British journal of anaesthesia最新文献

{"title":"Acute normovolaemic haemodilution in contemporary cardiac surgery: methodological gaps and future directions. Comment on Br J Anaesth 2026; 136: 836-46.","authors":"Tuhin Mistry,Abhijit Sukumaran Nair","doi":"10.1016/j.bja.2026.02.050","DOIUrl":"https://doi.org/10.1016/j.bja.2026.02.050","url":null,"abstract":"","PeriodicalId":9250,"journal":{"name":"British journal of anaesthesia","volume":"7 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147708518","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":"Longitudinal survey of UK anaesthetists progression in training: initial results.","authors":"Lewis Hendon-John,Sophie Winter,Tom Gale,Gergo Pinter,Chris Carey","doi":"10.1016/j.bja.2026.03.016","DOIUrl":"https://doi.org/10.1016/j.bja.2026.03.016","url":null,"abstract":"BACKGROUNDThere is a paucity of data relating to progression of trainees, and their wellbeing, during the 7-year UK anaesthesia training programme. We have established a longitudinal survey of the progression and wellbeing of the 2024 cohort of anaesthetists in training.METHODSIn July 2024, all UK doctors commencing anaesthesia training in August 2024 (n=548) were invited to complete an online questionnaire, gathering baseline quantitative data on demographics, wellbeing, career intentions and the application process, and qualitative data on concerns about training.RESULTSThe response rate was 62% (n=338 participants). Mean participant age was 29 (range 24-46) yr, 50.3% were female and 97.6% were UK graduates. Physical (11.9%) and mental (5.8%) health conditions, specific learning difficulty (7.8%) and self-identification as neurodivergent (6.7%) were reported. Enjoying procedural skills and the quality of anaesthetic training were the most frequent motivations for choosing anaesthesia. Proximity to friends, family and partner, and current location, were the most frequently cited factors determining training post selection. Regarding career intentions, 76% intended to undertake part-time training and 38% planned to apply for dual training in intensive care medicine. Nearly two in three participants reported a negative imbalance between effort and reward of their work, and nearly one in three reported high levels of stress.CONCLUSIONSThis study offers insight into the characteristics and experiences of incoming anaesthetists in training. The information gained from longitudinal follow-up will facilitate the development of strategies to reduce stress, facilitate progression, and make optimal use of training capacity.","PeriodicalId":9250,"journal":{"name":"British journal of anaesthesia","volume":"6 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147702192","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":"Incidence of severe airway trauma during routine use of a bougie for prehospital emergency anaesthesia: a retrospective cohort study.","authors":"Harry Ljungqvist,Jouni Nurmi","doi":"10.1016/j.bja.2026.02.035","DOIUrl":"https://doi.org/10.1016/j.bja.2026.02.035","url":null,"abstract":"","PeriodicalId":9250,"journal":{"name":"British journal of anaesthesia","volume":"47 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147695158","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":"Absence of oral intake during labour: frequency and determinants in a national population-based study.","authors":"Mégane Raineau,Aude Girault,Catherine Fischer,Camille Le Ray,Marie-Pierre Bonnet, ","doi":"10.1016/j.bja.2026.02.012","DOIUrl":"https://doi.org/10.1016/j.bja.2026.02.012","url":null,"abstract":"BACKGROUNDFasting during labour has adverse maternal and neonatal effects, and oral intake has many potential benefits. We aimed to describe the frequency and determinants of absence of oral intake during labour using population-based data.METHODSWomen from the 2021 French National Perinatal Survey who laboured and responded to the question 'Did you drink or eat during labour, i.e., in the delivery room?' were included. We investigated factors associated with absence of oral intake, using multivariable analyses stratified by use of neuraxial analgesia.RESULTSAmong 10 192 labouring women, 41.0% (95% confidence interval 40.0%-41.9%) had no oral intake, 52.4% (51.4%-53.4%) only drank, and 6.6% (6.1%-7.1%) ate. Among women with neuraxial analgesia, factors associated with absence of oral intake included low education level (1.17, 1.01-1.35), Sub-Saharan African origin (1.58, 1.19-2.09), and absence of a dedicated maternity anaesthesiologist (1.46, 1.20-1.76). Among women without neuraxial analgesia, factors included maternal age <30 yr (1.47, 1.09-1.98), overweight (1.49, 1.09-2.03), and multiparity (1.35, 1.00-1.85). Factors associated with both groups were prior Caesarean delivery, social deprivation, absence of a close relative at birth, absence of a room dedicated to physiologic birth and delivery in a private maternity unit.CONCLUSIONSWomen with sociodemographic vulnerabilities had reduced oral intake during labour. Implementation of oral intake guidelines should be improved, particularly in private maternity units and those without a dedicated maternity anaesthesiologist or rooms dedicated to physiologic birth.","PeriodicalId":9250,"journal":{"name":"British journal of anaesthesia","volume":"66 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147695204","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":"What are patients asking about regional anaesthesia? An analysis of common Google search questions and website quality.","authors":"Renee Ren,Junying Wang,Tina Chen,Mia Zonies,Alexandra Sideris,Jiabin Liu,Stavros Memtsoudis,Jashvant Poeran","doi":"10.1016/j.bja.2026.03.002","DOIUrl":"https://doi.org/10.1016/j.bja.2026.03.002","url":null,"abstract":"","PeriodicalId":9250,"journal":{"name":"British journal of anaesthesia","volume":"9 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147695010","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":"Pharmacotherapeutic interventions to improve postoperative sleep quality in older adult patients: a systematic review and meta-analysis.","authors":"Wencke Renette,Marie-Hélène Tanghe,Bojoura van Riel,Dieter Mesotten,Steffen Rex,Jeroen Hermanides,Mark L van Zuylen,Steven Thiessen","doi":"10.1016/j.bja.2026.03.012","DOIUrl":"https://doi.org/10.1016/j.bja.2026.03.012","url":null,"abstract":"BACKGROUNDPostoperative sleep impairment is common in older adult patients and is associated with delayed recovery and a negative impact on overall health, daily functioning, and quality of life. Older adults are particularly vulnerable because of age-related physiological changes and reduced functional reserves. We conducted a systematic review to assess the efficacy of pharmacotherapeutic interventions for improving postoperative sleep in older adults.METHODSPubMed, the Cochrane Library, and Embase were searched from inception to August 20, 2025. Randomised controlled trials investigating pharmacological interventions aimed at improving postoperative sleep in patients aged ≥60 yr were included. Risk of bias was assessed using the Cochrane Risk of Bias 2.0 tool, and certainty of evidence was evaluated using the GRADE framework. Random-effects meta-analysis was performed where appropriate. The review was registered in PROSPERO (CRD420250651275).RESULTSOf the 525 identified studies, 21 met the inclusion criteria. Assessed interventions included dexmedetomidine, esketamine, alprazolam, remimazolam, melatonin, and zolpidem. Dexmedetomidine was the most consistently effective, improving both subjective and objective sleep. Subgroup meta-analysis comparing dexmedetomidine with placebo showed a moderate, statistically significant improvement in sleep quality (standardised mean differences -0.51; 95% confidence interval -0.86 to -0.17; p<0.001; I2=94%). Evidence for other agents was limited. Overall certainty of evidence was very low to low.CONCLUSIONSPharmacological interventions potentially improve postoperative sleep in older adults, but current evidence is limited. Dexmedetomidine appears most promising, with potential benefits across administration regimens. High-quality trials are needed to establish optimal dosing and timing and to assess longer-term effects on sleep and recovery in this vulnerable population.","PeriodicalId":9250,"journal":{"name":"British journal of anaesthesia","volume":"63 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147695205","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":"Five years later: how Ireland’s inhaled anaesthetic gas emissions have changed from 2019 to 2024. Comment on BrJ Anaesth 2023; 130: e13–e6","authors":"Ola L. Nordrum, Oscar Duffy, Tricia Cummins, Damien Clarke, Anna Impiumi, Dónall Ó’Cróinín, Tim Keady","doi":"10.1016/j.bja.2026.02.030","DOIUrl":"https://doi.org/10.1016/j.bja.2026.02.030","url":null,"abstract":"","PeriodicalId":9250,"journal":{"name":"British journal of anaesthesia","volume":"23 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147726798","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":"What can UK Biobank’s 500 000 participants teach us about chronic pain?","authors":"Eoin M. Kelleher, Anushka Irani","doi":"10.1016/j.bja.2026.02.027","DOIUrl":"https://doi.org/10.1016/j.bja.2026.02.027","url":null,"abstract":"The UK Biobank is increasingly used for the study of chronic pain, yet many clinicians and researchers are unfamiliar with the strengths and limitations of this cohort. Here, we provide practical guidance for interpreting UK Biobank pain research, highlighting key examples of how the UK Biobank has advanced our understanding of pain. We describe the available pain assessments, compare the UK Biobank with other population cohorts, and discuss key methodological considerations, including selection bias, collider effects, and temporal misalignment between data modalities. When interpreted appropriately and triangulated with complementary study designs, the UK Biobank represents a valuable resource for advancing our understanding of the epidemiology, outcomes, and treatment of chronic pain.","PeriodicalId":9250,"journal":{"name":"British journal of anaesthesia","volume":"18 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147726799","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":"High-dose versus low-dose dexamethasone for postoperative analgesia after Caesarean delivery: a randomised, double-blind, two-centre trial","authors":"Eva Roofthooft, Charlotte De Loecker, Fried’l D'Hoore, Ralph Kempenaers, Steffen Fieuws, Henrik Kehlet, Cynthia A. Wong, Steffen Rex, Marc Van de Velde","doi":"10.1016/j.bja.2026.02.005","DOIUrl":"https://doi.org/10.1016/j.bja.2026.02.005","url":null,"abstract":"Caesarean delivery constitutes major surgery causing moderate to severe pain, so strategies to reduce postoperative pain are needed. High-dose dexamethasone improves perioperative analgesia in non-obstetric patients. We hypothesised that high-dose dexamethasone improves analgesia and recovery after Caesarean delivery.","PeriodicalId":9250,"journal":{"name":"British journal of anaesthesia","volume":"62 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147726800","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":"Physiology, monitoring, and optimisation of perioperative tissue oxygenation: a narrative review.","authors":"Jens Meier,Sigismond Lasocki,Patrick Meybohm,Daniela Filipescu,Thorsten Haas,Julien Pottecher,Emmanuel Rineau,Stefano Romagnoli,Alina Bergholz,Bernd Saugel","doi":"10.1016/j.bja.2026.01.047","DOIUrl":"https://doi.org/10.1016/j.bja.2026.01.047","url":null,"abstract":"Maintenance of tissue oxygenation in patients having surgery is important as tissue hypoxia is a major determinant of organ failure. Tissue oxygenation follows a stepwise physiological pathway involving the macrocirculation, the microcirculation, and the cellular oxygen metabolism. This narrative review endorsed by the Network for the Advancement of Patient Blood Management, Haemostasis and Thrombosis outlines the physiology of tissue oxygenation, evaluates methods for intraoperative tissue oxygenation monitoring, and summarises therapeutic strategies to ensure adequate tissue oxygenation. In the macrocirculation, oxygen is delivered to peripheral organs by convection (through the bulk flow of oxygenated blood generated by cardiac output). Effective tissue perfusion requires both sufficient blood flow and perfusion pressure. Interventions targeting the macrocirculation include fluid therapy, blood transfusions, and targeted management of arterial pressure and cardiac output. Within the microcirculation, oxygen diffuses from capillaries into the surrounding tissues. The microcirculation distributes blood flow according to local metabolic demands. Most techniques for intraoperative microcirculation monitoring, such as handheld vital microscopy, near-infrared spectroscopy, laser Doppler, laser speckle imaging, fluorescence angiography, or the urethral perfusion index, are not implemented in clinical practice. The role of therapeutic interventions specifically targeting the microcirculation remains uncertain. At the cellular level, oxygen is consumed within the mitochondria, where it serves as the final electron acceptor in oxidative phosphorylation to generate adenosine triphosphate. Direct monitoring of cellular oxygen metabolism remains experimental and is not routinely available. Therapeutic strategies aiming to directly improve cellular oxygen metabolism are evolving. Future research is needed to better understand how to optimise tissue oxygenation during surgery to improve patient-centred outcomes.","PeriodicalId":9250,"journal":{"name":"British journal of anaesthesia","volume":"16 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147726317","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}