Combined Fascial Plane Blocks Fail to Superiorize Paravertebral Block in Mastectomy: Results from a 1,507-Patient Cluster-Randomized Trial
Posted inAnesthesiology news Plastic Surgery

Combined Fascial Plane Blocks Fail to Superiorize Paravertebral Block in Mastectomy: Results from a 1,507-Patient Cluster-Randomized Trial

A large-scale cluster-randomized trial involving 1,507 patients demonstrated that adding PECS I blocks to paravertebral or serratus anterior plane blocks does not reduce postoperative opioid use or improve recovery compared to paravertebral block alone in mastectomy with reconstruction.
Risk-Stratified Proactive Blood Pressure Management Fails to Improve Long-Term Functional Recovery After Noncardiac Surgery: Insights from the PRETREAT Trial
Posted inAnesthesiology General Surgery news

Risk-Stratified Proactive Blood Pressure Management Fails to Improve Long-Term Functional Recovery After Noncardiac Surgery: Insights from the PRETREAT Trial

The PRETREAT randomized clinical trial demonstrates that proactive, risk-stratified intraoperative blood pressure targets do not reduce six-month functional disability compared to standard care in noncardiac surgery patients, suggesting that higher MAP targets may not translate into long-term functional benefits.
High PEEP and Recruitment Manoeuvres Fail to Reduce Pulmonary Complications in One-Lung Ventilation: Insights from the PROTHOR Trial
Posted inAnesthesiology news Respiratory

High PEEP and Recruitment Manoeuvres Fail to Reduce Pulmonary Complications in One-Lung Ventilation: Insights from the PROTHOR Trial

The international PROTHOR trial reveals that using higher PEEP and recruitment manoeuvres during one-lung ventilation does not decrease postoperative pulmonary complications compared to a lower PEEP strategy, while notably increasing intraoperative hemodynamic risks like hypotension and arrhythmias.
Perioperative Dexmedetomidine Fails to Reduce Major Complications After Cardiac Surgery: Results from the DOCS Trial
Posted inAnesthesiology Cardiology news

Perioperative Dexmedetomidine Fails to Reduce Major Complications After Cardiac Surgery: Results from the DOCS Trial

The DOCS trial, a multi-center randomized controlled study, found that perioperative dexmedetomidine infusion did not significantly reduce in-hospital mortality or major complications in adults undergoing cardiac surgery with cardiopulmonary bypass, challenging the hypothesis of its broad organ-protective benefits.
Individualized Driving Pressure-Guided PEEP Fails to Reduce Pulmonary Complications in Open Abdominal Surgery: Results from the DESIGNATION Trial
Posted inAnesthesiology General Surgery news

Individualized Driving Pressure-Guided PEEP Fails to Reduce Pulmonary Complications in Open Abdominal Surgery: Results from the DESIGNATION Trial

The DESIGNATION trial demonstrates that driving pressure-guided high PEEP with recruitment maneuvers does not reduce postoperative pulmonary complications compared to standard low PEEP in patients undergoing open abdominal surgery, while significantly increasing the risk of intraoperative hypotension and the need for vasoactive support.
The Paradox of Personalized PEEP: Why Driving Pressure-Guided Ventilation Failed to Improve Outcomes in Emergency Surgery
Posted inAnesthesiology Critical Care news

The Paradox of Personalized PEEP: Why Driving Pressure-Guided Ventilation Failed to Improve Outcomes in Emergency Surgery

This article evaluates the IMPROVE-2 trial and a recent meta-analysis on driving pressure-guided PEEP. Despite physiological improvements in lung compliance, individualized PEEP failed to reduce postoperative respiratory failure in emergency surgery, highlighting a disconnect between respiratory mechanics and clinical survival.
Dexmedetomidine Reduces Agitation and Accelerates Recovery in Non-Intubated ICU Patients with Hyperactive Delirium: Insights from the 4D Trial
Posted inAnesthesiology Critical Care news

Dexmedetomidine Reduces Agitation and Accelerates Recovery in Non-Intubated ICU Patients with Hyperactive Delirium: Insights from the 4D Trial

The 4D randomized clinical trial demonstrates that dexmedetomidine significantly reduces agitation duration and improves clinical outcomes in non-intubated ICU patients with hyperactive delirium, providing a safe and effective alternative to standard care without increasing the need for mechanical ventilation.
Prophylactic Tranexamic Acid in General Surgery: Significant Reduction in Major Bleeding Without Thromboembolic Risk
Posted inAnesthesiology General Surgery news

Prophylactic Tranexamic Acid in General Surgery: Significant Reduction in Major Bleeding Without Thromboembolic Risk

A systematic review and meta-analysis of 26 RCTs reveals that prophylactic tranexamic acid (TXA) significantly reduces blood loss and transfusion needs in general surgery. While safety profiles are favorable, procedural nuances—particularly in abdominal versus hepatobiliary cases—highlight the importance of tailored clinical application.
Posted inAnesthesiology Diabetes & Endocrinology news

European Perioperative Diabetes Care: Significant Practice Variation Impacts 30-Day Recovery Outcomes

The MOPED study of over 6,000 European patients reveals significant international variations in perioperative diabetes management. Findings demonstrate that higher preoperative HbA1c levels and practice inconsistencies are linked to fewer days at home within 30 days of surgery, highlighting an urgent need for clinical harmonization.
Ketamine vs. Etomidate: Does Your Choice of Induction Agent Influence Mortality in the Critically Ill?
Posted inAnesthesiology Critical Care news

Ketamine vs. Etomidate: Does Your Choice of Induction Agent Influence Mortality in the Critically Ill?

This article explores recent evidence comparing ketamine and etomidate for rapid sequence intubation. While new cohort data suggests a mortality benefit for ketamine, meta-analyses of randomized trials show clinical equipoise, highlighting the complex trade-offs between adrenal suppression and hemodynamic stability.