The report from Olsen and colleagues on bone cement implantation syndrome (BCIS) in this edition of the British Journal of Anaesthesia coincides with the recent publication of the Anaesthesia Sprint Audit of Practice (ASAP). BCIS has been reported for many years and it is perhaps surprising that it took until 2009 for a full explanation and classification of BCIS to emerge. Olsen and colleagues...

Accurate disease definitions are essential for clinical decisionmaking, trial enrolment, and mechanistic research. Since it was first recognized over four decades ago multiple attempts have been made to adequately define the acute respiratory distress syndrome (ARDS). However, up to half of the patients captured by definitions to date do not have the disease. This poor diagnostic accuracy may, ...

Editor—We read the recent article written by Dr Bartha and colleagues addressing goal-directed haemodynamic treatment (GDHT) in patients with proximal femoral fracture with great interest. This subset of surgical patients is indeed elderly and at high risk with 20% 4 month mortality. 3 Therefore, an evidence base to guide clinicians in their perioperative care to optimize clinical outcome is ve...

In this issue of the British Journal of Anaesthesia, Sury and colleagues present extensive audit data derived from a survey of anaesthetic departments in the UK, with the general aim of characterizing current National Health Service (NHS) anaesthetic activity. A more specific aim was to provide a context for the release of the upcoming 5th National Audit Project (NAP5) in which the incidence an...

In a past issue of the British Journal of Anaesthesia, Desmet and colleagues report that i.v. dexamethasone is equivalent to perineural dexamethasone in prolonging the analgesic duration of a single-shot interscalene block with ropivacaine. In their study, 150 patients presenting for arthroscopic shoulder surgery with an interscalene brachial plexus block (BPB) were randomized into three groups...

The merits of a coordinated consistent approach to the perioperative journey appear obvious, but only relatively recently has there been a substantial focus on this area through initiatives such as the ASA’s Perioperative Surgical Home (POSH) and the Royal College of Anaesthetists Perioperative Medicine Programme. These approaches include consistent structured elements in the patient pathway, s...

Whether anaesthetic technique during potentially curative cancer surgery influences recurrence is a question that dates to two publications about 15 yr ago, each of which presented associations between use regional anaesthesia and improved outcomes.1Exadaktylos A.K. Buggy D.J. Moriarty D.C. Mascha E. Sessler D.I. Can anesthetic for primary breast affect or metastasis?.Anesthesiology. 2006; 105:...

Editor—In their comment to the recent review article, ‘Environmental sustainability in anaesthesia and critical care’,1McGain F. Muret J. Lawson C. Sherman J.D. Environmental care.Br J Anaesth. 2020; 125: 680-692Abstract Full Text PDF PubMed Scopus (98) Google Scholar Slingo Slingo2Slingo M. D.J. Response McGain et al – 2021; 126: e195-e197Abstract (3) attempt downplay calls reduce inhaled anae...

In their article in this issue of the British Journal Anaesthesia, Proekt & Kelz1Proekt A. Kelz M.B. Explaining anaesthetic hysteresis with effect site equilibration: looking for a black cat dark room.Br J Anaesth. 2020; Abstract Full Text PDF Scopus (3) Google Scholar refer to an aphorism attributed Confucius that ‘the hardest thing all is find room, especially if there no cat’. Proving someth...

Pain, the most frequently reported medical symptom,1Kirsch B. Berdine H. Zablotsky D. Wenzel G. Meyer C. Implementation of a pain management strategy: identifying as fifth vital sign.Vet Health Syst J. 2000; 5: 49-59Google Scholar continues to be poorly assessed in health care setting.2Breivik Borchgrevink P.C. Allen S.M. et al.Assessment pain.Br J Anaesth. 2008; 101: 17-24https://doi.org/10.10...