0zYA3IzU9
#Anesthesia #VATS

[Anesthesiology and Perioperative Science @journal_aps]

💉TAP block: abdominal wall pain only.
🔥Intrathecal hydromorphone: somatic + visceral analgesia.
📊In gastrectomy, 150 μg intrathecal hydromorphone outperformed TAP block with lower pain scores/opioid use — no respiratory depression.

https://t.co/Vgp3ytveNt
#Anesthesia #Pain

[Anesthesiology and Perioperative Science @journal_aps]

🧠EEG alpha may reveal a “vulnerable brain.”
📉Low intra-op alpha = higher POD risk.
⚡Some patients even show HIGH pre-op alpha… then collapse under surgical stress.

Dynamic alpha changes may predict delirium better than static values 👀

🔗https://t.co/8dltKiiZbY
#EEG #POD

[British Journal of Anaesthesia @BJAJournals]

More on perioperative neurocognitive disorders #PNDs, and the possible use of #dexmedetomidine in this #BJA #editorial

https://t.co/HC1vj4PJ61

[Anesthesiology and Perioperative Science @journal_aps]

🧠Anesthesia shapes immunity.

💉Volatile agents + opioids may suppress NK/T-cell function.
🛡️Propofol + regional anesthesia may better preserve anti-tumor immunity.
🎯Future anesthesia = immune-friendly anesthesia.

#Anesthesia #Immunology

https://t.co/sv1hWLKofu
#Anesthesia

[Anesthesiology and Perioperative Science @journal_aps]

🎯TSSA = precision spinal anesthesia.
💉Low-dose block. Stable hemodynamics. Faster recovery.
⚠️But excessive cephalad spread can cause High/Total Spinal → apnea & cardiovascular collapse.

📌Dose + baricity + positioning = everything.

🔗https://t.co/sdUNH5q92C
#TSSA

[Anesthesiology and Perioperative Science @journal_aps]

🚑Intubation isn't just “putting in a tube” — it's airway protection + life support

📈Pre-oxygenate. Visualize the cords. Confirm with ETCO₂.
⏱️One procedure. Seconds matter
💡From OR to ICU, mastering the airway saves lives every day.

#Intubation #AirwayManagement

[Anesthesiology and Perioperative Science @journal_aps]

📡 Submental sagittal POCUS offers a bedside “window” to the airway.
🔍 It visualizes tongue, floor-of-mouth muscles, and the hyoid, while quantifying HMD/HMDR 📏.
💡 It shifts difficult airway assessment from subjective judgment to objective metrics for earlier risk detection.

[NEJM @NEJM]

In the RSI trial involving critically ill patients undergoing intubation in EDs or ICUs, the use of ketamine for the induction of anesthesia did not lead to significantly lower in-hospital mortality than etomidate. Full trial results and Research Summary: https://t.co/KjMmYm2WSD

[British Journal of Anaesthesia @BJAJournals]

#Sevoflurane reduced internalisation of #GABAAreceptors in this #murinemodel, contributing towards #cognitiveimpairment in aged mice

https://t.co/f06F4FhN4z

[British Journal of Anaesthesia @BJAJournals]

Can we predict severe postdischarge #pain after ambulatory #gynaecological surgery?

This new #BJAOpen article identified younger age, pre-op pain, preop #opioid use, and high pain expectancy as key predictors.

Read full article here: https://t.co/0WVwn24qRD

[Anesthesiology and Perioperative Science @journal_aps]

ERAC works… but not everywhere🤔

📊Most guidelines=high-resource bias
🌍Real world=diverse+constrained
⚠️Copy-paste protocols→fail

Even PROMs ask: “What is recovery?”—but miss culture 🧠

Time to shift:
➡️ Contextualization✅

🔗https://t.co/IkLyTj5H51
#ERAC

[Anesthesiology and Perioperative Science @journal_aps]

Chloride = dose matters 🎯
U-shaped AKI risk 📉 (~118 mEq/L sweet spot)
🧠 Two-Hit:
Healthy kidneys 💪 vs eGFR <60 🚨

⚠️ “Silent toxicity”: normal Cl⁻ ≠ safe
👉 Precision fluids > one-size-fits-all

🧐https://t.co/R6vjjMkNw0
#Anesthesia #AKI #FluidTherapy

[Anesthesiology and Perioperative Science @journal_aps]

🧠⚡Neuropathic pain = network disorder

🎛️lncRNAs = master switches
Control neurons, glia & inflammation → pain + mood
💊🧬RNA therapies rising
(ASO/RNAi/CRISPR)

Barrier? Translation 🚧 + BBB
🔥Precision analgesia ahead

Read: https://t.co/r7eJca5A5F
#PainResearch #lncRNA

[Anesthesiology and Perioperative Science @journal_aps]

💡China expert consensus on TLIP block—10 key takeaways
📡Ultrasound-guided , anatomy-driven, 💉volume-dependent
⚠️Safer dosing , smarter approaches, broader indications

🚀From spine surgery to pain care—analgesia upgraded
https://t.co/BwfQI82uIa
#RegionalAnesthesia #TLIP

[Anesthesiology and Perioperative Science @journal_aps]

✨Modified lateral intermuscular TLIP block is here!

👉Needle direction inside → outside
🎯Target between longissimus & iliocostalis fascia!
👀Clearer sonoanatomy
⏱️faster performance
📈higher success rate
⚠️Also reduces risk of neuraxial spread

#RegionalAnesthesia

[Anesthesiology and Perioperative Science @journal_aps]

🦠“Dirty” OR ≠ higher infection risk!
High CFU ≠ Staphylococcus aureus transmission ❗
👉Contamination ≠ transmission ≠ infection
👉Quantity ≠ risk

📊CFU = cleanliness score, not an alarm
💡 https://t.co/uPXGxUfoqO
#PatientSafety #InfectionControl

[Anesthesiology and Perioperative Science @journal_aps]

Ketamine ❌ POD? Not so fast…🤔

📊 One huge study may skew results
💉 “Ketamine” ≠ same exposure
⏱️ Early ≠ late delirium
⚠️ Small bias may flip outcomes
👉 Evidence still shaky—need better RCTs! 🔬

🧐https://t.co/ONPb0PML0V
#Anesthesia #Delirium #Ketamine #EBM

[Anesthesiology and Perioperative Science @journal_aps]

🧠Can RIC really protect the brain? New meta-analysis just dropped!

📊15 RCTs, ~3000 patients:
❌No reduction in POD
❌No reduction in POCD
⚠️Slight improvement in global cognition (MMSE/MoCA ↑)

🤔 Neuroprotection ≠ clinical benefit?

https://t.co/fRk6xtvX4R
#POCD #Delirium