Anaesthesia and Intensive Care最新文献

{"title":"Text corrigendum for: Preliminary pharmacokinetics and patient experience of jet-injected dexmedetomidine in healthy adults.","authors":"Nicola M Whittle","doi":"10.1177/0310057X251377330","DOIUrl":"10.1177/0310057X251377330","url":null,"abstract":"","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"185"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145792694","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}

{"title":"Coagulation management in endovascular aortic repair in a patient with congenital prekallikrein deficiency: a case report.","authors":"Takero Iwai, Hiroki Yamauchi, Osamu Ogasawara, Taiki Kojima","doi":"10.1177/0310057X251377323","DOIUrl":"10.1177/0310057X251377323","url":null,"abstract":"<p><p>Prekallikrein deficiency is a rare autosomal recessive coagulation disorder that prolongs the activated clotting time. Guidelines for safe intraoperative coagulation control in patients with prekallikrein deficiency undergoing endovascular aortic repair are limited. We present a case of a 70-year-old man with prekallikrein deficiency who underwent endovascular aortic repair and required intraoperative anticoagulation control. Intraoperative anticoagulation with heparin and protamine was successfully managed using the activated clotting time measurements after preoperative administration of two units of fresh frozen plasma for prekallikrein replenishment. Preoperative prekallikrein replenishment by fresh frozen plasma administration contributed to safe intraoperative anticoagulation management.</p>","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"168-172"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145342859","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}

{"title":"Strategies to enhance the likelihood of detecting true effects in randomised controlled trials.","authors":"Mandy Hm Chu, Henry Mk Wong, Kwok M Ho","doi":"10.1177/0310057X251366319","DOIUrl":"10.1177/0310057X251366319","url":null,"abstract":"","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"101-103"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146140880","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}

{"title":"Combined erector spinae plane and serratus posterior superior interfascial plane blocks for comprehensive pain management in breast surgery: A potential route to pectoral nerve coverage.","authors":"Luca Gentili, Giorgio Panfili, Massimo Caula, Fabio Nania, Giuseppe Sepolvere, Paolo Scimia","doi":"10.1177/0310057X251366320","DOIUrl":"10.1177/0310057X251366320","url":null,"abstract":"<p><p>Postoperative pain management in breast cancer surgery remains challenging, particularly in procedures involving submammary tissue expander placement, where patients often report inadequate pain control. The complex innervation of the breast region, involving intercostal nerves (T2-T6), brachial plexus branches, and supraclavicular nerves (C3-C4), necessitates comprehensive anaesthetic coverage. We present four cases utilising a novel combined approach of erector spinae plane (ESP) and serratus posterior superior interfascial plane (SPSIP) blocks for perioperative pain management. The technique involves ultrasound-guided administration of ropivacaine 0.25% (20 ml for each block) targeting the T3 level for ESP and the fascial plane between the second and third ribs for SPSIP. This combination provides extensive hemithoracic analgesia from C3 to T10, potentially covering both superficial and deep tissue components of surgical pain. Our cases demonstrated excellent postoperative pain control with minimal analgesic requirements. The proximity of injection sites allows efficient block performance without patient repositioning. This additive approach shows promise in achieving comprehensive analgesia for breast surgery, including cases involving tissue expanders, though larger targeted studies are needed to confirm these preliminary findings.</p>","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"173-177"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146027880","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}

{"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":"10.1177/0310057X251377313","url":null,"abstract":"<p><p>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 (<i>P</i>=0.017) and peak intraoperative serum lactate concentration >2 mmol/L (<i>P</i>=0.038). An increased NELA score was associated with mortality; however, it was not associated with the requirement for any ICU therapy (<i>P</i>=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.</p>","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"140-147"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","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}

{"title":"Characteristics of potentially inappropriate, and inappropriately prolonged, ICU admissions in dying ICU patients: A retrospective cohort study.","authors":"Sandra Lussier, Carys Jones, Stephen Thornhill, Ary Serpa Neto, Daryl Jones","doi":"10.1177/0310057X251379092","DOIUrl":"10.1177/0310057X251379092","url":null,"abstract":"<p><p>Little is known about the characteristics of potentially inappropriate or unnecessarily prolonged intensive care unit (ICU) admissions in Australia, nor the exposure rate of non-ICU clinicians to dying ICU patients. We conducted a single-centre retrospective cohort study at a university-affiliated hospital in Victoria, Australia, of patients admitted to the ICU between January 2022 and June 2023, who transitioned to end-of-life care during their ICU admission. Decisions regarding appropriateness were adjudicated during a bi-weekly morbidity and mortality meeting. Out of 287 patients 279 were included in the final analysis. One hundred and eight (39%) patients were deemed to have had a potentially inappropriate admission, and 37 (13%) were deemed to have had a potentially inappropriately prolonged admission. Significantly higher proportions of patients were admitted from either the ward (32.4% versus 22.4%, <i>P</i>=0.02) or another hospital (15.7% versus 6.4%, <i>P</i>=0.02) if they were deemed to have had a potentially inappropriate admission. Significantly higher proportions of patients deemed to have had a potentially inappropriately prolonged admission had treatment limitations (16.2% versus 40.5%, <i>P</i>=0.006), lower Australian and New Zealand Risk of Death scores (median score 27.2 versus 45.5, <i>P</i>=0.006) and a clinical frailty score of 5 or more (63.9% versus 45.1%, <i>P</i>=0.048). They also had a significantly longer median ICU length of stay (median length of stay 13.4 days versus 2.6 days, <i>P</i> <0.001) and received significantly higher rates of invasive supports such as tracheostomy (16.2% versus 1.2%, <i>P</i> <0.001). The four major themes linked to these admissions were 1) lack of planning/appropriate treatment limitations, 2) lack of recognition of dying, 3) issues with communication/consensus and 4) provision of highly invasive treatments. The median rate of exposure of individual ward-based clinicians was 1 dying ICU patient per 18 months. Early framing of goals of care, reassessment of treatment goals during an ICU admission, dedicated communication skills training, and embedded frailty assessments might reduce non-beneficial and prolonged ICU admissions.</p>","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"148-156"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145660114","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}

{"title":"Thanks to Reviewers.","authors":"","doi":"10.1177/0310057X261418562","DOIUrl":"https://doi.org/10.1177/0310057X261418562","url":null,"abstract":"","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"310057X261418562"},"PeriodicalIF":1.2,"publicationDate":"2026-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146200137","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}

{"title":"Comment on: A case of cardiorespiratory collapse following bilateral sub-Tenon's blocks from brainstem anaesthesia.","authors":"Deidre A Sun, Lisa C De Gabriele, Peter Sumich","doi":"10.1177/0310057X251377297","DOIUrl":"https://doi.org/10.1177/0310057X251377297","url":null,"abstract":"","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":"54 1","pages":"84"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145931611","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}

{"title":"Reducing use of desflurane in the anaesthetic department: A controlled interrupted time series analysis.","authors":"Luise Kazda, Kristen M Pickles, Anthony Hull, Alexandra L Barratt","doi":"10.1177/0310057X251374691","DOIUrl":"10.1177/0310057X251374691","url":null,"abstract":"<p><p>Desflurane is a potent and expensive greenhouse gas. Reducing its use is a global priority. This anaesthetist-led quality improvement project involved educational, motivational and system-change initiatives implemented in the anaesthesia department of Bankstown-Lidcombe Hospital (BLH) (September 2021-March 2024), with the aim of reducing desflurane consumption. A quasi-experimental interrupted time series design with control site was employed to estimate changes in usage, greenhouse gas emissions and financial cost of anaesthetic agents per 100 surgeries. Prior to intervention, use of desflurane at BLH was stable. During and after intervention, a significant downward trend in desflurane use was observed, reducing by an average of 0.1 units (1 unit = 1 bottle) per month per 100 surgeries from September 2021 onwards (95% confidence interval (CI) -0.21 to -0.01, <i>P</i> = 0.035). The intervention, while not directly targeting sevoflurane use, was similarly associated with a downward trend in sevoflurane usage of an average of 0.5 units per month per 100 surgeries from September 2021 onwards (95% CI -189.74 kg to -10.43 kg, <i>P</i> = 0.004). No significant changes in use of desflurane or sevoflurane were observed at the control site, although use of both agents declined slightly over the study period. Estimated CO₂ equivalent (CO₂e) emissions were reduced by an average of 124.7 kg per month per 100 surgeries from September 2021 onwards (95% CI -223.3 kg to -26.1 kg, <i>P</i> = 0.018). Average monthly cost per 100 surgeries at BLH reduced by AU$100.34 per month (95% CI -AU$162.58 to -AU$38.10, <i>P</i> = 0.003). There were no changes in CO₂e emissions or costs at the control site. A clinician-led intervention highlights the importance of creating opportunity and motivation for change amongst staff as well as ongoing education, advocacy and engagement with department and executive to achieve positive environmental and financial outcomes.</p>","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"63-71"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12779768/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145660160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antifibrinolytics: Tranexamic acid in trauma.","authors":"Christine M Ball, Peter J Featherstone","doi":"10.1177/0310057X251401384","DOIUrl":"10.1177/0310057X251401384","url":null,"abstract":"","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"4-6"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145767058","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}