Anaesthesia & Intensive Care Medicine RSS feed. https://www.anaesthesiajournal.co.uk/issues?journalCode=mpaic&publicationCode=mpaic&rss=yes Elsevier Inc. en © 2026 Published by Elsevier Inc. All rights reserved. Anaesthesia & Intensive Care Medicine 1472-0299 2026-05-13-07:00 © 2026 Published by Elsevier Inc. All rights reserved. permissionshelpdesk@elsevier.com https://www.anaesthesiajournal.co.uk/article/S1472-0299(26)00045-7/fulltext?rss=yes Drug elimination is a key determinant of anaesthetic drug effect, duration, and safety. It leads to the irreversible loss of active drug from the body and occurs via the processes of drug metabolism and excretion. This review explains the two key phases of metabolism, as well as the main routes of excretion of drugs and their metabolites. Patient factors that impact metabolism and excretion, including organ dysfunction, age, and genetics, are also discussed. Case studies are included to illustrate the impact of alterations in drug elimination in everyday practice. Modes of drug elimination and bioactive metabolites Francesco Dernie, Fu Liang Ng 10.1016/j.mpaic.2026.03.010 Anaesthesia & Intensive Care Medicine 27, 5 (2026) 2026-05-07 Anaesthesia & Intensive Care Medicine 2026-05-07 27 5 S1472-0299(26)X2004-5 Pharmacology 309 314 https://www.anaesthesiajournal.co.uk/article/S1472-0299(26)00044-5/fulltext?rss=yes Quantitative pharmacokinetic analysis allows the mathematical description of the movement of drug around the body after administration. Numerical parameters such as volume of distribution, clearance and terminal half-life are used to describe this movement. These parameters are defined through pharmacokinetic analysis. There are a number of methods used for pharmacokinetic analysis. These include compartmental modelling, which divides the body into mathematical compartments and represents the movement of drugs between these. Quantitative pharmacokinetics Cleodie C Swire, Reya V Shah, Dagan O Lonsdale 10.1016/j.mpaic.2026.03.009 Anaesthesia & Intensive Care Medicine 27, 5 (2026) 2026-04-29 Anaesthesia & Intensive Care Medicine 2026-04-29 27 5 S1472-0299(26)X2004-5 Pharmacology 305 308 https://www.anaesthesiajournal.co.uk/article/S1472-0299(26)00042-1/fulltext?rss=yes The origins of general anaesthesia for dentistry are inextricably linked to the dawn of anaesthesia as a specialty, and the availability of the very first inhalational anaesthetic agents. Its delivery, regulation and safety profile have evolved significantly since then, with its practice now conducted solely by trained anaesthetists in a hospital setting. Dental chair anaesthesia and nasal masks have largely been replaced by more modern techniques and equipment; nevertheless, the patients that necessitate these interventions present their own unique challenges. General anaesthesia for dentistry Flora F McLennan, Patrick A Ward 10.1016/j.mpaic.2026.03.007 Anaesthesia & Intensive Care Medicine 27, 5 (2026) 2026-04-24 Anaesthesia & Intensive Care Medicine 2026-04-24 27 5 S1472-0299(26)X2004-5 Dental and Maxillofacial 292 298 https://www.anaesthesiajournal.co.uk/article/S1472-0299(26)00039-1/fulltext?rss=yes Dental damage is the most common complication in anaesthesia. It negatively affects patients’ quality of life and is the most likely reason for complaint or litigation against anaesthetists. Major risk factors include poor premorbid dental status and prostheses, difficult airways and laryngoscopy. The maxillary incisors are most commonly affected, with enamel fractures and subluxation the most frequently reported injuries. All patients should have an individualized risk assessment, informed consent discussion and risk mitigation strategy in place. Dental damage in anaesthesia Andrew J Goddard 10.1016/j.mpaic.2026.03.004 Anaesthesia & Intensive Care Medicine 27, 5 (2026) 2026-04-24 Anaesthesia & Intensive Care Medicine 2026-04-24 27 5 S1472-0299(26)X2004-5 Dental and Maxillofacial 269 274 https://www.anaesthesiajournal.co.uk/article/S1472-0299(26)00043-3/fulltext?rss=yes Anaesthesia for orthognathic surgery requires thorough preoperative planning and multidisciplinary involvement. Patients are generally young and healthy, though there is an increasing trend in treatment of patients with obstructive sleep apnoea syndrome, associated with increased premorbid disease burden. Principles of perioperative management include close cooperation between surgeon and anaesthetist, a multifaceted approach to minimizing blood loss, multimodal analgesia, anti-emesis prophylaxis, and a carefully planned, communicated and executed airway management strategy. Anaesthesia for orthognathic surgery Emma C Millar, Victoria A Cook, Patrick A Ward 10.1016/j.mpaic.2026.03.008 Anaesthesia & Intensive Care Medicine 27, 5 (2026) 2026-04-23 Anaesthesia & Intensive Care Medicine 2026-04-23 27 5 S1472-0299(26)X2004-5 Dental and Maxillofacial 299 304 https://www.anaesthesiajournal.co.uk/article/S1472-0299(26)00040-8/fulltext?rss=yes Maxillofacial surgery involves procedures on the facial skeleton, oral cavity and soft tissues of the head and neck. These frequently require shared airway access and close collaboration between anaesthetic and surgical teams. These cases present distinct anaesthetic challenges including difficult airway management and complex perioperative planning. This review focuses on general principles relevant across maxillofacial anaesthesia, with a particular emphasis on ‘major’ surgery, including complex cancer resections and free flap reconstructive procedures. Anaesthesia for maxillofacial surgery Niamh S Toner, Audrey Jeffrey, Pamela Milligan 10.1016/j.mpaic.2026.03.005 Anaesthesia & Intensive Care Medicine 27, 5 (2026) 2026-04-23 Anaesthesia & Intensive Care Medicine 2026-04-23 27 5 S1472-0299(26)X2004-5 Dental and Maxillofacial 275 282 https://www.anaesthesiajournal.co.uk/article/S1472-0299(26)00038-X/fulltext?rss=yes Maxillofacial trauma is common and can cause significant physical and psychological morbidity. It can be extremely challenging managing patients with maxillofacial injuries, whether in the emergency setting or in the elective operating theatre environment. Airway management interventions should be carefully planned so that the safest and most effective technique is utilized. Advanced airway management techniques such as awake tracheal intubation, submental intubation or awake tracheostomy may be required. Anaesthesia for maxillofacial trauma Jian Ying Quek, Cristina Niciu, Kevin Fitzpatrick 10.1016/j.mpaic.2026.03.003 Anaesthesia & Intensive Care Medicine 27, 5 (2026) 2026-04-23 Anaesthesia & Intensive Care Medicine 2026-04-23 27 5 S1472-0299(26)X2004-5 Dental and Maxillofacial 261 268 https://www.anaesthesiajournal.co.uk/article/S1472-0299(26)00037-8/fulltext?rss=yes Flexible bronchoscope-assisted tracheal intubation remains an indispensable technique in airway management – as the first-line approach in known or anticipated difficult airways or as a rescue technique in unanticipated difficulty. It can be performed in awake patients or following induction of general anaesthesia, dependent upon the individual patient's risk factors, physiological (in)stability and clinical circumstances. In the fourth National Audit Project of airway complications in the UK (2011), awake tracheal intubation was an under-utilized technique, such that it must be considered in the presence of predictors of difficulty. Flexible bronchoscope-assisted tracheal intubation Jian Ying Quek, Dmitrijs Sokolovs 10.1016/j.mpaic.2026.03.002 Anaesthesia & Intensive Care Medicine 27, 5 (2026) 2026-04-23 Anaesthesia & Intensive Care Medicine 2026-04-23 27 5 S1472-0299(26)X2004-5 Dental and Maxillofacial 249 260 https://www.anaesthesiajournal.co.uk/article/S1472-0299(26)00069-X/fulltext?rss=yes Identification of the difficult airway Self-assessment Vijayanand Nadella 10.1016/j.mpaic.2026.04.001 Anaesthesia & Intensive Care Medicine 27, 5 (2026) 2026-04-22 Anaesthesia & Intensive Care Medicine 2026-04-22 27 5 S1472-0299(26)X2004-5 Test yourself 323 324 https://www.anaesthesiajournal.co.uk/article/S1472-0299(26)00057-3/fulltext?rss=yes Clinical informatics, the interdisciplinary science of managing and applying health data, has undergone a profound transformation from a specialist domain into a core pillar of modern healthcare. This shift has profound implications for the perioperative and critical care clinician, moving beyond the simple digitization of records to the widespread implementation of advanced analytical systems and tools to support clinical decision-making, improve patient and systematic safety and reduce medical errors. Clinical relevance of informatics systems Nicholas R Plummer 10.1016/j.mpaic.2026.03.012 Anaesthesia & Intensive Care Medicine 27, 5 (2026) 2026-04-22 Anaesthesia & Intensive Care Medicine 2026-04-22 27 5 S1472-0299(26)X2004-5 Informatics 319 322 https://www.anaesthesiajournal.co.uk/article/S1472-0299(26)00056-1/fulltext?rss=yes Clinical audit and quality improvement are essential processes that help to ensure that patients receive safe, effective, and high-quality care. By participating in clinical audit and quality improvement initiatives, anaesthetists can gain a deeper understanding of the care provided to patients and identify areas for improvement. Ensuring good data quality is crucial for these processes, and can be achieved by following a systematic approach to data management, including training on data collection and management techniques, strict data validation procedures and regular data quality checks. Clinical audit, quality improvement and data quality Jonathan E. Dickerson 10.1016/j.mpaic.2026.03.011 Anaesthesia & Intensive Care Medicine 27, 5 (2026) 2026-04-22 Anaesthesia & Intensive Care Medicine 2026-04-22 27 5 S1472-0299(26)X2004-5 Informatics 315 318 https://www.anaesthesiajournal.co.uk/article/S1472-0299(26)00041-X/fulltext?rss=yes Safe airway management is a key component of anaesthesia, emergency medicine and critical care. Complications arising from airway management can be associated with serious morbidity and mortality. Prediction of difficulties during airway management, with the aim of facilitating better decision-making, planning and preparation, has historically been limited to the use of bedside tests that focus on identification of anatomical features that might impair direct laryngoscopy and tracheal intubation success. Identification of the difficult airway Gülsüm Karabulut, Alistair F McNarry, Patrick A Ward 10.1016/j.mpaic.2026.03.006 Anaesthesia & Intensive Care Medicine 27, 5 (2026) 2026-04-22 Anaesthesia & Intensive Care Medicine 2026-04-22 27 5 S1472-0299(26)X2004-5 Dental and Maxillofacial 283 291 https://www.anaesthesiajournal.co.uk/article/S1472-0299(26)00036-6/fulltext?rss=yes Dental sedation enables the safe and effective treatment of adult and paediatric patients unable to tolerate minor procedures under local anaesthesia alone. Sedation exists along a continuum, ranging from anxiolysis to general anaesthesia, such that it can be challenging to achieve and maintain an optimal depth of sedation throughout procedures with fluctuating levels of surgical stimuli in varied and potentially demanding patient groups. Careful patient and technique selection, continuous monitoring and the ability to immediately manage complications are essential requirements. Sedation for dental procedures Joseph E. Jermy, Jennifer Service, Claire Gillan 10.1016/j.mpaic.2026.03.001 Anaesthesia & Intensive Care Medicine 27, 5 (2026) 2026-04-22 Anaesthesia & Intensive Care Medicine 2026-04-22 27 5 S1472-0299(26)X2004-5 Dental and Maxillofacial 243 248 https://www.anaesthesiajournal.co.uk/article/S1472-0299(26)00014-7/fulltext?rss=yes Variation in response to drugs used in anaesthesia is seen between individuals and it is well established that patients' genetics are a major influence. Our understanding of the role differences in the genome play, especially by identifying genetic polymorphisms of interest, is improving. This may lead to availability of precision anaesthesia, where drug choices and dosages are tailored to individuals’ genetic makeup. Furthermore analysis of the downstream products of gene transcription, in particular of proteins and metabolic products, may allow further treatment personalization. Omics and anaesthesia: pharmacogenomics, proteomics and metabolomics Cameron W Whytock, Clifford L Shelton 10.1016/j.mpaic.2026.02.001 Anaesthesia & Intensive Care Medicine (2026) 2026-03-04 Anaesthesia & Intensive Care Medicine 2026-03-04 Pharmacology https://www.anaesthesiajournal.co.uk/article/S1472-0299(25)00106-7/fulltext?rss=yes This article covers the principles of trauma care relating to specific competencies within the military higher training module. The majority of these principles relate to the pre-hospital assessment and management of patients, introducing some of the nuances of military medicine in comparison to civilian practice. Initial assessment and management of trauma encountered in the field Emma Coley, Sarah Fadden 10.1016/j.mpaic.2025.05.005 Anaesthesia & Intensive Care Medicine (2025) 2025-07-08 Anaesthesia & Intensive Care Medicine 2025-07-08 Trauma & military anaesthesia https://www.anaesthesiajournal.co.uk/article/S1472-0299(23)00082-6/fulltext?rss=yes A major incident is one that causes casualties on a scale beyond the emergency and healthcare services' usual ability to manage. Major incident planning and rehearsal is vital to ensuring an appropriate response. Delivery of a major incident response requires command and coordination within and between emergency services, hospitals and specialist charitable organizations. Casualty management will require the set-up of major incident infrastructure at the scene to effectively extricate, triage, treat and transport casualties to appropriate facilities. Major incidents Richard Bayliss, Tom Hurst 10.1016/j.mpaic.2023.04.010 Anaesthesia & Intensive Care Medicine (2023) 2023-05-30 Anaesthesia & Intensive Care Medicine 2023-05-30 Major incidents https://www.anaesthesiajournal.co.uk/article/S1472-0299(26)00087-1/fulltext?rss=yes Editorial Board 10.1016/S1472-0299(26)00087-1 Anaesthesia & Intensive Care Medicine 27, 5 (2026) 2026-05 Anaesthesia & Intensive Care Medicine 2026-05 27 5 S1472-0299(26)X2004-5 i https://www.anaesthesiajournal.co.uk/article/S1472-0299(26)00085-8/fulltext?rss=yes Contents 10.1016/S1472-0299(26)00085-8 Anaesthesia & Intensive Care Medicine 27, 5 (2026) 2026-05 Anaesthesia & Intensive Care Medicine 2026-05 27 5 S1472-0299(26)X2004-5 OFC