British journal of anaesthesia最新文献_第2页

Microglia-neuronal communication mediated by P2X4R-BDNF-TrkB promotes synaptic plasticity and anterior cingulate cortex hyperactivity in muscle pain chronicity. P2X4R-BDNF-TrkB介导的小胶质细胞-神经元通讯促进了肌肉疼痛慢性中的突触可塑性和前扣带皮质亢进。

IF 9.8 1区医学

British journal of anaesthesia Pub Date : 2025-07-23 DOI: 10.1016/j.bja.2025.04.048

Yanan Liang,Meiling Luo,Qianxi Xu,Siqi Zhang,Shuangyang Niu,Xiaohe Li,Weizhen Sun,Menghan Song,Likai Wang,Xiangxin Xing,Jie Wang,Mengqi Feng,Linlin Zhao,Handong Chen,Run Sheng,Yonghui Wang

{"title":"Microglia-neuronal communication mediated by P2X4R-BDNF-TrkB promotes synaptic plasticity and anterior cingulate cortex hyperactivity in muscle pain chronicity.","authors":"Yanan Liang,Meiling Luo,Qianxi Xu,Siqi Zhang,Shuangyang Niu,Xiaohe Li,Weizhen Sun,Menghan Song,Likai Wang,Xiangxin Xing,Jie Wang,Mengqi Feng,Linlin Zhao,Handong Chen,Run Sheng,Yonghui Wang","doi":"10.1016/j.bja.2025.04.048","DOIUrl":"https://doi.org/10.1016/j.bja.2025.04.048","url":null,"abstract":"BACKGROUNDMicroglia-neuronal communication is crucial for the development and maintenance of pain. However, the exact mechanisms underlying this interaction and its role in anterior cingulate cortex (ACC) circuitry in pain regulation are under exploration.METHODSWe explored the role of P2X4R-brain-derived neurotrophic factor (BDNF)-TrkB signalling of ACC in regulating muscle pain (MP). Mechanical and thermal pain thresholds along with open field tests were used to assess pain and anxiety-like behaviours. Golgi staining, transmission electron microscopy, and patch-clamp recordings were performed to evaluate synaptic plasticity changes. Meanwhile, cFos staining and calcium imaging substantiate the neuronal excitability. In addition, we used chemogenetic and optogenetic approaches to manipulate ACC neuronal activity.RESULTSThe ACC exhibited increased excitability, together with enhanced synaptic plasticity in rats with chronic MP. Microglial inhibition alleviated pain and anxiety-like behaviours. Furthermore, microglial P2X4R promoted BDNF expression, which acted on TrkB to regulate neuronal excitability and synaptic plasticity in ACC; these effects were reversed by P2X4R knockdown and TrkB inhibition in MP. Chemogenetic and optogenetic suppression of ACC hyperactivity relieved chronic MP and anxiety-like behaviours.CONCLUSIONSOur findings highlight a critical microglia-neuronal communication via the P2X4R-BDNF-TrkB signalling, which enhances synaptic plasticity and cortical excitability in the anterior cingulate cortex, thereby participating in the regulation of muscle pain. Understanding how to assess and modulate microglia-neuronal communication and abnormal cortical activity will be key to developing novel therapies for MP disorders.","PeriodicalId":9250,"journal":{"name":"British journal of anaesthesia","volume":"11 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144701065","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}

引用次数: 0

Corrigendum to 'Epidural analgesia versus dural puncture epidural analgesia in labouring parturients: a meta-analysis of randomised controlled trials'(Br J Anaesth 2025; 134: 1402-14). “难产产妇硬膜外镇痛与硬膜穿刺硬膜外镇痛：随机对照试验的荟萃分析”的更正(Br J anesth 2025；134: 1402 - 14)。

IF 9.8 1区医学

British journal of anaesthesia Pub Date : 2025-07-23 DOI: 10.1016/j.bja.2025.07.032

Preet Mohinder Singh,David T Monks,Adithya D Bhat,Anuradha Borle,Manpreet Kaur,Phillip Yang,Muthuraj Kanakaraj

引用次数: 0

Technology, evidence, and continuing clinical education: a role for self-directed learning? 技术、证据和继续临床教育：自主学习的角色？

IF 9.8 1区医学

British journal of anaesthesia Pub Date : 2025-07-23 DOI: 10.1016/j.bja.2025.07.004

Craig S Webster,Jennifer M Weller

引用次数: 0

A black swan spotted during emergence from general anaesthesia: alpha and delta oscillations present in a conversing patient. 全身麻醉苏醒时发现的黑天鹅：在谈话患者中出现α和δ振荡。

IF 9.8 1区医学

British journal of anaesthesia Pub Date : 2025-07-23 DOI: 10.1016/j.bja.2025.06.029

Adam W Kaplon,Sebastian Gallo,Christian S Guay,Keith H Baker

引用次数: 0

Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers in the perioperative period: withdraw or continue? A multicentre randomised controlled trial. 围手术期血管紧张素转换酶抑制剂和血管紧张素受体阻滞剂：停用还是继续使用？一项多中心随机对照试验。

IF 9.8 1区医学

British journal of anaesthesia Pub Date : 2025-07-22 DOI: 10.1016/j.bja.2025.05.056

Lynn A Miggelbrink,Wilton A van Klei,Marianne C Verhaar,Folkert W Asselbergs,Wilko Spiering,Wolfgang F F A Buhre,Markus W Hollmann,Felix van Lier,Eric H P A van Dongen,Patrick Schober,Thijs C D Rettig,Hans J B Reitsma,Eva P C van Schaik,Lisette M Vernooij,Judith A R van Waes

引用次数: 0

Factors associated with a reduction in the preventive effect of intravenous dexamethasone on rebound pain after axillary brachial plexus block. 静脉注射地塞米松对腋窝臂丛阻滞后反跳性疼痛预防作用降低的相关因素。

IF 9.8 1区医学

British journal of anaesthesia Pub Date : 2025-07-22 DOI: 10.1016/j.bja.2025.05.055

Nassim Touil,Athanasia Pavlopoulou,Olivier Barbier,Xavier Libouton,Damien Gruson,Jean-Luc Gala,Patricia Lavand'homme

{"title":"Factors associated with a reduction in the preventive effect of intravenous dexamethasone on rebound pain after axillary brachial plexus block.","authors":"Nassim Touil,Athanasia Pavlopoulou,Olivier Barbier,Xavier Libouton,Damien Gruson,Jean-Luc Gala,Patricia Lavand'homme","doi":"10.1016/j.bja.2025.05.055","DOIUrl":"https://doi.org/10.1016/j.bja.2025.05.055","url":null,"abstract":"BACKGROUNDRebound pain after regional anaesthesia remains a significant clinical problem. Intravenous dexamethasone is commonly used as an adjuvant to prevent rebound pain although its effectiveness varies among patients. We aimed to identify phenotypic and biological factors influencing glucocorticoid sensitivity contributing to dexamethasone resistance in the prevention of rebound pain.METHODSPatients undergoing ambulatory upper limb surgery with an axillary brachial plexus block were enrolled prospectively to receive dexamethasone (0.1 mg kg-1 i.v.) before surgery. Preoperative factors analysed encompassed clinical aspects (central sensitivity, anxiety, and pain scores) and biological parameters (salivary cortisol, annexin-A1, and blood inflammatory markers). Postoperative outcomes comprised rebound pain incidence (numerical rating scale >7 within the first 24 h) and persistent pain at 3 months.RESULTSOf the 104 patients included, 36 (34.6%) developed rebound pain. Preoperative nocturnal awakening pain (odds ratio [OR]=3.09, P=0.03), severe anxiety (OR=3.54, P=0.01), high catastrophising score (OR=4.14, P=0.01), and low salivary cortisol levels (<1147 pg ml-1) (OR=3.33, P=0.02) were associated with an increased risk of rebound pain. Persistent pain at 3 months (27%) was associated with the presence of postoperative rebound pain (P=0.04).CONCLUSIONSPreoperative nocturnal pain, severe anxiety, high catastrophising, and low salivary cortisol levels are factors that might reduce the efficacy of dexamethasone in preventing rebound pain. These findings support the development of personalised preventive strategies.CLINICAL TRIAL REGISTRATIONNCT05763433.","PeriodicalId":9250,"journal":{"name":"British journal of anaesthesia","volume":"98 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144693498","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}

引用次数: 0

Predicting arterial pressure without prejudice: towards effective hypotension prediction models 无偏见地预测动脉压：建立有效的低血压预测模型

IF 9.8 1区医学

British journal of anaesthesia Pub Date : 2025-07-19 DOI: 10.1016/j.bja.2025.06.016

Simon Tilma Vistisen, Paul Elbers

引用次数: 0

Solving the enigma of burst suppression. Response to Br J Anaesth 2025. 解决突发抑制之谜。对中国经济的回应，2025。

IF 9.8 1区医学

British journal of anaesthesia Pub Date : 2025-07-18 DOI: 10.1016/j.bja.2025.06.019

Jyun-You Liou,M Bruce Maciver,Jamie W Sleigh

引用次数: 0

Response of the Conox quantitative electroencephalographic monitor to neuromuscular block in awake volunteers. Conox定量脑电图监测仪对清醒志愿者神经肌肉阻滞的反应。

IF 9.8 1区医学

British journal of anaesthesia Pub Date : 2025-07-18 DOI: 10.1016/j.bja.2025.05.023

Peter J Schuller,Jan P G Pretorius,Kym B Newbery

{"title":"Response of the Conox quantitative electroencephalographic monitor to neuromuscular block in awake volunteers.","authors":"Peter J Schuller,Jan P G Pretorius,Kym B Newbery","doi":"10.1016/j.bja.2025.05.023","DOIUrl":"https://doi.org/10.1016/j.bja.2025.05.023","url":null,"abstract":"BACKGROUNDThe Conox monitor analyses the frontal EEG to generate two indices of anaesthetic effects: qCON, intended to indicate the level of consciousness, and qNOX, designed to reflect responsiveness to noxious stimuli. Two similar quantitative EEG devices, BIS and Entropy, have been shown to require muscle activity (EMG) to generate accurate index values in awake individuals. Without EMG, these devices produce misleadingly low values and incorrectly suggest sedation or anaesthesia despite the cortical EEG showing the subjects are awake. As EMG affects frequency bands used by Conox, it too could be incorporating muscle activity to generate high values in awake individuals.METHODSWe replayed EEGs recorded during awake paralysis to the Conox monitor via an electronic playback system to test whether it requires EMG to generate accurate values in awake subjects.RESULTSBoth qCON and qNOX decreased after neuromuscular block to values consistent with sedation or anaesthesia, despite subjects being fully awake. qCON decreased below 60 in 15 of 19 trials, and qNOX decreased below 60 in 11 of 19 trials. Overall, 42% of qCON values during paralysis were <60, the level supposedly indicating anaesthesia.CONCLUSIONSConox requires muscle activity to generate accurate values in awake individuals. Consequently, it might be an unreliable indicator of awareness in patients who have received neuromuscular blocking drugs. Studies conducted without neuromuscular block can provide misleading guidance when applied to Conox use in paralysed patients. Clinicians should approach manufacturer guidelines with caution and not rely solely on index values to guide dosing of anaesthetic drugs.","PeriodicalId":9250,"journal":{"name":"British journal of anaesthesia","volume":"672 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144664260","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}

引用次数: 0

Associate Editorial Board and cover image caption 副编辑委员会和封面图片说明

IF 9.1 1区医学

British journal of anaesthesia Pub Date : 2025-07-18 DOI: 10.1016/S0007-0912(25)00392-7

引用次数: 0