ArticleBJA open2025
Maintenance of prehospital anaesthesia in trauma patients: inconsistencies and variability in practice.
Article in BJA open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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Who cites it
2 citing papers in PubMed.
- Maintenance of prehospital anaesthesia using an intermittent bolus regime in blunt trauma patients with a high GCS and hemodynamic reserve: a retrospective cohort study.Scandinavian journal of trauma, resuscitation and emergency medicine · 2026Observational
- Pre-hospital emergency anaesthesia in 2025: ten years on from the modification of induction regimes.Scandinavian journal of trauma, resuscitation and emergency medicine · 2025Review
Corrections and comments
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Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Literature on prehospital anaesthesia predominantly focuses on preparation and induction, while there is limited guidance on anaesthesia maintenance. The hypothesis of this study was that for prehospital trauma patients, protocols and practice for anaesthesia maintenance may vary considerably between services. Hence, we sought to describe the practice of prehospital anaesthesia maintenance for trauma patients in Australia, New Zealand, and the UK. Methods: An online practice survey of prehospital and retrieval services in Australia, New Zealand, and the UK was conducted from May to September 2022. Branching logic of between five and 140 questions covered services' background information, protocols relating to anaesthesia maintenance, and perceived effectiveness and governance. Results: Forty-two services were approached with an 81% response rate. While most services (88%) had some form of maintenance protocol, only 14% had one specific for trauma patients. Most services (61%) used a combination of intermittent boluses and continuous infusions. Ketamine and midazolam were the favoured hypnotics, and fentanyl the favoured opioid. However, there was considerable variation in drug selection and dosing, and in the detail contained within protocols. There was high self-reported confidence in effectiveness and governance of anaesthesia maintenance practices. Conclusions: Protocols for anaesthesia maintenance in prehospital trauma patients show considerable variation in content and detail across the surveyed services. Further consideration of pharmacokinetics and the specific aims of anaesthesia maintenance is warranted. More research is needed to establish the optimal choice of drugs, dosing, delivery, and adjustment criteria for anaesthesia maintenance in prehospital trauma patients.
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