Anaesthesia and Intensive Care最新文献

Challenges with labour epidural placement in a parturient with a lumbar arachnoid cyst: a case report. 腰蛛网膜囊肿患者硬膜外分娩的挑战：1例报告。

IF 1.2 4区医学

Anaesthesia and Intensive Care Pub Date : 2025-10-22 DOI: 10.1177/0310057X251377800

Joseph Burton, Luke Baitch

引用次数: 0

Residual neuromuscular blockade following electroconvulsive therapy. 电休克治疗后残留的神经肌肉阻滞。

IF 1.2 4区医学

Anaesthesia and Intensive Care Pub Date : 2025-10-22 DOI: 10.1177/0310057X251378510

Siaavash Maghami, Dale Currigan

{"title":"Residual neuromuscular blockade following electroconvulsive therapy.","authors":"Siaavash Maghami, Dale Currigan","doi":"10.1177/0310057X251378510","DOIUrl":"https://doi.org/10.1177/0310057X251378510","url":null,"abstract":"Post-procedural residual neuromuscular paralysis is an uncommon but serious complication in the general surgical population. Whilst the incidence of post-procedural residual neuromuscular paralysis in the general surgical population has been widely reported, there are no published data on the definition or incidence of this complication in patients undergoing electroconvulsive therapy (ECT). In our single-centre, prospective observational audit we studied the incidence of residual neuromuscular blockade following ECT between January and April 2021. Out of 25 procedures carried out over this time period, 23 were included for analysis. A total of 14 patients (61%) left the ECT suite with potentially clinically significant residual neuromuscular blockade. The median suxamethonium dose was 0.83mg/kg (interquartile range 0.68-0.91). Despite the known complications resulting from post-procedural residual neuromuscular blockade, neuromuscular monitoring is not mandated in guidelines published by the Australian and New Zealand College of Anaesthetists or the American Society of Anesthesiologists. Our preliminary findings suggest that further research into the scope and significance of residual neuromuscular blockade following ECT is warranted.","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"310057X251378510"},"PeriodicalIF":1.2,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145342549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The 2025 awards for papers published in Anaesthesia and Intensive Care in 2024. 2024年发表在《麻醉与重症监护》杂志上的2025年论文奖。

IF 1.2 4区医学

Anaesthesia and Intensive Care Pub Date : 2025-10-22 DOI: 10.1177/0310057X251363263

Philip J Peyton, Michael Cooper

引用次数: 0

Critical hyponatraemia secondary to severe bilateral renal artery stenosis requiring intensive care - an unusual aetiopathogenesis for a common problem. 严重双侧肾动脉狭窄继发的危重低钠血症需要重症监护-一个常见问题的不寻常的病因。

IF 1.2 4区医学

Anaesthesia and Intensive Care Pub Date : 2025-10-22 DOI: 10.1177/0310057X251377310

Nicolas Sieben, Stephen Luke, Sananta Dash

{"title":"Critical hyponatraemia secondary to severe bilateral renal artery stenosis requiring intensive care - an unusual aetiopathogenesis for a common problem.","authors":"Nicolas Sieben, Stephen Luke, Sananta Dash","doi":"10.1177/0310057X251377310","DOIUrl":"https://doi.org/10.1177/0310057X251377310","url":null,"abstract":"A woman in her early sixties presented to the emergency department with an altered level of consciousness and severe hypertension (blood pressure 197/111 mmHg) on a background of Grave's disease, osteoporosis and hypertension. She was intubated following prolonged seizure activity attributed to critical hyponatraemia (serum sodium 108 mmol/L). Abnormal renal function (estimated glomerular filtration rate 51 ml/min per 1.73m2) was also identified on admission. She was transferred to the intensive care unit for further investigation and management of hypertension and hyponatraemia, where she made an excellent recovery and a unifying diagnosis of bilateral renal artery stenosis was made. Renal artery stenosis has been previously described with chronic and unilateral presentations not requiring intensive care support. This case report describes the pathophysiology of this previously unreported presentation of severe symptomatic hyponatraemia and hypertension due to bilateral renal artery stenosis and the challenges faced in intensive care to determine the diagnosis.","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"310057X251377310"},"PeriodicalIF":1.2,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145342850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Coagulation management in endovascular aortic repair in a patient with congenital prekallikrein deficiency: a case report. 血管内主动脉修复术中的凝血管理：一例先天性钾激肽缺乏症。

IF 1.2 4区医学

Anaesthesia and Intensive Care Pub Date : 2025-10-22 DOI: 10.1177/0310057X251377323

Takero Iwai, Hiroki Yamauchi, Osamu Ogasawara, Taiki Kojima

引用次数: 0

Enhanced care units provide a tailored and scalable solution to managing postoperative pathophysiology. 增强型护理单位为管理术后病理生理提供了量身定制的可扩展解决方案。

IF 1.2 4区医学

Anaesthesia and Intensive Care Pub Date : 2025-10-22 DOI: 10.1177/0310057X251366321

Chad Oughton, Ian Richardson, Sandeep Kusre, Bernhard Riedel

{"title":"Enhanced care units provide a tailored and scalable solution to managing postoperative pathophysiology.","authors":"Chad Oughton, Ian Richardson, Sandeep Kusre, Bernhard Riedel","doi":"10.1177/0310057X251366321","DOIUrl":"https://doi.org/10.1177/0310057X251366321","url":null,"abstract":"Postoperative complications increase morbidity and mortality. With an ever-increasing number of older and more frail patients requiring surgery, the demand for effective postoperative care is escalating. Currently, there is a notable disparity between postoperative ward-based care and the care provided in high dependency units (HDUs) and intensive care units (ICUs). This gap exposes intermediate-risk patients, with limited access to HDU/ICU facilities, to an increased risk of postoperative morbidity and mortality and has significant health economic implications. Mounting evidence supports preventive approaches, including the use of specialised, anaesthesia-led postoperative care delivered in enhanced care units (ECUs) which can bridge this gap effectively. Anaesthetists have a critical role in delivering enhanced perioperative care and are ideally positioned to lead this transformative approach. Current traditional ward-based approaches identify patient deterioration after it has occurred, exposing patients to avoidable hypotension and hypoxia and potentially non-specific treatment modalities such as intravenous fluid therapy for hypotension and low-flow nasal oxygen for hypoxia. Strategies for reducing early postoperative morbidity and mortality following surgery must focus on implementing policies which enhance perioperative care systems tailored to the unique pathophysiology of the postoperative period. Appropriate effector responses ideally would treat these perturbations before they occur or rapidly after identification using tailored therapeutic strategies specific to an individual patient's physiology. In this commentary, we highlight key aspects of postoperative pathophysiology that support the call for increasing access to appropriate postoperative care facilities, and offer ECUs as one scalable solution.","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"310057X251366321"},"PeriodicalIF":1.2,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145342876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Do not stop teaching anaesthesia trainees direct laryngoscopy. 不要停止教麻醉学员直接喉镜检查。

IF 1.2 4区医学

Anaesthesia and Intensive Care Pub Date : 2025-10-22 DOI: 10.1177/0310057X251364278

Anthony M-H Ho, Glenio B Mizubuti, Daenis Camiré, Jordan Leitch, Tracy Cupido, Saam Azargive, Cian Hurley

引用次数: 0

Utility of the NELA score and other variables in predicting the need for ICU admission post emergency laparotomy. NELA评分和其他变量在预测急诊剖腹手术后ICU入院需求中的应用

IF 1.2 4区医学

Anaesthesia and Intensive Care Pub Date : 2025-10-22 DOI: 10.1177/0310057X251377313

Ashleigh J Punch, Bradley A Wibrow, Angela Jacques, Amyleigh Hall, Siobhan N Delaney, Matthew H Anstey

{"title":"Utility of the NELA score and other variables in predicting the need for ICU admission post emergency laparotomy.","authors":"Ashleigh J Punch, Bradley A Wibrow, Angela Jacques, Amyleigh Hall, Siobhan N Delaney, Matthew H Anstey","doi":"10.1177/0310057X251377313","DOIUrl":"https://doi.org/10.1177/0310057X251377313","url":null,"abstract":"The preoperative risk score and key recommendations designed by the National Emergency Laparotomy Audit (NELA) have resulted in improved outcomes for patients undergoing emergency laparotomy. However, the recommended routine intensive care/high dependency unit (ICU) admission for high-risk patients is not always logistically possible and predictive models are needed to identify patients who will benefit. We conducted a study of patients undergoing emergency laparotomy at our tertiary hospital in Western Australia between 2018 and 2023 to identify factors that were associated with the need for ICU admission after emergency laparotomy, as defined by the requirement for a vasopressor infusion, continuous renal replacement therapy or ventilation. Of 1100 patients identified, 875 were included in the primary analysis. In multivariate analysis, the only independent predictive factors of the need for ICU therapies were the American Society of Anesthesiologists grade (P=0.017) and peak intraoperative serum lactate concentration >2 mmol/L (P=0.038). An increased NELA score was associated with mortality; however, it was not associated with the requirement for any ICU therapy (P=0.993). Although only 35.8% of high-risk patients were admitted to ICU, there was no apparent increase in adverse outcomes including mortality or unexpected ICU admission, and 27.4% of patients that were admitted to ICU received no specific therapies. This study provides a basis for the development of new predictive models for ICU admission post emergency laparotomy, and suggests the possibility that routine elective admission might not necessarily add value beyond that achieved by other NELA standards.","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"310057X251377313"},"PeriodicalIF":1.2,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145342575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Pain and recovery profiles following common orthopaedic surgeries in children. 儿童普通骨科手术后的疼痛和恢复情况。

IF 1.2 4区医学

Anaesthesia and Intensive Care Pub Date : 2025-10-21 DOI: 10.1177/0310057X251362256

Andrew Lowe, Chloe Y Batchelor, Thomas Fe Drake-Brockman, Britta S von Ungern-Sternberg, David L Sommerfield

{"title":"Pain and recovery profiles following common orthopaedic surgeries in children.","authors":"Andrew Lowe, Chloe Y Batchelor, Thomas Fe Drake-Brockman, Britta S von Ungern-Sternberg, David L Sommerfield","doi":"10.1177/0310057X251362256","DOIUrl":"https://doi.org/10.1177/0310057X251362256","url":null,"abstract":"Little evidence exists on the postoperative trajectory after paediatric orthopaedic surgery. Pain and behavioural disturbance can have short- and long-term impacts on children and their families. An improved understanding of procedure-specific postoperative trajectories can enhance recovery. The primary outcome was to examine the duration and severity of postoperative pain experienced by children undergoing 10 commonly performed orthopaedic procedures. Secondary outcomes include rates of behavioural disturbances, nausea and vomiting, and parental satisfaction. Parents of children were invited to participate via telephone and followed up regularly until pain, nausea and vomiting, and behavioural disturbances were at baseline. Children's pain scores were measured using a parental proxy numerical rating scale. Three hundred and thirty-five patients were recruited across 10 routine paediatric orthopaedic surgical groups. Most (93.1%) fracture pain resolved after two days but lengthened with metal insertion or in more complex procedures such as tibial fracture manipulations and slipped upper femoral epiphysis (SUFE) pinning. Rates of postoperative nausea (24%) and vomiting (8%) were low but increased with longer operations and opioid use. Most patients received non-opioid simple analgesia on discharge, except for the SUFE pinning group, who typically received opioids for two days postoperatively. Occurrence of behavioural disturbances correlated with pain severity across groups. Pain generally resolved within two days and was managed with simple analgesia. Regional anaesthetic techniques were underutilised. Increased regional use and potentially short-term opioid analgesia at home in the SUFE and tibial fractures cohorts have been recommended at our institution. Improvement to discharge information includes procedure-specific recommendations on regular simple analgesia and expected recovery trajectory.","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"310057X251362256"},"PeriodicalIF":1.2,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145342603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Early expiratory flow flattening: an alternative sign of delayed cycling in non-invasive ventilation. 早期呼气流量平缓：无创通气延迟循环的另一种体征。

IF 1.2 4区医学

Anaesthesia and Intensive Care Pub Date : 2025-10-16 DOI: 10.1177/0310057X251377296

Michalis Agrafiotis

引用次数: 0