British journal of anaesthesia最新文献

英文中文

Accuracy of continuous glucose monitoring during noncardiac surgery: physiological dynamics, not just technological accuracy. Comment on Br J Anaesth 2025; 135: 912–9 非心脏手术期间连续血糖监测的准确性：生理动力学，而不仅仅是技术准确性。Br [J][研究][2025]；135: 912 - 9

IF 9.2 1区医学 Q1 ANESTHESIOLOGY

British journal of anaesthesia

Pub Date : 2026-01-01 DOI: 10.1016/j.bja.2025.09.033

Zheng Zhang , Yi Duan , HongYu Huo, YuZe Wang, Zhifeng Gao

引用次数: 0

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 非心脏手术患者术中低血压和累积去甲肾上腺素剂量与术后急性肾损伤的关系：药物滴定悖论的因果意义。生物工程学报，2025；134: 54 - 62

IF 9.2 1区医学 Q1 ANESTHESIOLOGY

British journal of anaesthesia

Pub Date : 2026-01-01 DOI: 10.1016/j.bja.2025.09.039

Thomas W. Schnider , Charles F. Minto , Jamie W. Sleigh

引用次数: 0

Photoacoustic detection of propofol in breath gas for monitoring depth of anaesthesia: achieving clinical application. Comment on Br J Anaesth 2025; 135: 1203–11 呼吸气体中异丙酚监测麻醉深度的光声检测：实现临床应用。Br [J][研究][2025]；135: 1203 - 11所示

IF 9.2 1区医学 Q1 ANESTHESIOLOGY

British journal of anaesthesia

Pub Date : 2026-01-01 DOI: 10.1016/j.bja.2025.09.036

Xiaoxiao Li , Pan Chang , Wensheng Zhang

引用次数: 0

The analgesic effects of novel fascial plane blocks compared with intrathecal morphine after Caesarean delivery: intrathecal long-acting opioids remain the gold standard. Comment on Br J Anaesth 2025; 134: 1415–31 剖宫产后新型筋膜平面阻滞与鞘内吗啡镇痛效果比较：鞘内长效阿片类药物仍是金标准。Br [J][研究][2025]；134: 1415 - 31所示。

IF 9.2 1区医学 Q1 ANESTHESIOLOGY

British journal of anaesthesia

Pub Date : 2026-01-01 DOI: 10.1016/j.bja.2025.09.057

Neel Desai , Ryan Howle , Eric Albrecht

引用次数: 0

Regional anaesthesia modalities for primary total hip arthroplasty. Comment on Br J Anaesth 2025; 135: 469–82 初次全髋关节置换术的区域麻醉方式。Br [J][研究][2025]；135: 469 - 82

IF 9.2 1区医学 Q1 ANESTHESIOLOGY

British journal of anaesthesia

Pub Date : 2026-01-01 DOI: 10.1016/j.bja.2025.10.042

Tuhin Mistry , Abhijit Sukumaran Nair

引用次数: 0

European Malignant Hyperthermia Group 2025 guidelines for the investigation of malignant hyperthermia susceptibility. 欧洲恶性热疗小组2025恶性热疗易感性调查指南。

IF 9.2 1区医学 Q1 ANESTHESIOLOGY

British journal of anaesthesia

Pub Date : 2026-01-01 DOI: 10.1016/j.bja.2025.11.006

Henrik Rüffert, Robyn Gillies, Philip M Hopkins, Klaus P E Glahn, Stephan Johannsen, Erik-Jan Kamsteeg, Anna Hellblom, Kathryn Stowell, Jonathan Bilmen, Martina Klincova, Thierry Girard

Since malignant hyperthermia (MH) was first described in 1960, the number of cases of this potentially life-threatening reaction to anaesthesia with fatal or serious outcomes has been markedly reduced thanks to continuous advances in knowledge about triggering, clinical course, and treatment. Another essential and evolving pillar of patient safety remains diagnostics, which serve to confirm or rule out suspected cases of MH and to identify other individuals at risk of MH for prevention. For more than 40 yr, the British Journal of Anaesthesia has published the updated consensus diagnostic protocols of the European Malignant Hyperthermia Group at regular intervals. The presented diagnostic guidelines have been comprehensively revised 10 yr after the last update after substantial advances in DNA-based testing methods. In addition to the previous classification of MH susceptibility by the in vitro halothane/caffeine contracture test, a new diagnostic designation, the MH genotype, has been introduced. The latter is reflected in the revised diagnostic pathways, which also include the adapted European Malignant Hyperthermia Group curation system for the classification of genetic variants with regard to their relevance to MH. In addition to minor changes in the in vitro halothane/caffeine contracture test protocol, the guidelines address updated patient referral criteria and clinical interpretation of diagnostic results. And for the first time, the guidelines provide a consensus definition of a clinical MH event.

自1960年首次描述恶性高热（MH）以来，由于对触发、临床过程和治疗的知识不断进步，这种可能危及生命的麻醉反应导致致命或严重后果的病例数量已显著减少。患者安全的另一个重要和不断发展的支柱是诊断，用于确认或排除MH疑似病例，并确定其他有MH风险的个体以进行预防。40多年来，《英国麻醉杂志》定期发表欧洲恶性热疗组的最新共识诊断方案。在基于dna的检测方法取得重大进展后，本诊断指南在上次更新10年后进行了全面修订。除了先前通过体外氟烷/咖啡因挛缩试验对MH易感性进行分类外，还引入了一种新的诊断名称——MH基因型。后者反映在修订后的诊断途径中，其中还包括改编的欧洲恶性热疗组管理系统，用于对与MH相关的遗传变异进行分类。除了体外氟烷/咖啡因挛缩试验方案的微小变化外，指南还涉及更新的患者转诊标准和诊断结果的临床解释。该指南首次对临床MH事件提供了一致的定义。

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引用次数: 0

Mitochondrial bioenergetics and intracellular calcium concentration in primary myotubes from mouse models of malignant hyperthermia 恶性高热小鼠原代肌管线粒体生物能量学和细胞内钙浓度

IF 9.2 1区医学 Q1 ANESTHESIOLOGY

British journal of anaesthesia

Pub Date : 2026-01-01 DOI: 10.1016/j.bja.2025.05.060

Vikas Kaura , Leon Chang , Philip Morgan Hopkins , Marie-Anne Shaw

Background

Malignant hyperthermia (MH) is a potentially fatal hypermetabolic reaction to general anaesthesia arising from skeletal muscle calcium dysregulation. Previous studies of resting cells support an association between MH susceptibility, mitochondrial dysfunction, and defects in fatty acid metabolism, which are understood to be downstream consequences of calcium dysregulation. We hypothesised that in mouse models of MH susceptibility, genotypes associated with higher cytoplasmic calcium concentrations would have a proportionally higher mitochondrial oxygen consumption rate (OCR). We aimed to test this and validate a cell-based assay system.

Methods

A high-throughput mitochondrial assay was used to compare OCR between myotubes derived from control and three different genotypes of mice containing ryanodine receptor 1 variants (p.G2435R heterozygous and homozygous, p.T4826I heterozygous) that confer susceptibility to MH.

Results

Baseline comparisons showed effects of genotype on OCR (P<0.0001), with Ryr1 p.G2435R homozygous myotubes having the highest basal normalised OCR (P<0.01). Ryr1 p.G2435R homozygous required a greater proportion of basal respiration to produce adenosine triphosphate (ATP), and had a higher proton leak and greater non-mitochondrial OCR (P<0.01). All genotypes except Ryr1 p.G2435R homozygous were primarily dependent on the glucose/pyruvate pathway for achieving their maximal OCR upon uncoupling.

Conclusions

The high-throughput method used produced data consistent with findings in skeletal muscle fibres, but with a greater sensitivity to genotypic effects. This validates the use of cultured myotubes in lieu of muscle fibres in studying mitochondrial bioenergetics in models of MH, and indicates that mitochondrial bioenergetics are not directly affected by myoplasmic calcium concentrations in young MH mice.

恶性高热（MH）是由骨骼肌钙调节失调引起的全身麻醉的潜在致命的高代谢反应。先前对静息细胞的研究支持MH易感性、线粒体功能障碍和脂肪酸代谢缺陷之间的关联，而脂肪酸代谢缺陷被认为是钙失调的下游后果。我们假设，在MH易感性小鼠模型中，与较高细胞质钙浓度相关的基因型将按比例增加线粒体耗氧率（OCR）。我们的目标是测试这一点，并验证一个基于细胞的分析系统。

{"title":"Mitochondrial bioenergetics and intracellular calcium concentration in primary myotubes from mouse models of malignant hyperthermia","authors":"Vikas Kaura , Leon Chang , Philip Morgan Hopkins , Marie-Anne Shaw","doi":"10.1016/j.bja.2025.05.060","DOIUrl":"10.1016/j.bja.2025.05.060","url":null,"abstract":"<div><h3>Background</h3><div>Malignant hyperthermia (MH) is a potentially fatal hypermetabolic reaction to general anaesthesia arising from skeletal muscle calcium dysregulation. Previous studies of resting cells support an association between MH susceptibility, mitochondrial dysfunction, and defects in fatty acid metabolism, which are understood to be downstream consequences of calcium dysregulation. We hypothesised that in mouse models of MH susceptibility, genotypes associated with higher cytoplasmic calcium concentrations would have a proportionally higher mitochondrial oxygen consumption rate (OCR). We aimed to test this and validate a cell-based assay system.</div></div><div><h3>Methods</h3><div>A high-throughput mitochondrial assay was used to compare OCR between myotubes derived from control and three different genotypes of mice containing ryanodine receptor 1 variants (p.G2435R heterozygous and homozygous, p.T4826I heterozygous) that confer susceptibility to MH.</div></div><div><h3>Results</h3><div>Baseline comparisons showed effects of genotype on OCR (<em>P</em><0.0001), with <em>Ryr1</em> p.G2435R homozygous myotubes having the highest basal normalised OCR (<em>P</em><0.01). <em>Ryr1</em> p.G2435R homozygous required a greater proportion of basal respiration to produce adenosine triphosphate (ATP), and had a higher proton leak and greater non-mitochondrial OCR (<em>P</em><0.01). All genotypes except <em>Ryr1</em> p.G2435R homozygous were primarily dependent on the glucose/pyruvate pathway for achieving their maximal OCR upon uncoupling.</div></div><div><h3>Conclusions</h3><div>The high-throughput method used produced data consistent with findings in skeletal muscle fibres, but with a greater sensitivity to genotypic effects. This validates the use of cultured myotubes in lieu of muscle fibres in studying mitochondrial bioenergetics in models of MH, and indicates that mitochondrial bioenergetics are not directly affected by myoplasmic calcium concentrations in young MH mice.</div></div>","PeriodicalId":9250,"journal":{"name":"British journal of anaesthesia","volume":"136 1","pages":"Pages 333-342"},"PeriodicalIF":9.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144899248","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}

引用次数: 0

Association of loneliness and social isolation with postoperative outcomes: a retrospective registry study 孤独感和社会隔离与术后预后的关系：一项回顾性登记研究。

IF 9.2 1区医学 Q1 ANESTHESIOLOGY

British journal of anaesthesia

Pub Date : 2026-01-01 DOI: 10.1016/j.bja.2025.09.004

Kaylyssa Philip , Amber Jolly , Calvin Diep , Rachel D. Savage , Duminda N. Wijeysundera , Christopher Witiw , Karim S. Ladha

Background

Loneliness and social isolation are highly prevalent public health concerns. However, their impacts in acute care settings such as the postoperative period are unclear. This study explored whether loneliness, social isolation, or both are associated with a primary composite outcome of 30-day major postoperative complication, 30-day postoperative emergency admission, and 90-day mortality.

Methods

This retrospective cohort study used the UK Biobank. Individuals with complete loneliness and social isolation data, an eligible surgery within 1 yr of baseline, and national health registry linkage were included. Loneliness and social isolation were defined with validated, self-reported measures. Participants were stratified into four groups by baseline loneliness and social isolation status. Logistic regression models assessed associations between loneliness–social isolation groups and postoperative outcomes with comprehensive covariate adjustment.

Results

Some 27 905 UK Biobank participants met eligibility criteria. Individuals who were socially isolated but not lonely had increased odds of the primary outcome (adjusted odds ratio 1.36, 95% confidence interval 1.10–1.68, P=0.004), mainly driven by higher odds of 30-day major postoperative complication (odds ratio 1.35, 95% confidence interval 1.04–1.72, P=0.018). In a subgroup analysis, this association remained statistically significant in males but not females.

Conclusions

Individuals, particularly males, who were socially isolated but not lonely had increased odds of postoperative complications. Our results are consistent with other reports that loneliness and social isolation are weakly correlated, and that social isolation is more consistently associated with adverse physical outcomes. These findings suggest that targeted, interventional programmes addressing social isolation in surgical patients might assist in mitigating postoperative risks.

背景：孤独和社会隔离是非常普遍的公共卫生问题。然而，它们在急性护理环境（如术后）中的影响尚不清楚。本研究探讨了孤独、社会隔离或两者是否与30天主要术后并发症、30天术后急诊住院和90天死亡率的主要综合结局相关。方法回顾性队列研究使用英国生物库。具有完整的孤独和社会隔离数据、基线1年内合格手术和国家健康登记联系的个体被纳入研究。孤独和社会孤立是通过有效的、自我报告的测量来定义的。参与者根据基线孤独感和社会隔离状态分为四组。通过综合协变量调整，Logistic回归模型评估了孤独-社会隔离组与术后预后之间的关系。结果27905名英国生物银行参与者符合资格标准。社会隔离但不孤独的个体主要结局的发生率增加（校正优势比1.36,95%可信区间1.10 ~ 1.68，P=0.004），主要是由于术后30天主要并发症的发生率较高（优势比1.35,95%可信区间1.04 ~ 1.72，P=0.08）。在亚组分析中，这种关联在男性中仍然具有统计学意义，但在女性中没有。结论社会孤立但不孤独的个体，尤其是男性，术后并发症的发生率增加。我们的研究结果与其他报告一致，即孤独和社会孤立之间存在弱相关性，而社会孤立与不良的身体结果之间的关系更为一致。这些发现表明，针对手术患者社会隔离的有针对性的介入方案可能有助于减轻术后风险。

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引用次数: 0

Vasoplegia and cardiopulmonary bypass: role of oxidation-reduction dysregulation as a mechanism and therapeutic target 血管截瘫和体外循环：氧化还原失调作为机制和治疗靶点的作用。

IF 9.2 1区医学 Q1 ANESTHESIOLOGY

British journal of anaesthesia

Pub Date : 2026-01-01 DOI: 10.1016/j.bja.2025.10.023

Bruce D. Spiess

Vasoplegia is a leading cause of morbidity and mortality after cardiopulmonary bypass. Current treatments are not improving outcomes. Use of hydroxocobalamin (vitamin B-12) is a novel approach to increase perfusion pressure. Zakaria and colleagues demonstrate its efficacy, although it is not universal. The mechanisms by which vitamin B-12 works merit understanding and investigation. Vitamin B-12 is an antioxidant that protects proteins, DNA, and lipids from attack by the unpaired electrons of free radicals. The observations that vitamin B-12 and other antioxidants, including ascorbic acid and methylene blue, all partially treat vasoplegia should signal to cardiac teams that focused research on the effects of oxidation-reduction dysregulation by inflammation needs further exploration.

血管截瘫是体外循环术后发病率和死亡率的主要原因。目前的治疗并没有改善结果。使用羟钴胺素（维生素B-12）是一种增加灌注压的新方法。扎卡里亚和他的同事证明了它的有效性，尽管它并不普遍。维生素B-12的作用机制值得理解和研究。维生素B-12是一种抗氧化剂，可以保护蛋白质、DNA和脂质免受自由基不成对电子的攻击。观察到维生素B-12和其他抗氧化剂，包括抗坏血酸和亚甲基蓝，都能部分治疗血管麻痹，这应该给那些专注于炎症引起的氧化还原失调影响研究的心脏团队一个信号，需要进一步探索。

引用次数: 0

Robotic process automation to identify patients at high risk for perioperative myocardial infarction or injury. Response to Br J Anesth 2025; 135: 1868–9 机器人过程自动化识别围手术期心肌梗死或损伤高危患者。对Br J esth 2025的响应；135: 1868 - 9

IF 9.2 1区医学 Q1 ANESTHESIOLOGY

British journal of anaesthesia

Pub Date : 2026-01-01 DOI: 10.1016/j.bja.2025.10.044

Koray Durak , Christian Puelacher , Danielle Menosi Gualandro , Christian Mueller

引用次数: 0

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