Anaesthesia最新文献

{"title":"Peri-operative use of high-flow nasal oxygen in obstetric patients: a systematic review.","authors":"Robert Craig,Lucy Curran,Sohail Bampoe,Peter Odor,Lindsay Blake,Brendan Carvalho,James O'Carroll","doi":"10.1111/anae.16665","DOIUrl":"https://doi.org/10.1111/anae.16665","url":null,"abstract":"INTRODUCTIONHigh-flow nasal oxygen devices have gained interest in pre-oxygenation and peri-operative oxygenation strategies. However, their role in obstetric anaesthesia remains poorly defined. This systematic review aimed to evaluate the use of high-flow nasal oxygen in obstetric patients during the peri-operative period, focusing on maternal oxygenation and clinical outcomes.METHODSWe included studies published in any language, conducted in all countries. Search terms included terminology concerning obstetric anaesthesia related to the use of high-flow nasal oxygen in the peri-operative period. Included papers were assessed for risk of bias. Studies were included for detailed review if they evaluated the use of high-flow nasal oxygen as a pre-oxygenation strategy in obstetric patients and reported maternal or neonatal outcomes.RESULTSA total of 649 abstracts were screened with 11 articles included. There was variation in pre-oxygenation strategies and primary outcomes. Available evidence suggests that high-flow nasal oxygen was not superior to facemask pre-oxygenation in achieving target end-tidal oxygen concentrations. High-flow nasal oxygen may increase the partial pressure of oxygen in arterial blood, but the evidence of increased apnoea time was inconsistent. There were no reported adverse maternal effects or differences in neonatal Apgar scores, umbilical cord gases or fetal heart rate assessments.DISCUSSIONThe advantages of peri-operative high-flow nasal oxygen over conventional oxygenation methods for obstetric patients remain uncertain. Current evidence does not show a clear benefit of high-flow nasal oxygen in achieving pre-oxygenation targets or prolonging time to desaturation in low-risk patients, whilst the benefits in high-risk patients remain uncertain and warrant further investigation.","PeriodicalId":7742,"journal":{"name":"Anaesthesia","volume":"11 1","pages":""},"PeriodicalIF":10.7,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144311578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Issue Information – Editorial Board","authors":"","doi":"10.1111/anae.16340","DOIUrl":"https://doi.org/10.1111/anae.16340","url":null,"abstract":"","PeriodicalId":7742,"journal":{"name":"Anaesthesia","volume":"80 7","pages":""},"PeriodicalIF":7.5,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anae.16340","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144300186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What's a woman got to do to get an epidural round here? Testing mothers and their capacity to the limits","authors":"David G. Bogod, Kate McCombe","doi":"10.1111/anae.16663","DOIUrl":"https://doi.org/10.1111/anae.16663","url":null,"abstract":"Click on the article title to read more.","PeriodicalId":7742,"journal":{"name":"Anaesthesia","volume":"153 1","pages":""},"PeriodicalIF":10.7,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144305176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An obituary for postoperative use of modified‐release opioids","authors":"Nicholas Levy, Dileep N. Lobo, Pamela E. Macintyre","doi":"10.1111/anae.16661","DOIUrl":"https://doi.org/10.1111/anae.16661","url":null,"abstract":"","PeriodicalId":7742,"journal":{"name":"Anaesthesia","volume":"145 1","pages":""},"PeriodicalIF":10.7,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144311315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing emergency front-of-neck airway training: a mixed methods study on the impact of external noise and startle stressors","authors":"James Cassidy, Jennifer Reynolds, Tamryn Miller, Thomas Miller, Jeremy M Brown, Ben Morton, Peter Groom","doi":"10.1111/anae.16650","DOIUrl":"https://doi.org/10.1111/anae.16650","url":null,"abstract":"Our aim was to investigate whether emergency front-of-neck airway training utilising low-fidelity manikins in a ‘tea-trolley’ format could be improved by the incorporation of stress inoculation training. This would be an important advance as clinicians report that cognitive overload impairs performance during real emergencies. We hypothesised that environmental noise and simulated blood splatter would result in a heightened stress experience.","PeriodicalId":7742,"journal":{"name":"Anaesthesia","volume":"23 1","pages":""},"PeriodicalIF":10.7,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144305167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intra-operative ventilation: searching for the Holy Grail","authors":"Harish Venkatesh, Kindha McLaren, Akshay Shah, Sanooj Soni","doi":"10.1111/anae.16664","DOIUrl":"https://doi.org/10.1111/anae.16664","url":null,"abstract":"Click on the article title to read more.","PeriodicalId":7742,"journal":{"name":"Anaesthesia","volume":"4 1","pages":""},"PeriodicalIF":10.7,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144305213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bullying: a silent threat to clinician well-being and patient safety.","authors":"Todd Nelson","doi":"10.1111/anae.16660","DOIUrl":"https://doi.org/10.1111/anae.16660","url":null,"abstract":"","PeriodicalId":7742,"journal":{"name":"Anaesthesia","volume":" ","pages":""},"PeriodicalIF":7.5,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144281999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mandatory training for rare anaesthetic events – a virtue ethics view","authors":"Thomas Donaldson","doi":"10.1111/anae.16659","DOIUrl":"https://doi.org/10.1111/anae.16659","url":null,"abstract":"<p>I read with interest the letters by Murphy [<span>1</span>] and Frerk and Evans [<span>2</span>] about philosophical approaches to mandatory training for rare anaesthetic events. The utilitarian and Kantian philosophical approaches that they advocate highlight the importance of striving for good outcomes when rare anaesthetic emergencies occur, as well as aiming for universal anaesthetic competence in managing these situations. However, as duty-based philosophical approaches, both utilitarianism and Kantianism consider the right action to be solely an individual's responsibility. Systems-based and human factors approaches to the management of anaesthetic emergencies highlight that the factors that influence decision-making, performance and outcome in these situations are much more extensive than the decision-making of individuals in the moment [<span>3</span>]. Virtue ethics offers a different philosophical approach, emphasising the importance of mandatory training and simulation that provide opportunities to prepare to respond correctly to rare anaesthetic events as clinical teams, not just as individuals.</p>\u0000<p>Virtue ethics seeks to understand correct action in the context of being a good (or virtuous) person. Aristotle, one of the most influential ancient virtue ethicists, considered education and training to be fundamental to the development of both excellence in practical skills and virtuous characters, which may both be necessary to respond rightly to life's moral challenges [<span>4</span>]. This means that virtuous action is not something that can simply be achieved in the moment that an ethical dilemma arises. Virtuous acts occur when people who have trained in skills and developed good character traits are prepared to respond appropriately to the challenges they face. This suggests that virtuous anaesthetists should be interested in developing excellent technical skills and virtuous characteristics, like vigilance, composure and adaptability, so they are prepared to respond to rare anaesthetic events correctly.</p>\u0000<p>Swanton (a modern virtue ethicist) has argued that developing team-working (dialogic) virtues promotes the collaboration required to overcome the complex problems we encounter in life and our own individual limitations [<span>5</span>]. Simulation training offers an important opportunity to grow in these virtues and to develop ways of working together effectively as teams to identify and manage rare anaesthetic events. Virtue ethics highlight the moral importance of ensuring good human factors approaches to our multidisciplinary team-working, if we hope to respond with excellence and virtue when rare anaesthetic events occur. Mandatory training and simulation can both be ways in which anaesthetists and the teams they work within can prepare virtuously for rare anaesthetic emergencies.</p>","PeriodicalId":7742,"journal":{"name":"Anaesthesia","volume":"4 1","pages":""},"PeriodicalIF":10.7,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144252846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Top 10 research priorities for sepsis research determined by patients, carers and clinicians","authors":"Joanne McPeake, Nahid Ahmad, Kimberley Bradley, Andrew Conway Morris, Paul Dark, Colin Graham, Walter Hall, Susan Moug, Mark Oakes, Emily Perry, Simon Stockley, Jane Weaver, Bronwen Connolly, Nazir Lone","doi":"10.1111/anae.16634","DOIUrl":"https://doi.org/10.1111/anae.16634","url":null,"abstract":"SummaryIntroductionSepsis is a high burden syndrome associated with increased morbidity and mortality in both the acute and longer‐term phases of illness. Multiple treatment uncertainties remain that require resolution through high‐quality research. This study aimed to identify the top 10 research priorities for sepsis research in the UK.MethodsWe conducted a priority setting partnership study co‐produced by sepsis survivors, carers and clinicians. This included five stages: initiation of steering group formation and confirmation of the scope of the priority setting partnership; identification of clinical uncertainties through an electronic survey; analysis and verification of uncertainties; interim prioritisation to the top 25 ranked questions; and final prioritisation to determine the top 10 research priorities, using the nominal group technique.ResultsOur initial survey respondents comprised 447/718 (62.3%) people who had survived sepsis, their friends and family members; 218/718 (30.4%) clinicians; and 53/718 (7.1%) multiple/other roles who identified 53 distinct research uncertainties. Our interim prioritisation survey comprised 429/941 (45.8%) people who had survived sepsis, their friends and family members; 431/941 (46.0%) clinicians; and 73/941 (8.2%) multiple/other roles, with the top 25 ranked summary questions taken forwards for final prioritisation. From these, final workshop participants (n = 27) agreed a top 10 list of research priorities. Improved sepsis diagnosis; characterisation and management of the post‐sepsis syndrome; and non‐antibiotic treatment of sepsis were the top three priorities.DiscussionWe establised priorities for sepsis research through a rigorous process of consensus involving sepsis survivors, carers and clinicians. These priorities will support future delivery of meaningful research to improve outcomes from sepsis.","PeriodicalId":7742,"journal":{"name":"Anaesthesia","volume":"18 1","pages":""},"PeriodicalIF":10.7,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Airway management in patients living with obesity: best practice recommendations from the Society for Obesity and Bariatric Anaesthesia","authors":"Andrew McKechnie, Helen A. Iliff, Rebecca Black, Imran Ahmad, Angela Chesworth, Paul Chesworth, Nordene Davis, Catherine Griffiths","doi":"10.1111/anae.16647","DOIUrl":"https://doi.org/10.1111/anae.16647","url":null,"abstract":"Patients living with obesity present specific challenges for airway management. They have been overrepresented repeatedly in studies looking at complications associated with airway management. Whilst generic airway guidelines offer assistance, there are no evidence-based guidelines specific to this group of patients to support safe and effective airway management.","PeriodicalId":7742,"journal":{"name":"Anaesthesia","volume":"359 1","pages":""},"PeriodicalIF":10.7,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144219490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}