British journal of anaesthesia最新文献

{"title":"Vasopressor use after noncardiac surgery. Comment on Br J Anaesth 2025; 135: 1609–17","authors":"Yimamujiang Aximu , Xuping Zhang , Peipei Zhang","doi":"10.1016/j.bja.2025.12.034","DOIUrl":"10.1016/j.bja.2025.12.034","url":null,"abstract":"","PeriodicalId":9250,"journal":{"name":"British journal of anaesthesia","volume":"136 3","pages":"Pages 1051-1052"},"PeriodicalIF":9.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146032853","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}

{"title":"Prophylactic norepinephrine infusion to reduce severe hypotension during induction of anaesthesia in patients undergoing cardiac surgery: a randomised controlled single-centre clinical trial","authors":"Come Gaillard ,&nbsp;Lea Breul ,&nbsp;Adrien Foucher ,&nbsp;Jean-Christophe Rigal ,&nbsp;Charles-Henri David ,&nbsp;Fouzia Souab ,&nbsp;Manon Canevet ,&nbsp;Mael Ryan ,&nbsp;Arthur Bailly ,&nbsp;Hélène Morin ,&nbsp;Julien Cadiet ,&nbsp;Cloé Geay ,&nbsp;Bertrand Rozec ,&nbsp;Mickael Vourc’h","doi":"10.1016/j.bja.2025.10.055","DOIUrl":"10.1016/j.bja.2025.10.055","url":null,"abstract":"<div><h3>Background</h3><div>The EPITUBE trial aimed to determine whether a prophylactic infusion of norepinephrine reduced severe hypotension after induction of general anaesthesia and tracheal intubation in patients undergoing cardiac surgery.</div></div><div><h3>Methods</h3><div>We performed a randomised controlled single-centre clinical trial including patients undergoing cardiac surgery. In the experimental group, infusion of norepinephrine started from the start of preoxygenation at an infusion rate of 0.06 μg kg⁻¹ min⁻¹, secondarily titrated to maintain mean arterial pressure (MAP) between 65 and 80 mm Hg. In the control group, ephedrine was administered if MAP decreased &lt;65 mm Hg. Primary outcome was the occurrence of MAP &lt;55 mm Hg. Secondary measures included tracheal intubation-related complications, postoperative complications, duration of ICU stay, and mortality.</div></div><div><h3>Results</h3><div>Of 210 patients randomised and analysed in the intention-to-treat analysis, the incidence of severe hypotension was not different between the groups: 43.8% in the norepinephrine group <em>vs</em> 44.8% in the control group (odds ratio 0.96, 95% confidence interval [CI] 0.56–1.66, <em>P</em>=0.99). The incidence of MAP &lt;65 mm Hg was lower in the norepinephrine group than in the control group: 63.8% <em>vs</em> 78.1% (odds ratio 0.49, 95% CI 0.26–0.90, <em>P</em>=0.02). The rate of intubation-related complications was not different between the norepinephrine and control groups, 22.9% <em>vs</em> 32.4%, respectively (odds ratio 0.62, 95% CI 0.33–1.14, <em>P</em>=0.13). There was no difference in postoperative outcomes including acute kidney injury, time on ventilator, or length of stay in the ICU.</div></div><div><h3>Conclusions</h3><div>In patients undergoing cardiac surgery, infusion of norepinephrine before general anaesthesia at a starting dose of 0.06 μg kg⁻¹ min⁻¹ did not reduce severe hypotension compared with on-demand ephedrine.</div></div><div><h3>Clinical trial registration</h3><div>ClinicalTrials.gov Identifier: NCT05335954.</div></div>","PeriodicalId":9250,"journal":{"name":"British journal of anaesthesia","volume":"136 3","pages":"Pages 856-864"},"PeriodicalIF":9.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145728516","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}

{"title":"Preoxygenation with high-flow nasal oxygen at various flow rates in elective surgical patients: a prospective, randomised, single-blind clinical trial","authors":"Albin Sjöblom ,&nbsp;Frida Hoffman ,&nbsp;Magnus Hedberg ,&nbsp;Ida-Maria Forsberg ,&nbsp;Malin Jonsson Fagerlund","doi":"10.1016/j.bja.2025.11.017","DOIUrl":"10.1016/j.bja.2025.11.017","url":null,"abstract":"<div><h3>Background</h3><div>High-flow nasal oxygen (HFNO) is increasingly used for preoxygenation. Previous studies of preoxygenation have explored flow rates below 60 L min⁻¹. This study aimed to compare different HFNO flow rates during preoxygenation to identify the most effective flow rate for clinical use.</div></div><div><h3>Methods</h3><div>This randomised trial included patients aged 18–84 yr of ASA physical status 1–3 scheduled for elective surgery. Preoxygenation was conducted using HFNO at randomised flow rates of 45, 70, or 95 L min⁻¹. After preoxygenation, patients rated their level of preoxygenation-related discomfort. HFNO was discontinued at apnoea start. After intubation, apnoea was maintained until Sp<span>o</span>₂ reached 93%. Primary outcome was apnoea time until Sp<span>o</span>₂=93%. Secondary outcomes were Pa<span>o</span>₂ levels during preoxygenation and preoxygenation-related discomfort.</div></div><div><h3>Results</h3><div>Of 72 participants included in the final analysis, baseline characteristics were similar and the mean duration of preoxygenation was 250 s in all three groups. Apnoea times did not differ, with median durations of 472, 523, and 483 s for 45, 70, and 95 L min⁻¹, respectively (<em>P</em>=0.59). At apnoea onset, 95 L min⁻¹ produced higher Pa<span>o</span>₂ than 45 L min⁻¹. No other differences in Pa<span>o</span>₂ were observed during preoxygenation. The level of discomfort was lower for 45 L min⁻¹ compared with 70 and 95 L min⁻¹.</div></div><div><h3>Conclusions</h3><div>There was no difference in the safe apnoea time between preoxygenation with the three flow rates. As 45 L min⁻¹ generated the least discomfort while providing preoxygenation effectiveness comparable with higher flow rates, increasing preoxygenation flow rate from 45 to 70 L min⁻¹ will likely not prolong safe apnoea time.</div></div><div><h3>Clinical trial registration</h3><div>NCT 06736132.</div></div>","PeriodicalId":9250,"journal":{"name":"British journal of anaesthesia","volume":"136 3","pages":"Pages 983-990"},"PeriodicalIF":9.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145784513","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}

{"title":"Optimisation of volatile anaesthetic capture efficiency by reducing system loss: a prospective observational study","authors":"Andrew Goddard,&nbsp;Sarah Cross,&nbsp;John Cafferkey","doi":"10.1016/j.bja.2025.11.048","DOIUrl":"10.1016/j.bja.2025.11.048","url":null,"abstract":"","PeriodicalId":9250,"journal":{"name":"British journal of anaesthesia","volume":"136 3","pages":"Pages 1030-1032"},"PeriodicalIF":9.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145877826","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}

{"title":"Bupivacaine pharmacokinetics in the absence or presence of perineural dexamethasone in axillary block: an exploratory trial","authors":"Daniela Bravo ,&nbsp;Germán Aguilera ,&nbsp;Ady Giordano ,&nbsp;Sebastián Layera ,&nbsp;Hans Erpel ,&nbsp;Diego Mora ,&nbsp;Carla Ramírez ,&nbsp;Álvaro Jara ,&nbsp;Julián Aliste","doi":"10.1016/j.bja.2025.12.009","DOIUrl":"10.1016/j.bja.2025.12.009","url":null,"abstract":"<div><h3>Clinical trial registration</h3><div>NCT05359731</div></div>","PeriodicalId":9250,"journal":{"name":"British journal of anaesthesia","volume":"136 3","pages":"Pages 1090-1092"},"PeriodicalIF":9.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145993080","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}

{"title":"Difficult Airway Society 2025 guidelines for the management of unanticipated difficult tracheal intubation in adults: sugammadex is not a prehospital airway rescue strategy. Comment on Br J Anaesth 2026; 136: 283–307","authors":"Roman Sýkora ,&nbsp;Jiří Chvojka ,&nbsp;Metoděj Renza ,&nbsp;František Duška","doi":"10.1016/j.bja.2025.12.042","DOIUrl":"10.1016/j.bja.2025.12.042","url":null,"abstract":"","PeriodicalId":9250,"journal":{"name":"British journal of anaesthesia","volume":"136 3","pages":"Pages 1042-1043"},"PeriodicalIF":9.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145993037","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}

{"title":"Use of smart glasses imaging for interscalene brachial plexus block: adopting new technology into the workplace. Response to Br J Anaesth 2026; 136: 750-1","authors":"Lingling Jiang ,&nbsp;Liu Ping","doi":"10.1016/j.bja.2025.12.050","DOIUrl":"10.1016/j.bja.2025.12.050","url":null,"abstract":"","PeriodicalId":9250,"journal":{"name":"British journal of anaesthesia","volume":"136 3","pages":"Pages 1078-1079"},"PeriodicalIF":9.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146056081","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}

{"title":"Desflurane vapouriser leak undetected by an automated pre-use check system","authors":"Katsuhide Masui,&nbsp;Kei Takahashi,&nbsp;Takero Arai,&nbsp;Yasuhisa Okuda,&nbsp;Takashi Asai","doi":"10.1016/j.bja.2025.11.050","DOIUrl":"10.1016/j.bja.2025.11.050","url":null,"abstract":"","PeriodicalId":9250,"journal":{"name":"British journal of anaesthesia","volume":"136 3","pages":"Pages 1038-1039"},"PeriodicalIF":9.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145888683","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}

{"title":"Red cell distribution width does not improve prediction of postsurgical infectious complications","authors":"Nikki de Mul ,&nbsp;Gabriele Mondelli ,&nbsp;Lisette M. Vernooij ,&nbsp;Saskia Haitjema ,&nbsp;Willem-Jan M. Schellekens ,&nbsp;Johannes B. Reitsma ,&nbsp;Olaf L. Cremer","doi":"10.1016/j.bja.2025.11.040","DOIUrl":"10.1016/j.bja.2025.11.040","url":null,"abstract":"","PeriodicalId":9250,"journal":{"name":"British journal of anaesthesia","volume":"136 3","pages":"Pages 1009-1011"},"PeriodicalIF":9.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145877881","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}

{"title":"Erector spinae plane block versus paravertebral block for major oncological breast surgery. Response to Br J Anaesth 2025; 135: 1858–9","authors":"Julien Raft ,&nbsp;Sylvain Dureau ,&nbsp;Anne-Sophie Lamotte ,&nbsp;Aline Albi-Feldzer","doi":"10.1016/j.bja.2025.11.043","DOIUrl":"10.1016/j.bja.2025.11.043","url":null,"abstract":"","PeriodicalId":9250,"journal":{"name":"British journal of anaesthesia","volume":"136 3","pages":"Pages 1071-1073"},"PeriodicalIF":9.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145897235","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}