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A retrospective audit of decision-to-delivery interval and associated metrics in category one Caesarean sections at University of Limerick Maternity Hospital, 2024 2024年利默里克大学妇产医院第一类剖宫产患者决策至分娩间隔及相关指标的回顾性审计
Pub Date : 2025-09-01 Epub Date: 2025-08-21 DOI: 10.1016/j.bjao.2025.100446
U. Ali , Kieron Moloney , Andras Mikor
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引用次数: 0
Introduction of Sip-Til-Send at a district general hospital: a quality improvement project 某地区综合医院Sip-Til-Send质量改进工程的介绍
Pub Date : 2025-09-01 Epub Date: 2025-08-21 DOI: 10.1016/j.bjao.2025.100443
Abdallah Khalil, Patrick Ross
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引用次数: 0
Improving perioperative pain management in patients undergoing major colorectal surgery through intraoperative and postoperative analgesia strategies 通过术中及术后镇痛策略改善大肠癌手术患者围手术期疼痛管理
Pub Date : 2025-09-01 Epub Date: 2025-08-21 DOI: 10.1016/j.bjao.2025.100457
Afnan Mahmoud, Joseph Hogan, Surumi Sheikh, Marta Blanco Cabana
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引用次数: 0
Reply to Walker and Nott 回复沃克和诺特
Pub Date : 2025-09-01 Epub Date: 2025-07-24 DOI: 10.1016/j.bjao.2025.100423
Anton Utas , Stefanie Seifert , Knut Taxbro
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引用次数: 0
Ethical decision making in airway management: a difficult Airway Society position statement on good practice 气道管理中的道德决策:气道协会关于良好实践的艰难立场声明
Pub Date : 2025-09-01 Epub Date: 2025-06-19 DOI: 10.1016/j.bjao.2025.100416
Barry McGuire , Simon Crawley , Nicki Dill , Paul Greig , Rehana Iqbal , Mathew Patteril , Kate Rivett , Anika Sud , Anne-Marie Slowther
Practitioners involved in airway management must balance ethical issues in their practice. Ethical tensions exist because clinicians must maintain clinical standards while maximising skill development, exploring advances in airway practice, and incorporating new learning to benefit future patients. Balancing the benefits and risks to the patient and choosing the right techniques in the right situations and with the right level of patient understanding and respect for patient autonomy can be challenging.
These challenges are shared by airway practitioners from many professional backgrounds; however, this document has been developed specifically to support anaesthetists in their airway management decisions, and for simplicity, the term ‘anaesthetists’ will be used throughout the document. However, the ethical considerations will have relevance to all airway practitioners.
Practice combined with training is central to professional development. Most patients are aware that training is entwined with care and trust anaesthetists to deliver this safely. Trainers should use airway teaching methods appropriate to the trainee's needs and skills.
Informed consent is required for airway management, and the level of detail should be proportionate to the risks involved. Patients have individual preferences and appreciation of risks, so these conversations must be individualised.
Anaesthetists should support the development of new airway devices and techniques. New methods must be assessed within governance structures, and it may be appropriate to collect data or feedback as part of the introduction to practice.
Ethical practice requires doing what is best, doing it openly, honestly, and in patients' interests. The modern ethical and legal landscape has emphasised patient information, discussion, and documentation. We hope this position statement provides guidance, structure, and clarity for the benefit of our patients and our specialty.
参与气道管理的从业人员必须在实践中平衡道德问题。伦理上的紧张关系之所以存在,是因为临床医生必须保持临床标准,同时最大限度地提高技能发展,探索气道实践的进步,并将新的学习纳入未来的患者。平衡对患者的益处和风险,在正确的情况下选择正确的技术,以及患者对患者自主权的适当理解和尊重,可能是一项挑战。这些挑战是来自许多专业背景的气道从业人员共同面临的;然而,本文件是专门为支持麻醉师气道管理决策而制定的,为简单起见,“麻醉师”一词将在整个文件中使用。然而,道德方面的考虑将与所有气道从业人员相关。实践与培训相结合是专业发展的核心。大多数患者都意识到,培训与护理和信任麻醉师安全交付麻醉是密不可分的。培训师应使用适合学员需要和技能的气道教学方法。气道管理需要知情同意,详细程度应与所涉及的风险成比例。病人有个人的偏好和对风险的理解,所以这些谈话必须是个体化的。麻醉师应该支持新的气道设备和技术的发展。新方法必须在治理结构中进行评估,收集数据或反馈作为实践介绍的一部分可能是合适的。道德实践要求做最好的事情,公开、诚实地做,并为病人的利益服务。现代伦理和法律环境强调患者信息、讨论和记录。我们希望这份立场声明能为我们的患者和我们的专业提供指导、结构和清晰。
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引用次数: 0
Patient preference for intraoperative opioid use and early recovery after noncardiac surgery: protocol for a randomised factorial design trial of opioid-free versus opioid-based anaesthesia (the PERFECT trial) 患者对术中阿片类药物使用的偏好和非心脏手术后的早期恢复:无阿片类药物与基于阿片类药物的麻醉的随机因子设计试验方案(PERFECT试验)
Pub Date : 2025-09-01 Epub Date: 2025-06-18 DOI: 10.1016/j.bjao.2025.100420
Yann Gricourt , Nancy M. Boulos , Amelie Delaporte , Brenton Alexander , Stephane Besada , Ryan Bakhit , Aline Toukhtarian , Ido Neuman , Daniel Pearce , Meziar M. Nourian , Arthur Chebishian , Amy Zhou , Janice Boktor , Dylan Mayanja , Tristan Grogan , David Boldt , Maxime Cannesson , Patrice Forget , Alexandre Joosten

Introduction

Although opioids are commonly used to relieve pain associated with surgery, they are not consequence free. Moreover, the USA and many western countries are currently experiencing a significant health crisis because of opioid addiction and its related overdose potential. There have been no studies that have evaluated patient preference regarding opioid use and its potential impact on the quality of recovery. The aim of this study is to compare the effect of patient preference on intraoperative opioid use on early postoperative quality of recovery after moderate risk laparoscopic/robotic abdominal surgery.

Methods

This trial is an interventional, pragmatic, partially randomised factorial trial. Adults (N=240) scheduled for moderate-risk abdominal surgery under laparoscopic/robotic assistance (colorectal, urologic, and gynaecologic) will be allocated into four groups, according to their preference (choice of opioid-free vs opioid-based anaesthesia vs no choice and, if no choice, then the patient is randomised to opioid-based vs opioid-free anaesthesia). Anaesthesia providers and patients who choose their anaesthesia type will be unblinded of the allocation group. The primary endpoint will be the Quality of Recovery-15 score at postoperative day 1. Secondary endpoints will include patient satisfaction, postoperative nausea and vomiting, intraoperative bradycardia, postoperative opioid consumption, postoperative hypoxemia, and health-related quality of life using the EuroQoL 5-Dimension 5-Level (EQ-5D-5L).

Conclusions

This trial will provide evidence on whether patient preference on intraoperative opioid use can improve patient quality of recovery after moderate-risk abdominal surgery.

Clinical trial registration

NCT06855641.

Protocol version number and date

2.0, 24 February 2025.
虽然阿片类药物通常用于缓解手术相关疼痛,但它们并不是没有后果的。此外,美国和许多西方国家目前正经历着严重的健康危机,因为阿片类药物成瘾及其相关的过量可能性。目前还没有研究评估患者对阿片类药物使用的偏好及其对康复质量的潜在影响。本研究的目的是比较患者对术中阿片类药物使用的偏好对中等风险腹腔镜/机器人腹部手术术后早期恢复质量的影响。方法本试验为干预性、实用性、部分随机因子试验。计划在腹腔镜/机器人辅助下进行中等风险腹部手术的成年人(N=240)(结直肠、泌尿和妇科)将根据他们的偏好分为四组(选择无阿片类药物麻醉vs无阿片类药物麻醉vs无阿片类药物麻醉,如果没有选择,则患者随机分配到阿片类药物麻醉vs无阿片类药物麻醉)。麻醉提供者和选择麻醉类型的患者将被解除分配组的盲法。主要终点将是术后第1天的恢复质量-15评分。次要终点将包括患者满意度、术后恶心和呕吐、术中心动过缓、术后阿片类药物消耗、术后低氧血症和与健康相关的生活质量(使用EuroQoL 5-Dimension 5-Level (EQ-5D-5L))。结论本试验将提供证据,证明患者对术中阿片类药物的使用偏好是否能提高中等风险腹部手术后患者的康复质量。临床试验注册号nct06855641。协议版本号和日期2.0,2025年2月24日。
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引用次数: 0
Auditing the implementation of perioperative anaemia management guidelines in patients undergoing elective primary hip and knee arthroplasties in Lancashire and South Cumbria 审核兰开夏郡和南坎布里亚郡择期原发性髋关节和膝关节置换术患者围手术期贫血管理指南的实施情况
Pub Date : 2025-09-01 Epub Date: 2025-08-21 DOI: 10.1016/j.bjao.2025.100444
Brawin A. Kajenthra, Tarun S. Sripadam, Jacob C. Andrews, Jake R. Hewitt, George A. Hughes, Matthew Whymark, Daniel Harvey, Hermann Jacobs, Karen Allen, Jonathan Creamer, Marwan Mandor, Ariam Teklemichael, Emanuel Williams, Muhammad Sohaib Afzal, Muhammad Ibrahim, Khaled Aboukhalaf, Daniel Myers
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引用次数: 0
An audit of the perioperative use of non-steroidal anti-inflammatory drugs 围手术期非甾体抗炎药使用的审计
Pub Date : 2025-09-01 Epub Date: 2025-08-21 DOI: 10.1016/j.bjao.2025.100445
Andrew Richardson
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引用次数: 0
Establishment of a Population Health Management clinic in a District General Hospital 在地区总医院设立人口健康管理诊所
Pub Date : 2025-09-01 Epub Date: 2025-08-21 DOI: 10.1016/j.bjao.2025.100472
Arora Deepika, Chowdhury Priyakam
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引用次数: 0
Enhancing epidural care in wards: a quality improvement project on educating ward nurses 加强病房硬膜外护理:教育病房护士的质素改善计划
Pub Date : 2025-09-01 Epub Date: 2025-08-21 DOI: 10.1016/j.bjao.2025.100447
G. Srirahini
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引用次数: 0
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