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Non-operating room anaesthesia: general considerations 非手术室麻醉：一般注意事项
IF 0.3
Anaesthesia and Intensive Care Medicine Pub Date : 2026-04-01 Epub Date: 2026-03-30 DOI: 10.1016/j.mpaic.2026.02.016
Alexandra Muir, Robert Hart
{"title":"Non-operating room anaesthesia: general considerations","authors":"Alexandra Muir,&nbsp;Robert Hart","doi":"10.1016/j.mpaic.2026.02.016","DOIUrl":"10.1016/j.mpaic.2026.02.016","url":null,"abstract":"<div><div>Non-operating room anaesthesia (NORA) refers to the administration of anaesthesia outside of the traditional operating room environment. This may include procedures performed in the radiology department, interventional cardiology suites, or endoscopy units. With the increasing demand for minimally invasive procedures, the requirement to provide anaesthesia outside the theatre environment is becoming more common. Non-operating room anaesthesia provides a unique set of challenges including airway management, monitoring, procedural access, patient positioning, temperature management, delivery of anaesthesia and management of complications. This review will consider these aspects and provide a guide to the safe implementation of non-operating room anaesthesia.</div></div>","PeriodicalId":45856,"journal":{"name":"Anaesthesia and Intensive Care Medicine","volume":"27 4","pages":"Pages 218-221"},"PeriodicalIF":0.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147653120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The metabolic and endocrine response to trauma 代谢和内分泌对创伤的反应
IF 0.3
Anaesthesia and Intensive Care Medicine Pub Date : 2026-04-01 Epub Date: 2026-03-30 DOI: 10.1016/j.mpaic.2026.02.017
Christina Dunn, Andrew McGuire
{"title":"The metabolic and endocrine response to trauma","authors":"Christina Dunn,&nbsp;Andrew McGuire","doi":"10.1016/j.mpaic.2026.02.017","DOIUrl":"10.1016/j.mpaic.2026.02.017","url":null,"abstract":"<div><div>Major injury provokes an immediate neuroendocrine, inflammatory and metabolic response. Early sympathetic activation, cortisol release and renin–angiotensin–aldosterone activity preserve perfusion but drive tachycardia, vasoconstriction, hyperglycaemia and early catabolism. Endothelial injury, acidosis, hypothermia and low ionized calcium contribute to trauma-induced coagulopathy and the lethal diamond. These processes inform modern resuscitation, which prioritizes rapid haemorrhage control, balanced resuscitation, permissive hypotension when appropriate and prevention of secondary physiological insults.</div><div>Whole blood and viscoelastic testing increasingly support targeted haemostatic therapy. Anaesthetic management must anticipate severe cardiovascular instability and avoid worsening shock physiology. Beyond the acute phase, sustained hypermetabolism, insulin resistance and protein breakdown hinder recovery, with burns representing the most extreme form. Early enteral nutrition, safe glucose targets and identification of longer-term endocrine disturbances are central to limiting muscle loss and supporting rehabilitation.</div></div>","PeriodicalId":45856,"journal":{"name":"Anaesthesia and Intensive Care Medicine","volume":"27 4","pages":"Pages 222-226"},"PeriodicalIF":0.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147653121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Major incidents 重大事件
IF 0.3
Anaesthesia and Intensive Care Medicine Pub Date : 2026-04-01 Epub Date: 2026-03-30 DOI: 10.1016/j.mpaic.2026.02.019
Tom Hurst
{"title":"Major incidents","authors":"Tom Hurst","doi":"10.1016/j.mpaic.2026.02.019","DOIUrl":"10.1016/j.mpaic.2026.02.019","url":null,"abstract":"<div><div>A major incident is one that causes casualties on a scale beyond the emergency and healthcare services’ usual ability to manage. Major incident planning and rehearsal are vital to ensuring an appropriate response. Delivery of a major incident response requires command and coordination within and between emergency services, hospitals and specialist organizations. Casualty management will require the set-up of major incident infrastructure at the scene to effectively extricate, triage, treat and transport casualties to appropriate facilities. There is a role for specialist doctors within the pre-hospital phase of managing a major incident, either within the ambulance command structure or operationally. Debrief and reviewing previous major incidents may identify individual, local and systemic factors that could be altered to improve the response to a future incident.</div></div>","PeriodicalId":45856,"journal":{"name":"Anaesthesia and Intensive Care Medicine","volume":"27 4","pages":"Pages 235-239"},"PeriodicalIF":0.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147653116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Complications of regional anaesthesia 局部麻醉的并发症
IF 0.3
Anaesthesia and Intensive Care Medicine Pub Date : 2026-03-01 Epub Date: 2026-03-05 DOI: 10.1016/j.mpaic.2026.02.020
Fiona Helen Watson, Anna Jane Johnstone
{"title":"Complications of regional anaesthesia","authors":"Fiona Helen Watson,&nbsp;Anna Jane Johnstone","doi":"10.1016/j.mpaic.2026.02.020","DOIUrl":"10.1016/j.mpaic.2026.02.020","url":null,"abstract":"<div><div>Regional anaesthesia (RA) is a core competency across all stages of training in the 2021 Royal College of Anaesthetists (RCOA) curriculum. Anaesthetists must understand RA-related complications to ensure informed consent and safe patient care. Complications are categorized as related to either central neuraxial blockade, peripheral nerve blockade or both. Advances in ultrasound technology, needle visibility, simulation training and structured courses have enhanced RA education. National safety initiatives aim to reduce risk and harm. The 8th National Audit Project will further clarify complication incidences and mitigation strategies.</div></div>","PeriodicalId":45856,"journal":{"name":"Anaesthesia and Intensive Care Medicine","volume":"27 3","pages":"Pages 135-139"},"PeriodicalIF":0.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147453759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Upper limb regional anaesthesia 上肢局部麻醉
IF 0.3
Anaesthesia and Intensive Care Medicine Pub Date : 2026-03-01 Epub Date: 2026-03-04 DOI: 10.1016/j.mpaic.2026.02.003
Paul A Paterson, Jonathan Seeley
{"title":"Upper limb regional anaesthesia","authors":"Paul A Paterson,&nbsp;Jonathan Seeley","doi":"10.1016/j.mpaic.2026.02.003","DOIUrl":"10.1016/j.mpaic.2026.02.003","url":null,"abstract":"<div><div>Upper limb regional anaesthesia is a key skill to be mastered in anaesthetic training, offering patients improved postoperative analgesia and potentially a lower-risk alternative to general anaesthesia.</div><div>With the advent of ultrasound imaging as the gold standard in regional anaesthetic practice, upper limb blocks are now more reliable and accessible than ever before. This article focuses on the anatomical principles of four key brachial plexus blocks as well as practical tips to facilitate clinical practice.</div><div>The blocks covered include the two Plan A blocks, interscalene and axillary, as well as the supraclavicular and infraclavicular blocks. Pertinent examples of their clinical use are detailed and the extent of each block illustrated for easy reference. Recent developments relating to safe practice in ultrasound-guided regional anaesthesia are also highlighted.</div></div>","PeriodicalId":45856,"journal":{"name":"Anaesthesia and Intensive Care Medicine","volume":"27 3","pages":"Pages 150-157"},"PeriodicalIF":0.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147453762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Lower limb nerve blocks 下肢神经阻滞
IF 0.3
Anaesthesia and Intensive Care Medicine Pub Date : 2026-03-01 Epub Date: 2026-03-05 DOI: 10.1016/j.mpaic.2026.02.002
David G Johnstone, Amy LK Sadler
{"title":"Lower limb nerve blocks","authors":"David G Johnstone,&nbsp;Amy LK Sadler","doi":"10.1016/j.mpaic.2026.02.002","DOIUrl":"10.1016/j.mpaic.2026.02.002","url":null,"abstract":"<div><div>Regional anaesthesia plays a central role in lower limb surgery, offering analgesic benefits, reduced opioid requirements and enhanced recovery. Femoral, adductor canal and popliteal sciatic lower limb blocks are considered ‘Plan A’ blocks and thus form part of a core set of reliable, reproducible techniques which are widely applicable to a variety of clinical situations. ‘Plan B’ options such as ankle blocks can offer more advanced flexible alternatives tailored to specific surgical or patient requirements. The combination of these strategies supports safe, effective perioperative care and contributes to improved functional outcomes after lower limb surgery.</div></div>","PeriodicalId":45856,"journal":{"name":"Anaesthesia and Intensive Care Medicine","volume":"27 3","pages":"Pages 144-149"},"PeriodicalIF":0.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147453761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Intravenous regional anaesthesia 静脉局部麻醉
IF 0.3
Anaesthesia and Intensive Care Medicine Pub Date : 2026-03-01 Epub Date: 2026-03-05 DOI: 10.1016/j.mpaic.2026.02.004
Alastair J.M. Baird, Colin B. Donald
{"title":"Intravenous regional anaesthesia","authors":"Alastair J.M. Baird,&nbsp;Colin B. Donald","doi":"10.1016/j.mpaic.2026.02.004","DOIUrl":"10.1016/j.mpaic.2026.02.004","url":null,"abstract":"<div><div>Intravenous regional anaesthesia, or Bier’s block, is a useful and safe technique for anaesthetizing distal limbs for short surgical procedures. It is most commonly used for reduction of forearm fractures within the emergency department and can be a useful method of providing anaesthesia in patients who may be unsuitable for a general anaesthetic, or when skills or equipment for other forms of regional anaesthesia are unavailable. When performed as recommended it has a proven safety record.</div></div>","PeriodicalId":45856,"journal":{"name":"Anaesthesia and Intensive Care Medicine","volume":"27 3","pages":"Pages 158-160"},"PeriodicalIF":0.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147453763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Systemic toxic effects of local anaesthetics 局部麻醉剂的全身毒性作用
IF 0.3
Anaesthesia and Intensive Care Medicine Pub Date : 2026-03-01 Epub Date: 2026-03-15 DOI: 10.1016/j.mpaic.2026.02.007
Stefan Andersson, Ravi Anandampillai
{"title":"Systemic toxic effects of local anaesthetics","authors":"Stefan Andersson,&nbsp;Ravi Anandampillai","doi":"10.1016/j.mpaic.2026.02.007","DOIUrl":"10.1016/j.mpaic.2026.02.007","url":null,"abstract":"<div><div>Local anaesthetics are widely used in the provision of local/regional anaesthesia and the management of acute and chronic pain. Their mechanism of action temporarily inhibits voltage-gated sodium channels in neuronal plasma membranes. Local anaesthetic systemic toxicity (LAST) is a serious yet largely preventable complication that can occur by any of the multiple routes of administration. LAST pre-dominantly affects the central nervous and cardiovascular systems. Awareness of LAST and vigilance during administration of local anaesthetics may help in early recognition and successful management of the toxicity. Intralipid emulsion (ILE) infusions have been successfully used in reversing local anaesthetic-induced cardiotoxicity. Since 2007 in the UK, ILE infusion has been incorporated into the safety guidelines for management of LAST.</div></div>","PeriodicalId":45856,"journal":{"name":"Anaesthesia and Intensive Care Medicine","volume":"27 3","pages":"Pages 140-143"},"PeriodicalIF":0.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147453760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Special senses in critical illness 危重疾病的特殊感觉
IF 0.3
Anaesthesia and Intensive Care Medicine Pub Date : 2026-03-01 Epub Date: 2026-03-05 DOI: 10.1016/j.mpaic.2026.02.006
Emma Jackson, Mohamed Elsaadany
{"title":"Special senses in critical illness","authors":"Emma Jackson,&nbsp;Mohamed Elsaadany","doi":"10.1016/j.mpaic.2026.02.006","DOIUrl":"10.1016/j.mpaic.2026.02.006","url":null,"abstract":"<div><div>This article explores the role of special senses in critical care, emphasizing their importance in patient assessment and recovery. Special senses, including vision, hearing, balance, smell, and taste, are mediated by complex sensory organs located in the head and lack of normal sensory input in critically ill patients can lead to delirium, and increase in morbidity and mortality. The article also emphasizes the importance of a comprehensive understanding of the special senses, which can prevent many serious complications related to critical illnesses and potentially aid in accelerated recovery, ultimately improving patient outcomes.</div></div>","PeriodicalId":45856,"journal":{"name":"Anaesthesia and Intensive Care Medicine","volume":"27 3","pages":"Pages 170-173"},"PeriodicalIF":0.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147453757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Peripheral nerve catheter techniques 外周神经导管技术
IF 0.3
Anaesthesia and Intensive Care Medicine Pub Date : 2026-03-01 Epub Date: 2026-03-05 DOI: 10.1016/j.mpaic.2026.02.005
Ayman HM Mustafa
{"title":"Peripheral nerve catheter techniques","authors":"Ayman HM Mustafa","doi":"10.1016/j.mpaic.2026.02.005","DOIUrl":"10.1016/j.mpaic.2026.02.005","url":null,"abstract":"<div><div>Peripheral nerve catheters (PNCs) or perineural catheters are used synonymously to describe placing a catheter in close proximity to nerve plexuses or individual nerves for the provision of continuous pain relief. The indications of PNCs extend beyond upper and lower extremity orthopaedic surgery to perioperative analgesia in patients undergoing a broad range of surgical procedures (e.g. abdominal, vascular, thoracic, breast and trauma surgeries). PNC use can facilitate early mobilization after surgery by providing high-quality analgesia that in turn leads to reduced opioid consumption and associated opioid-related side effects. Perioperative PNC analgesia can result in reduced length of in-hospital stay and improved rates of patient satisfaction. Insertion of PNCs can be done by either anaesthetist or surgeon. Long-term benefits are still to be ascertained. Risks are similar to those for peripheral nerve block, although catheter dislodgement remains a specific problem.</div></div>","PeriodicalId":45856,"journal":{"name":"Anaesthesia and Intensive Care Medicine","volume":"27 3","pages":"Pages 161-164"},"PeriodicalIF":0.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147453764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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