Abstract:
BACKGROUND AND OBJECTIVE:The epidural and subarachnoid spaces should be identified at the first attempt, since multiple punctures increase the risk of postdural puncture headache, epidural haematoma and neural trauma. The study aimed to describe the predictors of successful neuraxial blocks at the first attempt. METHODS:After institutional Review Board approval, 1481 patients undergoing spinal or epidural anaesthesia were prospectively enrolled. For each block we recorded: gender, age, height, weight, body habitus, anatomical landmarks (palpability of the spinous processes), spinal anatomy, patient positioning, premedication, needle type and gauge, approach, spinal level of the block, and the provider's level of experience. Retrieval of cerebrospinal fluid or loss of resistance to saline or air identified the subarachnoid and epidural spaces, respectively. The outcome variable was the first attempt success or failure (whether or not the needle was correctly located with one skin puncture and produced adequate surgical anaesthesia). Backward stepwise logistic regression tested its association with the other variables. RESULTS:The first-attempt rate of success was 61.51%. Independent predictors (Odds ratio, 95% confidence limits) were the quality of anatomical landmarks (1.92 (1.57; 2.35)), the provider's level of experience (1.24 (1.15; 1.33)) and the adequacy of patient positioning (3.84 (2.84; 5.19)). CONCLUSIONS:The successful location of the subarachnoid or the epidural space at the first attempt is influenced by the quality of patients' anatomical landmarks, the adequacy of patient positioning and the provider's level of experience.
journal_name
Eur J Anaesthesioljournal_title
European journal of anaesthesiologyauthors
de Filho GR,Gomes HP,da Fonseca MH,Hoffman JC,Pederneiras SG,Garcia JHdoi
10.1017/s0265021502000716subject
Has Abstractpub_date
2002-06-01 00:00:00pages
447-51issue
6eissn
0265-0215issn
1365-2346journal_volume
19pub_type
临床试验,杂志文章abstract:BACKGROUND AND OBJECTIVE:The glutamate-nitric oxide-cyclic guanosine monophosphate pathway has been identified as a potential target for anaesthetic agents. However, mice deficient in neuronal nitric oxide synthase have a similar susceptibility to volatile anaesthetic agents to wild-type mice and are not affected by no...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1017/S0265021505002188
更新日期:2006-03-01 00:00:00
abstract:BACKGROUND:Use of dipyrone (metamizole) in perioperative and ICU pain therapy remains controversial due to a lack of solid evidence weighing dipyrone benefit against its potential life-threatening complications. Although dipyrone has known analgesic and antipyretic properties, its mechanisms of actions are incompletely...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1097/EJA.0000000000000627
更新日期:2017-10-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:We have evaluated the effects of propofol and its relationship with K+ channels on human isolated umbilical vessels. METHODS:Umbilical vessel rings were suspended in isolated organ baths containing Krebs-Ringer solution. In the first series of experiments the effect of propofol (10(-9)-10(-4) ...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1017/S0265021505001924
更新日期:2006-05-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Intravenous administration of compound sodium lactate (CSL) 30 ml kg to women undergoing gynaecological laparoscopy reduced the incidence of vomiting, nausea and antiemetic use when compared with 10 ml kg. The aim of this study was to evaluate the effect of intravenous fluid administration on n...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/EJA.0b013e32831c8793
更新日期:2009-03-01 00:00:00
abstract::We report the case of a 33-year-old woman who developed a dense hemiplegia immediately after an uncomplicated general anaesthetic for diagnostic laparoscopy. She had a history of recurrent hemiplegic migraine with a strong family history. Her migraine was normally associated with visual disturbances and a unilateral h...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1046/j.1365-2346.1998.00368.x
更新日期:1998-09-01 00:00:00
abstract:PURPOSE OF REVIEW:To evaluate the efficacy of a single preoperative dose of 600 mg of gabapentin for reducing postoperative pain and tramadol consumption after minilap open cholecystectomy. METHOD:A total of 120 adult patients of either sex were randomly assigned to receive 600 mg of gabapentin or a matched placebo or...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/EJA.0b013e328334de85
更新日期:2010-04-01 00:00:00
abstract::In anaesthetized dogs, stellate ganglion blockade led to a moderate disturbance in left ventricular diastolic function. We investigated the effect of a left-sided block, following injection of 10 mL bupivacaine 0.5%, on echocardiographic variables of ventricular function in eight otherwise healthy patients with sympat...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1046/j.1365-2346.2000.00606.x
更新日期:2000-02-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Hydroxyethyl starch is frequently used for volume substitution during surgical procedures and for isovolaemic haemodilution. Haemodilution has also been shown to improve tissue oxygen tension in skeletal muscle: However, effects of this volume substitute on tissue oxygen tension of the liver du...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1017/s0265021505000323
更新日期:2005-03-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Postoperative nausea and vomiting causes discomfort in many patients despite both antiemetic prophylactics and improved anaesthetic techniques. Stimulation of acupoint P6 is described as an alternative method for prophylaxis of postoperative nausea and vomiting.In a randomised, double-blinded s...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/EJA.0b013e32833f6f42
更新日期:2011-06-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Recent evidence indicates that platelet function may recover more rapidly after cessation of aspirin therapy than previously thought. The present study evaluated the effect of aspirin on platelet function using platelet aggregometry in healthy individuals and in aspirin-treated patients schedul...
journal_title:European journal of anaesthesiology
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更新日期:2010-07-01 00:00:00
abstract:BACKGROUND:Work disruption in operating rooms hinders flow of patients and increases chances of error. Previous studies have largely considered the types of disruption occurring in operating rooms, but have not analysed systematically the objective impact of disruption. OBJECTIVE:The objective was to evaluate the impa...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,多中心研究
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abstract:BACKGROUND AND OBJECTIVE:Astrocytes exposed to hypoxia produce pro-inflammatory cytokines and upregulate intercellular adhesion molecule-1 on cerebral endothelium. This study investigated the effects of midazolam on this response. METHODS:Mouse astrocytes were exposed to 4 h of hypoxia and 24 h of reoxygenation. Astro...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1017/S0265021506000652
更新日期:2006-09-01 00:00:00
abstract:BACKGROUND:Magnesium potentiates the effects of nondepolarising muscle relaxants. However, few studies have used magnesium chloride (MgCl2). Sugammadex reverses neuromuscular block by steroidal nondepolarising muscle relaxants. OBJECTIVES:To assess the effects of MgCl2 on rocuronium-induced neuromuscular blockade and ...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1097/EJA.0000000000000714
更新日期:2018-03-01 00:00:00
abstract::This paper focuses on the potential role of second messenger systems as general anaesthetic targets. Intracellular free calcium, cyclic nucleotides (cAMP, cGMP), inositol polyphosphates, the protein kinase-activating second messenger diacylglycerol, and the transducing G proteins involved in receptor-coupled second me...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,评审
doi:
更新日期:1995-01-01 00:00:00
abstract::There is disagreement concerning the role of nitric oxide (NO) in general anaesthesia. The present study was conducted to determine whether the anaesthetic drug isoflurane alters levels of NO metabolites, NOx (NO2 and NO3), in the hippocampus of rats during and after anaesthesia. Results showed resting hippocampal NOx...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1046/j.1365-2346.1999.00459.x
更新日期:1999-04-01 00:00:00
abstract::Prolongation of the QT interval may produce potentially hazardous dysrhythmias. The effects on the QT interval of midazolam followed by administration of either vecuronium or atracurium have been investigated. Thirty patients, ASA I or II, without cardiovascular problems, electrolyte abnormalities or receiving any med...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1995-11-01 00:00:00
abstract:CONTEXT:We hypothesised that the Blind Intubation Device (BID) would be effective for nasotracheal intubation (NTI) in anaesthetised adults with Mallampati class 3. We also hypothesised that BID may cause less haemodynamic changes due to the avoidance of direct stimulation induced by the Macintosh blade. OBJECTIVE:The...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/EJA.0b013e328349a9f9
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journal_title:European journal of anaesthesiology
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journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章
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journal_title:European journal of anaesthesiology
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更新日期:1998-05-01 00:00:00
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journal_title:European journal of anaesthesiology
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journal_title:European journal of anaesthesiology
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journal_title:European journal of anaesthesiology
pub_type: 杂志文章,多中心研究
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更新日期:2013-03-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Although the PROWESS trial demonstrated a mortality benefit, subsequent studies in different patient populations have not reproduced the effect. As a result, concerns have been expressed about the clinical effectiveness of drotrecogin alfa (activated). Therefore the aim of this audit was to rev...
journal_title:European journal of anaesthesiology
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doi:10.1017/S0265021507002992
更新日期:2008-03-01 00:00:00
abstract::Perioperative myocardial infarction or ischaemia is a potential consequence of cardiac surgery and elevated free fatty acids can increase the severity of myocardial ischaemic damage. We investigated perioperative changes in serum free fatty acids, and other serum lipids, as a consequence of using propofol infusions fo...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
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abstract::We prospectively evaluated the effects of pneumoperitoneum and reverse Trendelenburg position on cardiopulmonary function in 20 ASA physical status II-III morbidly obese patients (body mass index > 35 kg m(-2)) undergoing laparoscopic gastric banding. After general anaesthesia was induced, patients' lungs were ventila...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章
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更新日期:2000-05-01 00:00:00
abstract::The effect of the administration of a 50 mg dose of an angiotensin converting enzyme inhibitor (captopril) on the mean arterial pressure following sternotomy in 13 patients undergoing coronary artery bypass surgery was indistinguishable from the response in 13 patients who had not received the drug. ...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1984-09-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:A variable incidence rate of renal dysfunction (3-35%) after cardiac surgery with cardiopulmonary bypass has been reported. The aim was to define the typical pattern of renal dysfunction that follows coronary surgery with cardiopulmonary bypass using albumin, immunoglobulin (IgG), alpha1-microg...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
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更新日期:2003-06-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Most therapeutic options for postoperative delirium are only symptom oriented; therefore, the best approach remains prevention. The aim of this study was to identify predisposing and precipitating factors for early postoperative delirium. METHODS:A total of 1002 patients were screened for deli...
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更新日期:2010-05-01 00:00:00