Background: Optimal ventilatory settings during general anaesthesia are unknown. The goal of this trial was to test different ventilatory settings and blood pressure targets during general anaesthesia. This manuscript focuses on the ventilatory interventions. Methods: This was a multicentre, randomised factorial trial conducted at eight hospitals in Denmark. Four hundred and eighty‐three patients ASA 3–5, scheduled for major surgery under general anaesthesia, were included. Patients were randomised to positive end‐expiratory pressure (PEEP) of 5, 8, or 10 cm H ₂ O, tidal volume of 6, 8, or 10 mL/kg, and fraction of inspired oxygen (FiO ₂ ) of 30% or 80%. The primary outcome was feasibility of delivering the ventilatory interventions, while secondary outcomes included intra‐ and postoperative complications, hospital length of stay, quality of life and recovery, and mortality. Results: Feasibility goals were not met, but clear separation within each intervention was achieved. There were no differences between groups in most postoperative outcomes. Cardiac arrhythmias appeared more frequently in the PEEP‐8‐ and 10‐cm‐H ₂ O groups (OR 9.32, 95% CI 1.59; 178 and OR 6.71, 95% CI 1.00; 134), compared to the PEEP‐5‐cm‐H ₂ O group. Outcomes did not differ between tidal volume interventions. Pneumonia (OR 4.04, 95% CI 1.40; 14.6) and emergence delirium (OR 5.56, 95% CI 1.94; 20.4) were more frequent in patients allocated to FiO ₂ of 80% than 30%. Conclusion: Adherence to interventions was acceptable, although below feasibility goals. Few postoperative complications were more frequent in patients receiving PEEP 8 and 10, and in patients receiving FiO ₂ of 80%. These findings should be interpreted with caution given the uncertainty of the estimates. Trial Registration: Clinicaltrials.gov: NCT06047119

Background: There is limited high‐quality evidence to guide haemodynamic and respiratory management during general anaesthesia. The goal of this trial was to test the feasibility of testing different ventilatory settings and blood pressure targets. Previous trials on blood pressure targets have suffered from poor adherence and limited between‐group separation. This manuscript focuses on the overall feasibility, as well as blood pressure targets. Methods: This was a multicentre, randomised, factorial, clinical trial conducted at eight hospitals in Denmark. 483 patients ASA 3–5, scheduled for major surgery under general anaesthesia, were included. Patients were randomised to a minimum mean arterial blood pressure (MAP) target of 60, 70 or 80 mmHg, or 90% of baseline systolic blood pressure. The primary outcomes focused on feasibility, while secondary outcomes included intra‐ and postoperative complications, hospital length of stay, quality of life and recovery and mortality. Results: Out of 1690 eligible patients, 483 (29%) were randomised, below the goal of 50%. Separation in blood pressure was achieved and blood pressure during vasoactive treatment was within predefined target ranges. There was no difference in most of the postoperative outcomes. Some complications, including acute kidney injury (OR 4.74, 95% CI 1.17; 31.8) and cardiac arrhythmias (OR 8.13, 95% CI 1.35; 156), were more common in the MAP‐80‐mmHg group compared to the MAP‐60‐mmHg group. The MAP‐80‐mmHg group had fewer days alive and out of hospital within 30 days (median difference −1.88 days, 95% CI −3.50; −0.26). Conclusions: While not all feasibility goals were achieved, separation in blood pressure and adherence to targets were adequate. Larger trials are needed to determine the optimal blood pressure target during general anaesthesia. Trial Registration: Clinicaltrials.gov : NCT06047119.

Background/Objectives: Older patients are more susceptible to the process of understanding and retrieving information. To provide adequate preoperative information, reduce their vulnerability and anxiety, and thereby facilitate pre-, intra-, and postoperative care, the adoption of new information technologies is essential. This study aimed to explore elderly patients’ experiences and perceptions of a Virtual Reality (VR)-based preoperative informational tool designed for individuals scheduled to undergo TKA. Method: A qualitative content analysis was conducted from February to June 2025 based on 14 semi-structured post-discharge interviews. Participants were recruited as part of a randomized controlled trial. Results: One main theme and two categories describe patients’ experiences of using VR information, which is perceived as a valuable supplement to standard preoperative information. The category “Using VR as an information tool” includes how patients experienced the immersive environment, how it affected them, and their views on using the VR glasses. The category “Apply the information provided” described how patients evaluated and applied the VR content in relation to their expectations and the actual surgical experience. Conclusions: Immersive virtual reality (VR) shows promise as a preoperative information tool, improving patients’ understanding of the perioperative process and supporting engagement in their own care. Its effectiveness depends on reliable technical performance and adaptation to individual needs. VR should complement, not replace, communication with healthcare professionals. Further research is needed to identify optimal timing for VR delivery and its impact on preoperative anxiety and patient experience.