Paravertebral block does not reduce chronic post-thoracotomy pain versus epidural; laryngeal mask cuts airway events in children

• Research Nov 5, 2026
  TOPIC-2: paravertebral block does not reduce chronic post-thoracotomy pain versus thoracic epidural in 770-patient trial
  In the open-label, multicenter TOPIC-2 trial at 15 U.K. thoracic centers, chronic post-thoracotomy pain at six months occurred in 59 of 272 participants (22%) with paravertebral blockade and 47 of 292 (16%) with thoracic epidural (adjusted risk ratio 1.32; 95% CI 0.93 to 1.86; P = .12), a difference that was not significant. Thoracic epidural gave marginally better acute pain relief one day after the operation, and postoperative complications were comparable, the authors said in The BMJ.
  Sources: The BMJ, PubMed
• Research Nov 4, 2026
  Laryngeal mask airway lowers respiratory adverse events to 22.5% from 57.5% in 400 children having adenotonsillectomy
  A multicenter randomized trial in The BMJ assigned 400 children aged 2 to under 7 years to laryngeal mask airway or endotracheal tube ventilation for adenotonsillectomy. Perioperative respiratory adverse events, the primary outcome, occurred in 22.5% (45 of 200) with the laryngeal mask and 57.5% (115 of 200) with the endotracheal tube, an absolute risk difference of -35.0 percentage points (95% CI -43.5 to -25.7; P < .001). The authors said the result applies to ventilation by experienced anesthesiologists.
  Sources: The BMJ, PubMed
• Research Nov 6, 2026
  OPTIPAM trial of individualized blood pressure targets in cardiac surgery stops early for bleeding with no outcome difference
  The French multicenter OPTIPAM trial, published in Anesthesiology, targeted mean arterial pressure within 10% of preoperative baseline during cardiac surgery and for 24 hours after, versus a standard target of 65 mm Hg or higher. It enrolled 172 patients before the data and safety monitoring board stopped it. The primary composite of death, acute kidney injury or neurologic complications within seven days occurred in 32% versus 29% (relative risk 1.1; 95% CI 0.7 to 1.8; P = .76), and hemorrhagic complications in 18% versus 3% (P = .003).
  Sources: Anesthesiology, PubMed
• Policy Nov 5, 2026
  CMS proposed conditions of participation overhaul seeks comment on flexibility in physician supervision of nurse anesthetists
  The Centers for Medicare & Medicaid Services (CMS) on Nov. 5 proposed revisions to the conditions of participation after reviewing all 21 provider and supplier types, which it estimated would save $320 million. The proposed rule solicits comment on approaches to allow providers flexibility regarding the requirement for physician supervision of certified registered nurse anesthetists, according to the CMS fact sheet.
  Source: CMS
• FDA Nov 2, 2026
  Class 1 recall covers 12,358 Cardinal Health kits containing recalled BD Alaris pump infusion sets
  The Food and Drug Administration (FDA) posted a Class 1 recall on Nov. 2 for Cardinal Health Presource kits containing BD Alaris Pump Infusion Sets used with the BD Alaris Pump Module Model 8100, distributed in the U.S. and Canada. The kits contain infusion sets that were recalled for performance issues, according to the recall entry, and Cardinal Health sent customers an urgent medical device correction notice.
  Source: FDA

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