British journal of anaesthesia最新文献_第3页

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IF 9.1 1区医学

British journal of anaesthesia Pub Date : 2025-03-19 DOI: 10.1016/S0007-0912(25)00119-9

引用次数: 0

Psychomotor Responses to Independent Visual, Auditory and Tactile Electrical stimuli during Sevoflurane sedation (PRIVATES). 七氟醚镇静期间对独立视觉、听觉和触觉电刺激的精神运动反应（PRIVATES）。

IF 9.1 1区医学

British journal of anaesthesia Pub Date : 2025-03-19 DOI: 10.1016/j.bja.2025.01.034

Vivien C Hollmann, Alastair R J Darwood, Pawandeep S Sarai, Paul H Strutton, William Harrop-Griffiths, Christopher J Mullington

{"title":"Psychomotor Responses to Independent Visual, Auditory and Tactile Electrical stimuli during Sevoflurane sedation (PRIVATES).","authors":"Vivien C Hollmann, Alastair R J Darwood, Pawandeep S Sarai, Paul H Strutton, William Harrop-Griffiths, Christopher J Mullington","doi":"10.1016/j.bja.2025.01.034","DOIUrl":"https://doi.org/10.1016/j.bja.2025.01.034","url":null,"abstract":"Background: Patient-controlled sedation has potential benefits, including rapid recovery and improved patient satisfaction. During patient-controlled sedation, the recipient presses a button to self-administer the sedative. The safety and efficacy of this method is dependent upon the dose relationships between the sedative's desired effects, its impact on the ability to press a button, and adverse effect occurrence. This study aimed to investigate the relationship between sedation, psychomotor function, and adverse effect occurrence during clinician-controlled sevoflurane sedation.Methods: 15 healthy participants (10 males) were administered a sevoflurane dose-escalation protocol starting at 0 kPa and increasing in 0.2 kPa increments until a protocol endpoint occurred. Sevoflurane was delivered using conventional anaesthetic apparatus. At each sevoflurane dose, Richmond Agitation-Sedation Scale (RASS) and psychomotor function were assessed. Protocol endpoints included airway, respiratory, or cardiovascular compromise; agitation (RASS ≥+2); and sedation >3 h.Results: The protocol endpoint was sedation >3 h for nine (60%) participants, agitation for five (33%) participants, and tonic movements for one (7%) participant. The median [range] sevoflurane dose was 0.4 [0.2-1.0] kPa when RASS <0 (sedation dose), 1.2 [0.6-2.0] kPa when participants were unable to complete reaction time testing (button-press dose), and 1.6 [1.2-2.2] kPa at the protocol endpoint (endpoint dose). The sedation dose was less than the button-press dose (P<0.0001), and the button-press dose was less than the endpoint dose (P=0.002).Conclusions: Patient-controlled sevoflurane sedation is potentially feasible in a healthy population within the dose range 0.4-1.2 kPa. Concurrent reaction time monitoring could minimise the risk of agitation.","PeriodicalId":9250,"journal":{"name":"British journal of anaesthesia","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669100","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

Dual antiplatelet therapy and tracheostomy practice in the intensive care unit. Comment on Br J Anaesth 2025; 134: 571-3. 重症监护室中的双重抗血小板疗法和气管切开术实践。评论《Br J Anaesth 2025; 134: 571-3》。

IF 9.1 1区医学

British journal of anaesthesia Pub Date : 2025-03-19 DOI: 10.1016/j.bja.2025.02.020

Mark Brown, Fayez Elsawy, Benjamin Allison, Brendan McGrath

引用次数: 0

Evaluation of a protocol to reduce the environmental impact of anaesthetic gases. Comment on Br J Anaesth 2024; 133: 1489-91. 评估减少麻醉气体对环境影响的方案。评论：Br J Anaesth 2024; 133: 1489-91。

IF 9.1 1区医学

British journal of anaesthesia Pub Date : 2025-03-19 DOI: 10.1016/j.bja.2025.02.019

Forbes McGain, Emily Balmaks, Eugenie Kayak, Cas Woinarski, Anthony Hull, Stephan Williams, Jane Muret

引用次数: 0

Discrepancies in adverse event reporting for ketamine trials. 氯胺酮试验的不良事件报告存在差异。

IF 9.1 1区医学

British journal of anaesthesia Pub Date : 2025-03-19 DOI: 10.1016/j.bja.2025.02.015

Jack Rea, Adam Khan, Nicholas Boyne, Alison Duke, Matt Vassar

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Effects of combined intrathecal dexmedetomidine and local anaesthetic on analgesia duration of spinal anaesthesia: a systematic review and meta-analysis of randomised controlled trials. 鞘内注射右美托咪定和局麻药对脊髓麻醉镇痛持续时间的影响：随机对照试验的系统回顾和荟萃分析。

IF 9.1 1区医学

British journal of anaesthesia Pub Date : 2025-03-19 DOI: 10.1016/j.bja.2025.02.022

Heitor Medeiros, Sara Amaral, Rafael A Lombardi, Elizabeth Korn, Ariel Mueller, Lucas P Trevisan, Hugo W Araújo, Wallace Andrino, A Sassan Sabouri

引用次数: 0

Advance care planning and goals of care discussions in perioperative care: a scoping review. 围手术期护理中的预先护理计划和护理目标讨论：范围界定综述。

IF 9.1 1区医学

British journal of anaesthesia Pub Date : 2025-03-19 DOI: 10.1016/j.bja.2025.01.031

Zoe Keon-Cohen, Heather Loane, Lorena Romero, Daryl Jones, Jane Banaszak-Holl

{"title":"Advance care planning and goals of care discussions in perioperative care: a scoping review.","authors":"Zoe Keon-Cohen, Heather Loane, Lorena Romero, Daryl Jones, Jane Banaszak-Holl","doi":"10.1016/j.bja.2025.01.031","DOIUrl":"https://doi.org/10.1016/j.bja.2025.01.031","url":null,"abstract":"Background: Advance care planning is well established in general medical wards, but its implementation in anaesthesia and perioperative care presents unique challenges. Effective communication and shared decision-making regarding treatment limitations are essential to clarify care goals and provide timely, high-quality end-of-life care. Terminally ill patients with complex care needs can experience a higher risk of postoperative mortality during anaesthesia.Methods: This scoping review examines the literature describing when and how advance care planning has been studied in perioperative care, focusing on patient characteristics, the content of advance care planning discussions, and impact on patient outcomes. The study follows PRISMA-ScR guidelines. Articles were collected from MEDLINE, CENTRAL, and CINAHL databases, using search terms from MeSH and synonyms for anaesthesia, surgery and perioperative care, advance care planning, living wills or advance directives, goals of care and terminal care, resuscitation orders, shared decision-making, and palliative care discussions.Results: Advance care planning documentation varies across surgical specialties and settings, with higher rates in emergency and palliative surgery. Patient factors, such as age and comorbidities, impact completion of advance care planning. Structurally, the presence of interdisciplinary teams, increased decision-making aids, and structured discussions improve implementation. Barriers included a lack of consistency in terminology, poor timing of needed conversations, a lack of cultural sensitivities, and patient fears of abandonment and palliative care.Conclusions: Further research is required to determine the most appropriate and beneficial methods and outcomes for implementing advance care planning into perioperative and end-of-life care, ensuring appropriate, timely, and patient-oriented care delivery.","PeriodicalId":9250,"journal":{"name":"British journal of anaesthesia","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669063","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

Use of low-glucose isotonic solutions intraoperatively in infants: reassuring data regarding the risk of intraoperative hypoglycaemia.

IF 9.1 1区医学

British journal of anaesthesia Pub Date : 2025-03-19 DOI: 10.1016/j.bja.2025.02.013

Per-Arne Lönnqvist

引用次数: 0

Etomidate and its derivatives: time to say goodbye? You say goodbye and I say hello. Response to Br J Anaesth 2025; 134: 11-3. 依托咪酯及其衍生物：该说再见了吗？你说再见，我说你好。对 Br J Anaesth 2025; 134: 11-3 的回应。

IF 9.1 1区医学

British journal of anaesthesia Pub Date : 2025-03-19 DOI: 10.1016/j.bja.2025.02.016

Yvonne Nyman, Per-Arne Lönnqvist

引用次数: 0

ED50 and ED95 of remimazolam for loss of consciousness in young children.

IF 9.1 1区医学

British journal of anaesthesia Pub Date : 2025-03-18 DOI: 10.1016/j.bja.2025.02.004

Yu-Hang Cai, Le-Qi Dong, John W Zhong, Zheng Lin, Cong-De Chen, Li-Bin Zhu, Xiao-Kun Lin, Peter Szmuk, Hua-Cheng Liu

{"title":"ED50 and ED95 of remimazolam for loss of consciousness in young children.","authors":"Yu-Hang Cai, Le-Qi Dong, John W Zhong, Zheng Lin, Cong-De Chen, Li-Bin Zhu, Xiao-Kun Lin, Peter Szmuk, Hua-Cheng Liu","doi":"10.1016/j.bja.2025.02.004","DOIUrl":"https://doi.org/10.1016/j.bja.2025.02.004","url":null,"abstract":"Background: The optimal single i.v. bolus dose of remimazolam for induction of general anaesthesia in children is not defined. We aimed to determine the 50% (ED50) and 95% (ED95) effective doses of remimazolam for inducing loss of consciousness in children.Methods: A total of 120 children, aged 1-12 yr, were divided into three groups, with 40 children in each group: toddler (1 to <3 yr), preschool (≥3 to <6 yr), and school-age group (≥6 to <12 yr). Each child received a single i.v. bolus of remimazolam, with doses determined using a biased coin design up-and-down method. The primary outcome was the ED50 and ED95 of remimazolam for inducing loss of consciousness. Secondary outcomes included the incidence of hypotension, respiratory depression, and adverse events.Results: The ED50 and ED95 of remimazolam were 0.42 mg kg-1 (95% confidence interval [CI] 0.37-0.44) and 0.57 mg kg-1 (95% CI 0.48-0.59), respectively, in the toddler group; 0.41 mg kg-1 (95% CI 0.35-0.47) and 0.57 mg kg-1 (95% CI 0.50-0.59), respectively, in the preschool group; and 0.30 mg kg-1 (95% CI 0.28-0.34) and 0.43 mg kg-1 (95% CI 0.37-0.44), respectively, in the school-age group. No significant cases of hypotension, respiratory depression, bradycardia, or other adverse events occurred in any of the three groups.Conclusions: A single i.v. bolus of remimazolam at estimated doses of 0.45-0.60 mg kg-1 for children aged 1-6 yr and 0.35-0.45 mg kg-1 for those aged 6-12 yr effectively induces loss of consciousness in children.Clinical trial registration: ClinicalTrials.gov (NCT06061159).","PeriodicalId":9250,"journal":{"name":"British journal of anaesthesia","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662602","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