BACKGROUND Sepsis-associated encephalopathy causes irreversible cognitive dysfunction, yet no effective pharmacological treatments are available. The hippocampus is particularly vulnerable to sepsis-induced damage, and impairments in hippocampal synaptic plasticity, particularly late-phase long-term potentiation (L-LTP), are implicated in cognitive dysfunction. Brain-derived neurotrophic factor (BDNF)

BACKGROUND Malignant hyperthermia (MH) is a life-threatening pharmacogenetic disorder triggered by certain anesthetics, characterized by muscle rigidity, elevated body temperature, and hypermetabolic crisis. This condition is primarily associated with genetic mutations in ryanodine receptor 1 (RYR1), which encodes the pivotal calcium release channel in the sarcoplasmic reticulum of skeletal muscle

BACKGROUND Postoperative delirium (POD), emergence delirium (ED), and postoperative cognitive dysfunction (POCD) are disorders of the neuropsychiatric spectrum affecting the elderly during the postoperative period, potentially sharing a common pathophysiological pathway. Disrupted sleep postoperatively correlates with both POD and POCD, revealing overlapping risk factors. This study investigates the

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nary quality improvement (QI) initiative that proactively educated parents about the importance of optimal opioid disposal practices and provided a home opioid disposal kit before discharge after pediatric ambulatory surgery. METHODS: Opioid disposal behaviors were assessed during a brief telephone interview pre- (Phase I) and post-implementation (Phase II) after surgery. For each phase, we aimed to

Cardiopulmonary bypass (CPB) impacts pharmacokinetics and -dynamics of drugs used during cardiac surgery. These alterations can lead to changes in drug efficacy resulting in under- or overdosing. This review summarizes current knowledge on the effects of CPB on commonly used intraoperative and continuously administered anesthetics and analgesics. Out of 197 articles initially identified, 22 were included

BACKGROUND Prehospital airway obstruction is a medical emergency requiring immediate intervention. When the insertion of a larger bore tube over an airway catheter is hindered by obstruction, flow-controlled ventilation (FCV) with expiratory ventilation assistance (EVA) may offer a solution by allowing for ventilation through the airway catheter. This method uses a continuous bidirectional flow, necessitating

BACKGROUND The mechanisms by which sevoflurane protects the brain from hypoxic-ischemic brain injury (HIBI) are unknown. Ferroptosis occurs during HIBI and is regulated by the nuclear factor erythroid 2-related factor 2 (Nrf2). This study investigated the roles of Nrf2-regulated ferroptosis in sevoflurane postconditioning (SPC)-mediated neuroprotection during HIBI. METHODS HIBI was induced in 7-day-old

BACKGROUND In cardiac surgery, modulating the inflammatory response with prophylactic steroids may reduce morbidity and mortality. We aimed to evaluate the association of dexamethasone use with clinical outcomes and its variation in clinical practice in a real-world setting. METHODS This retrospective, population-based study evaluated data of elective and urgent to on-pump cardiac surgery patients

BACKGROUND Cough reflex during extubation can lead to complications such as increased bleeding and hemodynamic instability, especially in thyroidectomy, therefore, effective suppression of cough reflex is clinically important. The aim of the study was to investigate the inhibitory effect of dexmedetomidine combined with lidocaine on the cough reflex during extubation in thyroidectomy. METHODS A total

Anesthesiology has a longstanding commitment to patient safety, characterized by innovative research, quality improvement, multidisciplinary collaboration, and engineering-based approaches to care systems. The field has been instrumental in advancing technological developments across the perioperative continuum, contributing to the ongoing mission of harm reduction and risk mitigation. However, modern

BACKGROUND Intraoperative cardiac arrest (IOCA) is a rare but catastrophic event with significant morbidity, mortality, and health care costs. This study aimed to characterize the frequency, risk factors, and outcomes of IOCA. METHODS Adults undergoing noncardiac surgery were identified in the 2016 to 2021 National Inpatient Sample. IOCA events were identified using the relevant International Classification

Perioperative care transitions or handoffs represent a high-risk period frequently compromised by communication failures and the loss of essential patient information. Handoffs play a pivotal role in mitigating these risks. A comprehensive assessment of implementation and clinical outcomes is essential to identify protocols that enhance patient safety, improve care quality, and support reproducibility

BACKGROUND Gastrointestinal function is mediated by the cholinergic pathway, which is impacted by neostigmine and glycopyrrolate, but not sugammadex. We hypothesized that sugammadex is associated with earlier gastric emptying in adults undergoing colorectal surgery, compared to neostigmine-glycopyrrolate. METHODS Patients were enrolled in a pragmatic, single-center, patient and assessor-blinded, randomized

BACKGROUND Processed electroencephalography parameters are used to guide anesthesia to adequate levels for surgical procedures. Despite known spectral differences between anesthetics, studies often assume similar anesthetic states when titrating to the same target values, presupposing a reductive one-size-fits-all approach for all anesthetic agents. We hypothesize this may introduce bias and aim to

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BACKGROUND The health care systems in low-income countries have extremely limited capacity to treat surgical diseases. The perioperative mortality rate has been suggested as a key quality metric to guide the expansion of care, but there is little information on how to risk-adjust this outcome measure. METHODS We did a 42-month observational cohort study of surgical operations at a Ugandan secondary

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BACKGROUND Postoperative neurocognitive disorders (PNDs) are frequent and serious complications that cause an enormous social and economic burden. A previous study demonstrated that certain electroencephalographic (EEG) patterns during emergence from general anesthesia are associated with a higher risk for PND. Compared to patients demonstrating the most favorable trajectory (Traj Ref: delta-dominant

BACKGROUND Focused anesthesia education may be beneficial for resource-constrained settings where inadequate training along with lack of infrastructure, staff, and supplies can contribute to high anesthetic morbidity and mortality rates. Some medical outreach efforts have transitioned from short-term and service-focused "missions" to education-focused global health interventions to build health care

BACKGROUND Delayed emergence from anesthesia presents clinical challenges, including prolonged stays in the postanesthesia care unit (PACU). The neurobiological mechanisms underlying delayed emergence, particularly in remimazolam-induced anesthesia, remain poorly understood. This study aimed to explore patterns of brain electrical activity of delayed emergence in remimazolam-induced anesthesia by comparing

BACKGROUND Nondepolarizing neuromuscular blocking agents (ND-NMBAs) are dose-dependently associated with residual paralysis, delayed recovery, and prolonged hospitalization, factors that can predispose patients to postoperative delirium. We hypothesized that neuromuscular blockade is associated with a higher risk of delirium after surgery, and that this can be mitigated by administration of reversal

BACKGROUND Minimum alveolar concentration (MAC) is used as the standard measure of potency for volatile anesthetic agents. However, there is a lack of effective and quantitative indicator of the combined potency of multiple coadministered inhalation and intravenous anesthetics. We hypothesized that an indicator of equivalent potency of multiple anesthetics, normalized by MAC and derived from response