Anesthesia Updates

This episode discusses the main findings of a new study from Sajdeya et al., 2025, published in Regional Anesthesia & Pain Medicine. The research asks a timely, important question: Does cannabis use affect postoperative pain in older adults? We've seen rising cannabis use among seniors, up to 5% nationally, but almost no data on how it affects acute surgical pain. This study finally gives us real evidence, using advanced NLP to detect cannabis use in the electronic record. And the findings? Well... they challenge a lot of assumptions.

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Disclaimer: Medicine is an ever-changing science. As new research and clinical experience broaden, changes in treatment and drug therapy are required. The authors and publishers have checked with sources believed to be reliable in efforts to provide accurate information within the available or accepted standards of care. However, given the possibility of human error or changes in medical practice, neither the authors nor the publisher, nor any other party involved in the preparation of this platform warrants that the information contained herein is in every aspect accurate or complete, and they disclaim all responsibility for any errors or omissions for the results obtained from the use of the information contained in this work. Readers are advised to confirm the information contained herein with other sources. For example, readers are advised to check the product information of each drug mentioned, and that any information contained on NYSORA's Podcast is accurate.

This episode discusses the main findings from a 2025 review by Suleiman et al. published in BJA, examining how we should manage direct oral anticoagulants (DOACs) in patients having neuraxial anesthesia and deep peripheral nerve blocks. Traditionally, the ASRA guidelines have leaned heavily on long DOAC interruption times and selective drug level testing to avoid the rare but devastating complication of spinal epidural hematoma. But new evidence—from the PAUSE strategy and the PAUSE-2 pilot trial—suggests that shorter, pharmacokinetics-based DOAC holds may offer comparable safety without increasing thromboembolic risk.

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#nysora⁠⁠ ⁠⁠#regionalanesthesia⁠⁠ ⁠⁠#anesthesia⁠⁠

Disclaimer: Medicine is an ever-changing science. As new research and clinical experience broaden, changes in treatment and drug therapy are required. The authors and publishers have checked with sources believed to be reliable in efforts to provide accurate information within the available or accepted standards of care. However, given the possibility of human error or changes in medical practice, neither the authors nor the publisher, nor any other party involved in the preparation of this platform warrants that the information contained herein is in every aspect accurate or complete, and they disclaim all responsibility for any errors or omissions for the results obtained from the use of the information contained in this work. Readers are advised to confirm the information contained herein with other sources. For example, readers are advised to check the product information of each drug mentioned, and that any information contained on NYSORA's Podcast is accurate.

In this episode of Updates in Anesthesiology, we discuss a 2025 Anesthesiology Clinical Focus Review on the perioperative management of patients receiving maintenance hemodialysis. This review reshapes how we assess, prepare, and manage a rapidly growing surgical population at exceptionally high perioperative risk. From hidden cardiovascular disease and fluid shifts to electrolyte traps, medication pitfalls, vascular access, and timing of dialysis.

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--------------------------------------------------------- ⁠⁠

#nysora⁠⁠ ⁠⁠#regionalanesthesia⁠⁠ ⁠⁠#anesthesia⁠⁠

Disclaimer: Medicine is an ever-changing science. As new research and clinical experience broaden, changes in treatment and drug therapy are required. The authors and publishers have checked with sources believed to be reliable in efforts to provide accurate information within the available or accepted standards of care. However, given the possibility of human error or changes in medical practice, neither the authors nor the publisher, nor any other party involved in the preparation of this platform warrants that the information contained herein is in every aspect accurate or complete, and they disclaim all responsibility for any errors or omissions for the results obtained from the use of the information contained in this work. Readers are advised to confirm the information contained herein with other sources. For example, readers are advised to check the product information of each drug mentioned, and that any information contained on NYSORA's Podcast is accurate.

In this episode of Updates in Anesthesiology, we discuss one of the most significant airway guideline updates in a decade. The Difficult Airway Society’s 2025 guidelines reshape how we approach unanticipated difficult tracheal intubation in adults. From first-attempt success and videolaryngoscopy for all, to peroxygenation, physiologically difficult airways, linear algorithms, and a renewed emphasis on human factors.

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--------------------------------------------------------- ⁠⁠

#nysora⁠⁠ ⁠⁠#regionalanesthesia⁠⁠ ⁠⁠#anesthesia⁠⁠

Disclaimer: Medicine is an ever-changing science. As new research and clinical experience broaden, changes in treatment and drug therapy are required. The authors and publishers have checked with sources believed to be reliable in efforts to provide accurate information within the available or accepted standards of care. However, given the possibility of human error or changes in medical practice, neither the authors nor the publisher, nor any other party involved in the preparation of this platform warrants that the information contained herein is in every aspect accurate or complete, and they disclaim all responsibility for any errors or omissions for the results obtained from the use of the information contained in this work. Readers are advised to confirm the information contained herein with other sources. For example, readers are advised to check the product information of each drug mentioned, and that any information contained on NYSORA's Podcast is accurate.

In this episode of Updates in Anesthesiology, Dr. Hadzic discusses a 2025 Anesthesia & Analgesia trial that challenges a long-standing airway management routine.Could high-flow nasal oxygen (HFNO) replace the laryngeal mask airway (LMA) for short general anesthesia cases without muscle paralysis? This randomized trial puts it to the test, reporting surprising results on safety, comfort, and carbon dioxide dynamics. Stick around as we unpack the science, the caveats, and what this could mean for the future of low-invasive airway management.

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#nysora⁠⁠ ⁠⁠#regionalanesthesia⁠⁠ ⁠⁠#anesthesia⁠⁠

Disclaimer: Medicine is an ever-changing science. As new research and clinical experience broaden, changes in treatment and drug therapy are required. The authors and publishers have checked with sources believed to be reliable in efforts to provide accurate information within the available or accepted standards of care. However, given the possibility of human error or changes in medical practice, neither the authors nor the publisher, nor any other party involved in the preparation of this platform warrants that the information contained herein is in every aspect accurate or complete, and they disclaim all responsibility for any errors or omissions for the results obtained from the use of the information contained in this work. Readers are advised to confirm the information contained herein with other sources. For example, readers are advised to check the product information of each drug mentioned, and that any information contained on NYSORA's Podcast is accurate.

In this episode of Updates in Anesthesiology, Dr. Hadzic discusses a 2025 RAPM study comparing the classic lidocaine–bupivacaine mix to 0.5% bupivacaine alone for infraclavicular blocks. The results? Mixing speeds onset but slashes duration by nearly 14 hours. Tune in to learn why faster isn’t always better, how adjuvants like dexamethasone already optimize your block, and when it’s finally time to ditch the mix.

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--------------------------------------------------------- ⁠⁠

#nysora⁠⁠ ⁠⁠#regionalanesthesia⁠⁠ ⁠⁠#anesthesia⁠⁠

Disclaimer: Medicine is an ever-changing science. As new research and clinical experience broaden, changes in treatment and drug therapy are required. The authors and publishers have checked with sources believed to be reliable in efforts to provide accurate information within the available or accepted standards of care. However, given the possibility of human error or changes in medical practice, neither the authors nor the publisher, nor any other party involved in the preparation of this platform warrants that the information contained herein is in every aspect accurate or complete, and they disclaim all responsibility for any errors or omissions for the results obtained from the use of the information contained in this work. Readers are advised to confirm the information contained herein with other sources. For example, readers are advised to check the product information of each drug mentioned, and that any information contained on NYSORA's Podcast is accurate.

In this episode of Updates in Anesthesiology, Dr. Hadzic discusses a 2025 review that reshapes how we manage bleeding in children. From restrictive transfusion thresholds and viscoelastic testing to the revival of whole blood and smarter use of TXA, pediatric hemostasis is entering a new era. Tune in to learn why kids aren’t just “small adults,” how to individualize transfusion decisions, and the five steps to safer blood management in your next pediatric case.

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--------------------------------------------------------- ⁠⁠

#nysora⁠⁠ ⁠⁠#regionalanesthesia⁠⁠ ⁠⁠#anesthesia⁠⁠

Disclaimer: Medicine is an ever-changing science. As new research and clinical experience broaden, changes in treatment and drug therapy are required. The authors and publishers have checked with sources believed to be reliable in efforts to provide accurate information within the available or accepted standards of care. However, given the possibility of human error or changes in medical practice, neither the authors nor the publisher, nor any other party involved in the preparation of this platform warrants that the information contained herein is in every aspect accurate or complete, and they disclaim all responsibility for any errors or omissions for the results obtained from the use of the information contained in this work. Readers are advised to confirm the information contained herein with other sources. For example, readers are advised to check the product information of each drug mentioned, and that any information contained on NYSORA's Podcast is accurate.

In this episode of Updates in Anesthesiology, Dr. Hadzic discusses the main findings from a 2025 BJA review by Tinsley et al. The study reported how to manage non-insulin diabetes medicines in the perioperative period safely. From metformin’s misunderstood safety profile to the hidden risks of SGLT-2 inhibitors and GLP-1 agonists, you’ll learn which drugs to hold, which to continue, and how to prevent complications like euglycaemic DKA and aspiration. 

Where else to find us:
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--------------------------------------------------------- ⁠⁠

#nysora⁠⁠ ⁠⁠#regionalanesthesia⁠⁠ ⁠⁠#anesthesia⁠⁠

Disclaimer: Medicine is an ever-changing science. As new research and clinical experience broaden, changes in treatment and drug therapy are required. The authors and publishers have checked with sources believed to be reliable in efforts to provide accurate information within the available or accepted standards of care. However, given the possibility of human error or changes in medical practice, neither the authors nor the publisher, nor any other party involved in the preparation of this platform warrants that the information contained herein is in every aspect accurate or complete, and they disclaim all responsibility for any errors or omissions for the results obtained from the use of the information contained in this work. Readers are advised to confirm the information contained herein with other sources. For example, readers are advised to check the product information of each drug mentioned, and that any information contained on NYSORA's Podcast is accurate.

A 2025 Anesthesiology meta-analysis shows that the best pain control after total hip arthroplasty comes from combining regional anesthesia with local infiltration analgesia (LIA). While LIA alone is effective, adding a quadratus lumborum or pericapsular nerve group (PENG) block significantly improves pain relief, reduces opioid use, and preserves mobility. The takeaway: stop choosing between techniques — regional + local is the new gold standard for hip surgery analgesia.

Where else to find us:
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--------------------------------------------------------- ⁠⁠

#nysora⁠⁠ ⁠⁠#regionalanesthesia⁠⁠ ⁠⁠#anesthesia⁠⁠

Disclaimer: Medicine is an ever-changing science. As new research and clinical experience broaden, changes in treatment and drug therapy are required. The authors and publishers have checked with sources believed to be reliable in efforts to provide accurate information within the available or accepted standards of care. However, given the possibility of human error or changes in medical practice, neither the authors nor the publisher, nor any other party involved in the preparation of this platform warrants that the information contained herein is in every aspect accurate or complete, and they disclaim all responsibility for any errors or omissions for the results obtained from the use of the information contained in this work. Readers are advised to confirm the information contained herein with other sources. For example, readers are advised to check the product information of each drug mentioned, and that any information contained on NYSORA's Podcast is accurate.

In this episode of Updates in Anesthesiology, Dr. Hadzic unpacks a landmark 2025 study, which challenges the long-held belief that intraoperative hypotension (MAP < 65 mm Hg) contributes to postoperative delirium in older adults. With nearly 40,000 patients analyzed and no association found, it’s time to rethink reflexively chasing MAP thresholds. Tune in to hear why blood pressure might not be the villain we thought, and what really matters for preventing POD.

Where else to find us:
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--------------------------------------------------------- ⁠⁠

#nysora⁠⁠ ⁠⁠#regionalanesthesia⁠⁠ ⁠⁠#anesthesia⁠⁠

Disclaimer: Medicine is an ever-changing science. As new research and clinical experience broaden, changes in treatment and drug therapy are required. The authors and publishers have checked with sources believed to be reliable in efforts to provide accurate information within the available or accepted standards of care. However, given the possibility of human error or changes in medical practice, neither the authors nor the publisher, nor any other party involved in the preparation of this platform warrants that the information contained herein is in every aspect accurate or complete, and they disclaim all responsibility for any errors or omissions for the results obtained from the use of the information contained in this work. Readers are advised to confirm the information contained herein with other sources. For example, readers are advised to check the product information of each drug mentioned, and that any information contained on NYSORA's Podcast is accurate.