British journal of anaesthesia
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Effects of lidocaine bolus and infusion on neuromonitoring by bispectral index (BIS®), electroencephalogram periodic and aperiodic activity, and Surgical Pleth Index® during propofol-remifentanil anaesthesia: a single-centre prospective observational study

Sep 22, 2026

The authors aimed to evaluate the dose-dependent effects of lidocaine on EEG spectral features and processed parameters like bispectral index (BIS) and spectral edge frequency (SEF) during propofol-remifentanil anesthesia. They found that lidocaine administration led to early changes in EEG activity, specifically an increase in delta-band and a decrease in beta-band activity, before any significant alterations in BIS, SEF, or Surgical Pleth Index (SPI) were observed. These findings suggest that lidocaine's antinociceptive effects may contribute to its anesthetic-sparing properties, although the interpretation of these EEG changes requires further investigation.

Comparing noninvasive blood pressure monitoring technologies: the challenge of between-arm differences

Sep 17, 2026

The authors examine the performance of a finger-cuff system for continuous noninvasive blood pressure monitoring in comparison to traditional oscillometric methods and invasive arterial measurements. They highlight that while the finger-cuff system meets ISO criteria for mean arterial and diastolic pressures, it does not for systolic pressure, and the observed discrepancies may be influenced by physiological differences between arms. Ultimately, the editorial argues that the study supports the use of finger-cuff technology for mean arterial pressure monitoring but does not conclusively establish its superiority over oscillometric methods.

Paternal neonatal sevoflurane exposure induces intergenerational anxiety via epididymal DNMT2-dependent sperm transfer RNA derived small RNA remodelling in rats

Sep 16, 2026

The authors investigate whether neonatal exposure to sevoflurane in male rats leads to intergenerational anxiety through epigenetic changes in sperm, specifically via DNA methyltransferase 2 (DNMT2)-dependent remodelling of transfer RNA-derived small RNAs (tsRNAs). Their findings reveal that such exposure induces anxiety-like behaviors in both the exposed males and their first-generation offspring, with underlying mechanisms involving altered HPA axis function and sperm tsRNA profiles. The study highlights the role of epididymal DNMT2 as a critical mediator in the inheritance of anxiety-related traits following anaesthesia exposure.

Liberal liquid fasting and aspiration: a mandate for patient-centred precision care in perioperative fasting

Sep 16, 2026

The authors investigate the discrepancy between recommended liquid fasting times and actual practices in perioperative care, questioning whether shorter fasting periods for clear liquids could be safely implemented without increasing the risk of aspiration. They highlight the rarity of aspiration events in elective patients and call for a systematic evaluation of aspiration cases to better inform fasting protocols. Ultimately, the authors advocate for patient-centered, liberal liquid fasting strategies that align with existing recommendations from anaesthesia societies.

Preoperative fasting: when failure to measure perpetuates harm

Sep 15, 2026

The authors investigate the issue of prolonged preoperative liquid fasting, which is a prevalent yet often overlooked source of avoidable harm in perioperative care. They argue that effective implementation of more liberal fasting protocols, supported by routine measurement and accountability, is essential for minimizing fasting durations and improving patient outcomes. The paper emphasizes that addressing this issue is critical for enhancing patient-centered care and ensuring safety in the perioperative setting.

Delphi-based consensus studies: persistent challenges of bias

Sep 15, 2026

The authors investigate the persistent biases that affect Delphi-based consensus studies, which are crucial in fields with limited evidence. They emphasize the need to recognize and address cognitive and methodological biases among stakeholders to enhance the rigor and credibility of these studies. The paper advocates for the development of structured frameworks to improve transparency and implement bias mitigation strategies throughout the Delphi process.

Turning over new stones and discovering new questions in the contributions of anaesthetic drugs to perioperative cardiac arrest

Sep 15, 2026

The authors explore the contributions of various anaesthetic drugs to the risk of perioperative cardiac arrest by utilizing data from the WHO VigiBase registry. They highlight the establishment of a Risk of Reporting (RoR) metric, which compares the incidence of cardiac arrest linked to specific anaesthetic agents against their usage, with propofol as a reference. This metric aims to guide future research on the relationship between anaesthetic medications and perioperative cardiac arrest risk.

Should a pharmacokinetic model be more than its data?

Sep 15, 2026

The authors investigate whether pharmacokinetic models should extend beyond merely fitting observed data to effectively predict drug behavior in diverse populations, particularly in pediatric drug development. They emphasize the importance of incorporating allometry and maturation in modeling to ensure reliable extrapolation of drug clearance predictions, which is crucial for safe and evidence-based dosing. The study highlights that models grounded in physiological principles not only meet regulatory standards but also enhance the credibility of predictions across different demographic groups.

Inequality in healthy lifespan after surgery: a longitudinal population study

Sep 11, 2026

The authors aimed to investigate the relationship between surgery and the onset of long-term disease across different socioeconomic and ethnic groups. Their longitudinal study found that surgery is associated with an increased risk of long-term disease, particularly among socioeconomically deprived individuals, who also undergo surgery at a younger age. This highlights significant health inequalities related to surgical treatment and its long-term impacts on healthy lifespan.

Drug allergy labels and complications after surgery: a prospective multicentre cohort study

Sep 10, 2026

The authors aimed to investigate the association between drug allergy labels and postoperative complications in surgical patients. Their multicentre study found that patients with drug allergy labels experienced a higher incidence of complications, including infections and allergic drug reactions, suggesting that these labels, often incorrect, may negatively impact surgical outcomes.