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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In 2020, the Sugammadex vs Neostigmine for Reversal of Neuromuscular Blockade and Postoperative Pulmonary Complications (STRONGER) study provided evidence for the first time that use of sugammadex is associated with fewer postoperative pulmonary complications than use of neostigmine. In a recent publication in the British Journal of Anaesthesia, a secondary analysis of the same data, the Association Between Neuromuscular Blockade Reversal Agent Choice and Postoperative Pulmonary Complications (STIL-STRONGER) study, has produced similar evidence of the advantages of sugammadex over neostigmine in high-risk and older patients undergoing prolonged, elective surgery. Here we consider the implications of the detailed statistical analysis used in these two studies and how its limitations could possibly have enhanced the statistical differences between the two drugs with respect to postoperative pulmonary complications.
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At this centenary of the British Journal of Anaesthesia (BJA) in 2023, six of its 12 editors/editors-in-chief detail developments over the decades that have led to the BJA becoming a high-impact international scientific journal. As a charity, the BJA supports academic research and training in anaesthesia, critical care, and pain medicine including funding of research grants and postgraduate education. Building on this foundation, the BJA continues to innovate as it aims to become fully electronic, expand into open access publishing, and increase the diversity of its editorial board.
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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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Pain is a multidimensional construct. The purpose of this cross-sectional, single-centre study was to evaluate the relationship between postpartum pain type with pain intensity and opioid use in people with and without opioid use disorder (OUD). ⋯ Postpartum pain type was associated with pain intensity and opioid use. Further research is required to address the multiple dimensions of postpartum pain in people with and without OUD to improve treatment of postpartum pain.