Anaesthesia最新文献

{"title":"Issue Information – Editorial Board","authors":"","doi":"10.1111/anae.16346","DOIUrl":"10.1111/anae.16346","url":null,"abstract":"","PeriodicalId":7742,"journal":{"name":"Anaesthesia","volume":"80 10","pages":""},"PeriodicalIF":6.9,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/epdf/10.1111/anae.16346","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145062509","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":"The reasons hypoactive delirium is often overlooked.","authors":"Shenglong Li,Longfei You","doi":"10.1111/anae.16785","DOIUrl":"https://doi.org/10.1111/anae.16785","url":null,"abstract":"","PeriodicalId":7742,"journal":{"name":"Anaesthesia","volume":"24 1","pages":""},"PeriodicalIF":10.7,"publicationDate":"2025-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145059119","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":"Postoperative cognitive decline following regional vs. general anaesthesia in older patients undergoing hip fracture surgery: a reply.","authors":"Ting Li,Chenchen Jiang,Fang G Smith","doi":"10.1111/anae.16779","DOIUrl":"https://doi.org/10.1111/anae.16779","url":null,"abstract":"","PeriodicalId":7742,"journal":{"name":"Anaesthesia","volume":"164 1","pages":""},"PeriodicalIF":10.7,"publicationDate":"2025-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145059087","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":"Pre-operative dexmedetomidine nasal spray and emergence agitation in adults.","authors":"Qingrui Sun,Xiaocou Wang,Yi Lu","doi":"10.1111/anae.16786","DOIUrl":"https://doi.org/10.1111/anae.16786","url":null,"abstract":"","PeriodicalId":7742,"journal":{"name":"Anaesthesia","volume":"9 1","pages":""},"PeriodicalIF":10.7,"publicationDate":"2025-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145059046","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 observational study of pre-hospital central venous access for patients with haemorrhagic shock due to major trauma.","authors":"Paolo Pallavicini,Luca Carenzo,Ryan Adams,Flora Bird,Ross Davenport,Robert Greenhalgh,Andrew E Wood,Jack Gallagher,Sara Williams,Daryl Newland,David J Lockey,Zane B Perkins,Ewoud Ter Avest, ","doi":"10.1111/anae.16778","DOIUrl":"https://doi.org/10.1111/anae.16778","url":null,"abstract":"INTRODUCTIONExsanguinating haemorrhagic shock due to major trauma is associated with high mortality. Rapid intravenous volume replacement with blood products is a crucial element of early treatment. When peripheral intravenous access cannot be obtained, pre-hospital placement of a large-calibre central venous catheter, known as a trauma line, can be a life-saving alternative.METHODSThis was a retrospective cohort study to evaluate the feasibility, efficacy and safety profile of inserting a 14-Fr trauma line in patients with exsanguinating haemorrhage due to major trauma in the pre-hospital setting. Success rates, outcomes and complications of trauma line insertion were determined by cross-referencing pre-hospital patient care records with emergency department notes, operating notes and post-mortem findings.RESULTSBetween 1 January 2019 and 31 July 2023, London's Air Ambulance attended 8104 patients. Trauma line insertion was attempted in 346 (4%) patients with success in 276 (80%). Successful trauma line insertion was associated with significantly greater transfusion of pre-hospital blood products compared with those in whom insertion was unsuccessful (median (IQR [range]) 4 (2-6 [0-12]) vs. 2 (0-4 [0-8]) units, respectively; p < 0.001). Survival to presentation to the emergency department was higher after successful trauma line insertion (149/279 (54%) vs. 25/70 (36%); p = 0.006). There were 184 (53%) patients transported to hospital. Complications in this group were reported in 8 (4%) patients: malpositioned trauma line (n = 3); vascular injuries (n = 2); iatrogenic pneumothorax (n = 2); and positive trauma line tip culture (n = 1).DISCUSSIONIn patients with exsanguinating haemorrhage who are in severe shock or traumatic cardiac arrest, pre-hospital trauma line insertion is feasible and associated with an acceptable risk of procedural complications. Trauma lines enable the delivery of a greater volume of blood products in the pre-hospital setting, which may be associated with increased pre-hospital survival.","PeriodicalId":7742,"journal":{"name":"Anaesthesia","volume":"29 1","pages":""},"PeriodicalIF":10.7,"publicationDate":"2025-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145059045","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":"Penicillin allergy risk stratification tool for use by non-allergists in the peri-operative setting: an agreement study and qualitative process evaluation.","authors":"Priyanthi Dias,Emma Walshaw,Sam Flatau,Eileen O'Grady,Philip M Hopkins,Lene Heise Garvey,Anna Littlejohns,Nikki Rousseau,Rupert M Pearse,Bethany Shinkins,Louise Savic","doi":"10.1111/anae.16758","DOIUrl":"https://doi.org/10.1111/anae.16758","url":null,"abstract":"INTRODUCTIONMany patients are labelled incorrectly as 'penicillin allergic'. This label is associated with poor health outcomes, regardless of whether the allergy is genuine. We designed a study to assess agreement between allergy specialists (consultant allergists or immunologists) and non-allergists when using a risk stratification tool to determine suitability for a penicillin challenge test.METHODSIn this two-centre mixed-method study, adult patients undergoing surgery who had been labelled penicillin allergic were assessed by a healthcare professional with no formal allergy training (consultant anaesthetist or peri-operative nurse) and an allergy specialist doctor using the risk stratification tool. Cohen's kappa was used to quantify agreement. We conducted a qualitative process evaluation based on individual and group interviews to explore user experience.RESULTSWe recruited 139 patients and 11 healthcare professionals; 101 patients completed both assessments (median (IQR [range]) age was 53 (40-66 [19-86]) y, 71% women). Allergist and non-allergist assessments agreed for 63 (62%) patients. In the remaining 38 (38%), most disagreements represented an overcautious approach by non-allergists, except in seven patients categorised as unsuitable (or uncertain) by the allergist but suitable by the non-allergist. Inter-rater agreement was moderate (unweighted κ 0.43, 95%CI 0.30-0.57; weighted κ 0.47, 95%CI 0.27-0.67). The prevalence and bias-adjusted score indicated poor inter-rater reliability (κ score 0.25, 95%CI 0.06-0.44). Qualitative analysis indicated low confidence in the tool among non-allergists, with a perceived need for allergy training and specialist support.DISCUSSIONThis penicillin allergy risk stratification tool, designed for use by healthcare professionals with no formal allergy training, showed poor agreement with allergy expert assessments.","PeriodicalId":7742,"journal":{"name":"Anaesthesia","volume":"72 1","pages":""},"PeriodicalIF":10.7,"publicationDate":"2025-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145059118","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":"Hyperangulated videolaryngoscopy: stylet, bougie or more practise?","authors":"Patrick A Ward,Gülsüm Karabulut","doi":"10.1111/anae.16780","DOIUrl":"https://doi.org/10.1111/anae.16780","url":null,"abstract":"","PeriodicalId":7742,"journal":{"name":"Anaesthesia","volume":"34 1","pages":""},"PeriodicalIF":10.7,"publicationDate":"2025-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145059163","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":"Establishment of reference ranges for ClotPro® in parturients.","authors":"Kamil Vrbica,Ondrej Hrdy,Jan Stingl,Lukas Hruban,Roman Gal","doi":"10.1111/anae.16776","DOIUrl":"https://doi.org/10.1111/anae.16776","url":null,"abstract":"","PeriodicalId":7742,"journal":{"name":"Anaesthesia","volume":"63 1","pages":""},"PeriodicalIF":10.7,"publicationDate":"2025-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145059120","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":"Emergency department hip fracture analgesia: choosing the right comparator for the PENG block.","authors":"Güneş Çelebioğlu","doi":"10.1111/anae.16783","DOIUrl":"https://doi.org/10.1111/anae.16783","url":null,"abstract":"","PeriodicalId":7742,"journal":{"name":"Anaesthesia","volume":"87 1","pages":""},"PeriodicalIF":10.7,"publicationDate":"2025-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145059081","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":"Development, external validation and integration into clinical workflow of machine learning models to support pre-operative assessment in the UK.","authors":"Alwyn Kotzé,Tom Lawton,Simon J Howell,Ruairi O'Driscoll,Michael Odling-Smee,Linqing Shangguan,Owen A Johnson,David C Wong","doi":"10.1111/anae.16777","DOIUrl":"https://doi.org/10.1111/anae.16777","url":null,"abstract":"INTRODUCTIONDemand for surgical treatment is growing and patient complexity is increasing. The NHS England standard contract now requires that pre-operative services risk stratify and optimise patients awaiting surgery. However, current pre-operative workflows (whether electronic or paper-based) remain based primarily on resource-intensive manual tasks. Lack of real-time data transfer has been identified as a key limitation to reducing the surgical backlog.METHODSWe developed certified electronic linkages between a live pre-operative assessment system (Smart PreOp, Aire Logic Ltd, Leeds, UK) and the GP Connect system from NHS England to retrieve clinical data directly from general practitioner records into pre-operative questionnaires. We developed machine learning models to categorise patients into lower- and higher-risk cohorts based on their predicted ASA physical status (1 or 2 vs. 3-5) and 30-day postoperative mortality risk. In contrast with previous prediction modelling studies, we constrained variable selection from the outset to variables that are available electronically in real time for all UK surgical patients regardless of where they present (the proposed procedure, demographics and medications lists).RESULTSThe development and external validation cohorts consisted of 110,732 and 67,878 patients, respectively, from two NHS Trusts using different electronic record systems. In external validation, at decision threshold 0.2, the ASA physical status prediction model had recall 0.69 and precision 0.95 for identifying lower-risk (ASA physical status 1 or 2) patients. The mortality prediction model discriminated well in external validation but was poorly calibrated, lending support to the existing literature showing that hospital-specific modelling improves mortality risk prediction. The technical architecture of the Smart PreOp system facilitates such hospital-specific modelling and periodic model updates.DISCUSSIONWe conclude that conducting modelling together with systems development can yield accurate prediction models that may be implemented directly into electronic health records. A prospective study of clinical impact and acceptability is warranted.","PeriodicalId":7742,"journal":{"name":"Anaesthesia","volume":"16 1","pages":""},"PeriodicalIF":10.7,"publicationDate":"2025-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145059116","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}