Anesth. Res., Volume 2, Issue 4 (December 2025) – 3 articles

Background: Sepsis is a life-threatening syndrome caused by a dysregulated host response to infection leading to organ dysfunction. Distinguishing sepsis from localized infection is crucial, as it guides clinical decision-making and biomarker interpretation. Biomarkers may support diagnosis, prognosis, and therapeutic choices, but their integration into practice remains debated. Methods: This narrative review was conducted in accordance with the SANRA (Scale for the Assessment of Narrative Review Articles) guidelines. A comprehensive literature search was performed in PubMed, Embase, and Cochrane CENTRAL (January 2000–September 2025). Studies evaluating sepsis-related biomarkers for diagnosis, prognostication, shock assessment, antimicrobial stewardship, and post-acute follow-up were considered. Findings: Established biomarkers such as procalcitonin (PCT), C-reactive protein (CRP), and lactate remain widely used for diagnosis, monitoring of inflammatory response, and assessment of severity. Emerging candidates include pancreatic stone protein (PSP), neutrophil gelatinase-associated lipocalin (NGAL), and monocyte HLA-DR (mHLA-DR), which may provide insights into infection dynamics, renal injury, and immune suppression, respectively. However, limitations in standardization and heterogeneous evidence hinder routine implementation. Interleukin-6 (IL-6), despite extensive study, shows limited specificity and inconsistent clinical applicability. Renin has been proposed as a marker of shock severity rather than infection. Comparative evidence highlights the need for stage-specific biomarker use across prehospital, emergency, ICU, and recovery phases. Conclusions: No single biomarker is universally applicable in sepsis. Their utility depends on timing, clinical setting, and patient phenotype. Combining classical and emerging biomarkers with point-of-care technologies and dynamic monitoring may enhance personalized management. Limitations include heterogeneity of evidence and lack of standardized thresholds. Future research should validate biomarker panels, integrate them into stewardship strategies, and explore their cost-effectiveness in clinical practice. Full article

The teaching of medical history, once central to medical education, has been progressively displaced by science- and competency-focused curricula. In anesthesiology, despite the presence of historical scholarship and institutional resources, the history of this specialty is rarely used as a formal educational tool. This narrative review explores how historical narratives can support the development of professionalism and professional identity in anesthesia training. An exploratory search of the literature revealed no prior studies explicitly linking anesthesia history to professional identity formation, underscoring a gap in current scholarship. Drawing on the foundational literature in medical education and selected historical examples, including figures such as Crawford Long, Henry Beecher, and Virginia Apgar, this review illustrates how reflective engagement with historical episodes can deepen ethical awareness, foster identity formation, and contextualize the evolving role of the anesthesiologist. It proposes a theoretical framework and strategies for integrating historical content into anesthesia curricula and argues that historical reflection can complement existing methods for teaching professionalism. The history of anesthesia, when purposefully employed, offers a powerful means to humanize training, support critical reflection, and better prepare trainees for the ethical and professional challenges of contemporary practice. Full article

Opioid use disorder remains a leading national cause of mortality. Physician opioid prescribing contributes to this crisis. In urogynecology, most of these prescriptions are aimed at addressing postoperative pain. This expert review examines the factors that contribute to postoperative pain and opioid use in urogynecologic patients. We discuss patient characteristics, physician interventions and alternative therapies that may influence postoperative pain and opioid use. By identifying patients at higher risk for postoperative pain and opioid use and utilizing evidence-based strategies to mitigate postoperative pain, physicians caring for urogynecology patients can both reduce postoperative opioid use while still providing adequate patient pain control. Full article