Articles: general-anesthesia.
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Editorial Comment
Clinical hypnosis: implications in anaesthesia and perioperative care.
A randomised trial published in the British Journal of Anaesthesia describes hypnosis compared with general anaesthesia in 60 children undergoing superficial surgery. We describe a definition of clinical hypnosis; the goals and conduct of hypnotic communication; and its potential as both an adjunct and, in suitable cases, alternative to traditional pharmacological anaesthesia.
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Editorial Comment Meta Analysis
There is (probably) no (meaningful) difference in (most) outcomes between 'spinal' and 'general' anaesthesia for hip fracture surgery: time to move forward.
A meta-analysis influenced by two recent large randomised controlled trials (REGAIN and RAGA) concluded that little, if any, difference in commonly measured outcomes exists between patients administered spinal or general anaesthesia for their hip fracture surgery. We explore whether there is genuinely no difference, or what the methodological problems in research might be that prevent any real difference from being observed. We also discuss the need for greater nuance in future research to determine how anaesthetists might deliver perioperative care towards improving postoperative recovery trajectories in patients following hip fracture.
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Editorial Comment
Linking and unlinking the paediatric brain: age-invariant neural correlates of general anaesthesia.
There is no single electroencephalographic metric for general anaesthesia that is validated for both children and adults. This is, in part, because of the changing electroencephalographic features associated with development. Here, we discuss how alterations in correlated brain activity during general anaesthesia advance our understanding of anaesthetic monitoring and the neurobiology of consciousness.
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Whilst the general presumption of the public is that general anaesthesia prevents awareness of any sensory stimuli, Lennertz and colleagues have shown in this issue of the British Journal of Anaesthesia that 11% of young adults were able to respond to auditory commands when neuromuscular blocking drugs were prevented from reaching one arm using the isolated forearm technique. This occurred with anaesthetic regimens that followed usual clinical practice in each of the 10 countries that enrolled patients, and it was significantly more common in women than in men. This high incidence demands attention. Further characterisation of the experience of these patients is essential to our understanding of the state of general anaesthesia.
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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.