Abstract:
BACKGROUND:The Alaris AEP monitor(TM) (Alaris, UK, version 1.4) is the first commercially available auditory evoked potential (AEP) monitor designed to estimate the depth of anaesthesia. It generates an "Alaris AEP index" (AAI), which is a dimensionless number scaled from 100 (awake) to 0. This study was designed to compare AAI and BIS(TM) (Aspect, USA, version XP) values at different levels of anaesthesia. METHODS:Adult female patients were premedicated with diazepam 0.15 mg kg(-1) orally on the morning of surgery. Electrodes for BIS and Alaris AEP monitoring and a headphone to give auditory stimuli were applied as recommended by the manufacturers. Anaesthesia was induced with remifentanil (0.4 microg kg(-1) min(-1)) and a propofol target-controlled infusion (Diprifusor(TM) TCI, AstraZeneca, Germany) to obtain a predicted concentration of initially 3.5 microg ml(-1). After loss of consciousness the patients were given 0.5 mg kg(-1) of atracurium. After tracheal intubation, remifentanil was given at 0.2 microg kg(-1) min(-1) and the propofol infusion was adjusted to obtain BIS target values of 30, 40, 50, and 60. AAI and BIS values were recorded and matched with the predicted propofol effect-site concentrations. Prediction probability was calculated for consciousness vs unconsciousness. Values are mean (SD). RESULTS:Fifty female patients, 53 (15), range 18-78 yr, ASA I or II were studied. Mean values before induction of anaesthesia were 95 (4), range 99-82 for BIS and 85 (12), range 99-55 for AAI. With loss of eyelash reflex both values were significantly reduced to 64 (13), range 83-39 for BIS (P<0.05) and 61 (22), range 99-15 for AAI (P<0.05). The prediction probability P(K) for consciousness vs unconsciousness (i.e. loss of eyelash reflex) was better for BIS (P(K)=0.99) than for AAI (P(K)=0.79). At a BIS of 30, 40, 50, and 60 the corresponding AAI values were 15 (6), 20 (8), 28 (11), and 40 (16), and these were significantly different. CONCLUSIONS:During propofol-remifentanil anaesthesia a decrease of the depth of anaesthesia as indicated by BIS monitoring is accompanied by corresponding effects shown by the AAI. However, wide variation in the awake values and considerable overlap of AAI values between consciousness and unconsciousness, suggests further improvement of the AAI system is required.
journal_name
Br J Anaesthjournal_title
British journal of anaesthesiaauthors
Kreuer S,Bruhn J,Larsen R,Hoepstein M,Wilhelm Wdoi
10.1093/bja/aeg189subject
Has Abstractpub_date
2003-09-01 00:00:00pages
336-40issue
3eissn
0007-0912issn
1471-6771pii
S0007-0912(17)36704-1journal_volume
91pub_type
杂志文章abstract::We have investigated the relationship between the extent of spinal block and occurrence of sedation. In a first series of 43 patients, the distribution of sedation score (measured on the Ramsey scale) was related to the extent of spinal block (pinprick). In a second series of 33 patients, the relationship between seda...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/81.6.970
更新日期:1998-12-01 00:00:00
abstract::Plasma diazepam concentrations were determined following oral, i.m. and i.v. administration to a group of pregnant women with pre-eclampsia and a group of normal pregnant women. Diazepam concentrations were greater following oral as compared with i.m. administration in the control group, who received a single 5-mg dos...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/48.11.1091
更新日期:1976-11-01 00:00:00
abstract:Background:In addition to general anaesthetic effects, sevoflurane can also induce hyperactive behaviours during induction and recovery, which may contribute to neurotoxicity; however, the mechanism of such effects is unclear. Volatile anaesthetics including isoflurane have been found to activate the kainate (GluK2) re...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aex043
更新日期:2017-11-01 00:00:00
abstract::We have compared mivacurium and succinylcholine in 27 paediatric patients with mild (Child's A) to moderate (Child's B) liver disease undergoing oesophagogastroduodenoscopy (OGD) and injection of oesophageal varices, with 10 healthy children receiving mivacurium for ENT procedures. With mivacurium 0.2 mg kg-1, the sev...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/81.3.463
更新日期:1998-09-01 00:00:00
abstract:BACKGROUND:Intraperitoneal insufflation of carbon dioxide (CO2) may promote collapse of dependent lung regions. The present study was undertaken to study the effects of CO2-pneumoperitoneum (CO2-PP) on atelectasis formation, arterial oxygenation, and arterial to end-tidal PCO2-gradient (Pa-E'(CO2)). METHODS:Fifteen an...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aep102
更新日期:2009-08-01 00:00:00
abstract:BACKGROUND:The properties of methadone suggest a potential advantage for epidural over i.v. administration for pain relief, but little supportive evidence exists. METHODS:To investigate the pharmacokinetic and the pharmacodynamic properties of epidural and i.v. methadone, four doses of methadone (0.1, 0.25, 0.5, and 0...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aet234
更新日期:2014-01-01 00:00:00
abstract::In a controlled, randomized study, we evaluated duration of neuromuscular block in 80 patients undergoing routine abdominal surgery. Forty patients were aged 18-50 yr (control group) and 40 patients were more than 65 yr (elderly group). All patients had normal plasma creatinine concentrations. After induction of anaes...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/74.6.709
更新日期:1995-06-01 00:00:00
abstract::The effects of different premedication (i.m. and i.v.) on the usefulness of midazolam or thiopentone as induction agents for minor surgery was studied in 194 women undergoing either dilatation and curettage or explorative fractionate curettage. Midazolam appeared to produce light sedation which required powerful preme...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/54.5.507
更新日期:1982-05-01 00:00:00
abstract:BACKGROUND:After cardiac surgery adequate postoperative analgesia is necessary. We assessed analgesia using intrathecal morphine and clonidine. METHODS:In a double-blind randomized study, 45 patients having coronary artery bypass graft surgery were allocated randomly to receive i.v. patient-controlled analgesia (PCA) ...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/aeg070
更新日期:2003-03-01 00:00:00
abstract::Blood samples were obtained from a radial artery cannula in a 60-yr-old man during coronary artery surgery. Serum potassium concentrations of 9.3, 8.4, and 7.4 mmol litre(-1) were obtained. A simultaneous venous blood sample gave a serum potassium concentration of 4.4 mmol litre(-1). The ECG was unchanged. After the a...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aeh199
更新日期:2004-09-01 00:00:00
abstract:BACKGROUND:Dexmedetomidine has been proposed as a perineural local anaesthetic (LA) adjunct to prolong peripheral nerve block duration; however, results from our previous meta-analysis in the setting of brachial plexus block (BPB) did not support its use. Many additional randomized trials have since been published. We ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,meta分析,评审
doi:10.1093/bja/aew411
更新日期:2017-02-01 00:00:00
abstract::This study tests the hypothesis that naloxone, but not its quarternary salt, naloxone methiodide (which does not enter the central nervous system), improves recovery from myocardial stunning in conscious dogs. Twenty dogs were chronically instrumented for measurement of heart rate, left atrial, aortic and left ventric...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/86.4.545
更新日期:2001-04-01 00:00:00
abstract::We have studied haemodynamic responses to 0, 0.25, 0.5, 0.75 and 1 MAC isoflurane administration in 10 patients during a zero-order propofol infusion and normocapnia. Isoflurane reduced mean arterial pressure (MAP), systemic vascular resistance and left ventricular stroke work in a dose-dependent manner (29%, 38% and ...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/69.1.36
更新日期:1992-07-01 00:00:00
abstract:BACKGROUND:We investigated the effects of spinal and general anaesthesia and surgical tourniquet on acute pain and early recovery after total knee arthroplasty (TKA). METHODS:Patients (n=413) were randomised to four parallel groups: spinal anaesthesia with or without tourniquet, and general anaesthesia with or without...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.bja.2020.03.036
更新日期:2020-11-01 00:00:00
abstract::This case series presents 10 patients undergoing vascular surgery with asymptomatic elevated high-sensitivity troponin T concentrations, measured at outpatient clinic before surgery. Patients were included in the RAVE (Rotterdam Antiplatelet therapy in Vascular patiEnts) pilot study. All included patients underwent co...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.bja.2019.08.013
更新日期:2019-11-01 00:00:00
abstract:BACKGROUND:The therapeutic potential of cardiac μ-opioid receptors in ischaemia-reperfusion (I/R) injury during opioid-modulating diseases, such as heart failure, is unknown. We aimed to explore the changes of cardiac μ-opioid receptor expression during heart failure, and its role in opioid-induced cardioprotection. M...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1016/j.bja.2017.11.110
更新日期:2018-07-01 00:00:00
abstract::All currently available aminoacylaniline local anaesthetics, except lignocaine, contain a chiral centre but are used as racemates, a fact usually ignored in pharmacokinetic studies. This study reports the cardiovascular effects, and the regional and total body clearances of the enantiomers of bupivacaine determined at...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/67.3.247
更新日期:1991-09-01 00:00:00
abstract::The experimental effort that has been expended in investigating the effects of general anaesthetics on LGICs has been enormous over the past decade. Members of all three LGIC superfamilies have been examined using electrophysiological techniques. Anaesthetics that have been examined include volatile anaesthetics, gase...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/aef161
更新日期:2002-07-01 00:00:00
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journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/76.1.5
更新日期:1996-01-01 00:00:00
abstract:BACKGROUND:The Bispectral Index (BIS) is a proprietary index of anaesthesia depth, which is correlated with the level of consciousness and probability of intraoperative recall. The present study investigates the use of a neural network technique to obtain a non-proprietary index of the depth of anaesthesia from the pro...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
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更新日期:2002-05-01 00:00:00
abstract:BACKGROUND:Cut-off points (CPs) of the numeric rating scale (NRS 0-10) are regularly used in postoperative pain treatment. However, there is insufficient evidence to identify the optimal CP between mild and moderate pain. METHODS:A total of 435 patients undergoing general, trauma, or oral and maxillofacial surgery wer...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aer195
更新日期:2011-10-01 00:00:00
abstract:BACKGROUND:Intubation of a patient with limited cervical spine movement or in whom movement of the cervical spine is not desirable is always a challenge even to the most experienced anaesthesiologist. The intubating laryngeal mask airway (ILMA) and the Bullard laryngoscope (BL) are two instruments recommended for endot...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aem127
更新日期:2007-08-01 00:00:00
abstract::The analgesic efficacy of a 150-mg meptazinol suppository was compared with that of morphine 10 mg i.m. in the treatment of moderate postoperative pain. Two groups of 15 female patients took part in a 4-h, randomized double-blind, double-dummy study on the first day after elective abdominal hysterectomy. Meptazinol di...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/60.5.542
更新日期:1988-04-01 00:00:00
abstract::We have examined the role of gamma-aminobutyric acid (GABA) neurones in propofol anaesthesia in mice using the righting reflex. Propofol i.p. increased the percentage of loss of the righting reflex in a dose-dependent manner with an ED50 value of 140 (95% confidence limits 123-160) mg kg-1 (n = 40; eight animals per d...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/83.4.665
更新日期:1999-10-01 00:00:00
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journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1016/j.bja.2019.12.042
更新日期:2020-02-14 00:00:00
abstract::The in vitro halothane and caffeine contracture tests have been performed on muscle tissue from six survivors of the neuroleptic malignant syndrome. The results, which are expressed in accordance with the criteria of the European MH Group, defined five of the subjects as MHN and one patient as MHE. It is concluded tha...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/59.12.1554
更新日期:1987-12-01 00:00:00
abstract::We have measured the onset and extent of the miotic effect of morphine and alfentanil in conscious patients. Forty unpremedicated ASA I and II patients were allocated randomly to four groups to receive either i.v. saline (control group), morphine 0.1 mg kg-1, alfentanil 4.0 micrograms kg-1 or a combination of these do...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/65.3.415
更新日期:1990-09-01 00:00:00
abstract::The value of the continuous monitoring of end-tidal carbon dioxide concentration as an indicator of the acute intraoperative interruption of pulmonary blood flow, in patients with pre-existing restrictions of pulmonary blood flow undergoing closed heart surgery, is illustrated by two case reports. Decreases in end-tid...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/57.12.1257
更新日期:1985-12-01 00:00:00
abstract::We have studied the plasma concentrations (Cp) and pharmacokinetics of sufentanil injected i.v. (IVS), intradurally (IS) or extradurally (ES) under general anaesthesia in 31 patients undergoing major abdominal surgery. Sufentanil appeared in plasma very rapidly and Cpmax was also attained rapidly after both extradural...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/66.4.458
更新日期:1991-04-01 00:00:00
abstract::We have compared insertion of a tracheal tube and laryngeal mask airway (LMA) both with and without the presence of a tube in the oesophagus in 20 ASA I and II patients undergoing elective laparoscopy. After induction of anaesthesia and neuromuscular block, we measured the times for an experienced anaesthetist to corr...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/73.5.688
更新日期:1994-11-01 00:00:00