Anaesthesia最新文献

{"title":"The role of regional anaesthesia and analgesia in the prevention of chronic postsurgical pain: there is no Holy Grail","authors":"Angeline Lee, Agnese Ozolina, Edward R. Mariano, Dario Bugada","doi":"10.1111/anae.70012","DOIUrl":"https://doi.org/10.1111/anae.70012","url":null,"abstract":"","PeriodicalId":7742,"journal":{"name":"Anaesthesia","volume":"17 1","pages":""},"PeriodicalIF":10.7,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145116411","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":"Dexmedetomidine for cardiac surgery: case closed?","authors":"Mike Charlesworth, Lachlan F. Miles","doi":"10.1111/anae.70015","DOIUrl":"https://doi.org/10.1111/anae.70015","url":null,"abstract":"","PeriodicalId":7742,"journal":{"name":"Anaesthesia","volume":"39 1","pages":""},"PeriodicalIF":10.7,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145116418","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":"Association between surgical start time and postoperative mortality, morbidity and healthcare utilisation in elective non‐cardiac surgeries: a retrospective, single‐centre study using propensity score matching","authors":"Ji‐Hoon Sim, Bumwoo Park, Yeseul Choi","doi":"10.1111/anae.16788","DOIUrl":"https://doi.org/10.1111/anae.16788","url":null,"abstract":"SummaryIntroductionThere is limited knowledge regarding the impact of surgical start time on postoperative outcomes in elective non‐cardiac surgery. This study investigated the association between surgical start time and surgical outcomes in elective non‐cardiac surgeries, including mortality; morbidity; and healthcare utilisation.MethodsWe analysed 291,051 patients who underwent non‐cardiac surgery. Patients were grouped by surgical start time: morning (08:00–13:00) vs. afternoon (13:00–18:00). Restricted mean survival time was calculated to assess survival differences. Outcomes were also stratified by weekday and season. Subgroup analyses evaluated associations between surgical timing and outcomes in high‐risk populations, including older adults.ResultsAfter propensity score matching, statistically significant differences were observed between the morning and afternoon groups for 30‐day mortality (0.12% vs. 0.17%, p = 0.015); 1‐year mortality (2.73% vs. 3.36%, p < 0.001); composite complications (5.48% vs. 5.94%, p = 0.003); ICU admissions (5.87% vs. 7.18%, p < 0.001); and intra‐operative transfusions (3.40% vs. 4.10%, p < 0.001). Restricted mean survival time analysis revealed significantly shorter survival times in the afternoon group across all time points. Afternoon surgery was associated with increased risk of 30‐day mortality (adjusted hazard ratio 1.33, 95%CI 1.07–1.66, p = 0.010); 1‐year mortality (adjusted hazard ratio 1.26, 95%CI 1.20–1.32, p < 0.001); composite complications (adjusted odds ratio 1.05, 95%CI 1.01–1.08, p = 0.010); ICU admission (adjusted odds ratio 1.09, 95%CI: 1.06–1.13, p < 0.001); and intra‐operative transfusions (adjusted odds ratio 1.27, 95%CI 1.21–1.33, p < 0.001). Subgroup analysis indicated that the impact of surgical start time on outcomes was more pronounced in high‐risk patients and also varied significantly depending on the type of surgery.DiscussionSurgical start timing was an independent risk factor for increased short‐ and long‐term postoperative mortality, morbidity and healthcare resource utilisation. The reasons for this are likely to be multifactorial.","PeriodicalId":7742,"journal":{"name":"Anaesthesia","volume":"30 1","pages":""},"PeriodicalIF":10.7,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145116412","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":"Real-world deployment and evaluation of PEri-operative AI CHatbot (PEACH): a large language model chatbot for peri-operative medicine","authors":"Yu He Ke, Liyuan Jin, Kabilan Elangovan, Bryan Wen Xi Ong, Chin Yang Oh, Jacqueline Sim, Kenny Wei-Tsen Loh, Chai Rick Soh, Jonathan Ming Hua Cheng, Aaron Kwang Yang Lee, Daniel Shu Wei Ting, Nan Liu, Hairil Rizal Abdullah","doi":"10.1111/anae.16755","DOIUrl":"https://doi.org/10.1111/anae.16755","url":null,"abstract":"Large Language Models are emerging as powerful tools in healthcare, particularly for complex, domain-specific tasks. This study describes the development and evaluation of PEri-operative AI CHatbot (PEACH). It was developed by embedding 35 institutional peri-operative protocols into a secure large language model environment, with iterative prompt engineering and internal testing to ensure clinical relevance and accuracy.","PeriodicalId":7742,"journal":{"name":"Anaesthesia","volume":"161 1","pages":""},"PeriodicalIF":10.7,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145089931","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":"Refining evidence on motor-sparing regional analgesia for hip arthroplasty: a reply.","authors":"Dario Bugada,Edward R Mariano","doi":"10.1111/anae.16782","DOIUrl":"https://doi.org/10.1111/anae.16782","url":null,"abstract":"","PeriodicalId":7742,"journal":{"name":"Anaesthesia","volume":"29 1","pages":""},"PeriodicalIF":10.7,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145077791","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":"Guidance for reporting artificial intelligence technology evaluations for ultrasound scanning in regional anaesthesia (GRAITE-USRA): an international multidisciplinary consensus reporting framework.","authors":"Xiaoxi Zhang,Jenny Ferry,David W Hewson,Gary S Collins,Matthew D Wiles,Yi Zhao,Alexander P L Martindale,Michael Tomaschek,James S Bowness, ","doi":"10.1111/anae.16733","DOIUrl":"https://doi.org/10.1111/anae.16733","url":null,"abstract":"INTRODUCTIONThe application of artificial intelligence to enhance the clinical practice of ultrasound-guided regional anaesthesia is of increasing interest to clinicians, researchers and industry. The lack of standardised reporting for studies in this field hinders the comparability, reproducibility and integration of findings. We aimed to develop a consensus-based reporting guideline for research evaluating artificial intelligence applications for ultrasound scanning in regional anaesthesia.METHODSWe followed methodology recommended by the EQUATOR Network for the development of reporting guidelines. Review of published literature and expert consultation generated a preliminary list of candidate reporting items. An international, multidisciplinary, modified Delphi process was then undertaken, involving experts from clinical practice, academia and industry. Two rounds of expert consultation were conducted, in which participants evaluated each item for inclusion in a final reporting guideline, followed by an online discussion.RESULTSA total of 67 experts participated in the first Delphi round, 63 in the second round and 25 in the roundtable consensus meeting. The GRAITE-USRA reporting guideline comprises 40 items addressing key aspects of reporting in artificial intelligence research for ultrasound scanning in regional anaesthesia. Specific items include ultrasound acquisition protocols and operator expertise, which are not covered in existing artificial intelligence reporting guidelines.DISCUSSIONThe GRAITE-USRA reporting guideline provides a minimum set of recommendations for artificial intelligence-related research for ultrasound scanning in regional anaesthesia. Its adoption will promote consistent reporting standards, enhance transparency, improve study reproducibility and ultimately support the effective integration of evidence into clinical practice.","PeriodicalId":7742,"journal":{"name":"Anaesthesia","volume":"38 1","pages":""},"PeriodicalIF":10.7,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145077794","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":"Association of Anaesthetists guidelines: safe vascular access 2025.","authors":"Andrew J Johnston,Matthew J Simpson,Victoria McCormack,Andrew Barton,James Bennett,Anil Chalisey,Jeremy Crane,Stefanie Curry,Helen Laycock,Dhupal Patel,Teikchoon See,John Shubhaker,Kathryn Singh,Sarah Thornton","doi":"10.1111/anae.16727","DOIUrl":"https://doi.org/10.1111/anae.16727","url":null,"abstract":"INTRODUCTIONSafe vascular access is integral to anaesthetic and critical care practice. However, despite technological and procedural advances, it remains a frequent source of adverse events and patient harm. Ensuring a safe and effective approach to the selection, insertion and care of vascular access devices should be a priority for all practitioners.METHODSThis updated consensus statement builds upon previous iterations of safe vascular access guidelines. An expert, multidisciplinary, multi-society working party agreed on major themes and conducted a review of literature and best practice to build a comprehensive body of work. This was followed by a two-round Delphi process to agree on specific recommendations and to inform these concise guidelines.RESULTSWe agreed successfully 15 recommendations encompassing operational, training and clinical issues with an emphasis on a holistic approach to vascular access and long-term vessel health. These recommendations were divided into six major themes, covering: process (vascular access teams and responsiveness key performance indicators); device selection; insertion, including the use of safety standards, ultrasound, catheter tip position and vein/catheter ratios; the management of anticoagulation therapy, catheter-related thrombosis and coagulopathies; specific patient groups, including patients requiring renal replacement therapy, following mastectomy and axillary lymph node resection and the use of peripheral vasoconstrictors; and training in advanced vascular access.DISCUSSIONIt is hoped that these guidelines, together with the larger body of work, will improve the care of patients who require vascular access, embed a more holistic approach to vascular access and lifetime vein preservation, and support staff and hospitals with vascular access service development.","PeriodicalId":7742,"journal":{"name":"Anaesthesia","volume":"35 1","pages":""},"PeriodicalIF":10.7,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071806","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":"Tipping the scales: obesity, anaesthesia and the new normal.","authors":"Andrew McKechnie,Zoë A Burton","doi":"10.1111/anae.16775","DOIUrl":"https://doi.org/10.1111/anae.16775","url":null,"abstract":"","PeriodicalId":7742,"journal":{"name":"Anaesthesia","volume":"171 1","pages":""},"PeriodicalIF":10.7,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071808","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":"List of Abstracts","authors":"","doi":"10.1111/anae.16747","DOIUrl":"10.1111/anae.16747","url":null,"abstract":"<p>\u0000 </p>","PeriodicalId":7742,"journal":{"name":"Anaesthesia","volume":"80 S4","pages":"3-7"},"PeriodicalIF":6.9,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/epdf/10.1111/anae.16747","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145068851","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":"Towards a comprehensive and efficient assessment of regional anaesthesia competency.","authors":"Zhe Li,Xiaowen Liu","doi":"10.1111/anae.16781","DOIUrl":"https://doi.org/10.1111/anae.16781","url":null,"abstract":"","PeriodicalId":7742,"journal":{"name":"Anaesthesia","volume":"35 1","pages":""},"PeriodicalIF":10.7,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071807","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}