British journal of anaesthesia
Audio Summaries

An integrated systemic approach to chronic primary pain from epigenome to brain: a narrative review

Jun 11, 2026

The authors aim to establish an integrated systemic approach to understanding chronic primary pain, which is recognized as a complex disease involving multiple physiological dysfunctions, including epigenetic modifications and neuroinflammation. By connecting insights from various scientific disciplines, they seek to create a holistic framework that links these dysfunctions to clinical features such as sensory hypersensitivity and psychological issues, ultimately enhancing therapeutic strategies and guiding future research.

Coagulopathy in obstetric bleeding: a narrative review and comparison with trauma-induced coagulopathy

Jun 11, 2026

The authors aim to explore the unique characteristics of coagulopathy in postpartum hemorrhage, which is a leading cause of maternal mortality, and how it differs from trauma-induced coagulopathy. They review recent advancements in understanding the pathophysiology and management of obstetric coagulopathy, highlighting the need for tailored resuscitation guidelines that account for the distinct physiological and pathological factors involved in obstetric cases.

Balancing the evidence with the SPAQI recommendations: from perioperative discontinuation towards continuation of SGLT2 inhibitors

Jun 11, 2026

The authors examine the perioperative management of sodium-glucose cotransporter 2 (SGLT2) inhibitors, questioning whether discontinuation or continuation is more beneficial for patients undergoing surgery. They highlight a risk-stratified approach that considers the potential for euglycaemic ketoacidosis versus the established cardio-renal benefits of SGLT2 inhibitors, advocating for careful metabolic monitoring rather than blanket discontinuation. The paper emphasizes the need for further research to validate these recommendations.

Dreaming during anaesthesia: a scoping review

Jun 10, 2026

This scoping review aims to synthesize existing evidence on the phenomenon of dreaming during anaesthesia, exploring its frequency, characteristics, predictors, outcomes, and neural correlates. The authors found that dream recall varies significantly between experimental and clinical settings, with a predominance of pleasant dreams and specific associations with certain anaesthetic agents. They highlight the need for standardized research approaches to address gaps in knowledge regarding definitions, assessment methods, and the potential therapeutic implications of anaesthesia dreaming.

Perioperative discontinuation of SGLT2-inhibitors and cardiac complications after noncardiac surgery: secondary analysis of two prospective observational cohort studies

Jun 10, 2026

This study investigates whether the perioperative discontinuation of sodium-glucose cotransporter-2 inhibitors (SGLT2i) increases the risk of cardiovascular complications following noncardiac surgery. The findings indicate that stopping SGLT2i is associated with a significantly higher incidence of cardiac events within 90 days post-surgery, challenging current clinical guidelines that recommend discontinuation to prevent euglycemic diabetic ketoacidosis. The authors call for randomized controlled trials to further explore these implications.

Differential associations between preoperative anaemia and postoperative outcomes in women and men undergoing surgery^✰

Jun 9, 2026

This study investigates the differential impact of preoperative anaemia on postoperative outcomes in men and women undergoing surgery. The authors found that while preoperative anaemia is linked to worse outcomes for both genders, the associations are significantly stronger in women, particularly regarding acute kidney injury, ischaemic events, and surgical site infections. This highlights the need for gender-specific considerations in managing preoperative anaemia to improve surgical outcomes.

Minimalist transcatheter aortic valve implantation for all? Consensus clinical guidance from Italy

Jun 4, 2026

This paper discusses the evolving practice of transcatheter aortic valve implantation (TAVI) in Italy, focusing on the question of whether a minimalist approach to anaesthesia and perioperative care can be safely applied to all patients. The authors present a consensus that supports using local anaesthesia or conscious sedation as the default strategy, emphasizing the need for careful patient selection and individualized care to enhance comfort and outcomes while minimizing invasiveness. They call for further clinical research to better align anaesthetic practices with patient-centered outcomes.

From Mendelson to modern labour wards: rethinking fasting in labour

Jun 2, 2026

The authors investigate the ongoing practice of fasting during labor, questioning whether current restrictions are necessary or merely a continuation of outdated protocols in light of the low risk of aspiration in modern obstetric care. They highlight the inequities in fasting practices, particularly affecting socially disadvantaged women, and advocate for a more individualized approach that prioritizes both safety and maternal wellbeing. Ultimately, the paper calls for a reevaluation of fasting policies to better align with contemporary clinical realities and equity considerations.

Agreement of minimally invasive pulse wave analysis with pulmonary artery and transpulmonary thermodilution cardiac output measurements in perioperative and intensive care medicine: a systematic review and meta-analysis

Jun 2, 2026

The authors aimed to assess the agreement between minimally invasive pulse wave analysis-derived cardiac output measurements and reference measurements from pulmonary artery and transpulmonary thermodilution in high-risk surgical and critically ill patients. Their systematic review and meta-analysis of 92 studies revealed that the pooled percentage errors for cardiac output and cardiac index measurements were 44.0% and 49.1%, respectively, both exceeding the clinically acceptable threshold of 30%. The results indicated significant variability in measurement accuracy based on patient population and device used.

Flow-controlled ventilation: general settings and compliance-guided positive end-expiratory pressure and driving pressure titrations

Jun 1, 2026

The authors investigate the application of flow-controlled ventilation (FCV) during general anaesthesia, aiming to clarify how it differs from conventional ventilation modes and to provide practical guidance for its implementation. They emphasize the importance of adjusting positive end-expiratory pressure (PEEP) and driving pressure based on dynamic compliance to optimize lung recruitment and ventilation efficacy. The paper seeks to enhance understanding and safety in the use of FCV in surgical settings.