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Explore NYSORA knowledge base for free:
In medicine, precision is not a luxury — it is a requirement. Education in a clinical practice must be always updated and standardized. Today, NYSORA launches NYSORA360, a next-generation clinical education and clinical reference platform, now powered by NAPKA, NYSORA’s AI-Powered Knowledge Assistant. This marks a new chapter in how anesthesiology is studied, taught, and practiced. Developed with NYSORA’s Think Tank—a select group of leading academics, educators, and clinicians—NAPKA is built to deliver real-time, expert-backed support for anesthesiology, regional anesthesia, pain management, and perioperative care. Powered by NYSORA’s trusted resources, it helps clinicians, educators, and students make faster, more informed decisions—at the point of care and during study. What NYSORA360 Delivers: An Instant access for for learning, quick consultations, and case preparation Structured, visual learning through illustrations, videos, and clinical insights NAPKA (Real-time tools like DoseCalc, Case Manager, and quick topic search) Always updated content, accessible anytime, across all devices. “We built NYSORA360 and NAPKA because the ways of accessing information and learning from large textbooks and multiple websites are obsolete,” said Dr. Admir Hadzic, Director of NYSORA. “NYSORA360 is the platform designed for the demands of modern anesthesiology — built by the people who have the same needs as you!.” Join the global community shaping the future of anesthesiology. Discover the tools trusted by clinicians worldwide—built by those who practice it.
May 9, 2025
Chronic low back pain (CLBP) continues to be a leading cause of disability globally, especially among aging populations. In recent years, restorative neurostimulation has emerged as a novel and effective treatment for patients with mechanical low back pain due to multifidus muscle dysfunction, particularly those unresponsive to conventional therapy. A new study by Ardeshiri et al. (2025) in Regional Anesthesia and Pain Medicine, aggregating data from three independent clinical trials, sheds light on the effectiveness of this therapy in older patients — a group historically underrepresented in clinical trials. Understanding the burden of chronic low back pain in older adults Chronic low back pain affects up to 80% of adults at some point in their lives, with prevalence increasing with age. The condition leads to: Loss of mobility and independence Increased fall risk and hospitalizations Reduced quality of life Higher healthcare utilization and costs Older patients often experience mechanical low back pain — pain linked to spinal movement or load — which is commonly rooted in dysfunction of the multifidus muscle, a deep spinal stabilizer. Unfortunately, this subgroup of patients often shows limited improvement from standard interventions such as physical therapy, analgesics, or corticosteroid injections. What is restorative neurostimulation? Restorative neurostimulation is an innovative therapy designed to target the underlying dysfunction of the multifidus muscle, rather than masking symptoms. It employs neuromodulation, a field that uses electrical stimulation to influence nerve activity. Key features of restorative neurostimulation: Target area: Medial branch of the dorsal ramus at the L2 spinal nerve Device components: Implantable pulse generator Leads positioned near spinal nerves Therapy regimen: Twice-daily 30-minute sessions Generates smooth, tetanic contractions to retrain the multifidus muscle Goal: Restore spinal stability and reduce pain by reversing muscle inhibition This therapy is branded as ReActiv8®, and has already demonstrated safety and efficacy in younger […]
May 9, 2025
In the ever-evolving landscape of cancer care, the role of anesthesia during cancer surgery has garnered significant scientific attention. Could the choice of anesthetic technique influence cancer recurrence and survival rates? A 2025 review by Dr. Mohd S. Ramly and Dr. Donal J. Buggy offers the latest insights into this critical question. Scientific background The “seed and soil” hypothesis, dating back to 1889, remains central: cancer cells (“seed”) metastasize if the body’s environment (“soil”) is receptive. Surgery can inadvertently promote cancer spread through: Stress-induced immune suppression Inflammatory responses stimulate residual tumor growth Formation of supportive metastatic niches Anesthetic agents could influence these biological processes by modulating immunity, inflammation, and cellular signaling. Anesthetic methods studied 1. Propofol total intravenous anesthesia (TIVA) vs. volatile anesthesia Laboratory findings: Propofol reduces angiogenesis and inflammation. Volatile agents like sevoflurane may promote cancer cell proliferation via hypoxia pathways. Clinical findings: Large trials in breast, gastrointestinal, and colorectal cancers show no significant difference in cancer recurrence or survival between propofol and volatile anesthesia. Ongoing studies like GA-CARES continue to explore this question. 2. Regional anesthesia and neuraxial blocks Hypothesized benefits: Blunting the surgical stress response. Reducing opioid requirement. Preserving natural killer (NK) cell function. Reality check: Major trials show no difference in cancer outcomes between general anesthesia with or without neuraxial techniques. 3. Intravenous lidocaine Early retrospective data suggested improved survival. However, a recent RCT in pancreatic cancer patients found neutral effects on recurrence and survival. Peritumoral infiltration during breast cancer surgery shows promising results with reduced local recurrence and improved survival. Other perioperative agents studied Nonsteroidal anti-inflammatory drugs (NSAIDs) Epidemiologic studies suggest a potential benefit, especially for colorectal and breast cancers. RCTs using long-term celecoxib showed no survival benefit. Routine perioperative NSAID use is not currently recommended for oncologic benefit. Opioids Opioids may have immunosuppressive or […]
May 8, 2025
