James P Rathmell
In 2024, Anesthesiology published a systematic review and meta-analysis of liposomal bupivacaine together with four editorials presenting both strong support for its conclusions and critical perspectives, with the editorial authors' industry affiliations and financial interests disclosed. A subsequent case study in Research Integrity and Peer Review characterized this presentation as a "retraction in situ" and questioned whether organizational and industry relationships compromised editorial independence. This Correspondence presents additional facts relevant to evaluating those conclusions. The research article remained intact. The coordinated presentation was commissioned by the Editor-in-Chief, while a senior editor serving as acting Editor-in-Chief independently managed peer review and made the publication decisions for all four editorials. Before the case study was published, its authors had submitted to Anesthesiology a manuscript advancing a similar critique. That manuscript underwent multiple rounds of external assessment, senior editorial-board review, and discussion by the full editorial board; its rejection was not unilateral. During my tenure, neither the American Society of Anesthesiologists nor Pacira BioSciences participated in or influenced the 2024 publication decisions for the research article or accompanying editorials, or the disposition of the authors' later submission. Greater procedural clarity could have been achieved through timelier publication, fuller disclosure of organizational relationships, and complete recusal of the Editor-in-Chief from consideration of the later submission. These are legitimate procedural lessons, but they do not establish external influence or editorial misconduct. The publication record instead reflects the transparent presentation of scientific disagreement, not a disguised retraction.