{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T13:11:38Z","timestamp":1789823498181,"version":"4.0.1"},"reference-count":82,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T00:00:00Z","timestamp":1783296000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bjaopen.org","clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["BJA Open"],"published-print":{"date-parts":[[2026,9]]},"DOI":"10.1016\/j.bjao.2026.100643","type":"journal-article","created":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T20:56:54Z","timestamp":1787605014000},"page":"100643","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":1,"special_numbering":"C","title":["Evaluation of the impact of high altitude on pre-hospital anaesthetic administration: a scoping review"],"prefix":"10.1016","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-0660-1697","authenticated-orcid":false,"given":"Olivia G.","family":"Hobrough","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-7752-7017","authenticated-orcid":false,"given":"Stuart W.","family":"Reilly","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4063-7682","authenticated-orcid":false,"given":"Owen W.","family":"Tomlinson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.bjao.2026.100643_bib1","series-title":"Number of tourists who visited Kilimanjaro National Park in Tanzania 2011\u20132023","year":"2023"},{"key":"10.1016\/j.bjao.2026.100643_bib2","series-title":"Oxford Handbook of Expedition and Wilderness Medicine","author":"Dallimore","year":"2023"},{"key":"10.1016\/j.bjao.2026.100643_bib3","article-title":"Heavy traffic at the top of Mount Everest","author":"Purga","year":"2021","journal-title":"N Y Times"},{"key":"10.1016\/j.bjao.2026.100643_bib4","doi-asserted-by":"crossref","DOI":"10.1073\/pnas.2102463118","article-title":"Global and country-level estimates of human population at high altitude","volume":"118","author":"Tremblay","year":"2021","journal-title":"Proc Natl Acad Sci U S A"},{"issue":"Suppl. 1","key":"10.1016\/j.bjao.2026.100643_bib5","doi-asserted-by":"crossref","first-page":"2S","DOI":"10.1016\/j.wem.2023.05.013","article-title":"Wilderness Medical Society Clinical Practice Guidelines for the Prevention, Diagnosis, and Treatment of Acute Altitude Illness: 2024 update","volume":"35","author":"Luks","year":"2024","journal-title":"Wilderness Environ Med"},{"key":"10.1016\/j.bjao.2026.100643_bib6","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1186\/cc5142","article-title":"High-altitude physiology and pathophysiology: implications and relevance for intensive care medicine","volume":"11","author":"Grocott","year":"2007","journal-title":"Crit Care"},{"key":"10.1016\/j.bjao.2026.100643_bib7","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1007\/s00540-009-0787-7","article-title":"Physiology and pathophysiology at high altitude: considerations for the anesthesiologist","volume":"23","author":"Leissner","year":"2009","journal-title":"J Anesth"},{"key":"10.1016\/j.bjao.2026.100643_bib8","series-title":"Altitude emergencies in the prehospital environment","article-title":"Joint trauma system clinical practice guideline","year":"2024"},{"key":"10.1016\/j.bjao.2026.100643_bib9","first-page":"17","article-title":"Humans at altitude: physiology and pathophysiology","volume":"13","author":"Brown","year":"2013","journal-title":"Contin Educ Anaesth Crit Care Pain"},{"key":"10.1016\/j.bjao.2026.100643_bib10","series-title":"London: Faculty of Intensive Care Medicine","article-title":"Pre-hospital emergency medicine","year":"2025"},{"key":"10.1016\/j.bjao.2026.100643_bib11","doi-asserted-by":"crossref","first-page":"1266","DOI":"10.3390\/clinpract13050114","article-title":"Clinical research in prehospital care: current and future challenges","volume":"13","author":"Cimino","year":"2023","journal-title":"Clin Pract"},{"key":"10.1016\/j.bjao.2026.100643_bib12","doi-asserted-by":"crossref","first-page":"2526","DOI":"10.1016\/S0140-6736(15)00985-X","article-title":"Pre-hospital emergency medicine","volume":"386","author":"Wilson","year":"2015","journal-title":"Lancet"},{"key":"10.1016\/j.bjao.2026.100643_bib13","doi-asserted-by":"crossref","first-page":"1154","DOI":"10.1007\/s00268-013-1964-2","article-title":"Trauma-related preventable deaths in Berlin 2010: need to change prehospital management strategies and trauma management education","volume":"37","author":"Kleber","year":"2013","journal-title":"World J Surg"},{"key":"10.1016\/j.bjao.2026.100643_bib14","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1016\/S0020-1383(02)00123-7","article-title":"Trauma deaths in an Italian urban area: an audit of pre-hospital and in-hospital trauma care","volume":"33","author":"Chiara","year":"2002","journal-title":"Injury"},{"key":"10.1016\/j.bjao.2026.100643_bib15","series-title":"Anaesthetic","year":"2025"},{"key":"10.1016\/j.bjao.2026.100643_bib16","series-title":"StatPearls. Treasure Island (FL)","article-title":"General anesthesia for surgeons","author":"Smith","year":"2023"},{"key":"10.1016\/j.bjao.2026.100643_bib17","doi-asserted-by":"crossref","first-page":"49","DOI":"10.18231\/j.sajcrr.2025.012","article-title":"Anesthesia in high altitude: a clinical communication","volume":"12","author":"Sarvesh","year":"2025","journal-title":"SAJCRR"},{"key":"10.1016\/j.bjao.2026.100643_bib18","doi-asserted-by":"crossref","first-page":"662","DOI":"10.1111\/j.1365-2044.2008.05446.x","article-title":"Anaesthesia and high altitude: a history","volume":"63","author":"Firth","year":"2008","journal-title":"Anaesthesia"},{"key":"10.1016\/j.bjao.2026.100643_bib19","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1186\/s13049-020-00790-1","article-title":"Multiple trauma management in mountain environments \u2013 a scoping review: evidence based guidelines of the International Commission for Mountain Emergency Medicine (ICAR MedCom). Intended for physicians and other advanced life support personnel","volume":"28","author":"Sumann","year":"2020","journal-title":"Scand J Trauma Resusc Emerg Med"},{"key":"10.1016\/j.bjao.2026.100643_bib20","doi-asserted-by":"crossref","first-page":"467","DOI":"10.7326\/M18-0850","article-title":"PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation","volume":"169","author":"Tricco","year":"2018","journal-title":"Ann Intern Med"},{"key":"10.1016\/j.bjao.2026.100643_bib21","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1080\/1364557032000119616","article-title":"Scoping studies: towards a methodological framework","volume":"8","author":"Arksey","year":"2005","journal-title":"Int J Soc Res Methodol"},{"key":"10.1016\/j.bjao.2026.100643_bib22","doi-asserted-by":"crossref","unstructured":"Hobrough O. Evaluation of high-altitude on anaesthetic administration in pre-hospital environments: a scoping review. OSF, 2025. Available from, https:\/\/osf.io\/gvp65. [Accessed 16 August 2026]","DOI":"10.1016\/j.bjao.2026.100643"},{"key":"10.1016\/j.bjao.2026.100643_bib23","series-title":"Joanna Briggs Institute Reviewers\u2019 Manual, 2015","year":"2015"},{"key":"10.1016\/j.bjao.2026.100643_bib24","series-title":"GRADE handbook","year":"2013"},{"key":"10.1016\/j.bjao.2026.100643_bib25","doi-asserted-by":"crossref","first-page":"150","DOI":"10.4103\/2045-9912.248265","article-title":"Frequency of anesthetic overdose with mean alveolar concentration-guided anesthesia at high altitude","volume":"8","author":"Giraldo","year":"2018","journal-title":"Med Gas Res"},{"key":"10.1016\/j.bjao.2026.100643_bib26","doi-asserted-by":"crossref","first-page":"107","DOI":"10.4103\/2045-9912.260654","article-title":"Minimum alveolar concentration based anesthesia in high altitude and anesthetic overdose: result needs cautious acceptance","volume":"9","author":"Reazaul Karim","year":"2019","journal-title":"Med Gas Res"},{"key":"10.1016\/j.bjao.2026.100643_bib27","doi-asserted-by":"crossref","first-page":"843","DOI":"10.1213\/00000539-198508000-00018","article-title":"Closed circuit anesthesia is accurate at any altitude","volume":"64","author":"Baumgarten","year":"1985","journal-title":"Anesth Analg"},{"key":"10.1016\/j.bjao.2026.100643_bib28","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1111\/j.1399-6576.2007.01561.x","article-title":"Propofol-fentanyl anaesthesia at high altitude: anaesthetic requirements and haemodynamic variations when compared with anaesthesia at low altitude","volume":"52","author":"Puri","year":"2008","journal-title":"Acta Anaesthesiol Scand"},{"key":"10.1016\/j.bjao.2026.100643_bib29","first-page":"89","article-title":"Anaesthesia for cleft lip surgery \u2013 challenge in rural Nepal","volume":"2","author":"Maharjan","year":"2004","journal-title":"Kathmandu Univ Med J (KUMJ)"},{"key":"10.1016\/j.bjao.2026.100643_bib30","doi-asserted-by":"crossref","first-page":"1313","DOI":"10.2147\/DDDT.S455844","article-title":"The median effective dose of intrathecal hyperbaric bupivacaine for Cesarean section at moderately high-altitude","volume":"18","author":"Yang","year":"2024","journal-title":"Drug Des Devel Ther"},{"key":"10.1016\/j.bjao.2026.100643_bib31","doi-asserted-by":"crossref","first-page":"909","DOI":"10.3109\/00016349.2010.484042","article-title":"Effects of intrapartum epidural analgesia at high altitudes: maternal, fetal, and neonatal outcomes. A randomized controlled trial of two formulations of analgesics","volume":"89","author":"Shokry","year":"2010","journal-title":"Acta Obstet Gynecol Scand"},{"key":"10.1016\/j.bjao.2026.100643_bib32","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1213\/ANE.0000000000005712","article-title":"Multicenter study evaluating nitrous oxide use for labor analgesia at high- and low-altitude institutions","volume":"134","author":"Wood","year":"2022","journal-title":"Anesth Analg"},{"key":"10.1016\/j.bjao.2026.100643_bib33","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1111\/j.1365-2044.1982.tb01100.x","article-title":"Nitrous oxide analgesia and altitude","volume":"37","author":"James","year":"1982","journal-title":"Anaesthesia"},{"key":"10.1016\/j.bjao.2026.100643_bib34","doi-asserted-by":"crossref","first-page":"610","DOI":"10.1016\/S0196-0644(80)80471-9","article-title":"Nitrous oxide at higher elevations","volume":"9","author":"Nieto","year":"1980","journal-title":"Ann Emerg Med"},{"key":"10.1016\/j.bjao.2026.100643_bib35","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1111\/j.1365-2044.1979.tb08535.x","article-title":"Clinical effects of nitrous oxide and oxygen mixtures at sea-level and at 1700 metres altitude","volume":"34","author":"Cleaton-Jones","year":"1979","journal-title":"Anaesthesia"},{"key":"10.1016\/j.bjao.2026.100643_bib36","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1089\/ham.2008.1075","article-title":"Methoxyflurane as an analgesic for prehospital use at high altitude","volume":"10","author":"Windsor","year":"2009","journal-title":"High Alt Med Biol"},{"key":"10.1016\/j.bjao.2026.100643_bib37","doi-asserted-by":"crossref","first-page":"987","DOI":"10.1080\/10903127.2022.2107125","article-title":"Efficacy and safety of methoxyflurane for treatment of acute traumatic pain by EMTs during alpine rescue operations: the \u201cPainDrop\u201d trial","volume":"27","author":"Egger","year":"2023","journal-title":"Prehosp Emerg Care"},{"key":"10.1016\/j.bjao.2026.100643_bib38","doi-asserted-by":"crossref","first-page":"760","DOI":"10.1136\/emj.2008.072561","article-title":"Prehospital use of ketamine in mountain rescue","volume":"26","author":"Ellerton","year":"2009","journal-title":"Emerg Med J"},{"key":"10.1016\/j.bjao.2026.100643_bib39","doi-asserted-by":"crossref","first-page":"959","DOI":"10.1111\/j.1365-2044.2007.05074.x","article-title":"Ketamine for emergency anaesthesia at very high altitude (4243 m above sea-level)","volume":"62","author":"Grocott","year":"2007","journal-title":"Anaesthesia"},{"key":"10.1016\/j.bjao.2026.100643_bib40","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1089\/15270290050074251","article-title":"Ketamine anesthesia at high altitude","volume":"1","author":"Bishop","year":"2000","journal-title":"High Alt Med Biol"},{"key":"10.1016\/j.bjao.2026.100643_bib41","doi-asserted-by":"crossref","first-page":"1078","DOI":"10.1111\/j.1460-9592.2010.03453.x","article-title":"Perioperative opioid requirements are decreased in hypoxic children living at altitude","volume":"20","author":"Rabbitts","year":"2010","journal-title":"Paediatr Anaesth"},{"key":"10.1016\/j.bjao.2026.100643_bib42","first-page":"649","article-title":"Effect of low dose sedation with diazepam on ventilatory response at moderate altitude","volume":"106","author":"R\u00f6ggla","year":"1994","journal-title":"Wien Klin Wochenschr"},{"key":"10.1016\/j.bjao.2026.100643_bib43","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1159\/000443332","article-title":"Pharmacokinetics of lidocaine hydrochloride metabolized by CYP3A4 in Chinese Han volunteers living at low altitude and in Native Han and Tibetan Chinese volunteers living at high altitude","volume":"97","author":"Zhang","year":"2016","journal-title":"Pharmacology"},{"key":"10.1016\/j.bjao.2026.100643_bib44","doi-asserted-by":"crossref","first-page":"981","DOI":"10.1213\/ANE.0000000000000209","article-title":"A pilot study for a prospective, randomized, double-blind trial of the influence of anesthetic depth on long-term outcome","volume":"118","author":"Short","year":"2014","journal-title":"Anesth Analg"},{"key":"10.1016\/j.bjao.2026.100643_bib45","doi-asserted-by":"crossref","first-page":"946","DOI":"10.1097\/ALN.0b013e318249d0a7","article-title":"Unresponsiveness \u2260 unconsciousness","volume":"116","author":"Sanders","year":"2012","journal-title":"Anesthesiology"},{"key":"10.1016\/j.bjao.2026.100643_bib46","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1186\/s12871-015-0104-y","article-title":"Spinal anaesthesia at low and moderately high altitudes: a comparison of anaesthetic parameters and hemodynamic changes","volume":"15","author":"Aksoy","year":"2015","journal-title":"BMC Anesthesiol"},{"key":"10.1016\/j.bjao.2026.100643_bib47","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1016\/j.wem.2018.02.011","article-title":"Methoxyflurane for procedural analgesia at 4470 m altitude","volume":"29","author":"Wilkes","year":"2018","journal-title":"Wilderness Environ Med"},{"key":"10.1016\/j.bjao.2026.100643_bib48","doi-asserted-by":"crossref","first-page":"852","DOI":"10.1111\/aas.12746","article-title":"Scandinavian SSAI clinical practice guideline on pre-hospital airway management","volume":"60","author":"Rehn","year":"2016","journal-title":"Acta Anaesthesiol Scand"},{"key":"10.1016\/j.bjao.2026.100643_bib49","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1080\/10903120500541514","article-title":"Drug-assisted intubation in the prehospital setting: position statement of the National Association of Emergency Physicians","volume":"10","author":"Connor","year":"2006","journal-title":"Prehosp Emerg Care"},{"key":"10.1016\/j.bjao.2026.100643_bib50","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1093\/bja\/aeh204","article-title":"Intrathecal drug spread","volume":"93","author":"Hocking","year":"2004","journal-title":"Br J Anaesth"},{"key":"10.1016\/j.bjao.2026.100643_bib51","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1111\/acem.12072","article-title":"Nitrous oxide for early analgesia in the emergency setting: a randomized, double-blind multicenter prehospital trial","volume":"20","author":"Ducass\u00e9","year":"2013","journal-title":"Acad Emerg Med"},{"key":"10.1016\/j.bjao.2026.100643_bib52","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1213\/ANE.0000000000005751","article-title":"Nitrous oxide for labor analgesia at altitude","volume":"134","author":"Firth","year":"2022","journal-title":"Anesth Analg"},{"key":"10.1016\/j.bjao.2026.100643_bib53","doi-asserted-by":"crossref","first-page":"439","DOI":"10.3109\/10903127.2010.497896","article-title":"Effectiveness of morphine, fentanyl, and methoxyflurane in the prehospital setting","volume":"14","author":"Middleton","year":"2010","journal-title":"Prehosp Emerg Care"},{"key":"10.1016\/j.bjao.2026.100643_bib54","doi-asserted-by":"crossref","first-page":"689","DOI":"10.2147\/JPR.S188675","article-title":"Low-dose methoxyflurane analgesia in adolescent patients with moderate-to-severe trauma pain: a subgroup analysis of the STOP! study","volume":"12","author":"Hartshorn","year":"2019","journal-title":"J Pain Res"},{"key":"10.1016\/j.bjao.2026.100643_bib55","doi-asserted-by":"crossref","first-page":"11","DOI":"10.2147\/JPR.S150600","article-title":"Management of trauma pain in the emergency setting: low-dose methoxyflurane or nitrous oxide? A systematic review and indirect treatment comparison","volume":"11","author":"Porter","year":"2018","journal-title":"J Pain Res"},{"key":"10.1016\/j.bjao.2026.100643_bib56","series-title":"Prescribing information and adverse event reporting","year":"2024"},{"key":"10.1016\/j.bjao.2026.100643_bib57","doi-asserted-by":"crossref","first-page":"824","DOI":"10.1093\/bja\/aev151","article-title":"Losing concentration: time for a new MAPP?","volume":"115","author":"James","year":"2015","journal-title":"Br J Anaesth"},{"key":"10.1016\/j.bjao.2026.100643_bib58","series-title":"The High Altitude Medicine Handbook","author":"Pollard","year":"2002"},{"key":"10.1016\/j.bjao.2026.100643_bib59","doi-asserted-by":"crossref","first-page":"2318","DOI":"10.1016\/j.ajem.2019.10.033","article-title":"Clinical practice of pre-hospital analgesia: an observational study of 20,978 missions in Switzerland","volume":"38","author":"Kiavialaitis","year":"2020","journal-title":"Am J Emerg Med"},{"key":"10.1016\/j.bjao.2026.100643_bib60","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1097\/00000542-200610000-00017","article-title":"Recurrent hypoxia in rats during development increases subsequent respiratory sensitivity to fentanyl","volume":"105","author":"Moss","year":"2006","journal-title":"Anesthesiology"},{"key":"10.1016\/j.bjao.2026.100643_bib61","first-page":"829","article-title":"Assessment of the strength of recommendation and quality of evidence: GRADE checklist. A descriptive study","volume":"140","author":"Bezerra","year":"2022","journal-title":"Sao Paulo Med J"},{"key":"10.1016\/j.bjao.2026.100643_bib62","doi-asserted-by":"crossref","first-page":"1097","DOI":"10.1213\/00000539-198412000-00008","article-title":"Anesthetic considerations at moderate altitude","volume":"63","author":"James","year":"1984","journal-title":"Anesth Analg"},{"issue":"48","key":"10.1016\/j.bjao.2026.100643_bib63","first-page":"33","article-title":"Characteristics of cardiohemodynamics and endothelium-dependent vascular reactivity in highlanders","volume":"2002","author":"Doloman","year":"1994","journal-title":"Fiziol Zh"},{"key":"10.1016\/j.bjao.2026.100643_bib64","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1111\/j.1365-2044.2004.03460.x","article-title":"The influence of esmolol on the dose of propofol required for induction of anaesthesia","volume":"59","author":"Wilson","year":"2004","journal-title":"Anaesthesia"},{"key":"10.1016\/j.bjao.2026.100643_bib65","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1161\/01.CIR.33.2.249","article-title":"Pulmonary pressure, cardiac output, and arterial oxygen saturation during exercise at high altitude and at sea level","volume":"33","author":"Banchero","year":"1966","journal-title":"Circulation"},{"key":"10.1016\/j.bjao.2026.100643_bib66","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/S0034-5687(99)00101-2","article-title":"Reduced maximal cardiac output at altitude: mechanisms and significance","volume":"120","author":"Wagner","year":"2000","journal-title":"Respir Physiol"},{"key":"10.1016\/j.bjao.2026.100643_bib67","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1111\/anae.13779","article-title":"AAGBI: safer pre-hospital anaesthesia 2017: Association of Anaesthetists of Great Britain and Ireland","volume":"72","author":"Lockey","year":"2017","journal-title":"Anaesthesia"},{"issue":"4S","key":"10.1016\/j.bjao.2026.100643_bib68","first-page":"S19","article-title":"Wilderness Medical Society Clinical Practice Guidelines for the Prevention and Treatment of Frostbite: 2019 update","volume":"30","author":"McIntosh","year":"2019","journal-title":"Wilderness Environ Med"},{"key":"10.1016\/j.bjao.2026.100643_bib69","doi-asserted-by":"crossref","first-page":"2019","DOI":"10.1038\/jcbfm.2011.81","article-title":"Cerebral artery dilatation maintains cerebral oxygenation at extreme altitude and in acute hypoxia: an ultrasound and MRI study","volume":"31","author":"Wilson","year":"2011","journal-title":"J Cereb Blood Flow Metab"},{"key":"10.1016\/j.bjao.2026.100643_bib70","doi-asserted-by":"crossref","first-page":"1846","DOI":"10.1038\/jcbfm.2015.142","article-title":"Regional differences in the cerebral blood flow velocity response to hypobaric hypoxia at high altitudes","volume":"35","author":"Feddersen","year":"2015","journal-title":"J Cereb Blood Flow Metab"},{"key":"10.1016\/j.bjao.2026.100643_bib71","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1016\/j.bjae.2019.06.001","article-title":"Spinal anaesthesia for ambulatory surgery","volume":"19","author":"Rattenberry","year":"2019","journal-title":"BJA Educ"},{"key":"10.1016\/j.bjao.2026.100643_bib72","doi-asserted-by":"crossref","unstructured":"Fink PB, Wheeler AR, Smith WR, et al. Wilderness medical society clinical practice guidelines for the treatment of acute pain in austere environments: 2024 update. Wilderness Environ Med; 35: 198\u2013218.","DOI":"10.1177\/10806032241248422"},{"key":"10.1016\/j.bjao.2026.100643_bib73","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1007\/s40138-016-0092-3","article-title":"Nitrous oxide, from the operating room to the emergency department","volume":"4","author":"Huang","year":"2016","journal-title":"Curr Emerg Hosp Med Rep"},{"key":"10.1016\/j.bjao.2026.100643_bib74","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1097\/00000542-196407000-00014","article-title":"High altitude physiology in relation to anesthesia and inhalation therapy","volume":"25","author":"Safar","year":"1964","journal-title":"Anesthesiology"},{"key":"10.1016\/j.bjao.2026.100643_bib75","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1136\/emermed-2013-202909","article-title":"STOP!: a randomised, double-blind, placebo-controlled study of the efficacy and safety of methoxyflurane for the treatment of acute pain","volume":"31","author":"Coffey","year":"2014","journal-title":"Emerg Med J"},{"key":"10.1016\/j.bjao.2026.100643_bib76","series-title":"Auerbach\u2019s Wilderness Medicine","author":"Auerbach","year":"2016"},{"key":"10.1016\/j.bjao.2026.100643_bib77","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1186\/s13049-019-0588-4","article-title":"Prehospital intravenous fentanyl administered by ambulance personnel: a cluster-randomised comparison of two treatment protocols","volume":"27","author":"Friesgaard","year":"2019","journal-title":"Scand J Trauma Resusc Emerg Med"},{"key":"10.1016\/j.bjao.2026.100643_bib78","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1111\/bph.15580","article-title":"Understanding and countering opioid-induced respiratory depression","volume":"180","author":"Bateman","year":"2023","journal-title":"Br J Pharmacol"},{"key":"10.1016\/j.bjao.2026.100643_bib79","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1097\/00000542-200610000-00009","article-title":"Recurrent hypoxemia in children is associated with increased analgesic sensitivity to opiates","volume":"105","author":"Brown","year":"2006","journal-title":"Anesthesiology"},{"key":"10.1016\/j.bjao.2026.100643_bib80","doi-asserted-by":"crossref","first-page":"806","DOI":"10.1097\/00000542-200404000-00009","article-title":"Recurrent hypoxemia in young children with obstructive sleep apnea is associated with reduced opioid requirement for analgesia","volume":"100","author":"Brown","year":"2004","journal-title":"Anesthesiology"},{"key":"10.1016\/j.bjao.2026.100643_bib81","series-title":"StatPearls. Treasure Island (FL)","article-title":"Benzodiazepines","author":"Bounds","year":"2024"},{"key":"10.1016\/j.bjao.2026.100643_bib82","unstructured":"Shokry M, Manaa EM, Shoukry RA, Shokeir MH, Elsedfy GO, Abd El-Aziz AES. Effects of Intrapartum Epidural Analgesia at High Altitudes: Maternal, Fetal, and Neonatal Outcomes. Vol. 1."}],"container-title":["BJA Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2772609626001176?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2772609626001176?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T12:37:27Z","timestamp":1789821447000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S2772609626001176"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":82,"alternative-id":["S2772609626001176"],"URL":"https:\/\/doi.org\/10.1016\/j.bjao.2026.100643","relation":{},"ISSN":["2772-6096"],"issn-type":[{"value":"2772-6096","type":"print"}],"subject":[],"published":{"date-parts":[[2026,9]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Evaluation of the impact of high altitude on pre-hospital anaesthetic administration: a scoping review","name":"articletitle","label":"Article Title"},{"value":"BJA Open","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.bjao.2026.100643","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 The Author(s). Published by Elsevier Ltd on behalf of British Journal of Anaesthesia.","name":"copyright","label":"Copyright"}],"article-number":"100643"}}