Journal of Clinical Anesthesia and Intensive Care

Commentary Open Access

Mind-body approaches for reducing the need for post-operative opioids: Evidence and opportunities

Bethany D. Pester , Robert R. Edwards , Marc O. Martel , Christopher J. Gilligan , Samantha M. Meints

While opioids remain our most potent analgesics in the management of pain, the many potential harms of prescription opioids have become increasingly clear. Despite the analgesic benefits for people with acute and chronic pain [1], opioid therapy (especially long-term opioid treatment) can result in significant problems such as opioid misuse, the development of opioid use disorder, and overdose. Some authors report that up to 20-30% of patients in primary and tertiary care settings who are maintained on long-term opioid therapy misuse opioids (i.e., use them in a manner other than how the opioids are prescribed) [2,3]. Misuse of opioids can cause or exacerbate additional health problems in people with chronic pain [1,4], and in fact, roughly 10% of patients prescribed long-term opioid therapy may develop an opioid use disorder (OUD), although prevalence varies between studies depending on differences in methodology and operational definitions [3]. 

J Clin Anesth Intensive Care, 2022, Volume 3, Issue 1, p1-5 | DOI: 10.46439/anesthesia.3.016

Case Report Open Access

Uncommon but serious: The risk of atrio-esophageal fistula (AEF) following atrial fibrillation ablation

Nicolas Wilmet , Ahmed Sanoussi , Hervé Deladrière , Seyed Javad Bidgoli

Atrial fibrillation (AF) affects 4% of individuals over 60 years old, an incidence rising to 9% in those over 80. For patients with symptomatic AF unresponsive to medication, catheter ablation is a common treatment, though it carries risks including cardiac tamponade, thromboembolic events, and rarely, atrio-esophageal fistula (AEF). AEF, a severe complication (up to 0.1%) with a mortality rate of 67%-100%, arises from thermal injury to the esophagus. Cardiac, neurologic or infection related symptoms appear 2 days to 6 weeks post-procedure.

J Clin Anesth Intensive Care, 2025, Volume 5, Issue 1, p1-6 | DOI: 10.46439/anesthesia.5.023

Commentary Open Access

The modern era of neuromuscular blockade: From inflammatory mechanisms to innovative neuromuscular and reversal agents

Ehab Farag , Vanessa Bou Sleiman , Maged Argalious

The introduction of neuromuscular blocking agents by Griffith and Johnson 83 years ago revolutionized anesthesia and surgical practices. Muscle relaxants are vital for facilitating endotracheal intubation, minimizing upper airway trauma, and creating optimal surgical conditions.

J Clin Anesth Intensive Care, 2025, Volume 5, Issue 1, p10-15 | DOI: 10.46439/anesthesia.5.025