European Journal of Anaesthesiology最新文献

{"title":"Reconsidering the recommendation against self-reported metabolic equivalents of task in pre-operative assessment in light of emerging evidence.","authors":"Hüseyin Ulaş Pinar","doi":"10.1097/EJA.0000000000002391","DOIUrl":"10.1097/EJA.0000000000002391","url":null,"abstract":"","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":"43 7","pages":"637-638"},"PeriodicalIF":7.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148149177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multisensory virtual reality reduces postoperative delirium in elderly patients undergoing laparoscopic gastrointestinal surgery: A single-centre randomised controlled trial.","authors":"Wenjun Luo, Yi Duan, Tingting Ni, Zhuqun Mao, Zhifeng Gao","doi":"10.1097/EJA.0000000000002380","DOIUrl":"10.1097/EJA.0000000000002380","url":null,"abstract":"<p><strong>Background: </strong>Effective interventions for postoperative delirium (POD) remain unclear. Research indicates that light and sound stimulation may enhance the functional connectivity of the medial visual network, while olfactory stimulation improves cognitive function. This study aims to address POD by integrating auditory, olfactory and visual stimuli to develop a multisensory virtual reality device.</p><p><strong>Objective: </strong>To assess the effect of multisensory virtual reality on reducing POD in patients undergoing laparoscopic gastrointestinal surgery.</p><p><strong>Design: </strong>Randomised controlled trial.</p><p><strong>Setting: </strong>Single-centre tertiary hospital in China between September 2023 and July 2024.</p><p><strong>Participants: </strong>A total of 342 patients aged 60 years or older, undergoing elective laparoscopic gastrointestinal surgery.</p><p><strong>Intervention: </strong>Participants were randomly assigned to either a multisensory virtual reality group, who received standard care along with a 20-min virtual reality session featuring a biophilic environment infused with juniper essential oil, or a standard care group, who received standard care alone for 20 min pre-operatively.</p><p><strong>Main outcome measures: </strong>The primary outcome was the incidence of POD, assessed twice daily using the Confusion Assessment Method (CAM) for the three postoperative days. Secondary outcomes included pre-operative mean arterial pressure (MAP), heart rate (HR) and assessments of delirium severity, duration, anxiety levels and pain scores during the same postoperative period.</p><p><strong>Results: </strong>The incidence of POD during the three postoperative days was lower in patients assigned to the multisensory virtual reality group (9.4%, 16 of 170 patients) than in those assigned to the standard care group (19.2%, 33 of 172 patients), P  = 0.010. Multisensory virtual reality reduced preoperative anxiety scores and anxiety scores during the three postoperative days, P  = 0.001 for all. No serious adverse events occurred during the intervention.</p><p><strong>Conclusions: </strong>The pre-operative use of multisensory virtual reality as a preventive measure may significantly reduce the incidence of POD during the first three postoperative 3 days after elective laparoscopic gastrointestinal abdominal surgery.</p><p><strong>Clinical trial number and registry: </strong>Chinese Clinical Trials Registry, ChiCTR2300075624.</p>","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":"615-626"},"PeriodicalIF":7.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13258079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147431661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prophylactic esketamine to reduce postpartum depression in primiparae: A multicentre, double-blind, randomised clinical trial.","authors":"Weijia Du, Zhiqiang Liu","doi":"10.1097/EJA.0000000000002399","DOIUrl":"10.1097/EJA.0000000000002399","url":null,"abstract":"","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":"43 7","pages":"638-639"},"PeriodicalIF":7.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148149170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brugada syndrome: safe epidural anaesthesia for labour and subsequent emergency caesarean delivery.","authors":"Peter Schulte, Julien Brocchi, Sébastien Buffler, Françoise Brand","doi":"10.1097/EJA.0000000000002430","DOIUrl":"10.1097/EJA.0000000000002430","url":null,"abstract":"","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":"43 7","pages":"636-637"},"PeriodicalIF":7.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13261815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148149124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on: prophylactic esketamine to reduce postpartum depression in primiparae.","authors":"Jing Wang, Hao Zhu, Jun-Ma Yu","doi":"10.1097/EJA.0000000000002409","DOIUrl":"10.1097/EJA.0000000000002409","url":null,"abstract":"","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":"43 7","pages":"641-642"},"PeriodicalIF":7.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148149161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between postoperative delirium in the postanaesthesia care unit and subsequent ward delirium: A retrospective cohort study.","authors":"Yotam Weiss, Shiri Zarour, Daniel Hikry, Tomer Talmy, Michal Itkin, Alexander Zegerman, Or Goren, Barak Cohen, Idit Matot","doi":"10.1097/EJA.0000000000002351","DOIUrl":"10.1097/EJA.0000000000002351","url":null,"abstract":"<p><strong>Background: </strong>The ageing surgical population underscores the need for routine postoperative delirium (POD) screening, particularly in the immediate postoperative period. The postanaesthesia care unit (PACU) presents a critical window for early detection and intervention, yet the clinical significance of PACU-diagnosed POD (PACU-POD) remains underexplored.</p><p><strong>Objectives: </strong>To examine whether PACU-POD is associated with subsequent ward-POD and other adverse postoperative outcomes.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>Tertiary academic hospital, single-centre, conducted between 2020 and 2022.</p><p><strong>Patients: </strong>Three thousand seven hundred and eighty-one patients aged at least 70 years who underwent elective noncardiac, noncranial surgery under general anaesthesia. POD was assessed using the 4AT and supplemented by CHART-DEL review.</p><p><strong>Main outcome measures: </strong>Primary outcome: ward-POD. Secondary outcomes: in-hospital falls, unplanned ICU admission, nonhome discharge and 30-day mortality. Exploratory outcomes: PACU and hospital length of stay.</p><p><strong>Results: </strong>PACU-POD was diagnosed in 9.1% of patients (341/3781), who were more likely to be older, 77.1 (73.7 to 82.7) vs. 75.7 (72.9 to 80.6) years; frailer (52 vs. 40%); cognitively impaired (36 vs. 18%); and undergoing high-risk (52 vs. 27%); prolonged surgeries, 196 (133 to 275) vs. 142 (95 to 204) minutes (all P  < 0.001). Ward-POD occurred in 6.2% of patients (234/3781) and was significantly more common among those with PACU-POD (24.6 vs. 4.3%, P  < 0.001). PACU-POD was independently associated with ward-POD [adjusted odds ratio (aOR) 4.4; 95% confidence interval (CI), 3.2 to 6.3], in-hospital falls (aOR 2.3; 95% CI, 1.2 to 4.4) and 30-day mortality (aOR 4.4; 95% CI, 1.5 to 13.0), as well as prolonged PACU, 185 [144 to 265] vs. 150 [115 to 210] minutes, P  < 0.001, and hospital stays, 6 [3 to 10] vs. 3 [2 to 6] days, P  = 0.01.</p><p><strong>Conclusion: </strong>PACU-POD is a strong early marker of increased risk for ward-POD and other postoperative complications. Routine PACU screening enables early diagnosis, risk stratification and targeted interventions. Future studies should evaluate whether early intervention starting during the PACU stay can improve the trajectory of POD and related complications.</p>","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":"594-602"},"PeriodicalIF":7.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146028708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of analgesia efficacy between single-orifice and multiorifice wire-reinforced catheters for labour analgesia with the dural puncture epidural technique: A double-blind randomised controlled trial.","authors":"Yu Zang, Weijia Du, Xiaobing Hu, Xin Fang, Wei Luo, Zhendong Xu","doi":"10.1097/EJA.0000000000002330","DOIUrl":"10.1097/EJA.0000000000002330","url":null,"abstract":"<p><strong>Background: </strong>No relevant clinical studies have investigated how epidural catheter design influences the transmeningeal flux of drugs.</p><p><strong>Objective: </strong>To compare the analgesic outcomes between single-orifice and multiorifice wire-reinforced catheters following dural puncture epidural (DPE) for labour analgesia.</p><p><strong>Design: </strong>Prospective double-blind randomised controlled study.</p><p><strong>Setting: </strong>Shanghai First Maternity and Infant Hospital.</p><p><strong>Patients: </strong>Between 1 September and 27 October 2024 healthy, nulliparous women with singleton pregnancies, cervical dilation of 2 to 5 cm, and requesting neuraxial analgesia were randomised to receive either a single-orifice or multiple-orifice polyurethane wire-reinforced epidural catheter as as part of the DPE technique along with a 25-G spinal needle.</p><p><strong>Intervention: </strong>Epidural analgesia was initiated following DPE with 12 ml of 0.1% ropivacaine and 0.3 μg ml -1 sufentanil injected manually in two divided doses of 6 ml. Maintenance was then provided via programmed intermittent epidural boluses of the same solution, delivered as 10 ml every 40 min at an infusion rate of 360 ml h -1 .</p><p><strong>Main outcome measures: </strong>The primary endpoint was the time required to achieve a numeric rating scale pain score 3 or less following the initial bolus.</p><p><strong>Results: </strong>Of 136 randomised participants, 131 were included in the analysis. Adequate analgesia was achieved significantly faster with single-orifice catheters than with multiorifice catheters, hazard ratio (HR) and 95% confidence intervals (CI) = 1.72 (1.17 to 2.53), P  = 0.003. Post hoc sensitivity analysis confirmed these results, HR = 1.79 (1.19 to 2.71), P  = 0.005.The median time (95% CI) to adequate analgesia was 11.0 (10.0 to 13.0) min for single-orifice and 14.0 (12.0 to 18.0) min for multiorifice catheters ( P  = 0.003). The single-orifice group demonstrated higher rates of adequate analgesia (89.2 vs. 72.7%, P  = 0.02) and bilateral S2 sensory blockade (95.4 vs. 83.3%, P  = 0.03) at 20 min, with no significant differences in other parameters.</p><p><strong>Conclusions: </strong>DPE using a 25-G spinal needle and with a single-orifice catheter produced a significantly faster onset of analgesia than DPE with a multiorifice catheter during labour initiation.</p><p><strong>Trial registration: </strong>Chinese Clinical Trial Registry (No: ChiCTR2400088640; Principal investigator: Yu Zang; Registration date: 22 August 2024).</p>","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":"575-583"},"PeriodicalIF":7.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145707768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"2025 ESAIC and ESPA Guidelines on neuromuscular block in anaesthetised children: Indications, monitoring and reversal: Erratum.","authors":"","doi":"10.1097/EJA.0000000000002428","DOIUrl":"10.1097/EJA.0000000000002428","url":null,"abstract":"","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":"43 7","pages":"646"},"PeriodicalIF":7.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148149150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to: dopaminergic connectivity and POCD: balancing statistical robustness with pathological sensitivity.","authors":"Florian Lammers-Lietz","doi":"10.1097/EJA.0000000000002424","DOIUrl":"10.1097/EJA.0000000000002424","url":null,"abstract":"","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":"43 7","pages":"635-636"},"PeriodicalIF":7.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148149241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of transcranial direct current stimulation on perioperative neurocognitive disorder in elderly patients undergoing abdominal tumour surgery: A randomised controlled trial.","authors":"Shirong Wei, Xin Xiang, Ming Yao, Huadong Ni","doi":"10.1097/EJA.0000000000002417","DOIUrl":"10.1097/EJA.0000000000002417","url":null,"abstract":"","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":"627-630"},"PeriodicalIF":7.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13258090/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147971622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}