Anesthesiology Clinics RSS feed. https://www.anesthesiology.theclinics.com/issues?journalCode=xatc&publicationCode=xatc&rss=yes Elsevier Inc. en © 2026 Published by Elsevier Inc. All rights reserved. Anesthesiology Clinics 1932-2275 2026-06-04-07:00 © 2026 Published by Elsevier Inc. All rights reserved. permissionshelpdesk@elsevier.com https://www.anesthesiology.theclinics.com/article/S1932-2275(26)00048-0/fulltext?rss=yes Viscoelastic hemostatic assays (VHAs), such as thromboelastography, rotational thromboelastometry, and Quantra, are increasingly used to guide postpartum hemorrhage (PPH) resuscitation. We review device principles, reference ranges, transfusion thresholds, and algorithmic integration. Pregnancy-specific VHA thresholds identify hypofibrinogenemia requiring replacement with cryoprecipitate or fibrinogen concentrate. Algorithms with VHA-guided bundles may reduce massive PPH morbidity and allogeneic transfusion requirements. VHA platelet indices correlate only at low counts; anticoagulants and temperature/pH can confound results. VHA-enabled, threshold-based algorithms expedite targeted therapy in PPH, reduce plasma exposure, and complement standard laboratories and clinical judgment. Viscoelastic Hemostatic Assays in Postpartum Hemorrhage and Pregnancy Adithya D. Bhat, Michaela K. Farber, John J. Kowalczyk 10.1016/j.anclin.2026.04.005 Anesthesiology Clinics (2026) 2026-06-04 Anesthesiology Clinics 2026-06-04 https://www.anesthesiology.theclinics.com/article/S1932-2275(26)00046-7/fulltext?rss=yes Pregnancy induces significant changes in the coagulation and fibrinolytic systems, creating a physiologic hypercoagulable state. While these adaptations protect against hemorrhage at delivery, they pose complex challenges in patients with underlying coagulation disorders. This review summarizes hemostasis in pregnancy, common inherited and acquired bleeding disorders, and the anesthetic considerations essential for safe peripartum management. Anesthetic and Peripartum Management of Inherited Coagulation Disorders in Pregnancy Talia Scott, Daniel Katz 10.1016/j.anclin.2026.04.003 Anesthesiology Clinics (2026) 2026-06-04 Anesthesiology Clinics 2026-06-04 https://www.anesthesiology.theclinics.com/article/S1932-2275(26)00044-3/fulltext?rss=yes This review discusses the rising impact of opioid use disorder (OUD) on peripartum care, highlighting the maternal and neonatal risks, including neonatal abstinence syndrome. It traces the US opioid crisis from aggressive 1990s prescribing to 2016 Center for Disease Control guidelines and notes enduring regional disparities in opioid prescriptions. The text distinguishes OUD from opioid-induced hyperalgesia and explains the pharmacology of methadone (full agonist) and buprenorphine (partial agonist), along with their implications for treatment during pregnancy. In obstetric anesthesia, coordinated, multimodal pain management is essential, with medication for opioid use disorder continuation, early neuraxial analgesia, and avoidance of withdrawal-precipitating agents. Peripartum Management for Patients Receiving Medication for Opioid Use Disorder Henry Paiste, Brendan Lynch, Grace Lim 10.1016/j.anclin.2026.04.001 Anesthesiology Clinics (2026) 2026-06-04 Anesthesiology Clinics 2026-06-04 https://www.anesthesiology.theclinics.com/article/S1932-2275(26)00049-2/fulltext?rss=yes Placenta accreta spectrum (PAS) is a complex obstetric condition with a rising incidence in parallel with the rising rate of cesarean delivery. Given the significant and rapid hemorrhage associated with cesarean hysterectomy it is critically important to prepare for resuscitation and transfusion. Both neuraxial and general anesthesia can be used, each having their own advantages and disadvantages. The diagnosis of PAS can have significant mental health effects on the mother that need to be considered both during pregnancy and postpartum. Placenta Accreta Spectrum F. Arran Seiler, Brett D. Einerson, Christine Warrick 10.1016/j.anclin.2026.04.006 Anesthesiology Clinics (2026) 2026-06-01 Anesthesiology Clinics 2026-06-01 https://www.anesthesiology.theclinics.com/article/S1932-2275(26)00045-5/fulltext?rss=yes Trauma-informed care continues to follow the 4R principles (realize the widespread nature of trauma, recognize what unresolved trauma looks like, respond by changing practices and protocols, and resist retraumatization) but has expanded to include 6 core guiding principles that include safety, trust, peer support, mutuality, empowerment, and the understanding of an individual’s cultural context. Additionally, it is now recommended that trauma-informed practices be offered as universal precautions to all individuals, regardless of trauma history, focusing on trauma prevention. Obstetric anesthesia providers play an important role in minimizing and eliminating preventable trauma and mitigating psychological harm. The Anesthesiologist’s Role in Trauma-Informed Care Tracey M. Vogel, Katherine M. Seligman, Erica Coffin 10.1016/j.anclin.2026.04.002 Anesthesiology Clinics (2026) 2026-06-01 Anesthesiology Clinics 2026-06-01 https://www.anesthesiology.theclinics.com/article/S1932-2275(26)00026-1/fulltext?rss=yes Administration of anesthetic care in the peripartum period represents numerous areas where vigilance in clinical care and implementation of systematic safety measures are needed to improve maternal outcomes. Obstetric anesthesia care often necessitates expeditious intervention in an environment where both maternal and fetal conditions change rapidly. A thorough understanding of the risks of each intervention as well as best practices to improve maternal safety are critical to optimize patient outcomes. Continued reassessment of protocols and implementation of new evidence and consensus-based guidelines are needed to continually enhance maternal safety in this complex health care environment. Patient Safety in Obstetric Anesthesiology: Current Challenges and Prevention Strategies Emily E. Sharpe, Mark D. Rollins 10.1016/j.anclin.2026.02.016 Anesthesiology Clinics (2026) 2026-04-08 Anesthesiology Clinics 2026-04-08 https://www.anesthesiology.theclinics.com/article/S1932-2275(26)00031-5/fulltext?rss=yes Maternal cardiac arrest occurs in 1 of 12,000 to 36,000 pregnancies and presents with unique etiologies and physiologic considerations. Pregnancy alters resuscitation dynamics, making key modifications to advanced cardiac life support protocols such as left uterine displacement, early and effective airway management, and consideration of perimortem cesarean delivery, crucial for successful resuscitation. Extracorporeal life support may be indicated in refractory cases and must account for unique maternal physiology, like increased oxygen consumption and cardiac output. Despite its complexity, maternal cardiac arrest can have favorable outcomes with timely multidisciplinary care, highlighting the importance of preparedness in maternal code response. Cardiac Arrest and Extracorporeal Membrane Oxygenation in the Peripartum Period A. Taylor Thomas, Jamel Ortoleva, Emily E. Naoum 10.1016/j.anclin.2026.02.019 Anesthesiology Clinics (2026) 2026-04-06 Anesthesiology Clinics 2026-04-06 https://www.anesthesiology.theclinics.com/article/S1932-2275(26)00027-3/fulltext?rss=yes Breakthrough pain during cesarean delivery refers to a patient reporting significant pain or intense uncomfortable pressure; it is a patient-reported outcome that occurs in up to one-third of patients, depending on anesthetic risk factors (eg, epidural anesthesia) and obstetric scenarios (eg, intrapartum cesarean delivery, prolonged surgery). In this review, important considerations to better understand what breakthrough pain during cesarean delivery under neuraxial anesthesia is, how to measure and report it, and strategies to prevent, mitigate and manage its occurrence and associated consequences are discussed. Experiencing breakthrough pain during cesarean delivery is associated with childbirth-related post-traumatic stress disorder. Breakthrough Pain During Cesarean Delivery Ruth Landau 10.1016/j.anclin.2026.02.017 Anesthesiology Clinics (2026) 2026-04-06 Anesthesiology Clinics 2026-04-06 https://www.anesthesiology.theclinics.com/article/S1932-2275(26)00025-X/fulltext?rss=yes Thrombotic pulmonary and venous embolism remains a leading cause of maternal mortality in the United States, prompting expanded venous thromboembolism prophylaxis guidelines from organizations such as the American College of Obstetricians and Gynecologists, Royal College of Obstetricians and Gynaecologists, American College of Chest Physicians, and American Society of Hematology. Increased pharmacologic thromboprophylaxis, particularly with heparins, complicates decisions regarding neuraxial anesthesia due to the risk of spinal epidural hematoma, while general anesthesia carries higher maternal risks. Guidance from the Society for Obstetric Anesthesia and Perinatology and American Society of Regional Anesthesia and Pain Medicine supports individualized risk assessment. Balancing Anticoagulation and Neuraxial Procedures in the Peripartum Period: An Update Roulhac D. Toledano, Lisa Leffert 10.1016/j.anclin.2026.02.015 Anesthesiology Clinics (2026) 2026-04-02 Anesthesiology Clinics 2026-04-02 https://www.anesthesiology.theclinics.com/article/S1932-2275(26)00028-5/fulltext?rss=yes This article reviews disparities in obstetric anesthesia within the broader context of maternal health inequities in the United States, where severe maternal morbidity and mortality remain disproportionately high among marginalized populations. The essential role of anesthesiologists in labor analgesia, cesarean delivery, postpartum pain, and critical care during obstetric emergencies is examined. Actionable strategies for change are focused at the institutional and individual levels, and research gaps are highlighted. Disparities in Obstetric Anesthesia Mellany Stanislaus, Allison Lee 10.1016/j.anclin.2026.02.018 Anesthesiology Clinics (2026) 2026-03-31 Anesthesiology Clinics 2026-03-31 https://www.anesthesiology.theclinics.com/article/S1932-2275(26)00019-4/fulltext?rss=yes Medical simulation is an essential strategy to meet the evolving patient safety demands of ambulatory surgical centers. As case volume and complexity expand, there is a heightened need for continuous staff training, professional development, and quality assurance. In situ simulation offers a practical means of preparing teams within their own clinical environment. It supports mastery of emergency protocols, uncovers latent safety threats, and identifies gaps in both technical (eg, defibrillator use) and nontechnical skills (eg, closed-loop communication). Simulation and Education in Health Care Melissa Mullen, Arnaldo Valedón, Rafael Vazquez 10.1016/j.anclin.2026.02.009 Anesthesiology Clinics 44, 2 (2026) 2026-03-26 Anesthesiology Clinics 2026-03-26 44 2 S1932-2275(26)X2002-X 301 318 https://www.anesthesiology.theclinics.com/article/S1932-2275(26)00016-9/fulltext?rss=yes Ambulatory surgical centers (ASCs) are projected to increase in numbers for a myriad of reasons. They provide a cost effective, efficient way to render medical care in a setting that is often also more convenient for patients and families. As a result of this growth, several questions arise for the ideal pediatric patient candidate for this setting. This review highlights selection criteria such as patient age, cardiopulmonary status, and preoperative comorbidities to further elucidate appropriate selection criteria for pediatric patients in ASCs. Preoperative Considerations for Pediatric Surgeries at Ambulatory Surgical Centers Archana Singaravelu Ramesh, Hanna Schrader, Balazs Horvath, Lucinda Everett 10.1016/j.anclin.2026.02.006 Anesthesiology Clinics 44, 2 (2026) 2026-03-20 Anesthesiology Clinics 2026-03-20 44 2 S1932-2275(26)X2002-X 239 251 https://www.anesthesiology.theclinics.com/article/S1932-2275(26)00012-1/fulltext?rss=yes The number of patients taking glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and sodium-glucose co-transporter 2 (SGLT 2) inhibitors presenting for elective surgery is increasing. Patients taking GLP-1 RAs with the highest risk of aspiration are non-fasters who have recently initiated the drug, have had a recent dose escalation, and/or have active gastrointestinal symptoms. Asymptomatic patients on stable doses of GLP-1 RAs can continue the medication throughout the peri-operative period. SGLT 2 inhibitor use carries a risk of euglycemic diabetic ketoacidosis, particularly in patients on insulin with prolonged fasting and should be held prior to elective procedures. Perioperative Management of Glucagon-like Peptide-1 Receptor Agonists and Sodium-Glucose Co-transporter 2 Inhibitors Gustavo A. Lozada, Rosalyn B. Chen, Sherwin Davoud, Grace S. Lee 10.1016/j.anclin.2026.02.002 Anesthesiology Clinics 44, 2 (2026) 2026-03-19 Anesthesiology Clinics 2026-03-19 44 2 S1932-2275(26)X2002-X 181 196 https://www.anesthesiology.theclinics.com/article/S1932-2275(26)00024-8/fulltext?rss=yes The opioid epidemic has fueled the rise of opioid use disorder (OUD), which has led to greater use of medication for opioid use disorder (MOUD), including buprenorphine, methadone, and naltrexone. The rise in ambulatory surgical procedures increases the likelihood of encountering a patient on MOUD and presents unique challenges for ambulatory anesthesiologists. Perioperative management of patients with OUD should ensure rapid recovery and effective analgesia, all while minimizing opioid-related complications. An emphasis on multimodal analgesia, enhanced recovery protocols, and close outpatient follow-up with the MOUD prescriber is crucial. Perioperative Management of Patients on Medication for Opioid Use Disorder Undergoing Ambulatory Surgery Brenda Beck, Kelly Lebak, Olabisi Lane 10.1016/j.anclin.2026.02.014 Anesthesiology Clinics 44, 2 (2026) 2026-03-18 Anesthesiology Clinics 2026-03-18 44 2 S1932-2275(26)X2002-X 383 394 https://www.anesthesiology.theclinics.com/article/S1932-2275(26)00020-0/fulltext?rss=yes This review synthesizes best practices for ambulatory pediatric tonsillectomy with or without adenoidectomy in ambulatory surgery centers. It emphasizes rigorous patient selection—particularly for severe obstructive sleep apnea, age, obesity, and complex comorbidities—along with individualized anesthetic plans (induction and airway choice), multimodal opioid-sparing analgesia, and robust post-operative nausea and vomiting prophylaxis. Standardized post-anesthesia care unit monitoring, discharge criteria, caregiver education, and escalation pathways address common complications (airway events, hemorrhage, pain, dehydration). Preparedness—pediatric advanced life support-certified staff, emergency equipment, and transfer agreements—underpins safety. Quality-improvement initiatives and emerging tools offer avenues to further reduce morbidity and unplanned admissions. Optimizing Anesthetic Care for Pediatric Tonsillectomy and Adenoidectomy in Ambulatory Surgery Centers Harrison D. Pravder, Stuart Pasch, Yoga Dasari, Niraja Rajan 10.1016/j.anclin.2026.02.010 Anesthesiology Clinics 44, 2 (2026) 2026-03-18 Anesthesiology Clinics 2026-03-18 44 2 S1932-2275(26)X2002-X 319 340 https://www.anesthesiology.theclinics.com/article/S1932-2275(26)00018-2/fulltext?rss=yes We hope to update the reader on recent literature investigating the use of regional anesthesia for laparoscopic and robotic surgery. These peripheral nerve blocks are now supported by evidence in robotic or laparoscopic surgery: (1). transversus abdominis plane (TAP) block for robotic prostatectomy, (2) paravertebral block (PVB) for robotic mitral valve repair, (3) SAPB for robotic thymectomy, (4) TAP or erector spinae plane block (ESPB) for laparoscopic cholecystectomy, (5) quadratus lumborum block (QLB), ESPB, or PVB for percutaneous nephrolithotomy, (6) QLB or ESPB for partial or full nephrectomy, and (7) TAP or QLB for laparoscopic colectomy. The Potential Benefits of Peripheral Nerve Blocks in Robotic and Laparoscopic Surgery Alberto Ardon, Nadia Hernandez 10.1016/j.anclin.2026.02.008 Anesthesiology Clinics 44, 2 (2026) 2026-03-17 Anesthesiology Clinics 2026-03-17 44 2 S1932-2275(26)X2002-X 269 299 https://www.anesthesiology.theclinics.com/article/S1932-2275(26)00017-0/fulltext?rss=yes Postoperative and postdischarge nausea and vomiting are common, costly complications that delay recovery and reduce satisfaction after ambulatory surgery. They stem from complex neurotransmitter pathways targeted by antiemetics. Accurate risk prediction is key, and multimodal prophylaxis is most effective. Postoperative Nausea and Vomiting Management, New Drugs in the Outpatient Setting Aryana Valedon, Anthony Tanella, Jaime B. Hyman 10.1016/j.anclin.2026.02.007 Anesthesiology Clinics 44, 2 (2026) 2026-03-17 Anesthesiology Clinics 2026-03-17 44 2 S1932-2275(26)X2002-X 253 268 https://www.anesthesiology.theclinics.com/article/S1932-2275(26)00015-7/fulltext?rss=yes Ambulatory extended recovery facilities, designed for 1-night stays, provide an alternative care setting for more complex patients and procedures than those treated in same-day surgery centers. Central to these programs are structured extended recovery after surgery pathways to promote rapid and safe recovery. Key considerations include patient and procedure selection, expanded on-site resources, emergency preparedness, quality monitoring and improvement, and adherence to state and federal regulatory requirements. The patient hotel model is another emerging alternative, fostering patient independence during recovery. Looking ahead, integration of machine learning and artificial intelligence into pathways can potentially expand and optimize these innovative care models. Reimagining Recovery: How Extended Ambulatory Models and Patient Hotels are Changing the Outpatient Surgical Paradigm Kara M. Barnett, Sonia Pyne, Hanae Tokita, Natalie B. Simon, Joanna Serafin, Kelly Lebak 10.1016/j.anclin.2026.02.005 Anesthesiology Clinics 44, 2 (2026) 2026-03-17 Anesthesiology Clinics 2026-03-17 44 2 S1932-2275(26)X2002-X 219 237 https://www.anesthesiology.theclinics.com/article/S1932-2275(26)00023-6/fulltext?rss=yes The 2024 guideline addresses perioperative cardiovascular risk in adults aged over 18 years planning noncardiac procedures, focusing on those with risk factors or conditions that increase perioperative risk. It emphasizes guideline-directed medical therapy, which includes clinical evaluation, targeted testing, and appropriate medical or interventional treatments for both short-term and long-term benefits. The guideline stresses the need for ongoing care and lifestyle modifications beyond the surgical period to reduce risk and improve long-term outcomes. Elevated risk is defined as a greater than 1% chance of major adverse cardiovascular events, but extensive preoperative testing is discouraged for low-risk procedures. Applying the 2024 American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines for Cardiac Evaluation and Managment of Patients Having Noncardiac Surgeries in an Ambulatory Setting BobbieJean Sweitzer 10.1016/j.anclin.2026.02.013 Anesthesiology Clinics 44, 2 (2026) 2026-03-14 Anesthesiology Clinics 2026-03-14 44 2 S1932-2275(26)X2002-X 369 381 https://www.anesthesiology.theclinics.com/article/S1932-2275(26)00022-4/fulltext?rss=yes The article reviews the rapid expansion of office-based anesthesia driven by rising outpatient procedure volumes, cost savings, and patient and provider preference. It highlights the 6 P’s: Patient, Procedure, Place, Personnel, Policies, and Practice Management as the core framework for safe practice. As more complex patients undergo ambulatory procedures, thoughtful patient and procedure selection, standardized protocols, accreditation, and robust emergency preparedness are essential. The authors emphasize the need for updated medical education and consistent regulatory oversight to ensure safety across diverse outpatient settings. Comprehensive Review of Office-Based Anesthesia Safety 2026 for the Next Generation Benjamin J. Swett, Fred E. Shapiro 10.1016/j.anclin.2026.02.012 Anesthesiology Clinics 44, 2 (2026) 2026-03-14 Anesthesiology Clinics 2026-03-14 44 2 S1932-2275(26)X2002-X 353 368 https://www.anesthesiology.theclinics.com/article/S1932-2275(26)00021-2/fulltext?rss=yes This contemporary review examines health care disparities that pediatric patients may experience throughout the perioperative period, focusing on the ambulatory surgery setting. Existing literature focused on outcomes during inpatient procedures; however, disparities may manifest preoperatively, intraoperatively and postoperatively in the outpatient setting. Inequities related to race/ethnicity, geographic location, language barriers, insurance status, and utilization of perioperative services are highlighted. Strategies to mitigate these disparities in the ambulatory setting include selecting patients carefully, encouraging accreditation of facilities, and increasing the number of fellowship-trained pediatric anesthesiologists. Future opportunities include system-level changes to promote more equitable perioperative care in the ambulatory setting. A Contemporary Review on Health Care Disparities in Pediatric Ambulatory Anesthesia Janet O. Adeola, Amanda Johnson, Steven K. Young 10.1016/j.anclin.2026.02.011 Anesthesiology Clinics 44, 2 (2026) 2026-03-14 Anesthesiology Clinics 2026-03-14 44 2 S1932-2275(26)X2002-X 341 351 https://www.anesthesiology.theclinics.com/article/S1932-2275(26)00013-3/fulltext?rss=yes Ambulatory anesthesia has grown rapidly, encompassing more complex procedures and higher-risk patients. Analysis of closed claims reveals that while major complications and mortality remain rare, moderate injuries such as dental trauma, nerve damage, and communication-related issues are frequent and remained largely stable in frequency over the past decade. Patient comorbidities—including obesity, obstructive sleep apnea, and diabetes—significantly increase perioperative risks. Improving patient safety in this setting depends on careful risk assessment, multimodal analgesia, opioid-sparing techniques, and transitional care strategies. Future efforts must prioritize evidence-based protocols, national standards, and innovative monitoring to ensure safe, high-quality outcomes. Closed Claims Analysis of Data for Ambulatory Anesthesia Emma Reichegger, Timur Yurttas, Markus M. Luedi, Richard D. Urman 10.1016/j.anclin.2026.02.003 Anesthesiology Clinics 44, 2 (2026) 2026-03-14 Anesthesiology Clinics 2026-03-14 44 2 S1932-2275(26)X2002-X 197 208 https://www.anesthesiology.theclinics.com/article/S1932-2275(26)00011-X/fulltext?rss=yes As ambulatory surgery centers (ASCs), office-based practices, and extended recovery models continue to expand, the scope and complexity of care delivered outside the traditional inpatient environment have grown dramatically. In the year 2000, there were approximately 2700 Medicare-certified ASCs in the Unites States performing greater than 6 million procedures per year. By 2023, the number had grown to approximately 6223 centers performing up to 70 million procedures per year. With this continued growth trajectory, over 109 million procedures can be expected by 2033. Outpatient Anesthesia in 2026: Scaling Care, Advancing Safety, Shaping the Future Steven K. Young, Brian M. Osman 10.1016/j.anclin.2026.02.001 Anesthesiology Clinics 44, 2 (2026) 2026-03-06 Anesthesiology Clinics 2026-03-06 44 2 S1932-2275(26)X2002-X Preface xv xvii https://www.anesthesiology.theclinics.com/article/S1932-2275(26)00043-1/fulltext?rss=yes Ambulatory care is accelerating in the United States and worldwide. In the United States, the Centers for Medicare and Medicaid Services has started a three-year transition to eliminate the IPO (Inpatient Only) list, allowing all surgical procedures to be performed and reimbursed in any location of care. This will drive ambulatory care in the most complex patients even further than toward the outpatient setting. Similarly, surgical interventions are becoming less invasive. The current issue of Anesthesiology Clinics includes multiple articles on care and patient safety of these more complex patients. Ambulatory Anesthesia: How Far Can We Go? Lee A. Fleisher 10.1016/j.anclin.2026.03.001 Anesthesiology Clinics 44, 2 (2026) 2026-06 Anesthesiology Clinics 2026-06 44 2 S1932-2275(26)X2002-X Foreword xiii xiv https://www.anesthesiology.theclinics.com/article/S1932-2275(26)00038-8/fulltext?rss=yes Obstetrical Anesthesia Forthcoming Issues 10.1016/S1932-2275(26)00038-8 Anesthesiology Clinics 44, 2 (2026) 2026-06 Anesthesiology Clinics 2026-06 44 2 S1932-2275(26)X2002-X xi https://www.anesthesiology.theclinics.com/article/S1932-2275(26)00037-6/fulltext?rss=yes Lee A. Fleisher Contents 10.1016/S1932-2275(26)00037-6 Anesthesiology Clinics 44, 2 (2026) 2026-06 Anesthesiology Clinics 2026-06 44 2 S1932-2275(26)X2002-X vii x https://www.anesthesiology.theclinics.com/article/S1932-2275(26)00036-4/fulltext?rss=yes LEE A. FLEISHER, MD Contributors 10.1016/S1932-2275(26)00036-4 Anesthesiology Clinics 44, 2 (2026) 2026-06 Anesthesiology Clinics 2026-06 44 2 S1932-2275(26)X2002-X iii vi https://www.anesthesiology.theclinics.com/article/S1932-2275(26)00035-2/fulltext?rss=yes Elsevier Copyright 10.1016/S1932-2275(26)00035-2 Anesthesiology Clinics 44, 2 (2026) 2026-06 Anesthesiology Clinics 2026-06 44 2 S1932-2275(26)X2002-X ii https://www.anesthesiology.theclinics.com/article/S1932-2275(26)00034-0/fulltext?rss=yes ANESTHESIOLOGY CLINICS Ambulatory Anesthesia Safe Practices in 2026 Steven K. Young, Brian M. Osman 10.1016/S1932-2275(26)00034-0 Anesthesiology Clinics 44, 2 (2026) 2026-06 Anesthesiology Clinics 2026-06 44 2 S1932-2275(26)X2002-X i https://www.anesthesiology.theclinics.com/article/S1932-2275(26)00014-5/fulltext?rss=yes We present a structured approach for managing patients with cardiac implantable electronic devices in ambulatory surgery centers. Safe peri-operative management requires thorough assessment of patient, device, and procedural factors. Key priorities include determining pacemaker dependency, anticipating electromagnetic interference (EMI), and understanding device-specific magnet responses. Magnets generally induce asynchronous pacing in pacemakers and disable anti-tachycardia therapies in implantable cardioverter defibrillators (ICDs), but knowledge of device-specific functions is essential. Patients needing formal device reprogramming, such as pacemaker-dependent individuals with ICDs undergoing procedures above the umbilicus, are not suitable for ambulatory surgical centers. EMI mitigation, proper monitoring, and individualized planning are essential. Management of Cardiac Implantable Electronic Devices in the Ambulatory Setting Robert M. Owen, Daniel Guay, BobbieJean Sweitzer 10.1016/j.anclin.2026.02.004 Anesthesiology Clinics 44, 2 (2026) 2026-06 Anesthesiology Clinics 2026-06 44 2 S1932-2275(26)X2002-X 209 218