Stephen Waite, Charlotte Collison, Ronan Mukherjee
<p>We read with interest the article by Ledda et al. [<span>1</span>], which highlights a drive to change from single-use to reusable gowns to be more environmentally sustainable. While laudable, we feel that it does not consider wider changes to our practice which could have an impact of greater magnitude.</p><p>Standard practice in many UK centres is to wear a sterile gown for spinal anaesthesia to reduce the incidence of infective complications. This practice is mandated in the 2014 Association of Anaesthetists guidance [<span>2</span>]. However, this practice is not standard globally. In the UK, practice varies for other neuraxial procedures, e.g. many doctors from medical specialities do not wear a sterile gown for lumbar punctures.</p><p>Most anaesthetists are cognisant of the risk of infective complications. However, the incidence of infection following single-shot spinal anaesthesia is very low. The 3rd UK National Audit Project (NAP3) reported only two cases of vertebral canal abscess and one of infective meningitis associated with approximately 325,000 spinal anaesthetics [<span>3</span>]. It noted failings of asepsis and specifically referenced the importance of sterile drapes and use of facemasks, but did not specifically mention sterile gowns. Beyond NAP3 there is very little evidence for the use of sterile gowns. Only a single randomised controlled trial has been identified [<span>4</span>], which investigated gowning on the incidence of catheter tip colonisation in lumbar epidural for labour analgesia. Siddiqui et al. concluded that the use of gowns did not affect catheter colonisation.</p><p>The volume of waste generated using sterile gowns for spinal anaesthesia is significant. In NHS Tayside, a health board with a patient population of 416,090 (2017 Census), we undertook 2877 spinal anaesthetics in 2022. Gowns generated nearly half a metric tonne of carbon dioxide equivalent (CO<sub>2</sub>e) from disposal in clinical waste. These gowns are manufactured in China, and it is challenging to estimate the (likely extensive) additional environmental cost of production and shipping to the UK. As stated, NAP3 estimated that there were approximately 325,000 spinal anaesthetics undertaken in the UK in 2009 [<span>3</span>]. Using a sterile gown for every spinal anaesthetic generates vast amounts of CO<sub>2</sub>e.</p><p>Many anaesthetists seem to be receptive to a change of practice in this area. Tuohey et al. raised similar concerns in 2023 and called for a change in practice in the UK and Australasia [<span>5</span>]. When we surveyed 51 anaesthetists in NHS Tayside, 89.9% of respondents were receptive to changing their practice if supported by a change in guidance. While changing to reusable alternatives may help environmentally and financially, it seems that high quality asepsis for single-shot spinal anaesthesia can still be achieved without the use of a sterile gown, and that individual clinicians should be encouraged to choose wha
{"title":"Sterile gowns for spinal anaesthesia – environmental cost without clinical gain?","authors":"Stephen Waite, Charlotte Collison, Ronan Mukherjee","doi":"10.1111/anae.16423","DOIUrl":"10.1111/anae.16423","url":null,"abstract":"<p>We read with interest the article by Ledda et al. [<span>1</span>], which highlights a drive to change from single-use to reusable gowns to be more environmentally sustainable. While laudable, we feel that it does not consider wider changes to our practice which could have an impact of greater magnitude.</p><p>Standard practice in many UK centres is to wear a sterile gown for spinal anaesthesia to reduce the incidence of infective complications. This practice is mandated in the 2014 Association of Anaesthetists guidance [<span>2</span>]. However, this practice is not standard globally. In the UK, practice varies for other neuraxial procedures, e.g. many doctors from medical specialities do not wear a sterile gown for lumbar punctures.</p><p>Most anaesthetists are cognisant of the risk of infective complications. However, the incidence of infection following single-shot spinal anaesthesia is very low. The 3rd UK National Audit Project (NAP3) reported only two cases of vertebral canal abscess and one of infective meningitis associated with approximately 325,000 spinal anaesthetics [<span>3</span>]. It noted failings of asepsis and specifically referenced the importance of sterile drapes and use of facemasks, but did not specifically mention sterile gowns. Beyond NAP3 there is very little evidence for the use of sterile gowns. Only a single randomised controlled trial has been identified [<span>4</span>], which investigated gowning on the incidence of catheter tip colonisation in lumbar epidural for labour analgesia. Siddiqui et al. concluded that the use of gowns did not affect catheter colonisation.</p><p>The volume of waste generated using sterile gowns for spinal anaesthesia is significant. In NHS Tayside, a health board with a patient population of 416,090 (2017 Census), we undertook 2877 spinal anaesthetics in 2022. Gowns generated nearly half a metric tonne of carbon dioxide equivalent (CO<sub>2</sub>e) from disposal in clinical waste. These gowns are manufactured in China, and it is challenging to estimate the (likely extensive) additional environmental cost of production and shipping to the UK. As stated, NAP3 estimated that there were approximately 325,000 spinal anaesthetics undertaken in the UK in 2009 [<span>3</span>]. Using a sterile gown for every spinal anaesthetic generates vast amounts of CO<sub>2</sub>e.</p><p>Many anaesthetists seem to be receptive to a change of practice in this area. Tuohey et al. raised similar concerns in 2023 and called for a change in practice in the UK and Australasia [<span>5</span>]. When we surveyed 51 anaesthetists in NHS Tayside, 89.9% of respondents were receptive to changing their practice if supported by a change in guidance. While changing to reusable alternatives may help environmentally and financially, it seems that high quality asepsis for single-shot spinal anaesthesia can still be achieved without the use of a sterile gown, and that individual clinicians should be encouraged to choose wha","PeriodicalId":7742,"journal":{"name":"Anaesthesia","volume":"79 12","pages":"1381"},"PeriodicalIF":7.5,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anae.16423","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142118767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Annerixt Gribnau, Gert J. Geurtsen, Hanna C. Willems, Jeroen Hermanides, Mark L. van Zuylen
<p>The current gold standard neuropsychological assessment for detecting postoperative neurocognitive disorders is too time-consuming, costly and burdensome to use in clinical practice. Brief screening instruments, such as the Montreal Cognitive Assessment (MoCA), are used frequently instead. However, previous research by our team suggested that the original MoCA is not suitable to detect postoperative neurocognitive disorders in older adult surgical patients [<span>1</span>]. To improve the accuracy of the MoCA, Kessels et al. presented norms controlling for age, sex and educational level [<span>2</span>]. Accordingly, our study aimed to compare the performance of the adjusted MoCA score in diagnosing postoperative neurocognitive disorder.</p><p>We prospectively enrolled patients aged ≥ 65 y scheduled for elective surgery, involving any type of anaesthesia or surgical procedure, from September 2019 to January 2021, after approval by our local research ethics committee. Patients who were not fluent in Dutch, had pre-operative cognitive impairment, severe hearing impairment or needed several procedures under anaesthesia were not studied. The original study is described in full elsewhere [<span>1</span>]. Simultaneous administration of neuropsychological assessment and MoCA occurred pre-operatively and 30–60 days postoperatively, using alternate versions to minimise practice effect. Performance on neuropsychological assessment was reported as T-scores after comparison to a Dutch norm group (https://andi.nl). For neuropsychological assessment, a decline of 1–2 SD on ≥ 1 cognitive domain score indicated mild postoperative cognitive disorder, and ≥ 2 SD decline indicated major postoperative neurocognitive disorder [<span>3</span>]. In the post hoc analysis, we transformed the original, education-uncorrected, MoCA scores to percentiles according to Kessels et al. [<span>2</span>]. Mild postoperative neurocognitive disorder was defined as a reliable change index decrease of 1–2 SD [<span>4</span>] and ≥ 2 SD decline indicated major postoperative neurocognitive disorder. Test–retest reliability was measured by intraclass correlation coefficient. Data were missing completely at random and were imputed.</p><p>Sensitivity, specificity and area under the receiver operating characteristic curve of the adjusted MoCA were calculated. We examined pre-operative, postoperative and pre- to postoperative correlations of MoCA and total neuropsychological assessment and domain scores. We transformed the outcome to z-scores to assess agreement between MoCA and neuropsychological assessment by Bland–Altman plots. Ordinary or regression limits of agreement were chosen based on the presence or absence of proportional bias [<span>5</span>].</p><p>A total of 73 patients completed neuropsychological assessment and MoCA. Baseline characteristics are detailed in online Supporting Information Appendix S1. Neuropsychological assessment identified 14 (19%) cases of postoperative
{"title":"Comparison between adjusted Montreal Cognitive Assessment and neuropsychological assessment for diagnosing postoperative neurocognitive disorders","authors":"Annerixt Gribnau, Gert J. Geurtsen, Hanna C. Willems, Jeroen Hermanides, Mark L. van Zuylen","doi":"10.1111/anae.16424","DOIUrl":"10.1111/anae.16424","url":null,"abstract":"<p>The current gold standard neuropsychological assessment for detecting postoperative neurocognitive disorders is too time-consuming, costly and burdensome to use in clinical practice. Brief screening instruments, such as the Montreal Cognitive Assessment (MoCA), are used frequently instead. However, previous research by our team suggested that the original MoCA is not suitable to detect postoperative neurocognitive disorders in older adult surgical patients [<span>1</span>]. To improve the accuracy of the MoCA, Kessels et al. presented norms controlling for age, sex and educational level [<span>2</span>]. Accordingly, our study aimed to compare the performance of the adjusted MoCA score in diagnosing postoperative neurocognitive disorder.</p><p>We prospectively enrolled patients aged ≥ 65 y scheduled for elective surgery, involving any type of anaesthesia or surgical procedure, from September 2019 to January 2021, after approval by our local research ethics committee. Patients who were not fluent in Dutch, had pre-operative cognitive impairment, severe hearing impairment or needed several procedures under anaesthesia were not studied. The original study is described in full elsewhere [<span>1</span>]. Simultaneous administration of neuropsychological assessment and MoCA occurred pre-operatively and 30–60 days postoperatively, using alternate versions to minimise practice effect. Performance on neuropsychological assessment was reported as T-scores after comparison to a Dutch norm group (https://andi.nl). For neuropsychological assessment, a decline of 1–2 SD on ≥ 1 cognitive domain score indicated mild postoperative cognitive disorder, and ≥ 2 SD decline indicated major postoperative neurocognitive disorder [<span>3</span>]. In the post hoc analysis, we transformed the original, education-uncorrected, MoCA scores to percentiles according to Kessels et al. [<span>2</span>]. Mild postoperative neurocognitive disorder was defined as a reliable change index decrease of 1–2 SD [<span>4</span>] and ≥ 2 SD decline indicated major postoperative neurocognitive disorder. Test–retest reliability was measured by intraclass correlation coefficient. Data were missing completely at random and were imputed.</p><p>Sensitivity, specificity and area under the receiver operating characteristic curve of the adjusted MoCA were calculated. We examined pre-operative, postoperative and pre- to postoperative correlations of MoCA and total neuropsychological assessment and domain scores. We transformed the outcome to z-scores to assess agreement between MoCA and neuropsychological assessment by Bland–Altman plots. Ordinary or regression limits of agreement were chosen based on the presence or absence of proportional bias [<span>5</span>].</p><p>A total of 73 patients completed neuropsychological assessment and MoCA. Baseline characteristics are detailed in online Supporting Information Appendix S1. Neuropsychological assessment identified 14 (19%) cases of postoperative ","PeriodicalId":7742,"journal":{"name":"Anaesthesia","volume":"79 11","pages":"1250-1252"},"PeriodicalIF":7.5,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anae.16424","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142118766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-27DOI: 10.1111/j.1365-2044.1997.tb00104.x
D. M. Lowe, S. W. M. Feaver
{"title":"Breathing system terminology","authors":"D. M. Lowe, S. W. M. Feaver","doi":"10.1111/j.1365-2044.1997.tb00104.x","DOIUrl":"https://doi.org/10.1111/j.1365-2044.1997.tb00104.x","url":null,"abstract":"","PeriodicalId":7742,"journal":{"name":"Anaesthesia","volume":"147 1","pages":""},"PeriodicalIF":10.7,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142084777","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}
Pub Date : 2024-08-27DOI: 10.1111/j.1365-2044.1997.tb00099.x
S. Rogers, M. W Davies
{"title":"My anaesthetic machine's on fire","authors":"S. Rogers, M. W Davies","doi":"10.1111/j.1365-2044.1997.tb00099.x","DOIUrl":"https://doi.org/10.1111/j.1365-2044.1997.tb00099.x","url":null,"abstract":"","PeriodicalId":7742,"journal":{"name":"Anaesthesia","volume":"19 1","pages":""},"PeriodicalIF":10.7,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142085452","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}
Pub Date : 2024-08-27DOI: 10.1111/j.1365-2044.1997.tb00097.x
R. D. Tunnell, A. W. Miller, G. B. Smith
{"title":"Mortality predicted by APACHE II. The effect of changes in physiological values on predicted hospital mortality","authors":"R. D. Tunnell, A. W. Miller, G. B. Smith","doi":"10.1111/j.1365-2044.1997.tb00097.x","DOIUrl":"https://doi.org/10.1111/j.1365-2044.1997.tb00097.x","url":null,"abstract":"","PeriodicalId":7742,"journal":{"name":"Anaesthesia","volume":"1 1","pages":""},"PeriodicalIF":10.7,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142084769","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}
Jasmeet Soar, Tim M. Cook, Richard A. Armstrong, Emira Kursumovic, Fiona C. Oglesby, Andrew D. Kane
<p>Ward and Illif ask whether there have been too many papers on the 7th UK National Audit Project (NAP7) and whether the “<i>primary purpose</i>” of the project has been lost [<span>1</span>]. NAP7 was a massive project during a pandemic. It is unsurprising that peri-operative cardiac arrest and its contributing factors have generated a large amount of information given this is the final common pathway for serious complications of anaesthesia and surgery [<span>2</span>]. These include those studied in previous NAPs (e.g. airway complications, anaphylaxis) [<span>2</span>]. Of note, NAP7 reported on more cases than NAPs 3–6 combined [<span>3</span>].</p><p>We have a duty to share our findings as widely as possible; for our patients, their families, our stakeholders and the thousands of anaesthetists in the UK and Ireland who contributed data to NAP7. In addition to providing new information about complications and for different patients or subspecialties (e.g. children [<span>4</span>], obstetrics [<span>5</span>]), secondary outputs have been driven by our stakeholders. NAP7 has provided novel and up-to-date information in several areas that are important or contentious for anaesthetists and our patients (e.g. impact of COVID-19 [<span>6</span>], use of monitoring [<span>7</span>], the independent sector [<span>8</span>], anaesthesia associates [<span>9</span>] and wellbeing [<span>3</span>]).</p><p>At all stages, we made efforts to minimise the number of chapters and the length of these to improve accessibility. An illustration of this is the NAP7 ‘airway and breathing’ chapter and paper [<span>10</span>] that reports on 113 cases and runs to 12 pages compared with NAP4 which included 133 anaesthesia airway cases and runs to 216 pages. The division of the report into discrete short chapters specifically enables and encourages readers to focus on areas most relevant to their areas of practice.</p><p>Many of the report chapters have been subsequently published as papers in <i>Anaesthesia</i>, often with additional data and discussion. No project is complete until it is disseminated, and it was, therefore, an intentional strategy to improve visibility of the project by publishing key topic chapters as papers, after full peer review. This further enabled dissemination through podcasts and social media. We judge this a success and thank <i>Anaesthesia</i> and its editors.</p><p>The prime purpose of the NAPs is “<i>through national effort to provide detailed numerical and case</i>-<i>based analysis of risk and complications of anaesthesia and surgery, to make these data available to patients and clinicians and in so doing so facilitate better communication and decision making and drive changes that improve safety</i>”. We believe all the findings and recommendations of NAP7 will help make anaesthesia safer and are important for anaesthetists and their patients – we have no regrets about sharing them as widely as possible.</p><p>Finally, we thank War
{"title":"NAP7 – what's the point?","authors":"Jasmeet Soar, Tim M. Cook, Richard A. Armstrong, Emira Kursumovic, Fiona C. Oglesby, Andrew D. Kane","doi":"10.1111/anae.16422","DOIUrl":"10.1111/anae.16422","url":null,"abstract":"<p>Ward and Illif ask whether there have been too many papers on the 7th UK National Audit Project (NAP7) and whether the “<i>primary purpose</i>” of the project has been lost [<span>1</span>]. NAP7 was a massive project during a pandemic. It is unsurprising that peri-operative cardiac arrest and its contributing factors have generated a large amount of information given this is the final common pathway for serious complications of anaesthesia and surgery [<span>2</span>]. These include those studied in previous NAPs (e.g. airway complications, anaphylaxis) [<span>2</span>]. Of note, NAP7 reported on more cases than NAPs 3–6 combined [<span>3</span>].</p><p>We have a duty to share our findings as widely as possible; for our patients, their families, our stakeholders and the thousands of anaesthetists in the UK and Ireland who contributed data to NAP7. In addition to providing new information about complications and for different patients or subspecialties (e.g. children [<span>4</span>], obstetrics [<span>5</span>]), secondary outputs have been driven by our stakeholders. NAP7 has provided novel and up-to-date information in several areas that are important or contentious for anaesthetists and our patients (e.g. impact of COVID-19 [<span>6</span>], use of monitoring [<span>7</span>], the independent sector [<span>8</span>], anaesthesia associates [<span>9</span>] and wellbeing [<span>3</span>]).</p><p>At all stages, we made efforts to minimise the number of chapters and the length of these to improve accessibility. An illustration of this is the NAP7 ‘airway and breathing’ chapter and paper [<span>10</span>] that reports on 113 cases and runs to 12 pages compared with NAP4 which included 133 anaesthesia airway cases and runs to 216 pages. The division of the report into discrete short chapters specifically enables and encourages readers to focus on areas most relevant to their areas of practice.</p><p>Many of the report chapters have been subsequently published as papers in <i>Anaesthesia</i>, often with additional data and discussion. No project is complete until it is disseminated, and it was, therefore, an intentional strategy to improve visibility of the project by publishing key topic chapters as papers, after full peer review. This further enabled dissemination through podcasts and social media. We judge this a success and thank <i>Anaesthesia</i> and its editors.</p><p>The prime purpose of the NAPs is “<i>through national effort to provide detailed numerical and case</i>-<i>based analysis of risk and complications of anaesthesia and surgery, to make these data available to patients and clinicians and in so doing so facilitate better communication and decision making and drive changes that improve safety</i>”. We believe all the findings and recommendations of NAP7 will help make anaesthesia safer and are important for anaesthetists and their patients – we have no regrets about sharing them as widely as possible.</p><p>Finally, we thank War","PeriodicalId":7742,"journal":{"name":"Anaesthesia","volume":"79 11","pages":"1262-1263"},"PeriodicalIF":7.5,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anae.16422","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142071835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-27DOI: 10.1111/j.1365-2044.1997.tb00095.x
T. J. Walker, G. C. Lockwood
{"title":"Uptake of desflurane: A reply","authors":"T. J. Walker, G. C. Lockwood","doi":"10.1111/j.1365-2044.1997.tb00095.x","DOIUrl":"https://doi.org/10.1111/j.1365-2044.1997.tb00095.x","url":null,"abstract":"","PeriodicalId":7742,"journal":{"name":"Anaesthesia","volume":"8 1","pages":""},"PeriodicalIF":10.7,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142084774","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}
Pub Date : 2024-08-27DOI: 10.1111/j.1365-2044.1997.tb00111.x
P. C. Stewart
{"title":"A persistent problem with glass ampoules","authors":"P. C. Stewart","doi":"10.1111/j.1365-2044.1997.tb00111.x","DOIUrl":"https://doi.org/10.1111/j.1365-2044.1997.tb00111.x","url":null,"abstract":"","PeriodicalId":7742,"journal":{"name":"Anaesthesia","volume":"4 1","pages":""},"PeriodicalIF":10.7,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142084776","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}
Pub Date : 2024-08-27DOI: 10.1111/j.1365-2044.1997.tb00112.x
R. Albanese
{"title":"A persistent problem with glass ampoules: A reply","authors":"R. Albanese","doi":"10.1111/j.1365-2044.1997.tb00112.x","DOIUrl":"https://doi.org/10.1111/j.1365-2044.1997.tb00112.x","url":null,"abstract":"","PeriodicalId":7742,"journal":{"name":"Anaesthesia","volume":"30 1","pages":""},"PeriodicalIF":10.7,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142085456","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：