British journal of anaesthesia
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Memory decline is one of the main manifestations in perioperative neurocognitive disorder. Short-term memory (STM) to long-term memory (LTM) transformation is one aspect of memory consolidation. Early-phase long-term potentiation (E-LTP) to late-phase long-term potentiation (L-LTP) is the molecular correlate of STM to LTM transformation. We examined whether the STM to LTM transformation was impaired after anaesthesia and surgery in older mice. ⋯ Reduced BDNF expression was involved in anaesthesia and surgery-induced impairment of the STM to LTM transition involving glutamatergic neurones in the hippocampal CA1 region of older mice. This provides a potential target that might be helpful for understanding and developing treatments for postoperative neurocognitive dysfunction.
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The GE Entropy™ module uses frontal EEG to compute the processed indices state entropy (SE), response entropy (RE), and burst suppression ratio (BSR) to guide maintenance of anaesthesia by supposedly minimising overly 'deep' or 'light' anaesthesia. It remains unclear whether the manufacturer-recommended index ranges accurately reflect anaesthesia levels or prevent complications such as burst suppression or arousal reactions. ⋯ Despite their intuitive appeal, the processed EEG index values SE, RE, ΔRE-SE, and BSR showed limited reliability in guiding maintenance of anaesthesia, especially in older patients. Anaesthesiologists should not rely exclusively on the recommended index value range, as it is often unattainable and does not prevent burst suppression or arousal indicators.
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Chronic postsurgical inguinal pain (CPIP) is the most common complication of groin hernia surgery. The characteristics of patients, their medical care, and choice of diagnostic tools remain to be defined to optimise preventive and therapeutic interventions. ⋯ German Trial Registry DRKS00024588 and DRKS00016790.
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Editorial
The misunderstood P-value: why statistical significance is not enough in clinical practice.
P-values have traditionally guided clinical research, but over-reliance on them can lead to misinterpretation and poor decision-making. This article highlights common misconceptions about P-values and suggests incorporating the minimum clinically important difference (MCID) along with other metrics such as effect sizes and Bayesian methods. Evidence-based practice is essential in anaesthesiology, and research findings should be evaluated in the context of patient outcomes to guide clinical decisions.