British journal of anaesthesia
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Editorial Historical Article
Professor John F. Nunn: scientist, anaesthetist and polymath.
John Francis Nunn (1925-2022) was an anaesthetist and clinical scientist who used his incomprehension of the science of anaesthesia in his early career to guide an extensive lifetime of innovative research. His interests outside of medicine led to him developing renowned expertise in such diverse areas as Egyptian hieroglyphs and the origins of the Earth's atmosphere. He was an outstanding communicator, writing four books alongside an impressive number of papers covering diverse topics from cell biology to history. His greatest contribution is in the understanding of respiratory physiology during anaesthesia which continues to underpin current routine anaesthetic practice and patient safety.
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Pain after paediatric appendectomy and tonsillectomy is often undertreated. Benchmarking of hospitals could reveal which measures are associated with improved patient- or parent-reported pain-related outcomes. ⋯ clinicaltrials.gov NCT02083835.
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Prehabilitation, or multimodality patient optimisation before major treatment, has demonstrated meaningful improvements in patients' outcomes. In the setting of lung cancer surgery, postoperative complications and length of hospital stay are reduced, but there is currently limited access to prehabilitation. Prehab4Cancer (P4C) is an innovative regional programme serving all areas of Greater Manchester (GM). ⋯ The P4C programme demonstrated feasibility at scale, high uptake, and promising impact on the status of patients with lung cancer before surgery. P4C is the first regional prehabilitation service internationally, and this evaluation provides a framework for implementing similar services in other regions.
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Over the 90 years since the first description of one-lung ventilation, the practice of thoracic surgery and anaesthesia continues to develop. Minimally invasive surgical techniques are increasingly being used to minimise the surgical insult and facilitate improved outcomes. Challenging these outcomes, however, are parallel changes in patient characteristics with more older and sicker patients undergoing surgery. Thoracic anaesthesia as a speciality continues to respond to these challenges with evolution of practice and strong academic performance.
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Chemotherapy-induced peripheral neuropathy (CIPN) is a debilitating condition impacting 30% of cancer survivors. This study is the first to explore whether a brain-based vulnerability to chronic sensory CIPN exists. ⋯ Before administration of any chemotherapy or appearance of CIPN symptoms, we observed altered patterns of brain activity in response to nociceptive stimulation in patients who later developed chronic sensory CIPN. This suggests the possibility of a pre-existing vulnerability to developing CIPN centred on brainstem regions of the descending pain modulatory system.