Anesthesiology

Rising early burnout and preference for less‑than‑full‑time training among UK anaesthesia trainees

Baseline data from the 2024 UK trainee cohort show 76% prefer less‑than‑full‑time training at the start of specialty training. Trainees report high effort‑reward imbalance and greater stress compared with prior generations. Non‑anaesthetic ACCS rotations correlated with higher burnout and concerns about training bottlenecks were common. These findings should inform training bodies to create flexible, psychologically safe, and sustainable training pathways. 1

Network meta‑analysis: intrathecal opioids reduce 24‑hour opioids and pain most after cardiac surgery

In 133 randomized trials (9,816 patients), intrathecal opioids reduced 24‑hour opioid use by -14.8 MME versus control. Intrathecal opioids also reduced 24‑hour pain by -1.2 cm on the VAS, the largest and most consistent effect. ESPB and PIPB produced smaller opioid reductions and may be reasonable when neuraxial techniques are contraindicated. Heterogeneity across trials was substantial, limiting certainty about comparative effectiveness and recovery outcomes. 2

Desflurane versus propofol in older adults: similar PND incidence but longer delirium duration with desflurane

In 126 patients ≥65 undergoing major urological surgery, overall PND incidence did not differ between propofol and desflurane. Delirium‑present days were longer with desflurane (median 1.5 vs 1 days; P = 0.044). Interleukin‑6 rose in both groups and was higher on day 3 in patients who developed delirium. The longer delirium duration with desflurane is exploratory given few delirium events and requires cautious interpretation. 3