British journal of anaesthesia
Audio Summaries

Individualised anaesthesia and analgesia in surgery: conceptual framework for improving postoperative pain

May 9, 2026

The authors explore the question of how to implement individualised anaesthesia and analgesia in surgical settings to improve postoperative pain management and patient outcomes. They argue that moving away from a one-size-fits-all approach requires comprehensive trials that consider various factors, including predictive risk, treatment options, and the alignment of patient and clinician values throughout the perioperative period. The study emphasizes the need for both clinical and ethical considerations in making personalized anaesthesia a reality.

Shrinking pharmacological options in modern anaesthesia

May 9, 2026

The authors investigate the implications of the decreasing diversity of anaesthetic drugs in clinical practice, questioning how this trend affects patient care and clinical resilience. They argue that while standardization enhances safety, the reduction in pharmacological options may compromise adaptability and preparedness in anaesthesia, highlighting the need to maintain a range of agents for patient-centered care.

Low cardiac index during periods of arterial hypotension and risk of acute kidney injury in cardiac surgery

May 7, 2026

The authors aimed to investigate the relationship between low cardiac index (CI) during periods of arterial hypotension and the risk of acute kidney injury (AKI) in patients undergoing cardiac surgery. Their findings indicate that exposure to joint hypotension and low CI (≤2 L min⁻¹ m⁻²) significantly increases the risk of AKI and length of stay in the ICU and hospital, suggesting a potential need for CI-guided therapy to mitigate these risks.

A minimally invasive anaesthetic approach for transcatheter aortic valve implantation: is this really supported by the evidence?

May 7, 2026

The authors critically assess the evidence supporting a shift towards minimally invasive anaesthetic techniques for transcatheter aortic valve implantation (TAVI), as recommended by a recent interdisciplinary consensus. They compare observational data with findings from randomized controlled trials to evaluate the safety and efficacy of these approaches, ultimately advocating for a tailored anaesthetic strategy that prioritizes patient safety and procedural success.

The environmental footprint and ecotoxicity of sevoflurane and propofol anaesthesia: a retrospective observational modelling study

May 7, 2026

The authors aimed to compare the environmental impact and water contamination potential of three anaesthetic strategies: total intravenous anaesthesia (TIVA) with propofol, target-controlled inhalational anaesthesia (TCIA) with sevoflurane, and manually optimised low-flow sevoflurane anaesthesia. Their findings indicate that TIVA with propofol resulted in significantly less water contamination and avoided the release of trifluoroacetic acid (TFA), while sevoflurane methods contributed to higher TFA emissions and its irreversible accumulation in the environment. These results highlight the importance of selecting anaesthetic practices that minimize ecological harm.

C1q-mediated synapse loss by microglial phagocytosis is associated with postoperative neurocognitive disorder in mice

May 7, 2026

The authors investigate the role of complement C1q in microglial activation and synapse loss as potential mechanisms contributing to postoperative neurocognitive disorders (PNDs) in mice. Their findings indicate that increased C1q levels lead to microglial phagocytosis of synapses, resulting in cognitive deficits following surgery, and suggest that targeting C1q and NF-κB activation may offer therapeutic strategies to mitigate PNDs.

Microglial activation disrupts hippocampal CA1 sharp-wave ripples via the CA3-CA1 neural circuit that contributes to postoperative memory consolidation deficits in aged mice

May 6, 2026

This study investigates how microglial activation affects sharp-wave ripples (SPW-Rs) in the hippocampal CA1 region and contributes to postoperative memory deficits in aged mice. The authors found that surgery-induced microglial activation leads to reduced SPW-R frequency and duration, impairing memory consolidation, while restoring CA3 pyramidal neuron activity can ameliorate these deficits. Ultimately, the research highlights the role of neuroinflammation in postoperative cognitive impairment among elderly patients.

Association of postoperative delirium with haemodynamic determinants of cerebral perfusion pressure during cardiac surgery: a retrospective cohort study

May 6, 2026

The authors aimed to investigate the relationship between postoperative delirium and the haemodynamic determinants of cerebral perfusion pressure (CPP) during cardiac surgery. Their retrospective cohort study found that delirium was associated with time spent in zones of low cerebral perfusion, specifically in ranges of low mean arterial pressure (MAP) and high central venous pressure (CVP), suggesting that optimizing cerebral perfusion may help reduce delirium in surgical patients. Further trials are recommended to explore this potential intervention.

TET1 downregulation in the dorsal root ganglion and spinal cord is required for short-term sleep disturbance to delay surgical pain recovery

May 6, 2026

This study investigates the role of TET1 downregulation in the dorsal root ganglion (DRG) and spinal dorsal horn (SDH) as a mechanism underlying the delay in surgical pain recovery associated with short-term sleep disturbances. The authors found that sleep disruption leads to decreased TET1 expression, which in turn reduces μ-opioid receptor (MOR) levels, prolonging pain. Restoring TET1 expression mitigated these effects, suggesting that TET1 plays a critical role in pain modulation during sleep disturbances.

What we used, what we saw, what we did: towards a shared language for videolaryngoscopy

May 2, 2026

The authors explore how to improve documentation practices in videolaryngoscopy, which is increasingly used for tracheal intubation. They argue that existing view-based descriptors, rooted in direct laryngoscopy, may not adequately reflect the complexities of videolaryngoscopy. Instead, they propose a new descriptive framework focusing on three elements: what was used, what was seen, and what was done, to enhance clarity and utility in airway documentation.