Pub Date : 2026-01-05DOI: 10.1016/j.bja.2025.11.045
George Zhong, Sarah Jane Wong
{"title":"Impact of genetic variations on the pharmacokinetics, dose requirements, and clinical effects of propofol: a modelling study. Comment on Br J Anaesth 2025; 135: 594–607","authors":"George Zhong, Sarah Jane Wong","doi":"10.1016/j.bja.2025.11.045","DOIUrl":"https://doi.org/10.1016/j.bja.2025.11.045","url":null,"abstract":"","PeriodicalId":9250,"journal":{"name":"British journal of anaesthesia","volume":"166 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145897415","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 : 2026-01-05DOI: 10.1016/j.bja.2025.11.033
Jiao Zhu , Daxiong Zeng
{"title":"Association of non-anaemic iron deficiency with postoperative outcomes after fast-track hip and knee arthroplasty. Comment on Br J Anaesth 2025; 135: 322–30","authors":"Jiao Zhu , Daxiong Zeng","doi":"10.1016/j.bja.2025.11.033","DOIUrl":"10.1016/j.bja.2025.11.033","url":null,"abstract":"","PeriodicalId":9250,"journal":{"name":"British journal of anaesthesia","volume":"136 2","pages":"Pages 792-793"},"PeriodicalIF":9.2,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145897232","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}
BACKGROUNDTransfemoral transcatheter aortic valve implantation (TAVI) is a minimally invasive treatment for patients with severe aortic stenosis who are at elevated surgical risk. Despite widespread use, optimal periprocedural anaesthetic management remains highly variable, and evidence-based guidance is lacking.METHODSAn interdisciplinary panel of Italian experts in anaesthesiology, cardiology, and cardiac surgery conducted a systematic review of the literature and used the RAND/UCLA Appropriateness Method to evaluate 1032 clinical scenarios across a range of risk profiles and comorbid conditions. Ratings were conducted over three rounds, including a moderated in-person meeting to refine and discuss appropriateness scores.RESULTSA minimally invasive approach, local anaesthesia alone, and conscious sedation were judged appropriate across most clinical scenarios. Invasive monitoring, such as placement of an additional arterial catheter or a central venous catheter, was recommended only in selected high-risk patients. Several approaches or interventions were consistently rated inappropriate across all evaluated scenarios, including nurse-administered anaesthesia, pulmonary artery catheterisation, and cardiac output monitoring using pulse wave analysis. Other approaches, such as general anaesthesia and deep sedation, were considered inappropriate in most cases but retained uncertainty in select clinical contexts. Several recommendations were rated as necessary to define a minimum standard of care.CONCLUSIONSThis Italian consensus statement provides practical, expert-driven recommendations to standardise anaesthetic care for transfemoral TAVI. While many recommendations reached strong consensus, areas of uncertainty remain, underscoring the need for further clinical research. Patient-centred, individualised decision-making remains essential, guided by institutional experience and procedural complexity.
{"title":"Management of anaesthesia transfemoral transcatheter aortic valve implantation: an Italian interdisciplinary consensus statement","authors":"Valentina Ajello, Stefano Fresilli, Filippo D'Amico, Giulia Franceschini, Tommaso Aloisio, Leonardo Gottin, Massimo Baiocchi, Fabio Guarracino, Pietro Bertini, Massimo Napodano, Mauro D'Amora, Ettore Panascia, Paolo Meani, Luca Weltert, Fabrizio Monaco, Marina Pieri, Fabio Sangalli, Cristina Santonocito, Simona Silvetti, Giovanni Landoni, Marco Ranucci, Sabino Scolletta, Gianluca Paternoster","doi":"10.1016/j.bja.2025.10.052","DOIUrl":"https://doi.org/10.1016/j.bja.2025.10.052","url":null,"abstract":"BACKGROUNDTransfemoral transcatheter aortic valve implantation (TAVI) is a minimally invasive treatment for patients with severe aortic stenosis who are at elevated surgical risk. Despite widespread use, optimal periprocedural anaesthetic management remains highly variable, and evidence-based guidance is lacking.METHODSAn interdisciplinary panel of Italian experts in anaesthesiology, cardiology, and cardiac surgery conducted a systematic review of the literature and used the RAND/UCLA Appropriateness Method to evaluate 1032 clinical scenarios across a range of risk profiles and comorbid conditions. Ratings were conducted over three rounds, including a moderated in-person meeting to refine and discuss appropriateness scores.RESULTSA minimally invasive approach, local anaesthesia alone, and conscious sedation were judged appropriate across most clinical scenarios. Invasive monitoring, such as placement of an additional arterial catheter or a central venous catheter, was recommended only in selected high-risk patients. Several approaches or interventions were consistently rated inappropriate across all evaluated scenarios, including nurse-administered anaesthesia, pulmonary artery catheterisation, and cardiac output monitoring using pulse wave analysis. Other approaches, such as general anaesthesia and deep sedation, were considered inappropriate in most cases but retained uncertainty in select clinical contexts. Several recommendations were rated as necessary to define a minimum standard of care.CONCLUSIONSThis Italian consensus statement provides practical, expert-driven recommendations to standardise anaesthetic care for transfemoral TAVI. While many recommendations reached strong consensus, areas of uncertainty remain, underscoring the need for further clinical research. Patient-centred, individualised decision-making remains essential, guided by institutional experience and procedural complexity.","PeriodicalId":9250,"journal":{"name":"British journal of anaesthesia","volume":"32 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2026-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145893893","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 : 2026-01-02DOI: 10.1016/j.bja.2025.11.047
Christopher J. Mullington, Giulia M.V. Iacona, Aimee R. Rolph, Hugo F.M. Manteigas, David A. Low, Paul H. Strutton
{"title":"The cutaneous sympathetic blockade associated with labour epidural analgesia. Response to Br J Anaesth 2026; 136: 388–9","authors":"Christopher J. Mullington, Giulia M.V. Iacona, Aimee R. Rolph, Hugo F.M. Manteigas, David A. Low, Paul H. Strutton","doi":"10.1016/j.bja.2025.11.047","DOIUrl":"https://doi.org/10.1016/j.bja.2025.11.047","url":null,"abstract":"","PeriodicalId":9250,"journal":{"name":"British journal of anaesthesia","volume":"11 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2026-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145893894","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 : 2026-01-02DOI: 10.1016/j.bja.2025.11.037
Berend Mets
{"title":"Bjørn Ibsen: intensive care and the conundrum of prolonging death","authors":"Berend Mets","doi":"10.1016/j.bja.2025.11.037","DOIUrl":"https://doi.org/10.1016/j.bja.2025.11.037","url":null,"abstract":"","PeriodicalId":9250,"journal":{"name":"British journal of anaesthesia","volume":"21 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2026-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145893895","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 : 2026-01-01DOI: 10.1016/j.bja.2025.09.039
Thomas W. Schnider , Charles F. Minto , Jamie W. Sleigh
{"title":"Association of intraoperative hypotension and cumulative norepinephrine dose with postoperative acute kidney injury in patients having noncardiac surgery: causal implications of the drug titration paradox. Br J Anaesth 2025; 134: 54–62","authors":"Thomas W. Schnider , Charles F. Minto , Jamie W. Sleigh","doi":"10.1016/j.bja.2025.09.039","DOIUrl":"10.1016/j.bja.2025.09.039","url":null,"abstract":"","PeriodicalId":9250,"journal":{"name":"British journal of anaesthesia","volume":"136 1","pages":"Pages 423-424"},"PeriodicalIF":9.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145404669","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 : 2026-01-01DOI: 10.1016/j.bja.2025.09.036
Xiaoxiao Li , Pan Chang , Wensheng Zhang
{"title":"Photoacoustic detection of propofol in breath gas for monitoring depth of anaesthesia: achieving clinical application. Comment on Br J Anaesth 2025; 135: 1203–11","authors":"Xiaoxiao Li , Pan Chang , Wensheng Zhang","doi":"10.1016/j.bja.2025.09.036","DOIUrl":"10.1016/j.bja.2025.09.036","url":null,"abstract":"","PeriodicalId":9250,"journal":{"name":"British journal of anaesthesia","volume":"136 1","pages":"Pages 420-422"},"PeriodicalIF":9.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145447390","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}
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