Regional anesthesia and pain medicine
Audio Summaries

Real-time AI-assisted nerve tracking for ultrasound-guided nerve identification: a prospective randomized trial

Sep 18, 2026

This study aimed to determine whether AI-assisted nerve tracking improves independent ultrasound-guided identification of the median nerve and supraclavicular brachial plexus after AI support is removed. The results showed no significant difference in first-attempt identification success between the AI-assisted and control groups, although the AI group reported greater confidence in identifying the brachial plexus after additional training. Overall, the findings suggest that brief AI-assisted training does not enhance immediate independent nerve identification skills.

Transcutaneous auricular vagus nerve stimulation to prevent rebound pain after interscalene block for arthroscopic shoulder surgery

Sep 15, 2026

The authors aimed to determine whether transcutaneous auricular vagus nerve stimulation (taVNS) could reduce rebound pain following interscalene block in patients undergoing arthroscopic shoulder surgery. The study found that taVNS significantly decreased the incidence of rebound pain and was associated with lower pain scores and improved quality of recovery and sleep, without increasing adverse events. These results suggest that taVNS may enhance postoperative pain management in this surgical context.

Caudal versus penile block and urethrocutaneous fistula formation following hypospadias repair in children <2 years: a multicenter randomized clinical trial

Sep 11, 2026

This multicenter randomized clinical trial aimed to compare the incidence of urethrocutaneous fistula (UCF) formation following hypospadias repair in children under 2 years old, specifically evaluating the effectiveness of caudal versus penile blocks. The study found no significant difference in UCF rates between the two anesthesia techniques, although the caudal block was associated with lower opioid use and pain scores. The authors caution that the exploratory nature of the findings, due to incomplete enrollment and follow-up, limits the conclusions that can be drawn.

Ultrasound-guided percutaneous temporary vagus nerve stimulation for refractory post-traumatic chronic pain and post-traumatic stress disorder (PTSD): first reported case and implantation technique

Sep 11, 2026

The authors aim to explore the efficacy of ultrasound-guided percutaneous temporary vagus nerve stimulation (VNS) as a treatment for a patient suffering from refractory chronic pain and post-traumatic stress disorder (PTSD) following multiple traumatic brain injuries. The case report details the successful implantation of a VNS device, which resulted in significant pain relief and improvement in gastrointestinal symptoms and fatigue, although PTSD symptoms showed an increase during follow-up. This study presents a novel approach to VNS delivery, highlighting its potential benefits for patients with coexisting chronic pain and PTSD.

Practical guide to intrathecal drug delivery: short-term and long-term management and complications

Sep 8, 2026

The authors aim to provide a comprehensive guide for the short-term and long-term management of intrathecal drug delivery (IDD) systems, addressing the underutilization of this therapy for refractory pain despite its benefits. They synthesize current evidence and clinical experience to outline best practices for patient selection, device management, and complication mitigation, while also considering specific challenges in cancer versus non-cancer populations. The guide emphasizes the importance of functional improvement and quality of life as key outcomes, aiming to enhance the safe and effective application of IDD in pain management.

Systematic review and meta-analysis of intrathecal drug delivery systems for the treatment of chronic refractory non-cancer pain

Sep 8, 2026

The authors aimed to evaluate the clinical outcomes and safety of intrathecal drug delivery (ITDD) systems for treating chronic non-cancer pain. Their systematic review and meta-analysis of 39 studies found a significant mean reduction in pain intensity, along with improvements in function and health-related quality of life; however, the evidence quality was low due to study limitations, highlighting the need for better reporting and controlled trials.

Bupivacaine serum concentrations during chronic intrathecal infusion for pain management: an observational single-center study

Sep 8, 2026

This study aimed to quantify serum concentrations of bupivacaine during chronic intrathecal infusion for cancer pain management and assess factors influencing systemic absorption. The findings indicate that while the mean serum concentration of bupivacaine was significantly below the toxicity threshold, it was positively correlated with the daily dose and influenced by body mass index and infusion flow rates. Overall, the research highlights the safety of bupivacaine use in this context, despite limited data on its systemic effects.

Sequential flex mode for intrathecal infusion after continuous mode failure: a retrospective follow-up study for refractory cancer pain management

Sep 8, 2026

The authors aimed to evaluate whether a novel sequential flex mode of intrathecal infusion could provide better pain relief for patients with refractory cancer pain compared to the traditional continuous flow rate mode, particularly after the latter has failed. In their retrospective study of 53 patients, they found that 71.7% experienced at least a 30% reduction in pain, with a significant decrease in median pain scores after switching to the sequential flex mode. The findings suggest that this new infusion strategy may enhance analgesic efficacy without increasing daily drug dosages.

Implanted intrathecal drug delivery systems: a narrative review for the perioperative, obstetric, and intensive care anesthesiologist

Sep 8, 2026

This narrative review aims to address the unique challenges anesthesiologists face when managing patients with implanted intrathecal drug delivery systems (IDDS) in perioperative, obstetric, and intensive care settings. The authors provide essential knowledge on IDDS technology, the appropriateness of neuraxial procedures, and potential complications, ultimately offering evidence-based best practices to enhance patient safety and clinical outcomes. Key topics include intrathecal pharmacology, device safety, and considerations for neuraxial anesthesia in this patient population.

Historical perspective on evolution of neuraxial delivery for pain (1975-2025)

Sep 8, 2026

The authors examine the historical development of neuraxial delivery methods for pain management over the past 50 years, aiming to understand how advancements in this field have shaped current practices. They reflect on the evolution of neuraxially targeted therapeutics and speculate on future directions for pain management in the 21st century.