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Monitoring of cerebral blood flow autoregulation: physiologic basis, measurement, and clinical implications Br. J. Anaesth. (IF 9.8) Pub Date : 2024-03-12 Eric L. Vu, Charles H. Brown IV, Kenneth M. Brady, Charles W. Hogue
Cerebral blood flow (CBF) autoregulation is the physiologic process whereby blood supply to the brain is kept constant over a range of cerebral perfusion pressures ensuring a constant supply of metabolic substrate. Clinical methods for monitoring CBF autoregulation were first developed for neurocritically ill patients and have been extended to surgical patients. These methods are based on measuring
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Intraoperative cell salvage: a survey of UK practice Br. J. Anaesth. (IF 9.8) Pub Date : 2024-03-12 Manisha M. Kumar, Falguni Choksey, Alister Jones, Craig Carroll, Bella Brownhill, Elmarie Cairns, Joanne Bark, Kairen Coffey, Louise Webster, Louisa Wood, Malcolm Chambers, Sarah Haynes, Sheena Gormley
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Influence of nitrous oxide added to general anaesthesia on postoperative mortality and morbidity: a systematic review and meta-analysis Br. J. Anaesth. (IF 9.8) Pub Date : 2024-03-11 Jasper M. Kampman, Kim Y.Q. Plasmans, Jeroen Hermanides, Markus W. Hollmann, Sjoerd Repping, Nicolaas H. Sperna Weiland
Nitrous oxide (NO) is a common adjuvant to general anaesthesia. It is also a potent greenhouse gas and causes ozone depletion. We sought to quantify the influence of NO as an adjuvant to general anaesthesia on postoperative patient outcomes. We searched Medline, EMBASE, and Cochrane Central for works published from inception to July 6, 2023. RCTs comparing general anaesthesia with or without NO were
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Therapeutic efficacy of intravenous lidocaine infusion compared with thoracic epidural analgesia in major abdominal surgery. Response to Br J Anaesth 2023; 132: 625–6 Br. J. Anaesth. (IF 9.8) Pub Date : 2024-03-06 Fabian D. Casas-Arroyave, Susana C. Osorno-Upegui, Mario A. Zamudio-Burbano
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Dose-dependent relationship between SGLT2 inhibitor hold time and risk for postoperative anion gap acidosis. Response to Br J Anaesth 2024; 131: 682–686 Br. J. Anaesth. (IF 9.8) Pub Date : 2024-03-05 B, e, n, j, a, m, i, n, , S, t, e, i, n, h, o, r, n
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Regional anaesthesia truncal blocks for acute postoperative pain and recovery. Response to Br J Anaesth 2024 Br. J. Anaesth. (IF 9.8) Pub Date : 2024-03-05 Aisling Ní Eochagáin, Donal J. Buggy
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Celebrating the state of the art and innovations in regional anaesthesia in the British Journal of Anaesthesia Br. J. Anaesth. (IF 9.8) Pub Date : 2024-03-05 David W. Hewson, Jenny Ferry, Alan J.R. Macfarlane
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Too loud to hear myself think: deleterious effects of noise in the operating room Br. J. Anaesth. (IF 9.8) Pub Date : 2024-03-05 Joyce A. Wahr, James H. Abernathy III
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Intraoperative hypotension is not associated with reduced atrial fibrillation or hospital length of stay. Response to Br J Anaesth 2023; 132: 181–3 Br. J. Anaesth. (IF 9.8) Pub Date : 2024-03-05 Filippo D'Amico, Giovanni Landoni
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Comparison of tracheal intubation conditions between the operating room and intensive care unit: impact of universal videolaryngoscopy Br. J. Anaesth. (IF 9.8) Pub Date : 2024-03-05 Manuel Taboada, Agustín Cariñena, Manuela De Miguel, Fátima García, Sara Alonso, Rocío Iraburu, Laura Barreiro, Laura Dos Santos, Ana Tubio, María Diaz-Vieito, Julián Álvarez, Teresa Seoane-Pillado
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Ward monitoring 4.0: real-time metabolic insights from continuous glucose monitoring into perioperative organ dysfunction Br. J. Anaesth. (IF 9.8) Pub Date : 2024-03-05 Henrike Janssen, Shaman Jhanji, Nick S. Oliver, Gareth L. Ackland, for the GlucoVITAL Investigators, Marta Korbonits, Sian Henson, Joyce Yeung, Rupert Pearse, Ben Shelley, Louise Hiller, Peter Jacob, James Noblet, Monica Jefford, Ana Gutierrez del Arroyo, Abeer Samman, Saja Alharbi, Sanjali Ahuja, Priya Dias
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Melanin bias in pulse oximetry explained by light source spectral bandwidth Br. J. Anaesth. (IF 9.8) Pub Date : 2024-03-05 Andrew Bierman, Kevin Benner, Mark S. Rea
Pulse oximetry uses noninvasive optical measurements of light transmission from each of two sources through vascularised living tissue over the cardiac cycle (SpO). From those measurements, the relative amount of oxygenated haemoglobin (SaO) in circulating blood can be deduced. Recent reports have shown that, compared with SaO measurements from blood samples, SpO measurements are biased erroneously
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Artificial intelligence for ultrasound scanning in regional anaesthesia: a scoping review of the evidence from multiple disciplines Br. J. Anaesth. (IF 9.8) Pub Date : 2024-03-05 James S. Bowness, David Metcalfe, Kariem El-Boghdadly, Neal Thurley, Megan Morecroft, Thomas Hartley, Joanna Krawczyk, J. Alison Noble, Helen Higham
Artificial intelligence (AI) for ultrasound scanning in regional anaesthesia is a rapidly developing interdisciplinary field. There is a risk that work could be undertaken in parallel by different elements of the community but with a lack of knowledge transfer between disciplines, leading to repetition and diverging methodologies. This scoping review aimed to identify and map the available literature
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Research priorities in regional anaesthesia: an international Delphi study Br. J. Anaesth. (IF 9.8) Pub Date : 2024-03-05 Jenny Ferry, Owen Lewis, James Lloyd, Kariem El-Boghdadly, Rachel Kearns, Eric Albrecht, Fernando Altermatt, Balakrishnan Ashokka, Amany E. Ayad, Ezzat S. Aziz, Lutful Aziz, Balavenkatasubramanian Jagannathan, Noreddine Bouarroudj, Ki Jinn Chin, Alain Delbos, Alex de Gracia, Vivian H.Y. Ip, Kwesi Kwofie, Sebastian Layera, Clara A. Lobo, Mohammed Mohammed, Eleni Moka, Milena Moreno, Bethan Morgan, Arthur
Regional anaesthesia use is growing worldwide, and there is an increasing emphasis on research in regional anaesthesia to improve patient outcomes. However, priorities for future study remain unclear. We therefore conducted an international research prioritisation exercise, setting the agenda for future investigators and funding bodies. We invited members of specialist regional anaesthesia societies
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Regional anaesthesia education for consultants and specialists in the UK: a mixed-methods analysis Br. J. Anaesth. (IF 9.8) Pub Date : 2024-03-05 Xiaoxi Zhang, Ross J. Vanstone, Lloyd Turbitt, Simeon West, Eoin Harty
Regional anaesthesia plays an important role in perioperative care, but gaps in proficiency persist among consultants and specialists. This study aimed to assess confidence levels in performing Plan A blocks among this cohort and to examine the barriers and facilitators influencing regional anaesthesia education. Utilising a mixed-methods design, we performed a quantitative survey to gauge self-reported
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Remimazolam versus propofol for sedation in gastrointestinal endoscopic procedures: a systematic review and meta-analysis Br. J. Anaesth. (IF 9.8) Pub Date : 2024-03-04 Eduardo Cerchi Barbosa, Paula Arruda Espírito Santo, Stefano Baraldo, Gilmara Coelho Meine
Propofol has a favourable efficacy profile in gastrointestinal endoscopic procedures, however adverse events remain frequent. Emerging evidence supports remimazolam use in gastrointestinal endoscopy. This systematic review and meta-analysis compares remimazolam and propofol, both combined with a short-acting opioid, for sedation of adults in gastrointestinal endoscopy. We searched MEDLINE, Embase,
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Multicentre validation of a machine learning model for predicting respiratory failure after noncardiac surgery Br. J. Anaesth. (IF 9.8) Pub Date : 2024-02-26 Hyun-Kyu Yoon, Hyun Joo Kim, Yi-Jun Kim, Hyeonhoon Lee, Bo Rim Kim, Hyongmin Oh, Hee-Pyoung Park, Hyung-Chul Lee
Postoperative respiratory failure is a serious complication that could benefit from early accurate identification of high-risk patients. We developed and validated a machine learning model to predict postoperative respiratory failure, defined as prolonged (>48 h) mechanical ventilation or reintubation after surgery. Easily extractable electronic health record (EHR) variables that do not require subjective
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Morphine-specific IgE testing in the assessment of neuromuscular blocking agent allergy. Comment on Br J Anaesth 2024; 132: 193–5 Br. J. Anaesth. (IF 9.8) Pub Date : 2024-02-23 Didier G. Ebo, Vito Sabato, Christel Mertens, Athina L. Van Gasse
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Noninferiority trials in acute pain research: a valid approach or a slippery slope? Br. J. Anaesth. (IF 9.8) Pub Date : 2024-02-22 Harsha Shanthanna, Girish P. Joshi
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FRailty in Australian patients admitted to Intensive care unit after eLective CANCER-related SURGery: a retrospective multicentre cohort study (FRAIL-CANCER-SURG study) Br. J. Anaesth. (IF 9.8) Pub Date : 2024-02-19 Ryan R. Ling, Ryo Ueno, Muhammad Alamgeer, Krishnaswamy Sundararajan, Raghav Sundar, Michael Bailey, David Pilcher, Ashwin Subramaniam
The association between frailty and short-term and long-term outcomes in patients receiving elective surgery for cancer remains unclear, particularly in those admitted to the ICU. In this multicentre retrospective cohort study, we included adults ≥16 yr old admitted to 158 ICUs in Australia from January 1, 2018 to March 31, 2022 after elective surgery for cancer. We investigated the association between
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Endoplasmic reticular stress as an emerging therapeutic target for chronic pain: a narrative review Br. J. Anaesth. (IF 9.8) Pub Date : 2024-02-19 Harper S. Kim, Donghwan Lee, Shiqian Shen
Chronic pain is a severely debilitating condition with enormous socioeconomic costs. Current treatment regimens with nonsteroidal anti-inflammatory drugs (NSAIDs), steroids, or opioids have been largely unsatisfactory with uncertain benefits or severe long-term side effects. This is mainly because chronic pain has a multifactorial aetiology. Although conventional pain medications can alleviate pain
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Effect of skin tone on the accuracy of the estimation of arterial oxygen saturation by pulse oximetry: a systematic review Br. J. Anaesth. (IF 9.8) Pub Date : 2024-02-17 Daniel Martin, Chris Johns, Lexy Sorrell, Eugene Healy, Mandeep Phull, Segun Olusanya, Mark Peters, Jeremy Fabes
Pulse oximetry-derived oxygen saturation (SpO) is an estimate of true arterial oxygen saturation (SaO). The aim of this review was to evaluate available evidence determining the effect of skin tone on the ability of pulse oximeters to accurately estimate SaO. Published literature was screened to identify clinical and non-clinical studies enrolling adults and children when SpO was compared with a paired
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Perioperative use of dexamethasone: an international study from the PAIN OUT registry Br. J. Anaesth. (IF 9.8) Pub Date : 2024-02-15 Drew McMichael, Philipp Baumbach, Marcus Komann, Ruth Edry, Valeria Martinez, Martha Melo, Esther Pogatzki-Zahn, Teresa Santeularia, Ulrike Stamer, Turgay Tuna, Hongwei Wang, Winfried Meissner, Ruth Zaslansky, Patrice Forget
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Melatonin treatment has consistent but transient beneficial effects on sleep measures and pain in patients with severe chronic pain: the DREAM–CP randomised controlled trial Br. J. Anaesth. (IF 9.8) Pub Date : 2024-02-14 Uzunma M. Onyeakazi, Malachy O. Columb, Adam Rosalind, Saravanakumar Kanakarajan, Helen F. Galley
Sleep disturbance is a major issue for patients with chronic pain. Melatonin has been shown to improve symptoms of fibromyalgia, but its efficacy in other chronic non-malignant pain conditions is not fully known. Hence, we determined the effect of melatonin in patients with severe noncancer chronic pain. This was a randomised double-blinded crossover trial of modified-release melatonin as Circadin™
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The road to Net Zero: incorporating virtual reality technology to reduce the carbon footprint of medical training Br. J. Anaesth. (IF 9.8) Pub Date : 2024-02-13 Jonathan R. Abbas, Elliott Bertram-Ralph, Iain A. Bruce, Brendan A. McGrath
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Danavorexton (TAK-925): an orexin receptor 2 agonist as a new ‘arousal’ agent Br. J. Anaesth. (IF 9.8) Pub Date : 2024-02-10 David G. Lambert, Kazuyoshi Hirota
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Opioid-free anaesthesia reduces postoperative nausea and vomiting after thoracoscopic lung resection. Comment on Br J Anaesth; 132: 267–76 Br. J. Anaesth. (IF 9.8) Pub Date : 2024-02-09 Fu S. Xue, Kai Su, Yi Cheng
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Corrigendum to ‘Dose-dependent relationship between SGLT2 inhibitor hold time and risk for postoperative anion gap acidosis: a single-centre retrospective analysis’ (Br J Anaesth 2023;131:682–6) Br. J. Anaesth. (IF 9.8) Pub Date : 2024-02-09 Benjamin Steinhorn, Jeanine Wiener-Kronish
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Therapeutic efficacy of intravenous lidocaine infusion compared with thoracic epidural analgesia in major abdominal surgery: factors affecting successful thoracic epidural analgesia. Comment on Br J Anaesth 2023; 131: 947–54 Br. J. Anaesth. (IF 9.8) Pub Date : 2024-02-09 Ratan K. Banik, Bryant W. Tran, Alexandra Belfar, A.K.M. Akhtaruzzaman, Eman Nada, Neil Hanson
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Chronic nicotine exposure elicits pain hypersensitivity through activation of dopaminergic projections to anterior cingulate cortex Br. J. Anaesth. (IF 9.8) Pub Date : 2024-02-09 Danyang Chen, Liang Shen, Yu-Zhuo Zhang, Bu-Fan Kan, Qian-Qian Lou, Dan-Dan Long, Ji-Ye Huang, Zhi Zhang, Shan-Shan Hu, Di Wang
Cigarette smoking is commonly reported among chronic pain patients in the clinic. Although chronic nicotine exposure is directly linked to nociceptive hypersensitivity in rodents, underlying neurobiological mechanisms remain unknown. Multi-tetrode recordings in freely moving mice were used to test the activity of dopaminergic projections from the ventral tegmental area (VTA) to pyramidal neurones in
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Digital health interventions for postoperative recovery in children: a systematic review Br. J. Anaesth. (IF 9.8) Pub Date : 2024-02-09 Karin Plummer, Japheth Adina, Amy E. Mitchell, Paul Lee-Archer, Justin Clark, Janelle Keyser, Catherine Kotzur, Abdul Qayum, Bronwyn Griffin
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Effects of colour-coded compartmentalised syringe trays on anaesthetic drug error detection under cognitive load Br. J. Anaesth. (IF 9.8) Pub Date : 2024-02-09 Victoria Laxton, Frances A. Maratos, David W. Hewson, Andrew Baird, Stephanie Archer, Edward J.N. Stupple
Anaesthetic drug administration is complex, and typical clinical environments can entail significant cognitive load. Colour-coded anaesthetic drug trays have shown promising results for error identification and reducing cognitive load. We used experimental psychology methods to test the potential benefits of colour-coded compartmentalised trays compared with conventional trays in a simulated visual
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Craniocaudal spread and clinical translation for combined erector spinae plane block and retrolaminar block in soft embalmed cadavers: a randomised controlled equivalence study Br. J. Anaesth. (IF 9.8) Pub Date : 2024-02-09 Graeme McLeod, Razan Sartawi, Chloe Chang, Ayman Mustafa, Pavan Raju, Clare Lamb
Erector spinae plane (ESP) block spread can be unpredictable. We previously improved the spread of ESP injection by addition of retrolaminar (RL) injection. However, it is not clear whether spread at high thoracic levels is similar to spread at midthoracic levels. Our primary objective was to demonstrate that craniocaudal dye spread was equivalent after combined ESP and RL injection using a 19 G Tuohy
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Preoperative N-terminal pro-B-type natriuretic peptide and myocardial injury after stopping or continuing renin–angiotensin system inhibitors in noncardiac surgery: a prespecified analysis of a phase 2 randomised controlled multicentre trial Br. J. Anaesth. (IF 9.8) Pub Date : 2024-02-09 Ana Gutierrez del Arroyo, Akshaykumar Patel, Tom E.F. Abbott, Salma Begum, Priyanthi Dias, Sameer Somanath, Alexander Middleditch, Stuart Cleland, David Brealey, Rupert M. Pearse, Gareth L. Ackland, the SPACE trial investigators, Gareth Ackland, Tim Martin, Maria Fernandez, Fatima Seidu, Mari-Liis Pakats, Otto Mahr, Neil MacDonald, Filipa Dos Santos, Amaia Arrieta Garcia, Ruzena Uddin, Salma Begum
Patients with elevated preoperative plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP >100 pg ml) experience more complications after noncardiac surgery. Individuals prescribed renin–angiotensin system (RAS) inhibitors for cardiometabolic disease are at particular risk of perioperative myocardial injury and complications. We hypothesised that stopping RAS inhibitors before surgery increases
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The first 100 years of the British Journal of Anaesthesia: a bibliometric analysis of the top-cited articles Br. J. Anaesth. (IF 9.8) Pub Date : 2024-02-09 Jacopo D'Andria Ursoleo, Rosario Losiggio, Fabrizio Monaco
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Modelling the economic constraints and consequences of anaesthesia associate expansion in the UK National Health Service: a narrative review Br. J. Anaesth. (IF 9.8) Pub Date : 2024-02-09 Stuart B. Hanmer, Mitchell H. Tsai, Daniel M. Sherrer, Jaideep J. Pandit
Shortages in the physician anaesthesia workforce have led to proposals to introduce new staff groups, notably in the UK National Health Service (NHS) Anaesthesia Associates (AAs) who have shorter training periods than doctors and could potentially contribute to workflow efficiencies in several ways. We analysed the economic viability of the most efficient staffing model, previously endorsed by both
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Pathological findings associated with the updated European Society of Cardiology 2022 guidelines for preoperative cardiac testing: an observational cohort modelling study Br. J. Anaesth. (IF 9.8) Pub Date : 2024-02-09 Alexandra Stroda, Eckhard Mauermann, Daniela Ionescu, Wojciech Szczeklik, Stefan De Hert, Miodrag Filipovic, Beatrice Beck Schimmer, Savino Spadaro, Purificación Matute, Michael T. Ganter, Alexey Ovezov, Sanem C. Turhan, Judith van Waes, Filipa Lagarto, Kassiani Theodoraki, Anil Gupta, Hans-Jörg Gillmann, Luca Guzzetti, Katarzyna Kotfis, Jan Larmann, Dan Corneci, Donal J. Buggy, Simon J. Howell, Giovanna
In 2022, the European Society of Cardiology updated guidelines for preoperative evaluation. The aims of this study were to quantify: (1) the impact of the updated recommendations on the yield of pathological findings compared with the previous guidelines published in 2014; (2) the impact of preoperative B-type natriuretic peptide (NT-proBNP) use for risk estimation on the yield of pathological findings;
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Intraoperative pharmacologic opioid minimisation strategies and patient-centred outcomes after surgery: a scoping review Br. J. Anaesth. (IF 9.8) Pub Date : 2024-02-08 Michael Verret, Nhat H. Lam, Manoj Lalu, Stuart G. Nicholls, Alexis F. Turgeon, Daniel I. McIsaac, Myriam Hamtiaux, John Bao Phuc Le, Ian Gilron, Lucy Yang, Mahrukh Kaimkhani, Alexandre Assi, David El-Adem, Makenna Timm, Peter Tai, Joelle Amir, Sriyathavan Srichandramohan, Abdulaziz Al-Mazidi, Nicholas A. Fergusson, Brian Hutton, Fiona Zivkovic, Megan Graham, Maxime Lê, Allison Geist, Mélanie Bérubé
Postoperative patient-centred outcome measures are essential to capture the patient's experience after surgery. Although a large number of pharmacologic opioid minimisation strategies (i.e. opioid alternatives) are used for patients undergoing surgery, it remains unclear which strategies are most promising in terms of patient-centred outcome improvements. This scoping review had two main objectives:
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Association between self-reported functional capacity and general postoperative complications: analysis of predefined outcomes of the MET-REPAIR international cohort study Br. J. Anaesth. (IF 9.8) Pub Date : 2024-02-06 Sebastian Roth, René M'Pembele, Johannes Nienhaus, Eckhard Mauermann, Daniela Ionescu, Wojciech Szczeklik, Stefan De Hert, Miodrag Filipovic, Beatrice Beck-Schimmer, Savino Spadaro, Purificación Matute, Daniel Bolliger, Sanem C. Turhan, Judith van Waes, Filipa Lagarto, Kassiani Theodoraki, Anil Gupta, Hans-Jörg Gillmann, Luca Guzzetti, Katarzyna Kotfis, Hinnerk Wulf, Jan Larmann, Dan Corneci, Frédérique
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Dose-dependent relationship between SGLT2 inhibitor hold time and risk for postoperative anion gap acidosis. Comment on Br J Anaesth 2023; 131: 682–686 Br. J. Anaesth. (IF 9.8) Pub Date : 2024-02-06 Amon Heijne, Ewald M. Bronkhorst
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Prehabilitation provision and practice in the UK: a freedom of information survey Br. J. Anaesth. (IF 9.8) Pub Date : 2024-02-06 Maria Pufulete, Vicky Coyle, Debbie Provan, Clare Shaw, Peter Kunzmann, David J. Bowrey, Rachael Barlow, Michael P.W. Grocott, Toral Shah, Charlotte Atkinson
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Teamwork matters: team situation awareness to build high-performing healthcare teams, a narrative review Br. J. Anaesth. (IF 9.8) Pub Date : 2024-02-02 Jennifer M. Weller, Ravi Mahajan, Kathryn Fahey-Williams, Craig S. Webster
Healthcare today is the prerogative of teams rather than of individuals. In acute care domains such as anaesthesia, intensive care, and emergency medicine, the work is complex and fast-paced, and the team members are diverse and interdependent. Three decades of research into the behaviours of high-performing teams provides us with clear guidance on team training, demonstrating positive effects on patient
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High-flow nasal oxygen versus conventional oxygen therapy and noninvasive ventilation in COVID-19 respiratory failure: a systematic review and network meta-analysis of randomised controlled trials Br. J. Anaesth. (IF 9.8) Pub Date : 2024-02-02 Walter Pisciotta, Alberto Passannante, Pietro Arina, Khalid Alotaibi, Gareth Ambler, Nishkantha Arulkumaran
Noninvasive methods of respiratory support, including noninvasive ventilation (NIV), continuous positive airway pressure (CPAP), and high-flow nasal oxygen (HFNO), are potential strategies to prevent progression to requirement for invasive mechanical ventilation in acute hypoxaemic respiratory failure. The COVID-19 pandemic provided an opportunity to understand the utility of noninvasive respiratory
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Enhancing spinal cord stimulation-induced pain inhibition by augmenting endogenous adenosine signalling after nerve injury in rats Br. J. Anaesth. (IF 9.8) Pub Date : 2024-02-02 Xiang Cui, Jing Liu, Ankit Uniyal, Qian Xu, Chi Zhang, Guangwu Zhu, Fei Yang, Eellan Sivanesan, Bengt Linderoth, Srinivasa N. Raja, Yun Guan
The mechanisms for spinal cord stimulation (SCS) to alleviate chronic pain are only partially known. We aimed to elucidate the roles of adenosine A1 and A3 receptors (A1R, A3R) in the inhibition of spinal nociceptive transmission by SCS, and further explored whether 2′-deoxycoformycin (dCF), an inhibitor of adenosine deaminase, can potentiate SCS-induced analgesia. We used RNAscope and immunoblotting
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Effects of the orexin receptor 2 agonist danavorexton on emergence from general anaesthesia and opioid-induced sedation, respiratory depression, and analgesia in rats and monkeys Br. J. Anaesth. (IF 9.8) Pub Date : 2024-02-01 Motohisa Suzuki, Eri Shiraishi, James Cronican, Haruhide Kimura
Delayed emergence from general anaesthesia, opioid-induced sedation, and opioid-induced respiratory depression is associated with perioperative complications. We characterised the preclinical effects of the orexin receptor 2 (OX2R)-selective agonist danavorexton (TAK-925) on emergence from anaesthesia and reversal of fentanyl-induced sedation, respiratory depression, and analgesia. Emergence from isoflurane-
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Leading in the development, standardised evaluation, and adoption of artificial intelligence in clinical practice: regional anaesthesia as an example Br. J. Anaesth. (IF 9.8) Pub Date : 2024-02-01 James S. Bowness, Xiaoxuan Liu, Pearse A. Keane
A recent study by Suissa and colleagues explored the clinical relevance of a medical image segmentation metric (Dice metric) commonly used in the field of artificial intelligence (AI). They showed that pixel-wise agreement for physician identification of structures on ultrasound images is variable, and a relatively low Dice metric (0.34) correlated to a substantial agreement on subjective clinical
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Environmental and financial impacts of perioperative paracetamol use: a multicentre international life-cycle analysis Br. J. Anaesth. (IF 9.8) Pub Date : 2024-01-30 Jessica F. Davies, Scott McAlister, Matthew J. Eckelman, Forbes McGain, Richard Seglenieks, Elena N. Gutman, Jonathan Groome, Natasha Palipane, Katherine Latoff, Dominic Nielsen, Jodi D. Sherman
Background Pharmaceuticals account for 19–32% of healthcare greenhouse gas (GHG) emissions. Paracetamol is a common perioperative analgesic agent. We estimated GHG emissions associated with i.v. and oral formulations of paracetamol used in the perioperative period. Methods Life-cycle assessment of GHG emissions (expressed as carbon dioxide equivalents CO2e) of i.v. and oral paracetamol preparations
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Phase III clinical trial comparing the efficacy and safety of adamgammadex with sugammadex for reversal of rocuronium-induced neuromuscular block. Comment on Br J Anaesth 2024; 132: 45–52 Br. J. Anaesth. (IF 9.8) Pub Date : 2024-01-30 Yusuke Miyazaki, Kaoru Suzuki, Hiroshi Sunaga
Abstract not available
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The debate rages on: physician-assisted suicide in an ethical light Br. J. Anaesth. (IF 9.8) Pub Date : 2024-01-29 John Shenouda, Michael Blaber, Robert George, James Haslam
The British Medical Association and some Royal Colleges have recently changed their stance on physician-assisted suicide from ‘opposed’ to forms of ‘neutral’. The Royal College of Anaesthetists will poll members soon on whether to follow suit. Elsewhere neutrality amongst professional bodies has preceded legalisation of physician-assisted suicide. We examine the arguments relevant to the anaesthesia
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Dose–response relationships of intravenous and perineural dexamethasone as adjuvants to peripheral nerve blocks: a systematic review and model-based network meta-analysis Br. J. Anaesth. (IF 9.8) Pub Date : 2024-01-27 Paul J. Zufferey, Robin Chaux, Pierre-Adrien Lachaud, Xavier Capdevila, Julien Lanoiselée, Edouard Ollier
Background Superiority of perineural over intravenous dexamethasone at extending nerve block analgesia has been suggested but without considering the dose–response relationships for each route of administration. Methods Randomised control studies that evaluated intravenous or perineural dexamethasone as an adjuvant to unilateral peripheral nerve blocks in adults were searched up to October 2023 in
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Perioperative management of long-acting glucagon-like peptide-1 (GLP-1) receptor agonists: concerns for delayed gastric emptying and pulmonary aspiration Br. J. Anaesth. (IF 9.8) Pub Date : 2024-01-29 Mark L. van Zuylen, Sarah E. Siegelaar, Mark P. Plummer, Adam M. Deane, Jeroen Hermanides, Abraham H. Hulst
Prescriptions and use of glucagon-like peptide-1 (GLP-1) receptor agonists are increasing dramatically, as indications are expanding from the treatment of diabetes mellitus to weight loss for people with obesity. As GLP-1 receptor agonists delay gastric emptying, perioperative healthcare practitioners could be concerned about an increased risk for pulmonary aspiration during general anaesthesia. We
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Perioperative use of glucagon-like peptide-1 receptor agonists and sodium-glucose cotransporter 2 inhibitors for diabetes mellitus Br. J. Anaesth. (IF 9.8) Pub Date : 2024-01-29 Ketan Dhatariya, Nicholas Levy, Kim Russon, Anil Patel, Claire Frank, Omar Mustafa, Philip Newland-Jones, Gerry Rayman, Sarah Tinsley, Jugdeep Dhesi
Type 2 diabetes mellitus is an increasingly common long-term condition, and suboptimal perioperative glycaemic control can lead to postoperative harms. The advent of new antidiabetic drugs, in particular glucagon-like peptide-1 (GLP-1) receptor agonists and sodium-glucose cotransporter 2 (SGLT2) inhibitors, has enabled perioperative continuation of these medicines, thus avoiding the harms of variable
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Intraoperative dexamethasone and chronic postsurgical pain: a propensity score-matched analysis of a large trial Br. J. Anaesth. (IF 9.8) Pub Date : 2024-01-24 Paul S. Myles, Tomas B. Corcoran, Matthew T. Chan, Mohammad Asghari-Jafarabadi, William K.K. Wu, Philip Peyton, Kate Leslie, Andrew Forbes
Background Dexamethasone has been shown to reduce acute pain after surgery, but there is uncertainty as to its effects on chronic postsurgical pain (CPSP). We hypothesised that in patients undergoing major noncardiac surgery, a single intraoperative dose of dexamethasone increases the incidence of CPSP. Methods We devised a propensity score-matched analysis of the ENIGMA-II trial CPSP dataset, aiming
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Use of cell salvage in obstetrics in Germany: analysis of national database of 305 610 cases with peripartum haemorrhage Br. J. Anaesth. (IF 9.8) Pub Date : 2024-01-23 Vanessa Neef, Benjamin Friedrichson, Thomas Jasny, Oliver Old, Florian J. Raimann, Suma Choorapoikayil, Andrea U. Steinbicker, Patrick Meybohm, Kai Zacharowski, Jan Andreas Kloka
Background One of the leading causes of maternal death worldwide is severe obstetric haemorrhage after childbirth. Use of intraoperative cell salvage is strongly recommended by international guidelines on patient blood management. Recent data provide strong evidence that use of cell salvage in obstetrics is effective and safe in women with postpartum haemorrhage resulting in fewer transfusion-related
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Best practices in cognitive aid design for clinical emergencies Br. J. Anaesth. (IF 9.8) Pub Date : 2024-01-23 Stuart Marshall
Abstract not available
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Intraoperative hypotension and postoperative outcomes. Response to Br J Anaesth 2024; 132: 178–80 Br. J. Anaesth. (IF 9.8) Pub Date : 2024-01-25 Filippo D'Amico, Giovanni Landoni
Abstract not available
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Rethinking ketamine as a panacea: adverse effects on oxygenation and postoperative outcomes Br. J. Anaesth. (IF 9.8) Pub Date : 2024-01-24 Megan L. Rolfzen, Ben Julian A. Palanca, Karsten Bartels
Ketamine is receiving renewed interest in perioperative medicine as an anaesthetic adjunct and a treatment for chronic conditions, including depression. Ketamine's complex pharmacologic profile results not only in several desirable effects, such as anaesthesia and analgesia, but also multiple adverse effects affecting the central nervous, cardiovascular, and respiratory systems. In addition to defining