Anaesthesia最新文献

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Pre‐operative anaemia and mortality: a reply 术前贫血和死亡率：一个答复

IF 10.7 1区医学 Q1 ANESTHESIOLOGY

Anaesthesia

Pub Date : 2026-02-16 DOI: 10.1111/anae.70170

Elisabeth M. Groenewegen, Peter G. Noordzij, Thijs C. D. Rettig

引用次数: 0

Liberal liquid fasting regimens and the risk of pulmonary aspiration 自由禁食和肺误吸的风险

IF 10.7 1区医学 Q1 ANESTHESIOLOGY

Anaesthesia

Pub Date : 2026-02-16 DOI: 10.1111/anae.70178

Anne Rüggeberg, Kariem El‐Boghdadly

引用次数: 0

Nitrous oxide capture and metal–organic frameworks: a step closer to a circular economy for medical gases? 一氧化二氮捕获和金属有机框架：离医用气体循环经济又近了一步？

IF 10.7 1区医学 Q1 ANESTHESIOLOGY

Anaesthesia

Pub Date : 2026-02-16 DOI: 10.1111/anae.70162

Charlotte Taylor, Cliff Shelton, Charlotte Hadley

引用次数: 0

Balancing analgesia and function with patient preference and expectation 平衡镇痛和功能与患者的偏好和期望

IF 10.7 1区医学 Q1 ANESTHESIOLOGY

Anaesthesia

Pub Date : 2026-02-16 DOI: 10.1111/anae.70168

Eanna O'Sullivan, Ranil Soysa

引用次数: 0

Peri‐operative management of diabetes mellitus: a multidisciplinary consensus statement from the Association of Anaesthetists and the Joint British Diabetes Societies for Inpatient Care group 糖尿病的围手术期管理：来自麻醉师协会和联合英国糖尿病学会住院病人护理组的多学科共识声明

IF 10.7 1区医学 Q1 ANESTHESIOLOGY

Anaesthesia

Pub Date : 2026-02-16 DOI: 10.1111/anae.70181

Nicholas A. Levy, Kariem El‐Boghdadly, Dileep N. Lobo, Daniel J. Stubbs, Parizad Avari, Donal Buggy, Claire Frank, Kim Howson, Jinty Moffett, Emma Morris, Omar G. Mustafa, Glynn Nash, Pádraig Ó Scanaill, Sarah Procter, Gerry Rayman, Kim Russon, Caroline Thomas, Sarah Tinsley, Allan Xu, Ketan Dhatariya

Summary Introduction Surgery in patients with diabetes mellitus is associated with increased morbidity and mortality compared with those who do not have diabetes mellitus. This is likely multifactorial and could be attributed to organisational issues; dysglycaemia; hospital‐acquired diabetic ketoacidosis; errors with insulin prescribing and administration; issues with fluids and electrolytes; and systemic and surgical site infections. There was a need to update guidance for the peri‐operative management of diabetes mellitus given improvements in our understanding, introduction of novel drugs and development of wearable technologies. Methods This was a multidisciplinary consensus statement with a diverse authorship group, including diabetologists; anaesthetists; surgeons; pharmacists; surgical diabetes inpatient specialist nurses; and patients with lived experience. We undertook a directed literature search and a three‐round Delphi process to develop, refine and agree recommendations. Results Following three rounds, 38 recommendations were included, spanning all phases of the peri‐operative pathway. Recommendations were made for organisations and general principles for the management of patients with diabetes, aiming to improve pathways, implement protocols and support training. We prioritise individualised care plans, encourage clinical judgement regarding proceeding with surgery with out‐of‐range HbA1c concentrations and recommend ensuring appropriate insulin regimens are prescribed and administered. We also provide guidance for capillary blood glucose and ketone monitoring and management; safe handovers of care; and multidisciplinary care plans for the peri‐operative use of wearables. Discussion This consensus statement provides principles to be applied throughout the entire peri‐operative pathway by healthcare professionals, institutions and patients. It is hoped that the implementation of these key recommendations will improve experience and outcomes for patients with diabetes mellitus having surgery.

与非糖尿病患者相比，手术治疗糖尿病患者的发病率和死亡率增加。这可能是多因素的，可能归因于组织问题；dysglycaemia;医院获得性糖尿病酮症酸中毒；胰岛素处方和给药错误；液体和电解质问题；以及全身和手术部位感染。鉴于我们对糖尿病的认识的提高、新药物的引进和可穿戴技术的发展，有必要更新糖尿病围手术期管理的指南。方法：这是一个多学科共识声明，有不同的作者群体，包括糖尿病学家；麻醉师;外科医生;药剂师;外科糖尿病住院专科护士；和有生活经验的病人。我们进行了有针对性的文献检索和三轮德尔菲过程，以制定、完善和同意建议。结果三轮后，纳入了38条建议，涵盖围术期通路的所有阶段。为糖尿病患者管理的组织和一般原则提出了建议，旨在改善途径，实施协议和支持培训。我们优先考虑个性化的护理计划，鼓励在HbA1c浓度超出范围的情况下进行手术的临床判断，并建议确保处方和使用适当的胰岛素方案。指导毛细管血糖、酮监测与管理；安全移交护理；以及围手术期使用可穿戴设备的多学科护理计划。本共识声明提供了医疗专业人员、机构和患者在整个围术期路径中应用的原则。希望这些关键建议的实施将改善糖尿病手术患者的体验和结果。

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引用次数: 0

Pain management after elective caesarean section under neuraxial anaesthesia: an updated systematic review and procedure-specific postoperative pain management (PROSPECT) recommendations. 择期剖宫产术后神经轴麻醉下的疼痛管理：更新的系统综述和手术特异性术后疼痛管理（PROSPECT）建议。

IF 6.9 1区医学 Q1 ANESTHESIOLOGY

Anaesthesia

Pub Date : 2026-02-15 DOI: 10.1111/anae.70141

Gillian Crowe, Benjamin Atterton, Eva Roofthooft, Girish P Joshi, Narinder Rawal, Christopher Wu, Axel R Sauter, Marie-Pierre Bonnet, Dominique Nuala Lucas, Marc Van de Velde

Introduction: Elective caesarean section is a common and painful procedure. Uncontrolled pain following caesarean section can profoundly and negatively on a wide range of patient and healthcare-centred outcomes. The aim of this systematic review was to update existing recommendations for postoperative pain management after elective caesarean section performed under neuraxial anaesthesia.

Methods: A systematic review using the PROcedure SPEcific Postoperative Pain ManagemenT (PROSPECT) methodology was undertaken. Randomised trials evaluating the efficacy of analgesic, anaesthetic and surgical interventions were retrieved. Systematic reviews and meta-analyses of randomised controlled trials were also reviewed. Trials evaluating pain management for emergency surgical deliveries or caesarean section performed under general anaesthesia were not included.

Results: Sixty-one randomised controlled trials were included. For patients undergoing elective caesarean section performed under neuraxial anaesthesia, we recommend that clinicians administer intrathecal morphine 50-100 μg or diamorphine 300 μg pre-operatively, and paracetamol, non-steroidal anti-inflammatory drugs and dexamethasone after delivery. If a neuraxial opioid is not administered, clinicians should use one of a range of recommended fascial plane blocks; alternatively, the wound should be infiltrated with local anaesthetic. The postoperative regimen should include regular paracetamol and non-steroidal anti-inflammatory drugs, with opioids used for rescue. The surgical technique should include a Joel-Cohen incision. The peritoneum should not be closed.

Discussion: An analgesic regimen to manage pain safely and effectively after elective caesarean section based on up-to-date evidence is presented. Consideration has been given to balancing analgesic efficacy and potential adverse effects. Future research should determine the optimal dose of dexamethasone and epidural long-acting opioid, establish the most effective regional analgesic technique and develop standardised outcome sets to better compare techniques.

导读：选择性剖宫产是一种常见且痛苦的手术。剖宫产术后不受控制的疼痛可对广泛的患者和以医疗保健为中心的结果产生深远的负面影响。本系统综述的目的是更新现有的在轴向麻醉下择期剖宫产术后疼痛管理的建议。方法：采用手术特异性术后疼痛管理（PROSPECT）方法进行系统回顾。我们检索了评估镇痛、麻醉和手术干预效果的随机试验。还回顾了随机对照试验的系统评价和荟萃分析。没有纳入评估在全身麻醉下急诊手术分娩或剖宫产疼痛管理的试验。结果：纳入61项随机对照试验。对于择期剖宫产患者，我们建议术前给予鞘内吗啡50-100 μg或吗啡300 μg，分娩后给予扑热息痛、非甾体类抗炎药和地塞米松。如果未给予轴向阿片类药物，临床医生应使用推荐的筋膜平面阻滞之一；或者，应局部麻醉浸润伤口。术后治疗方案应包括常规扑热息痛和非甾体类抗炎药，阿片类药物用于抢救。手术技术应包括Joel-Cohen切口。腹膜不应关闭。讨论：基于最新的证据提出了一种镇痛方案，以安全有效地管理择期剖宫产后的疼痛。考虑到平衡止痛效果和潜在的不良反应。未来的研究应确定地塞米松和硬膜外长效阿片类药物的最佳剂量，建立最有效的局部镇痛技术，并制定标准化的结果集，以便更好地比较技术。

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引用次数: 0

Reframing opioid‐free anaesthesia: high quality regional anaesthesia over ideology 重构无阿片类药物麻醉：高质量区域麻醉优于意识形态

IF 10.7 1区医学 Q1 ANESTHESIOLOGY

Anaesthesia

Pub Date : 2026-02-11 DOI: 10.1111/anae.70158

Kanika Arora, Nicola Stranix, Akshay Shah

引用次数: 0

Navigating the medicolegal landscape of artificial intelligence in anaesthesia and peri‐operative medicine 人工智能在麻醉和围手术期医学中的应用

IF 10.7 1区医学 Q1 ANESTHESIOLOGY

Anaesthesia

Pub Date : 2026-02-11 DOI: 10.1111/anae.70157

James O'Carroll, Kieran Brosnan, Paul McConnell

引用次数: 0

Keeping our nerve: what large datasets can (and might) reveal about peri‐operative nerve injury 保持我们的神经：什么大型数据集可以（和可能）揭示围手术期神经损伤

IF 10.7 1区医学 Q1 ANESTHESIOLOGY

Anaesthesia

Pub Date : 2026-02-11 DOI: 10.1111/anae.70159

Yin Y. Lim, Edward R. Mariano, Kelly E. Foster, Alan J. R. Macfarlane

引用次数: 0

Issue Information – Editorial Board 发行信息-编辑委员会

IF 6.9 1区医学 Q1 ANESTHESIOLOGY

Anaesthesia

Pub Date : 2026-02-11 DOI: 10.1111/anae.70132

引用次数: 0

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