A Springer Nature partner journal.
Joined June 2022
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🚨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
👉link.springer.com/article/10…
#SepticShock
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💥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.
🔗link.springer.com/article/10…
#Anesthesia #VATS
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💉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.
link.springer.com/article/10…
#Anesthesia #Pain
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🧠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 👀
🔗link.springer.com/article/10…
#EEG #POD
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Anesthesiology and Perioperative Science retweeted
More on perioperative neurocognitive disorders #PNDs, and the possible use of #dexmedetomidine in this #BJA #editorial
bjanaesthesia.org/article/S0…
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🧠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
link.springer.com/article/10…
#Anesthesia
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🎯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.
🔗link.springer.com/article/10…
#TSSA
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🚑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
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📡 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.
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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: nejm.org/doi/full/10.1056/NE…
ALT The New England Journal of Medicine Ketamine or Etomidate for Tracheal Intubation of Critically Ill Adults A Research Summary based on Casey JD et al. | 10.1056/NEJMoa2511420 | Published on December 9, 2025 Visual representations of the patients in the trial and the treatments they were assigned. Read the full Research Summary at NEJM.org.
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Anesthesiology and Perioperative Science retweeted
#Sevoflurane reduced internalisation of #GABAAreceptors in this #murinemodel, contributing towards #cognitiveimpairment in aged mice
bjanaesthesia.org/article/S0…
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Anesthesiology and Perioperative Science retweeted
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: bjaopen.org/article/S2772-60…
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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✅
🔗link.springer.com/article/10…
#ERAC
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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
🧐link.springer.com/article/10…
#Anesthesia #AKI #FluidTherapy
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🧠⚡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: link.springer.com/article/10…
#PainResearch #lncRNA
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💡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
link.springer.com/article/10…
#RegionalAnesthesia #TLIP
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✨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
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🦠“Dirty” OR ≠ higher infection risk!
High CFU ≠ Staphylococcus aureus transmission ❗
👉Contamination ≠ transmission ≠ infection
👉Quantity ≠ risk
📊CFU = cleanliness score, not an alarm
💡 link.springer.com/article/10…
#PatientSafety #InfectionControl
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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! 🔬
🧐link.springer.com/article/10…
#Anesthesia #Delirium #Ketamine #EBM
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🧠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?
link.springer.com/article/10…
#POCD #Delirium
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