Nagaraja S, Chikkanarasimha M, Sanket B
… +3 more, Kannan S, Surhonne N, Kalappa S
Saudi J Anaesth
· 2026 · PMID 41710629
·
Full text
BACKGROUND AND AIMS: An anatomical model was developed in-house to teach novices lung isolation skills bedside. To know the utility of the model, we planned a survey following a structured teaching program. The questionn...BACKGROUND AND AIMS: An anatomical model was developed in-house to teach novices lung isolation skills bedside. To know the utility of the model, we planned a survey following a structured teaching program. The questionnaire used for feedback purpose was tested for content validity and has been detailed. MATERIALS AND METHODS: Eleven questions were included in the survey. A Google form was prepared and mailed to 12 content experts to grade each question. In the Microsoft excel sheet, item-wise content validity index (I-CVI), scale-wise content validity index (S-CVI) and modified kappa statistic (κ) were calculated. The I-CVI of 0.78 and the S-CVI/average of 0.90 were considered acceptable. RESULTS: Eleven out of 12 content experts responded. SCVI and S-CVI/Ave were uniformly 0.99 and 0.91, respectively, for relevance, simplicity, clarity, and ambiguity for all 11 questions. CONCLUSION: The questionnaire designed to obtain feedback regarding the anatomical model to teach lung isolation techniques met the content validity in both qualitative and quantitative terms.
Altowairki RS, Mohammed MA, Bin Ghali KN
… +1 more, Albakheet NM
Saudi J Anaesth
· 2026 · PMID 41710627
·
Full text
Aortoiliac occlusive disease (AIOD) is a severe form of peripheral arterial disease requiring complex vascular reconstruction, typically performed under general anesthesia (GA). However, GA poses significant risks in pat...Aortoiliac occlusive disease (AIOD) is a severe form of peripheral arterial disease requiring complex vascular reconstruction, typically performed under general anesthesia (GA). However, GA poses significant risks in patients with advanced cardiac disease. We report the case of a 51-year-old male with bilateral critical limb ischemia and extensive AIOD, complicated by ischemic heart disease, reduced ejection fraction (20%-25%), diabetes, and hypertension. The patient underwent aortic bifemoral bypass, aortic endarterectomy, bilateral femoral endarterectomy, and profundoplasty under thoracic epidural anesthesia (TEA) with intraoperative sedation. TEA provides effective surgical anesthesia, adequate hemodynamic control, and excellent pain relief. Intraoperative hypotension was managed with a norepinephrine infusion. Postoperative analgesia was achieved using epidural ropivacaine-fentanyl infusion and multimodal medications. The patient had a stable course, required only brief ICU monitoring, and was transferred to the ward with well-controlled pain. This case demonstrates the feasibility and safety of TEA as an alternative to GA in high-risk vascular patients. TEA may reduce cardiac stress, improve pain control, and minimize pulmonary complications in select patients undergoing extensive aortic procedures. Further studies are warranted to support wider use of regional techniques in high-risk vascular surgeries.
Manoj A, Mahadeviah T, Ramasamy P
… +3 more, Paul P, Ramalingam S, Dominic JL
Saudi J Anaesth
· 2026 · PMID 41710626
·
Full text
BACKGROUND: The supraclavicular brachial plexus block is widely used for upper limb surgeries due to its effectiveness in providing anesthesia. Conventionally, success is gauged through sensory and motor assessments, whi...BACKGROUND: The supraclavicular brachial plexus block is widely used for upper limb surgeries due to its effectiveness in providing anesthesia. Conventionally, success is gauged through sensory and motor assessments, which are not only subjective but also require active patient cooperation. This poses challenges for patients who are sedated or under general anesthesia. Additionally, repeated sensory testing can be uncomfortable. Therefore, an objective and noninvasive method to assess block success is needed. Perfusion index (PI), derived from pulse oximetry, reflects peripheral perfusion changes following sympathetic blockade and could serve as a useful surrogate marker. This study aimed to assess the utility of PI and the PI ratio as early indicators of successful block onset and to identify optimal threshold values correlating with effective anesthesia. METHODS: Seventy patients undergoing elective upper limb orthopedic procedures received ultrasound-guided supraclavicular blocks. Data for PI were collected from the affected and unaffected limbs at the initial time point and again at 10, 15, and 20 minutes after the block was given. The PI ratio was derived by comparing values between limbs at each time point. RESULTS: In successful blocks, the PI increased significantly in the affected limb. A PI > 2.94 showed 50% sensitivity and 91.67% specificity, while a PI ratio > 1.25 offered 50.78% sensitivity and 100% specificity at 10 minutes, confirmed by receiver operating characteristic (ROC) analysis. CONCLUSION: Both PI and PI ratio are effective in predicting block success, with the PI ratio proving more reliable, especially at the 10-minute mark.
Saudi J Anaesth
· 2026 · PMID 41710625
·
Full text
BACKGROUND: A new peptide analgesic, a highly selective μ1-opioid receptor agonist (Taphalgin®) has shown the high efficacy in treating acute postoperative and chronic oncological pain, it appears to be a promising optio...BACKGROUND: A new peptide analgesic, a highly selective μ1-opioid receptor agonist (Taphalgin®) has shown the high efficacy in treating acute postoperative and chronic oncological pain, it appears to be a promising option for the treatment of patients with severe pain in outpatient clinics. METHODS: Prospective observational study with a control period 4 hours after a single injection. The onset and peak of the analgesic effect, duration of effect, patient satisfaction and tolerability of therapy were assessed. RESULTS: A total of 37 patients participated in the study. The pain intensity before the injection was 8.9 ± 1.2 according to numeric rating scale. Causes of severe pain included: radicular, oncologic and lumbar pain, vertebral fractures, joint injuries, tendon ruptures and others (e.g., hip fracture, nerve injury). Up to 95% of patients were already receiving pain therapy from non-steroidal anti-inflammatory drugs to strong opioids. After injection, pain intensity decreased with a peak at 30-45 minutes from 8.9±1.2 to 3.2±2.8 ( ≤ 0.0001) points on numeric rating scale and lasted for more than 3 hours. There was no difference in pain intensity at rest and with movement. Adverse events were reported in 19 of 37 patients (51.3%). Most adverse events were non-serious, did not require treatment and resolved on their own. CONCLUSIONS: The μ1-opioid receptor agonist Taphalgin® demonstrates high efficacy, ease of use, rapid onset of effect and good tolerability in patients with severe pain syndrome in outpatient settings.
Vilaça JLC, do Nascimento DR, Rocha AVC
… +1 more, Delgado MA
Saudi J Anaesth
· 2026 · PMID 41710624
·
Full text
Becker muscular dystrophy (BMD) is a genetic disorder caused by partial deficiency of dystrophin, leading to progressive skeletal muscle weakness and cardiac failure. Up to one-third of affected individuals develop dilat...Becker muscular dystrophy (BMD) is a genetic disorder caused by partial deficiency of dystrophin, leading to progressive skeletal muscle weakness and cardiac failure. Up to one-third of affected individuals develop dilated cardiomyopathy, eventually requiring heart transplantation at a young age. Although BMD is not directly linked to malignant hyperthermia (MH), patients may experience severe MH-like reactions, particularly when exposed to succinylcholine or volatile anesthetics. Therefore, total intravenous anesthesia (TIVA) is often preferred in this population, despite the cardioprotective benefits of volatile agents through myocardial preconditioning. We report the case of a teenager with BMD and advanced cardiomyopathy who successfully underwent heart transplantation under TIVA. Anesthesia was maintained with target-controlled infusion (TCI) of propofol and remifentanil. Additional boluses of ketamine and midazolam were administered to maintain a bispectral index (BIS) between 40 and 60. Postoperatively, the patient was admitted to the intensive care unit receiving low-dose infusions of dobutamine, sodium nitroprusside, and inhaled nitric oxide, and was safely extubated 3 h later. This case highlights the feasibility and safety of TIVA in patients with BMD undergoing major cardiac surgery.
Saudi J Anaesth
· 2026 · PMID 41710623
·
Full text
Post-dural puncture headache (PDPH) is a common complication of epidural anesthesia, especially after accidental dural puncture (ADP), while intracranial subdural hematoma (ISH) is a rare but serious complication. In thi...Post-dural puncture headache (PDPH) is a common complication of epidural anesthesia, especially after accidental dural puncture (ADP), while intracranial subdural hematoma (ISH) is a rare but serious complication. In this report, we describe the case of a 31-year-old pregnant woman who received epidural anesthesia during labor, and accidentally had a dural puncture, resulting in headache and subdural hematoma. A burr hole drainage was performed. The drainage tube was removed 8 days later, and she was discharged after her condition improved. Intracranial hemorrhage after accidental epidural puncture is very rare, and this potentially life-threatening complication needs to be taken seriously.
Alsalhi AA, Almazyad FH, Alharbi AZ
… +2 more, AlDhuwaihy A, AlSulaim YB
Saudi J Anaesth
· 2026 · PMID 41710622
·
Full text
Increasing global life expectancy has expanded the surgical population, raising concerns about postoperative outcomes. Dementia, especially Alzheimer's disease (AD), poses a significant public health challenge. This meta...Increasing global life expectancy has expanded the surgical population, raising concerns about postoperative outcomes. Dementia, especially Alzheimer's disease (AD), poses a significant public health challenge. This meta-analysis investigates anesthesia exposure and AD risk. Following PRISMA 2020 guidelines, we systematically searched five databases (2014-2022) for observational studies evaluating dementia risk in adults ≥60 years undergoing surgery with anesthesia. Two reviewers independently screened studies, extracted data, and assessed quality using the Newcastle-Ottawa Scale. Pooled odds ratios were calculated using a random-effects model, with subgroup and publication bias analyses conducted. Significant associations with dementia included hypertension (OR 1.36, 95% CI [1.16, 1.59]), hyperlipidemia (OR 1.19 [1.16, 1.22]), coronary artery disease (OR 2.45 [1.72, 3.50]), depression (OR 1.70 [1.27, 2.27]), and head injury (OR 1.31 [1.14, 1.51]). Subgroup analyses showed mixed results for age, surgery, and medication. Kidney-ureter-bladder surgery increased risk substantially (OR 2.52 [1.10, 5.76]). Publication bias was observed. No statistically significant association was found between general anesthesia and AD risk. However, significant heterogeneity, potential publication bias, inconsistent subgroups, and challenges in isolating anesthesia effects from surgery necessitate cautious interpretation. Large prospective cohort studies with standardized methods, adequate lag time, and rigorous confounder adjustments are imperative. Perioperative care optimization for older adults at risk of cognitive decline is clinically warranted.
Ulusoy E, Eglen MY, Kaciroglu A
… +3 more, Aydin ME, Dikici M, Ekinci M
Saudi J Anaesth
· 2026 · PMID 41710621
·
Full text
Fascial plane blocks have become increasingly popular for postoperative analgesia. Recently, Ekinci . have defined the peritibial fascial infiltration block (PFIB) for ankle fractures. This report discusses two cases whe...Fascial plane blocks have become increasingly popular for postoperative analgesia. Recently, Ekinci . have defined the peritibial fascial infiltration block (PFIB) for ankle fractures. This report discusses two cases where PFIB was utilized as part of a multimodal analgesic strategy. The first case involved a 13-year-old male with a lateral malleolus fracture following a bicycle accident. The second case concerned a 27-year-old male with bilateral malleolus fractures sustained in a motorcycle accident. In both cases, PFIB was administered preoperatively, and neither patient required supplemental analgesics postoperatively. The PFIB appears to be a promising adjunct in multimodal analgesia for ankle fractures. Further research is warranted to validate its efficacy and broader applications.
Badwi WMR, Baaj J, Chehab I
… +7 more, Elzogari IA, Bin Muammar AF, Alkulaibi R, Alzahrani F, Badawi S, Badawi F, Al-Shahrani A
Saudi J Anaesth
· 2026 · PMID 41710620
·
Full text
BACKGROUND: The incorporation of clinical simulation within educational frameworks is a fundamental aspect of professional advancement in anesthesiology, thereby creating a strong and efficient structure for the augmenta...BACKGROUND: The incorporation of clinical simulation within educational frameworks is a fundamental aspect of professional advancement in anesthesiology, thereby creating a strong and efficient structure for the augmentation of clinical skills. This investigation evaluates the impact of operating room simulation utilizing the SimMan 3G simulator on the skill development of fourth-year medical students specializing in anesthesiology at King Saud University. METHODS: This investigation employed a mixed-methods research paradigm, amalgamating various methodological strategies with a participant cohort consisting of 109 individuals. Evaluative assessments were conducted both prior to and following the intervention to assess the acquisition of skills in the areas of emergency management, airway management, and pharmacological reasoning. The quantitative results were further enriched by qualitative insights obtained from surveys and interviews. RESULTS: Significant advancements were discerned in pivotal technical areas, encompassing anesthesia induction and airway management, in conjunction with augmented decision-making proficiencies and refined stress management abilities. Assessments conducted after the training revealed that 75% of participants recognized an elevation in their clinical competencies, with the simulator attaining a mean effectiveness rating of 4.44 out of 5. Furthermore, students exhibited heightened self-assurance when functioning in high-stress environments. CONCLUSION: The utilization of operating room simulations utilizing the SimMan 3G markedly improves educational outcomes in the field of anesthesia, promoting progress in both technical and non-technical skill sets. These results underscore the critical need for a broader incorporation of simulation-based pedagogical approaches within medical educational systems. The post-intervention reflections should elucidate the essential requirement for enhancing realism, collaborating with larger cohorts, and incorporating cutting-edge technologies such as virtual reality (VR) and augmented reality (AR).
Alashari R, Alasmari M, Alsheikh M
… +2 more, Alharthy B, Tayeb B
Saudi J Anaesth
· 2026 · PMID 41710618
·
Full text
INTRODUCTION: Pain management is a global epidemic with grave effects on the patients and communities. Nurses are an important part of the multidisciplinary pain management team. Multiple studies have found inadequate kn...INTRODUCTION: Pain management is a global epidemic with grave effects on the patients and communities. Nurses are an important part of the multidisciplinary pain management team. Multiple studies have found inadequate knowledge and a negative attitude toward pain among nurses. We aim to examine the knowledge and attitude of nursing students in Saudi Arabia and the potential effects on future patient care. METHODS: We employed a previously validated tool; the Nurses' Knowledge and Attitude Survey Regarding Pain NKASRP. Our population included two of the major Nursing Colleges in Western Saudi Arabia. We published the survey and collected the data electronically. We analyzed the data calculating averages and regression analysis as needed. RESULTS: We collected 261 responses. Our results showed that the average score on the NKASRP was 44.9% - inadequate - with only two students passing the 80% cutoff point. Also, the score is not statistically different according to academic level, which implies that the curriculum does not improve the knowledge nor the attitude of nursing students over its course. CONCLUSION: Our study suggests there is a very strong need for the Nursing College Curriculum review by nursing educational leaders in Saudi Arabia regarding the pain education component. Improving curriculums might improve nursing students' outcomes, hence improving the quality of life for our patients and community.
Rai AR, Darshika, Gill RK
… +4 more, Saxena P, Kaur J, Parmar SK, Sukhija A
Saudi J Anaesth
· 2026 · PMID 41710617
·
Full text
BACKGROUND: Patient information leaflets (PILs) are simple, inexpensive, and an effective means of providing information to patients. Leaflets allow patients to understand what to expect and what to know at their own pac...BACKGROUND: Patient information leaflets (PILs) are simple, inexpensive, and an effective means of providing information to patients. Leaflets allow patients to understand what to expect and what to know at their own pace. This study aimed to prepare, validate, and evaluate the efficacy of a PIL for female patients undergoing elective Caesarean section. METHODOLOGY: After approval from the hospital ethics committee, a PIL was prepared in English. Readability and design of the leaflet were checked using standard tests: Flesch Reading Ease test (FRE), Flesch-Kincaid Grade Level (FKGL), and Baker Able Leaflet Design (BALD). It was translated into two regional languages. The PIL was tested among patients using a questionnaire. A total of 240 adult female patients scheduled for elective Caesarean section were included. Patient knowledge through pre-test and post-test was compared using the paired test. The influence of age and education level on the usefulness of the PIL was analyzed. RESULTS: The English leaflet had a FRE score of 76 and a FKGL score of 4.36 which indicated good readability. The English PIL had a BALD score of 26, whereas both regional languages had a score of 22. The mean age was 26.61 ± 4.75 years with a range from 18 to 40 years. The knowledge scores increased from 40 ± 19.06 in the pretest to 69.52 ± 13.85 in post-test. Younger age (negative effect; value 0.023) and intermediate level of education were the strongest predictors of greater knowledge gain. CONCLUSION: PILs are an economical and convenient tool for patient education. The intervention was effective across all education levels, with the largest effect sizes in the intermediate level of education group.
Saner FH, Schumann R, Alchibi L
… +7 more, Kareem SA, Marquez KAH, Saner YM, Abufarhaneh E, Broering DC, Raptis DA, HeALgroup.AI Collaborative (Appendix)
Saudi J Anaesth
· 2026 · PMID 41710616
·
Full text
BACKGROUND: ChatGPT is an Artificial intelligence (AI) language model that enhances readability in medical writing. However, the prevalence of ChatGPT-generated articles in English medical literature has not been systema...BACKGROUND: ChatGPT is an Artificial intelligence (AI) language model that enhances readability in medical writing. However, the prevalence of ChatGPT-generated articles in English medical literature has not been systematically studied. This research aims to evaluate the frequency of these manuscripts, their adoption across medical subspecialties, and the countries of origin for the publishing companies. METHODS: The term "delve" is primarily linked to ChatGPT-generated medical literature. In this observational study, we identified manuscripts as ChatGPT-generated based on this term in the title or abstract. We examined PubMed from December 01, 2022, to May 14, 2024, and applied descriptive statistics as needed. RESULTS: During the study period, 2.193.871 manuscripts were published in Pubmed. The term "delve" was found in the title and abstract of 1996 scientific manuscripts, suggesting that at least 0.09% of all publications were ChatGPT-generated. At the same time, PubMed hosted 982 journals. We report on those that published at least ten or more CHATGPT-derived manuscripts (top 25). Publishers with the highest number of ChatGPT-generated manuscripts were located in Switzerland (564; 27.6%), followed by the United States (552; 27.0%) and the United Kingdom (430; 21.0%). The Multidisciplinary Digital Publishing Institute (MDPI: 373; 20.3%) was the top publisher of ChatGPT-driven publications, followed by Elsevier (340; 18.5%) and Frontiers (160; 8.7%). CONCLUSION: Since the introduction of ChatGPT, medical publications are increasingly ChatGPT-supported or generated with an uncertain amount of author auditing and editing. High-frequency publishers were located in first-world countries.
Santonastaso DP, De Cassai A, Pilia E
… +30 more, Coppolino F, Melegari G, Piccioni F, Fattorini F, Tognù A, Sepolvere G, Scimia P, Curcio A, Bagaphou CT, Coviello A, Morelli A, Marandola D, Pietrantozzi D, Tedesco M, Gentili A, Rispoli M, Lubrano G, Mattiacci DM, Nespoli MR, D'Errico C, Costa F, Bizzarri F, Ranieri G, Rocco N, Tonetti T, Folli S, de Chiara A, Pace MC, Fusco P, Agnoletti V
Saudi J Anaesth
· 2026 · PMID 41710615
·
Full text
BACKGROUND: Despite being considered routine, breast surgery is associated with a high incidence of acute and chronic postoperative pain, which can significantly impact recovery and quality of life. Regional anesthesia t...BACKGROUND: Despite being considered routine, breast surgery is associated with a high incidence of acute and chronic postoperative pain, which can significantly impact recovery and quality of life. Regional anesthesia techniques have become increasingly relevant within multimodal analgesic strategies, yet clinical practice remains heterogeneous and lacks clear guidance. To address this, we aimed to develop a multidisciplinary, evidence-based consensus on the role of regional anesthesia in breast surgery. METHODS: An expert panel was appointed by the Italian Chapter of the European Society of Regional Anaesthesia, including anesthesiologists and breast surgeons (in partnership with the Italian National Association of Breast Surgeons). A four-round Delphi method was applied to refine an initial set of 24 PICO-formulated questions. Each question was evaluated for relevance and clarity using a 9-point Likert scale (1 = not relevant/clear, 9 = extremely relevant/clear). Finalized questions underwent systematic review or network meta-analysis depending on data availability. RESULTS: Eleven clinically relevant and clearly formulated PICO questions were identified after four Delphi rounds. These questions encompass acute and chronic pain control, block safety in anticoagulated patients, awake surgery, and the comparative efficacy of single-shot versus continuous blocks, among others. Each question will guide a systematic review and support the development of graded consensus statements. CONCLUSION: This consensus project establishes a transparent, multidisciplinary framework for guiding the use of regional anesthesia in breast surgery. The ultimate objective is to formulate a set of consensus statements, graded according to evidence strength, which will serve as a foundation for future guidelines and standardized clinical decision-making.
Saudi J Anaesth
· 2026 · PMID 41710614
·
Full text
BACKGROUND: Goal-directed fluid therapy with dynamic variables enhances tissue oxygen delivery. A prospective, randomized comparative study was designed with stroke volume variation (SVV) and plethysmography variability...BACKGROUND: Goal-directed fluid therapy with dynamic variables enhances tissue oxygen delivery. A prospective, randomized comparative study was designed with stroke volume variation (SVV) and plethysmography variability index (PVI) to study fluid responsiveness, fluid requirement, and postoperative complications. MATERIALS AND METHODS: A total of 68 patients undergoing major abdominal oncosurgeries were randomly allotted to the SVV or PVI group. SVV was measured with the FlotracEV1000 arterial pressure-based waveform analyzer, and for values >11, a colloid bolus of 200 mL was given. PVI was measured with a MasimoRad-97 plethysmography analyzer as variations in the pulse oximeter plethysmography waveform amplitude, and for values >11, a colloid bolus of 200 mL was given. Fluid response was noted in both groups. RESULTS: Total fluids ( = 0.058) and colloids ( = 0.268) given were comparable in both groups. Crystalloids required were less in PVI versus SVV, with ( = 0.034). Fluid responsiveness for SVV (84.7%) and PVI (83.8%) was good and values statistically comparable ( = 0.884). In SVV, the receiver operating characteristic (ROC) (AUC) was 0.50, which implies that pre-bolus SVV cannot be considered as a predictor of sensitivity for fluid responsiveness. In PVI (AUC), it was 0.70, which implies that prebolus PVI can be considered as a predictor of sensitivity for fluid responsiveness. Postoperative serum lactate and creatinine values were normal, and SICU stay was short and statistically comparable between the two groups. Bowel sounds appeared earlier in PVI ( < 0.03) patients. CONCLUSION: Both SVV and PVI are valid predictors for fluid responsiveness and guides for fluid therapy: reduced postoperative complications and length of stay noted in both groups. PVI is a more sensitive dynamic variable than SVV.
Saudi J Anaesth
· 2026 · PMID 41710613
·
Full text
Local anesthetics are essential in dental practice, but their systemic effects can pose significant risks for medically compromised patients. This review aims to identify and evaluate the safest local anesthetic agents f...Local anesthetics are essential in dental practice, but their systemic effects can pose significant risks for medically compromised patients. This review aims to identify and evaluate the safest local anesthetic agents for use in dental procedures in patients with systemic medical conditions to minimize adverse outcomes and improve clinical safety. To achieve this, a comprehensive literature search was performed in PubMed, Scopus, Web of Science, and Google Scholar for studies published from January 2000 to April 2025. Thirty-five studies addressing local anesthetic use in patients with cardiovascular disease, hepatic or renal impairment, diabetes, thyroid disorders, bleeding tendencies, pregnancy, elderly populations, and amide allergies were included. Data were synthesized to develop clinical recommendations for anesthetic selection based on systemic conditions. Lidocaine remains the standard amide anesthetic, with a strong safety profile in pregnancy and diabetes. Mepivacaine, due to minimal vasodilation, is preferred in cardiovascular and thyroid disorders. Articaine's rapid plasma metabolism benefits patients with liver or kidney impairment. Prilocaine is effective for hepatic impairment but poses methemoglobinemia risks, especially in pregnancy. Chloroprocaine, an ester anesthetic, is recommended for patients with confirmed amide allergies. Emerging strategies, such as buffered formulations, low epinephrine anesthetics, and ultrasound guided techniques, may enhance safety in high risk groups. Local anesthetic selection must be tailored to each patient's medical status. Mepivacaine, lidocaine, and articaine are among the safest agents for various systemic conditions. An evidence based, condition specific approach enhances safety and treatment outcomes in medically compromised dental patients.
Bansal S, Gupta SK, Dutta S
… +2 more, Shah RB, Singhal S
Saudi J Anaesth
· 2026 · PMID 41710612
·
Full text
BACKGROUND: Suzetrigine, a novel nonopioid analgesic, selectively inhibits voltage-gated sodium channel 1.8 (NaV1.8) and has recently been approved for the management of moderate to severe acute pain. This meta-analysis...BACKGROUND: Suzetrigine, a novel nonopioid analgesic, selectively inhibits voltage-gated sodium channel 1.8 (NaV1.8) and has recently been approved for the management of moderate to severe acute pain. This meta-analysis aimed to evaluate the efficacy and safety of suzetrigine by cumulating data from available evidence. METHODS: A literature search was conducted using ClinicalTrials.gov, PubMed, and Cochrane Central Register of Controlled Trials. Five randomized controlled trials (RCTs) were included in the systematic review, with four RCTs in the meta-analysis. The primary efficacy outcomes were time-weighted sum of pain intensity difference over 48 h (SPID 48) and 24 h (SPID 24) between suzetrigine and placebo. Secondary outcomes included proportion of participants achieving ≥30%, ≥50%, and ≥70% reduction in numeric pain rating scale (NPRS) scores at 48 h and safety analysis. RESULTS: Suzetrigine showed significantly better efficacy versus placebo in reducing pain, with a standard mean difference of 5.55 (95% CI 2.97-8.13, < 0.00001) for SPID 48 and 5.33 (95% CI 2.50-8.16, < 0.00001) for SPID 24. Odds of achieving ≥30%, ≥50%, and ≥70% reduction in NPRS scores at 48 h were significantly higher in the suzetrigine group (OR 1.95, 1.74, and 1.81, respectively; all < 0.00001). Suzetrigine showed comparable efficacy to hydrocodone bitartrate-acetaminophen (HB/APAP) with a better safety profile, showing lower incidence of adverse events and gastrointestinal side effects. CONCLUSION: Suzetrigine appears to be an effective, well-tolerated option for acute pain management, showing superiority to placebo and comparable efficacy to HB/APAP, with a better safety profile. However, future long-term studies are needed to assess its efficacy and safety in various acute pain settings.
Jakšić L, Bosinci E, Stranjanac V
… +1 more, Petrov I
Saudi J Anaesth
· 2026 · PMID 41710611
·
Full text
Regional anesthesia has been proven useful in hand surgery after trauma, most commonly via brachial plexus blocks (BPB), with widely established benefits. Distal nerve blocks at the elbow are used much less frequently. A...Regional anesthesia has been proven useful in hand surgery after trauma, most commonly via brachial plexus blocks (BPB), with widely established benefits. Distal nerve blocks at the elbow are used much less frequently. A 15-year-old boy was admitted because of traumatic amputation of the 4 digit on his right hand. Difficult intubation was suspected. History was indicative of obstructive sleep apnea, and nil per os status was confirmed, with no apparent risk factors for regurgitation. Ultrasound-guided blocks of the median, radial, and ulnar nerves at the elbow were performed with 2% Lidocaine and 0.5% Levobupivacaine. Sedation was maintained with Propofol 3-4 mg/kg/h, with oxygen support via nasal cannula at 3 L/min. Basic monitoring of vital functions was applied. Throughout the procedure, the patient maintained perfect hemodynamic and respiratory stability. Postoperative analgesia was adequate, with no nonsteroidal anti-inflammatory drugs administered in the first 12 h postoperatively. Distal nerve blocks at the elbow may present a safe and effective anesthetic technique when managing traumatic injuries of the fingers, presenting a simpler and less risky technique than BPB and requiring less provider expertise. Previous studies have demonstrated the use of these blocks in acute pain management following fractures, but to our knowledge, no inquiry has been made into the use of these blocks for surgical anesthesia in amputation management. One needs to keep in mind the dermatomal distribution of innervation as other digits may not require covering all three nerves as the 4 digit does. Caution must be taken to account for any possibility of increased risk of regurgitation, as well as the use of an upper arm pneumatic tourniquet.