Latest Anesthesiology and Pain Medicine research

Top 10 this week

Week of 1 November 2026

1. 1

   Effects of perioperative esketamine infusion on chronic pain after video-assisted thoracoscopic lung resection: a multicentre, randomised, double-blind clinical trial

   British journal of anaesthesia · Q1 journal · RCT · Evidence level 1 (High) · 28 October 2026

   In a 873-patient analysis, chronic pain during coughing at 3 months affected 14.7% of patients given esketamine, versus 21.2% given saline - about 6 fewer per 100 patients. Esketamine also reduced early pain and supplemental analgesic use, without more adverse effects; the trial tested one dosing regimen in thoracoscopic lung resection, so results may not apply to other surgeries.

2. 2

   Processed electroencephalogram-guided anesthesia and its impact on postoperative delirium and perioperative efficiency: A systematic review and meta-analysis

   Journal of clinical anesthesia · Q1 journal · SR/MA of RCTs · Evidence level 1 (High) · 30 October 2026

   Across 87 randomized trials involving 30,611 adults, processed EEG-guided anesthesia was linked to a 27% lower risk of delirium and reduced anesthetic use. Patients also reached extubation, wake-up, orientation, and discharge from recovery a few minutes sooner; however, results varied across studies, and evidence for benefits was most consistent with BIS monitoring.

3. 3

   Effect of remimazolam versus propofol anaesthesia on postoperative delirium in neurovascular surgery: a randomised noninferiority trial

   British journal of anaesthesia · Q1 journal · RCT · Evidence level 1 (High) · 29 October 2026

   In 686 adults undergoing elective neurovascular surgery, delirium within five days occurred in 12.8% with remimazolam and 10.8% with propofol, meeting the trial's criterion for noninferiority. Remimazolam also reduced time with low blood pressure and was linked to more operating-room extubations. Delirium was less common than expected, which limits interpretation of the noninferiority result.

4. 4

   Effect of Pre-operative Intravenous Crystalloid Bolus on Post-Induction Blood Pressure - a randomized blinded intervention trial

   Anesthesiology · Q1 journal · RCT · Evidence level 1 (High) · 7 August 2026

   Pre‑op crystalloid bolus effect on post‑induction hypotension

5. 5

   Ultrasound-Guided Stellate Ganglion Block in Fibromyalgia: A Randomized, Single-Center, Single-Blind, Sham-Controlled Trial

   Pain research & management · Q1 journal · RCT · Evidence level 1 (High) · 1 January 2026

   In a sham-controlled trial of 60 patients on stable duloxetine, ultrasound-guided stellate ganglion block reduced the Fibromyalgia Impact Questionnaire Revised score by roughly 30 points at one week and 23 points at one month, with pain scores dropping over three points. The intervention was safe but the study's single-center design and possible unblinding mean larger trials are needed.

6. 6

   Effects of different doses of esketamine as an adjunct to sufentanil-based patient-controlled intravenous analgesia on postoperative analgesia and opioid consumption following lumbar decompression surgery: a dose-finding randomized controlled trial

   Frontiers in pharmacology · Q1 journal · RCT · Evidence level 1 (High) · 14 October 2026

   In a 120-patient trial, adding esketamine to lower-dose sufentanil improved pain scores and reduced opioid use after lumbar decompression surgery compared with standard-dose sufentanil alone. Pain relief was similar across the three esketamine doses, while sedation rose with dose and the highest dose increased hypotension and dissociative symptoms, supporting 0.25 mg/kg as a possible balance within the doses tested.

7. 7

   36-Month prospective multicenter randomized controlled trial comparing endoscopic facet denervation and cryoneurolysis for chronic lumbar facet joint pain

   European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · Q1 journal · RCT · Evidence level 1 (High) · 4 September 2026

   In a 36-month randomized trial of 80 patients with lumbar facet joint pain, both cryoneurolysis and endoscopic facet denervation produced sustained reductions in pain, disability and quality-of-life scores, with no meaningful difference between the groups. Reintervention was needed in 20% versus 30% of patients, a non-significant gap. Larger studies are needed to determine if one technique is truly superior or interchangeable.

8. 8

   Postoperative Pain Treatment After Pancreatic Surgery: A Systematic Review With Meta-Analyses and Trial Sequential Analyses

   European journal of pain (London, England) · Q1 journal · SR/MA of RCTs · Evidence level 1 (High) · 1 November 2026

   Across 18 trials involving 1,468 patients, paravertebral blocks and continuous wound infiltration produced similar pain scores to epidurals on the first two days after surgery, and lower scores on day three. Cyclooxygenase inhibitors also reduced pain at rest on day two versus placebo or no treatment, but the evidence was low to very low certainty, leaving the best approach unsettled.

9. 9

   Short-term peripheral nerve stimulation for pain relief in adults: A systematic review and meta-analysis of randomized controlled trials

   Journal of clinical anesthesia · Q1 journal · SR/MA of RCTs · Evidence level 1 (High) · 29 October 2026

   Across eight randomized trials involving 543 adults, short-term peripheral nerve stimulation reduced average pain during the first 8 weeks, while electrodes were implanted. Average pain was not significantly lower after removal, although pain interference improved at some later time points. The findings are preliminary, and benefits varied between sham-controlled and usual-care trials and between acute and chronic pain.

10. 10

    Ultrasound-guided transversus abdominis plane block using ropivacaine and different doses of perineural dexmedetomidine for analgesia after cesarean section: a randomized controlled clinical trial

    Frontiers in pharmacology · Q1 journal · RCT · Evidence level 1 (High) · 24 July 2026

    TAP block with dexmedetomidine dose‑finding for cesarean analgesia

Paper of the day, last two weeks

• Pericapsular Nerve Group Block Significantly Reduces Morphine Consumption and Improves Early Recovery Following Primary Total Hip Arthroplasty: A Randomized Double-Blind Sham-Controlled Trial

  The Journal of arthroplasty · Q1 journal · RCT · Evidence level 1 (High) · 6 November 2026

  In a randomized trial of 40 patients, the nerve block group used an average of 6.2 mg of morphine in the first 24 hours, compared with 30.2 mg after a sham procedure. Patients also reported less pain and nausea, but the small, single trial leaves the size and reliability of benefit in broader practice uncertain.

• Baclofen Vaginal Suppositories in Chronic Pelvic Pain: a Randomized, Double-Blind, Placebo Controlled Trial

  American journal of obstetrics and gynecology · Q1 journal · RCT · Evidence level 1 (High) · 5 November 2026

  In a randomized trial of 37 women with chronic pelvic pain, nightly vaginal baclofen for eight weeks reduced pelvic floor exam pain by a median 33.5 mm, compared with 7.2 mm with placebo. Overall pain also improved more, but other quality-of-life measures did not differ; the small trial leaves longer-term benefit and safety uncertain.

• Analgesic efficacy of regional and local analgesic techniques for anterior cruciate ligament reconstruction in adults undergoing general anesthesia: a systematic review and network meta-analysis

  BMC anesthesiology · Q1 journal · SR/MA of RCTs · Evidence level 1 (High) · 29 October 2026

  In a network meta-analysis of 31 trials and 2,470 adults, the combined blocks were associated with an estimated 40 mg less opioid use in the first 24 hours than control. But only six studies had low risk of bias, and the estimate became less certain when high-risk studies were excluded; no technique was shown to be clinically superior overall.

• Sugammadex versus neostigmine for neuromuscular blockade reversal in adults: A systematic review and meta-analysis of randomised controlled trials

  European journal of anaesthesiology · Q1 journal · SR/MA of RCTs · Evidence level 1 (High) · 3 November 2026

  Across 165 trials involving 19,124 adults, sugammadex shortened neuromuscular blockade reversal by about 10 minutes compared with neostigmine; about 28% fewer patients had at least one adverse event. Evidence also favored sugammadex for several specific complications, but many trials had unclear or high risk of bias, so the size of its safety advantage remains uncertain.

• Comparison of the anaesthetic efficacy and safety of different doses of esketamine combined with propofol in hysteroscopic surgery: a randomised, double-blind controlled trial

  BMC anesthesiology · Q1 journal · RCT · Evidence level 1 (High) · 28 July 2026

  In a randomized trial of 157 women, esketamine at 0.3 mg/kg with propofol reduced early postoperative pain compared with 0.15 mg/kg, with no intraoperative hypertension and fewer oxygen drops than with sufentanil. Higher-dose esketamine brought no extra pain benefit and more agitation, while propofol use was similar across groups; the best balance needs confirmation in other settings.

• Remimazolam versus propofol for elderly patients undergoing laparoscopic gastrointestinal surgery: a randomized trial concentrating on delirium and hemodynamic stability

  Frontiers in medicine · Q1 journal · RCT · Evidence level 1 (High) · 16 October 2026

  Among 186 patients aged 60 to 80, delirium within five days occurred in 11.3% to 12.9% with remimazolam and 6.5% with propofol, with no statistically significant difference. Remimazolam improved blood pressure stability and reduced treated hypotension and vasopressor use, but recovery was slower; low delirium rates mean the trial could not rule out a meaningful difference.

• Infraorbital versus sphenopalatine ganglion block for patient-reported recovery after septorhinoplasty: A randomized controlled trial

  Journal of clinical anesthesia · Q1 journal · RCT · Evidence level 1 (High) · 28 October 2026

  In a randomized trial of 89 adults, infraorbital nerve block produced a 12.5-point higher recovery score at 24 hours than sphenopalatine ganglion block, exceeding the threshold for a clinically important difference. Fewer patients needed rescue pain medicine, while nausea, anesthetic use and recovery-room time were similar; secondary findings remain hypothesis-generating.

• High-Flow Nasal Oxygenation Is Associated with Improved Respiratory Stability During Moderate Multimodal Analgosedation for Pars Plana Vitrectomy: A Randomized Controlled Trial

  Journal of clinical medicine · Q1 journal · RCT · Evidence level 1 (High) · 15 October 2026

  In a 164-patient randomized trial, high-flow oxygen did not improve the primary oxygenation outcome, and neither group had oxygen levels below 90%. However, readings of 90% to 93% were less frequent with high-flow oxygen during and after surgery. Exploratory findings suggested better breathing measures in the highest-risk patients, but whether these differences improve clinical outcomes remains unknown.

• Liberal vs. conventional pre-operative clear fluid fasting policies in children: a systematic review and meta-analysis of randomised and non-randomised studies

  Anaesthesia · Q1 journal · SR/MA of RCTs · Evidence level 1 (High) · 23 October 2026

  Pediatric preoperative fasting and aspiration risk under anaesthesia

• Efficacy and Safety of Perioperative Transcranial Electrical Stimulation for Postoperative Pain and Related Outcomes: A Systematic Review and Meta-Analysis With Trial Sequential and Subgroup Analyses

  Pain research & management · Q1 journal · SR/MA of RCTs · Evidence level 1 (High) · 1 January 2026

  Across 21 randomized trials involving 2,186 elective-surgery patients, perioperative brain stimulation was linked to lower day-one pain, less opioid use and 55% fewer cases of postoperative delirium. Nausea and vomiting also fell, but stimulation-site discomfort was more common; evidence certainty ranged from very low to moderate, and effects on recovery quality remain unclear.

• Effects of Esketamine and Magnesium Sulfate on Postoperative Fatigue Syndrome in Patients Undergoing Laparoscopic Cholecystectomy: A Randomized, Double-Blind, Placebo-Controlled, 2×2 Factorial Trial

  Journal of pain research · Q1 journal · RCT · Evidence level 1 (High) · 17 October 2026

  In a randomized trial of 128 patients having laparoscopic gallbladder surgery, esketamine reduced day-one fatigue scores by 1.12 points and improved early recovery scores. Magnesium sulfate also reduced fatigue in the primary model, but that effect was not confirmed in the corrected longitudinal analysis; its clinical importance and whether either drug changes longer-term fatigue remain unclear.

Evidence summaries in Anesthesiology and Pain Medicine

• Complex Regional Pain Syndrome