British journal of anaesthesia最新文献

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Contemporary local anaesthetic-associated adverse events and mortality: searching for the root causes of the pharmacovigilance signal. Br J Anaesth 2026;136:411–13 当代局麻相关的不良事件和死亡率：寻找药物警戒信号的根本原因。中国机械工程学报，2015,35(5):493- 493。doi: 10.1016 / j.bja.2025.06.044b

IF 9.2 1区医学 Q1 ANESTHESIOLOGY

British journal of anaesthesia

Pub Date : 2026-01-01 DOI: 10.1016/j.bja.2025.09.044

Emanuel Raschi , Tommaso Tonetti , Charles Khouri , Elisabetta Poluzzi , Fabrizio De Ponti

引用次数: 0

Cerebellar vermis and somatosensory–motor cortex differentially contribute to sex differences in acute pain perception in rats 小脑蚓部和体感运动皮层对大鼠急性疼痛感知的性别差异有不同的影响

IF 9.2 1区医学 Q1 ANESTHESIOLOGY

British journal of anaesthesia

Pub Date : 2026-01-01 DOI: 10.1016/j.bja.2025.09.016

Xingxing Liu , Ran Sun , Kun Zhang , Xiaoyu Xie , Xia Wu , Bingwen Zheng , Yingkun Guo , Lizhi Zhang , Wensheng Zhang

Background

Pain is a universal experience, yet sex differences in acute pain perception remain unclear. Here, we examined sex-specific brain responses to acute pain evoked by tail clamping in rats.

Methods

A suitable isoflurane concentration for resting-state functional magnetic resonance imaging (rs-fMRI) was identified to ensure sedation without suppressing nociceptive responsiveness. rs-fMRI was performed to assess sex differences in brain activity and functional connectivity during acute pain, with control groups receiving touch stimulation or isoflurane-only exposure to identify pain-specific activation. The fMRI findings were validated using immunofluorescence staining of sex-specifically activated brain regions and spinal cord and corresponding dorsal root ganglia.

Results

Acute pain significantly altered brain functional networks in both sexes. Female rats exhibited increased brain activity in the left cerebellar vermis, whereas males showed higher activity in the left secondary motor cortex (M2), extending into the left hindlimb (S1HL) and barrel field (S1BF) regions of the primary somatosensory cortex, a pattern distinct from non-nociceptive conditions. Functional connectivity revealed weak connections between the cerebellar vermis and somatosensory–motor cortex (M2, S1HL, and S1BF) in both sexes. Within the somatosensory–motor cortex, females showed strongest connectivity between S1HL and M2 (R=0.66), whereas males showed it between S1HL and S1BF (R=0.87). Immunostaining confirmed increased c-Fos and Egr-1 expression in sex-specific activated brain regions and in the spinal cord and dorsal root ganglion.

Conclusions

Differences in the activity and functional connectivity of the cerebellar vermis and somatosensory–motor cortex appear to contribute to sex differences in pain perception in rodents.

疼痛是一种普遍的体验，但急性疼痛感知的性别差异尚不清楚。在这里，我们研究了大鼠对夹尾引起的急性疼痛的性别特异性脑反应。方法确定静息状态功能磁共振成像（rs-fMRI）的合适异氟醚浓度，以确保镇静作用不抑制伤害性反应。采用磁共振成像（rs-fMRI）来评估急性疼痛期间大脑活动和功能连通性的性别差异，对照组接受触摸刺激或仅暴露于异氟醚以确定疼痛特异性激活。fMRI结果通过免疫荧光染色对性别特异性激活的脑区和脊髓以及相应的背根神经节进行验证。结果急性疼痛显著改变了两性的脑功能网络。雌性大鼠表现出左侧小脑蚓部的活动增加，而雄性大鼠表现出左侧次级运动皮层（M2）的活动增加，并延伸到左侧后肢（S1HL）和初级体感皮层的桶区（S1BF）区域，这种模式与非伤害性条件不同。功能连接显示两性小脑蚓部和体感觉运动皮层（M2、S1HL和S1BF）之间的连接较弱。在体感运动皮层中，女性的S1HL与M2之间的连通性最强（R=0.66），而男性的S1HL与S1BF之间的连通性最强（R=0.87）。免疫染色证实c-Fos和Egr-1在性别特异性激活的脑区以及脊髓和背根神经节中的表达增加。结论啮齿动物小脑蚓部和体感运动皮层的活性和功能连通性的差异可能是造成疼痛感知性别差异的原因之一。

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引用次数: 0

Viscoelastic coagulation testing in bleeding trauma patients: a retrospective analysis and development of a treatment algorithm 出血创伤患者的粘弹性凝血试验：一种治疗算法的回顾性分析和发展

IF 9.2 1区医学 Q1 ANESTHESIOLOGY

British journal of anaesthesia

Pub Date : 2026-01-01 DOI: 10.1016/j.bja.2025.09.040

Nikolaus Hofmann , Herbert Schöchl , Daniel Oberladstätter , Johannes Zipperle , Felix Schmitt , Maik von der Forst , Carlo Martin , Johannes Gratz

Background

Viscoelastic coagulation testing (VET) is a key tool for the early diagnosis and treatment of trauma-induced coagulopathy. However, differences exist between VET technologies. Our aim was to identify viscoelastic test thresholds for the ClotPro® analyser, and propose an approach to establishing a VET algorithm for the early management of trauma patients that aligns with current guidelines.

Methods

ClotPro® data were collected from trauma patients upon arrival, during surgical care, and throughout their ICU stay. Standard coagulation tests including prothrombin time index <70% or international normalised ratio >1.2, fibrinogen concentration <150 mg dl⁻¹, and platelet count <50 and <100 G L⁻¹ were compared with ClotPro® parameters from the extrinsically activated thromboelastometric test (EX-Test) and extrinsically activated test plus cytochalasin and tirofiban (FIB-Test), including clotting time, clot amplitude at 5 and 10 min running time (CA5/CA10), maximum clot firmness, and platelet contribution to clot firmness. On the basis of these data, we developed an algorithm for the early treatment of trauma-induced coagulopathy.

Results

We included 375 patients (67.8% male) with a median injury severity score of 16 (interquartile range, 9–27). Receiver operating characteristic curve analysis for detecting an international normalised ratio >1.2 using EX-Test clotting time yielded an area under the receiver operating characteristic curve (AUC) of 0.71. Detection of fibrinogen <150 mg dl⁻¹ using FIB-Test CA5 showed an AUC of 0.96. Platelet counts <50 and <100 G L⁻¹ were detected by CA5-derived platelet contribution, with AUCs of 0.93 and 0.94, respectively.

Conclusions

These ClotPro® cut-off values allow for early and reliable detection of hypofibrinogenaemia and thrombocytopenia. Only after correction of fibrinogen and platelet deficits should prolonged CT be considered a weak marker for the augmentation of coagulation factors.

背景：粘弹性凝血试验（VET）是创伤性凝血病早期诊断和治疗的重要工具。然而，职业教育技术之间存在差异。我们的目的是确定ClotPro®分析仪的粘弹性测试阈值，并提出一种方法来建立一个符合当前指南的创伤患者早期管理的VET算法。方法收集创伤患者入院时、手术期间和ICU住院期间的sclotpro数据。标准凝血试验包括凝血酶原时间指数<；70%或国际标准化比率>；1.2，纤维蛋白原浓度<；150 mg dl - 1，血小板计数<；50和<；100 G L - 1，与ClotPro®参数进行比较，这些参数来自外部激活的血栓弹性试验（EX-Test）和外部激活试验加细胞松弛素和替罗非班（FIB-Test），包括凝血时间，运行时间5和10分钟时的凝块振幅（CA5/CA10），最大凝块硬度，以及血小板对凝块硬度的贡献。在这些数据的基础上，我们开发了一种早期治疗创伤性凝血病的算法。结果纳入375例患者（67.8%为男性），损伤严重程度中位数评分为16（四分位数范围9-27）。使用EX-Test凝血时间检测国际标准化比率>；1.2的受试者工作特征曲线分析得出受试者工作特征曲线（AUC）下面积为0.71。使用FIB-Test CA5检测纤维蛋白原150 mg dl−1，AUC为0.96。ca5衍生血小板贡献检测血小板计数<；50和<；100 G L−1，auc分别为0.93和0.94。结论ClotPro的临界值可用于低纤维蛋白原血症和血小板减少症的早期可靠检测。只有在纠正了纤维蛋白原和血小板缺陷后，延长的CT才能被认为是凝血因子增强的弱标志。

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引用次数: 0

Development and validation of a mobile application for the Green Anaesthesia Calculator 开发和验证绿色麻醉计算器的移动应用程序。

IF 9.2 1区医学 Q1 ANESTHESIOLOGY

British journal of anaesthesia

Pub Date : 2026-01-01 DOI: 10.1016/j.bja.2025.09.051

Aditi Suri

引用次数: 0

Corrigendum to ‘Association of sugammadex, neostigmine, or pyridostigmine for reversal of neuromuscular block with postoperative bradycardia: a multicentre, retrospective observational study’ (Br J Anaesth 2025; 135: 1007–14) “糖玛德、新斯的明或吡地斯的明用于逆转术后心动过缓的神经肌肉阻滞的关联：一项多中心、回顾性观察研究”的更正（中国医学杂志，2025;135:1007-14）。

IF 9.2 1区医学 Q1 ANESTHESIOLOGY

British journal of anaesthesia

Pub Date : 2026-01-01 DOI: 10.1016/j.bja.2025.10.021

Hye-Bin Kim , Ah-Ran Oh , Jungchan Park , Heezoo Kim , Hyo Sung Kim , Dong Ju Lee , In Jung Kim , Jaeyeon Chung , Youn Joung Cho , Yunseok Jeon , Jae-Woo Ju , Karam Nam , for the Seoul PeRioperative OUTcome Research-1 (SPROUT-1) Group Investigators

引用次数: 0

Managing obstetric anaesthesia during wartime: strategic lessons from the June 2025 Israeli hospital response 战时产科麻醉管理：2025年6月以色列医院应对措施的战略教训

IF 9.2 1区医学 Q1 ANESTHESIOLOGY

British journal of anaesthesia

Pub Date : 2026-01-01 DOI: 10.1016/j.bja.2025.10.028

Tomer Talmy , Ayelet Dangot , Idit Matot , Boris Aptekman , Chaim Greenberger , Carolyn F. Weiniger

引用次数: 0

Retrospective comparison of three tubeless airway management strategies for endoscopic dilation of benign subglottic stenosis 内镜下良性声门下狭窄扩张的三种无管气道管理策略的回顾性比较

IF 9.2 1区医学 Q1 ANESTHESIOLOGY

British journal of anaesthesia

Pub Date : 2026-01-01 DOI: 10.1016/j.bja.2025.10.013

Kris R. Wiendels , Louise C. Oskam , Lucas T. van Eijk , Raymond A.B. van der Wal , Jimmie Honings

引用次数: 0

Preoperative risk prediction of major cardiovascular events in noncardiac surgery using the 12-lead electrocardiogram: limitations in database-derived risk prediction. Comment on Br J Anaesth; 2025; 135: 1161–71 使用12导联心电图预测非心脏手术中主要心血管事件的术前风险：数据库衍生风险预测的局限性[J]；2025年;135: 1161 - 71

IF 9.2 1区医学 Q1 ANESTHESIOLOGY

British journal of anaesthesia

Pub Date : 2026-01-01 DOI: 10.1016/j.bja.2025.10.043

Shohei Ono

引用次数: 0

Erector spinae plane block versus paravertebral block for major oncological breast surgery. Comment on Br J Anaesth 2025; 135: 772–8 竖脊肌平面阻滞与椎旁阻滞在乳腺肿瘤大手术中的应用。Br [J][研究][2025]；135: 772 - 8

IF 9.2 1区医学 Q1 ANESTHESIOLOGY

British journal of anaesthesia

Pub Date : 2026-01-01 DOI: 10.1016/j.bja.2025.10.040

Zhuocheng Bao

引用次数: 0

Erratum to ‘Anticoagulation during extracorporeal membrane oxygenation: questioning the current standards in balancing the risks of thrombosis and bleeding’ (Br J Anaesth 2025; 135: 1363-65) “体外膜氧合抗凝：对现有血栓和出血风险平衡标准的质疑”[J] .中华医学杂志，2015;35:1363-1365。

IF 9.2 1区医学 Q1 ANESTHESIOLOGY

British journal of anaesthesia

Pub Date : 2026-01-01 DOI: 10.1016/j.bja.2025.10.035

Johannes Gratz , Hergen Buscher , Eva Schaden

引用次数: 0

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