British journal of anaesthesia
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Randomized Controlled Trial Multicenter Study
From pain level to pain experience: redefining acute pain assessment to enhance understanding of chronic postsurgical pain.
Chronic postsurgical pain (CPSP) significantly impairs quality of life and poses a substantial healthcare burden, affecting up to a quarter of patients undergoing surgery. Although acute pain is recognised as a predictor for CPSP development, the role of patient experience remains underexplored. This study examines the predictive value of patient experience alongside traditional risk factors for CPSP after orthopaedic surgery. ⋯ This study underscores the role of patient-reported outcomes, specifically the pain experience dimension captured by the EVAN-G scale, in prediction of CPSP 90 days after surgery. It suggests a shift from conventional assessments of pain intensity to a comprehensive understanding of pain experience, advocating for tailored pain management approaches that could reduce chronic pain, thereby improving patient quality of life and functional recovery.
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Multicenter Study
Characterisation of older patients that require, but do not undergo, emergency laparotomy: a multicentre cohort study.
Older adults (≥65 yr) account for the majority of emergency laparotomies in the UK and are well characterised with reported outcomes. In contrast, there is limited knowledge on those patients that require emergency laparotomy but do not undergo surgery (NoLaps). ⋯ ISRCTN14556210.
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Pregnancy adds challenges for healthcare professionals, regardless of gender. We investigated experiences during pregnancy, attitudes towards pregnant colleagues, family planning decisions, and awareness of regulations among European anaesthesiologists and intensivists. ⋯ Improved support and working environments for pregnant colleagues and ability to express preferred clinical areas for work are needed. Department heads should commit to safety and family friendliness, and men transitioning to parenthood should not be neglected.
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Analgesia is an important effect of volatile anaesthetics, for which the spinal cord is a critical neural target. However, how supraspinal mechanisms modulate analgesic potency of volatile anaesthetics is not clear. We investigated the contribution of the central amygdala (CeA) to the analgesic effects of isoflurane and sevoflurane. ⋯ The analgesic potencies of volatile anaesthetics are partially mediated by modulation of NALCN in CeAGABA neurones.