British journal of anaesthesia最新文献

{"title":"Carbon emissions of single-use anaesthetic drug trays: more than meets the eye in life cycle assessment","authors":"Deirdre C. Kelleher ,&nbsp;Vivian H.Y. Ip","doi":"10.1016/j.bja.2024.10.009","DOIUrl":"10.1016/j.bja.2024.10.009","url":null,"abstract":"<div><div>Life cycle assessment is increasingly used in the healthcare sector to facilitate more environmentally informed supply and medication use. A thorough life cycle assessment comparing the carbon impacts of 10 different single-use anaesthetic drug trays yielded surprising findings. Although life cycle assessment can guide decision-making, results must be interpreted clinically and in light of all available options, including eliminating unnecessary consumption altogether. Effective life cycle assessment in healthcare that is clinically applicable requires expertise from both environmental scientists and clinicians.</div></div>","PeriodicalId":9250,"journal":{"name":"British journal of anaesthesia","volume":"134 2","pages":"Pages 291-293"},"PeriodicalIF":9.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638294","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":"Task-sharing with families for early detection of postoperative complications in resource-limited settings","authors":"Sakina Bhaloo ,&nbsp;James Glasbey ,&nbsp;Aneel Bhangu","doi":"10.1016/j.bja.2024.10.021","DOIUrl":"10.1016/j.bja.2024.10.021","url":null,"abstract":"<div><div>Postoperative mortality in Africa is twice that of wealthier countries. The SMARTER trial underscores this critical issue and aims to address the high mortality rates by harnessing a readily available resource requiring minimal funding. Conducted in Mbale, Uganda, this innovative trial trained family members to monitor basic vital signs following surgery. This task is usually performed by healthcare workers who are often a limited resource in low- and middle-income settings. Although the results demonstrate a potential for increasing the capacity to rescue in the postoperative period, there is a need for further research to assess real-world effectiveness. Any improvement in patient monitoring would be limited by the system's capacity to respond effectively to escalations made by family members and the possible inaccuracy of their monitoring. Intervening earlier in the preoperative pathway can reduce the need to rescue postoperatively, but the SMARTER intervention has the potential to contribute to the larger effort needed to reduce surgical deaths globally in resource-limited settings.</div></div>","PeriodicalId":9250,"journal":{"name":"British journal of anaesthesia","volume":"134 2","pages":"Pages 288-290"},"PeriodicalIF":9.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142913591","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":"Nonsteroidal anti-inflammatory drugs in the perioperative period: current controversies and concerns","authors":"Girish P. Joshi ,&nbsp;Henrik Kehlet ,&nbsp;Dileep N. Lobo","doi":"10.1016/j.bja.2024.10.018","DOIUrl":"10.1016/j.bja.2024.10.018","url":null,"abstract":"<div><div>Nonsteroidal anti-inflammatory drugs (NSAIDs) and cyclooxygenase (COX)-2-specific inhibitors provide significant analgesic and opioid-sparing benefits. However, these analgesics are commonly avoided owing to concerns of potential adverse effects. The evidence for NSAID-related adverse effects is conflicting and of poor quality, and these analgesics are safer than what has been implied. Thus, it is imperative that NSAIDs or COX-2-specific inhibitors are administered routinely unless there are well-founded contraindications.</div></div>","PeriodicalId":9250,"journal":{"name":"British journal of anaesthesia","volume":"134 2","pages":"Pages 294-296"},"PeriodicalIF":9.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142754761","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":"Resting-state brain functional connectivity in patients with chronic intractable pain who respond to spinal cord stimulation therapy","authors":"Kyohei Ueno ,&nbsp;Yoshitetsu Oshiro ,&nbsp;Shigeyuki Kan ,&nbsp;Yuki Nomura ,&nbsp;Hitoaki Satou ,&nbsp;Norihiko Obata ,&nbsp;Satoshi Mizobuchi","doi":"10.1016/j.bja.2024.10.011","DOIUrl":"10.1016/j.bja.2024.10.011","url":null,"abstract":"<div><h3>Background</h3><div>Spinal cord stimulation (SCS) is widely accepted as a useful treatment for patients with intractable chronic pain. However, its effectiveness varies between individuals. Therefore, a tool for evaluating its effectiveness in advance is eagerly awaited. We examined whether resting-state functional magnetic resonance imaging as a diagnostic and prognostic tool can predict responsiveness to SCS.</div></div><div><h3>Methods</h3><div>Twenty-nine patients with intractable chronic pain participated in this study. Participants were divided into responder and non-responder groups based on a pain relief rate after SCS trials. All participants underwent resting-state functional magnetic resonance imaging scans before the SCS trials. We searched for functional connectivity that differed significantly in strength between the two groups and was correlated with pain relief rate. We conducted receiver operating characteristic (ROC) analysis and a one-sample proportion test to determine the cut-off value and evaluate the predictive power of the functional connectivity-based prediction model.</div></div><div><h3>Results</h3><div>In total, 14 and 15 participants were assigned to the responder and non-responder groups, respectively. Functional connectivity between the middle anterior cingulate cortex and precuneus/posterior cingulate cortex showed significant between-group differences and a significant negative correlation with the pain relief rate. Moreover, this functional connectivity could accurately predict SCS responsiveness greater than chance (sensitivity: 71%; specificity: 87%; area under the curve: 0.814; <em>P</em>&lt;0.001).</div></div><div><h3>Conclusions</h3><div>For patients with intractable chronic pain, functional connectivity between the middle anterior cingulate cortex and precuneus/posterior cingulate cortex is a promising candidate biomarker to estimate responsiveness to spinal cord stimulation before treatment.</div></div>","PeriodicalId":9250,"journal":{"name":"British journal of anaesthesia","volume":"134 2","pages":"Pages 492-500"},"PeriodicalIF":9.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766422","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":"A renewed call for integrated perioperative medicine: recommendations from Darzi's independent investigation of the National Health Service in England","authors":"Rachel V.L. Blackman-Mack ,&nbsp;Theodore K. Bartholomew","doi":"10.1016/j.bja.2024.10.031","DOIUrl":"10.1016/j.bja.2024.10.031","url":null,"abstract":"","PeriodicalId":9250,"journal":{"name":"British journal of anaesthesia","volume":"134 2","pages":"Pages 564-565"},"PeriodicalIF":9.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142783692","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":"Dual antiplatelet therapy and tracheostomy practice in the intensive care unit: a survey of selected urban ICUs in the UK","authors":"Nick Barnett,&nbsp;Nithin Thoppuram,&nbsp;William Seligman,&nbsp;Anja Drebes","doi":"10.1016/j.bja.2024.11.029","DOIUrl":"10.1016/j.bja.2024.11.029","url":null,"abstract":"","PeriodicalId":9250,"journal":{"name":"British journal of anaesthesia","volume":"134 2","pages":"Pages 571-573"},"PeriodicalIF":9.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142926733","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":"Hypotension after general anaesthesia induction using remimazolam or propofol in geriatric patients undergoing sevoflurane anaesthesia with remifentanil. Comment on Br J Anaesth 2024; 133: 24–32","authors":"Jie Wang ,&nbsp;Dewen Zhu ,&nbsp;Xiaocou Wang ,&nbsp;Chunwei Lian","doi":"10.1016/j.bja.2024.11.015","DOIUrl":"10.1016/j.bja.2024.11.015","url":null,"abstract":"","PeriodicalId":9250,"journal":{"name":"British journal of anaesthesia","volume":"134 2","pages":"Pages 597-598"},"PeriodicalIF":9.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142812182","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":"Perioperative fluid management: why one-size-fits-all strategies are insufficient in high-risk patients. Comment on Br J Anaesth 2024; 133: 1263–75","authors":"Javier Ripollés-Melchor ,&nbsp;Ángel V. Espinosa ,&nbsp;Manuel I. Monge-García","doi":"10.1016/j.bja.2024.10.037","DOIUrl":"10.1016/j.bja.2024.10.037","url":null,"abstract":"","PeriodicalId":9250,"journal":{"name":"British journal of anaesthesia","volume":"134 2","pages":"Pages 592-594"},"PeriodicalIF":9.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142812184","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":"Patients' perceptions of brain health after surgery: a mixed-methods study of perioperative risk communication in older surgical patients in New Zealand.","authors":"Carolyn Deng, Tanisha Jowsey, Ines Becker, Doug Campbell, Jack Hill, Jignal Bhagvandas, Ralph Fuchs, Nicholas J Lightfoot, Kaveh Djamali, Jennifer Weller","doi":"10.1016/j.bja.2024.12.026","DOIUrl":"https://doi.org/10.1016/j.bja.2024.12.026","url":null,"abstract":"<p><strong>Background: </strong>We explored how adult surgical patients perceived their risk of major postoperative complications, including neurological complications, and how much information they wanted to receive about such risks.</p><p><strong>Methods: </strong>We undertook a mixed-methods study including a 13-item survey and thematic analysis of semi-structured interviews with patients undergoing noncardiac, non-neurologic surgery.</p><p><strong>Results: </strong>Of 557 distributed surveys, 547 were returned completed. Of these, 88% of respondents had previously undergone surgery. Respondents were most likely to indicate an extreme level of concern for major stroke (64%), followed by heart attack (56%), minor stroke (46%), and cognitive decline (43%). Women were more likely to indicate a higher level of concern for cognitive decline than men (odds ratio 1.6, 95% confidence interval 1.1-2.4, P=0.015). Seventeen people participated in interviews. Six themes were identified: (1) trust in healthcare professionals; (2) surgery to achieve hopes and ambitions; (3) previous experiences govern expectations and perception of risk; (4) positive outlook and spirituality as protective factors; (5) support matters; and (6) a personalised approach to risk discussion.</p><p><strong>Conclusions: </strong>Many participants did not know the risks of major perioperative complications but based their risk perception on previous experiences and trust in health professionals. Participants focused on hope more than their concerns. Information provision should be personalised as patients expressed differences in the desired amount of information on risks.</p>","PeriodicalId":9250,"journal":{"name":"British journal of anaesthesia","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143077901","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":"Use of glomerular filtration rate to estimate perioperative cardiac risk","authors":"Arman Valadkhani ,&nbsp;Max Bell","doi":"10.1016/j.bja.2024.11.022","DOIUrl":"10.1016/j.bja.2024.11.022","url":null,"abstract":"<div><div>Preoperative estimated glomerular filtration rate is an inexpensive but useful tool in predicting cardiovascular perioperative complications. Estimated glomerular filtration rate, especially considering its interaction with age, might act as a proxy for severity of cardiovascular disease. Further studies regarding the predictive power of estimated glomerular filtration rate to identify patients at risk of perioperative cardiovascular complications are essential.</div></div>","PeriodicalId":9250,"journal":{"name":"British journal of anaesthesia","volume":"134 2","pages":"Pages 263-265"},"PeriodicalIF":9.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143063843","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}