Abstract：
BACKGROUND:The solubility of desflurane compared with sevoflurane suggests more rapid recovery from desflurane anaesthesia. This could be important after prolonged anaesthesia and fast recovery may be advantageous in the elderly where slow recovery of mental function is a concern. We compared emergence from desflurane vs sevoflurane in elderly patients undergoing two or more hours of anaesthesia.
METHODS:Fifty ASA physical status I, II, or III patients, 65 yr of age or older, undergoing anaesthesia expected to last two or more hours were randomly assigned to receive desflurane/nitrous oxide or sevoflurane/nitrous oxide anaesthesia. Patients were given 1-2 microg x kg(-1) fentanyl i.v. and anaesthesia was induced with propofol 1.5-2.5 mg x kg(-1) i.v. and maintained with either desflurane 2-6% or sevoflurane 0.6-1.75% with nitrous oxide 65% in oxygen. Inspired anaesthetic concentrations were adjusted to obtain adequate surgical anaesthesia and to maintain mean arterial pressure within 20% of baseline values. Early and intermediate recovery times were recorded. Digit-Symbol Substitution Test (DSST) scores and Visual Analog Scale (VAS) scores for pain and nausea were recorded before pre-medication and every 15 min in the Post Anaesthesia Care Unit (PACU) until patients were discharged.
RESULTS:Early recovery times are given as median, quartiles. The times to extubation (5 (4-9); 9 (5-13) min), eye opening (5 (3-5); 11 (8-16) min), squeezing fingers on command (7 (4-9); 12 (8-17) min); and orientation (7 (5-9); 16 (10-21) min) were significantly less (P<0.05) for desflurane than for sevoflurane. Intermediate recovery, as measured by the DSST and time to ready for discharge from the PACU (56 (35-81); 71 (61-81) min) was similar in the two groups.
CONCLUSIONS:Early but not intermediate recovery times of elderly patients undergoing a wide range of surgical procedures requiring two or more hours of anaesthesia is significantly (P journal_name journal_title authors doi subject pub_date pages issue eissn issn pii journal_volume pub_type
abstract：:We have determined the effect of pretreatment with mivacurium on the potency of suxamethonium and the effect of prior administration of suxamethonium on the potency of mivacurium. We studied 100 ASA I or II patients during thiopentone-fentanyl-nitrous oxide-isoflurane anaesthesia. Neuromuscular block was recorded as t...
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/74.1.26
更新日期：1995-01-01 00:00:00
abstract：:The effects of some anaesthetics and other agents used in anaesthetic practice on the neuromuscular blocking activity of cumulative doses of Org NC 45 have been studied in cats anaesthetized with chloralose. As expected from studies with other neuromuscular blocking drugs, both inhalation and i.v. anaesthetics reduced...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/53.8.785
更新日期：1981-08-01 00:00:00
abstract：:Volume loading with crystalloid solution results in more pronounced haemodilution in patients who develop arterial hypotension during induction of extradural anaesthesia than in those who remain normotensive. The aim of this study was to describe the time course of this increase in haemodilution. Heart rate, systolic ...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/77.2.223
更新日期：1996-08-01 00:00:00
abstract：:The clinical understanding of the dynamics of myocardial contraction is hampered by an over-simplified interpretation of the intramural pattern of force generation. This limits the anaesthetist's knowledge of the direct effects of commonly used anaesthetics. A discrimination between a negative inotropic effect and cha...
journal_title：British journal of anaesthesia
pub_type： 杂志文章,评审
doi：10.1093/bja/60.suppl_1.2s
更新日期：1988-01-01 00:00:00
abstract：BACKGROUND:The pathophysiology of the serotoninergic system in malignant hyperthermia (MH) is not completely understood. The serotonin-2 (5HT(2A)) receptor agonist 1-(2,5-dimethoxy-4-iodophenyl)-2-aminopropane hydrochloride (DOI) induces typical MH symptoms, including skeletal muscle rigidity, an increase in body tempe...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/aeg172
更新日期：2003-08-01 00:00:00
abstract：BACKGROUND:The perioperative period may be associated with a marked neurohumoral stress response, significant fluid losses, and varied fluid replacement regimes. Acute changes in serum sodium concentration are therefore common, but predictors and outcomes of these changes have not been investigated in a large surgical ...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/aeu409
更新日期：2015-04-01 00:00:00
abstract：:To determine if improved postoperative recovery in surgical inpatients receiving intraoperative therapeutic suggestions are applicable in an outpatient population, 70 consenting, unpremedicated adults undergoing elective outpatient hernia repair under general anaesthesia were allocated randomly to either a therapeutic...
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/82.6.861
更新日期：1999-06-01 00:00:00
abstract：:We have examined the correlation between the evoked electromyographic response in the first dorsal interosseous muscle of the hand, temperature and forearm position in 40 female patients after enflurane anaesthesia with spontaneous breathing. In 20 patients the supinated forearm with the wrist extended was immobilized...
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/72.4.407
更新日期：1994-04-01 00:00:00
abstract：:We describe three histaminoid reactions occurring on induction of anaesthesia. The patients were all resuscitated successfully and subsequent skin testing suggested sensitivity to rocuronium. In this hospital, the incidence of such reactions is of the order of 1 in 3000. This may be coincidental but suggests that ther...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/oxfordjournals.bja.a013365
更新日期：2000-01-01 00:00:00
abstract：:In obstetric patients undergoing postpartum tubal ligation, we found that metoclopramide produced dose-dependent prolongation of suxamethonium-induced neuromuscular block. Mean block times after suxamethonium 1 mg kg-1 were 8.0 min, 9.83 min and 12.45 min for control and metoclopramide 10 mg and metoclopramide 20 mg g...
journal_title：British journal of anaesthesia
pub_type： 临床试验,杂志文章
doi：10.1093/bja/65.2.220
更新日期：1990-08-01 00:00:00
abstract：:Haemodynamic effects may occur after stellate ganglion block (SGB) arising from autonomic imbalance and local anaesthetic infiltration to barosensitive areas. We report seven patients who developed severe hypertension (systolic arterial pressure >200 mm Hg) after SGB in our pain clinic service. We postulate that diffu...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/aei134
更新日期：2005-06-01 00:00:00
abstract：:A double-blind randomized trial was conducted to compare etidocaine, the new local anaesthetic agent, with bupivacaine. One hundred patients were each given a single dose of one of the drugs during the surgical induction of labour. The results showed that etidocaine had a quicker onset of action than bupivacaine, but ...
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/47.12.1305
更新日期：1975-12-01 00:00:00
abstract：BACKGROUND:The perioperative management of two-stage oesophagectomy has not been standardized and the prevailing practice regarding the timing of extubation after the procedure varies. This audit has evaluated the outcome, in particular the respiratory morbidity and mortality, after immediate extubation in patients who...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/aeg091
更新日期：2003-04-01 00:00:00
abstract：:The use of di-isopropyl phenol (Diprivan) for induction of anaesthesia was assessed in doses ranging from 1 to 3 mg kg-1. With less than 1.75mg kg-1 not all patients were anaesthetized; 2.0 mg kg-1 appeared to be a satisfactory induction dose. Involuntary muscle movement, cough and hiccup at induction were rare with a...
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/53.11.1197
更新日期：1981-11-01 00:00:00
abstract：:Seven patients are described in whom a prophylactic blood patch was instituted within 15 min of accidental dural puncture. Five of the patients received extradural anaesthesia before the blood patch, and one after the blood patch had been performed. In three of these patients further "top-up" doses of local anaestheti...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/57.5.538
更新日期：1985-05-01 00:00:00
abstract：:Eighteen patients were studied, during operations under subarachnoid or extradural anaesthesia combined with general anaesthesia, to assess the influence of occlusion of inspiration on the duration of inspiration, and the likelihood of a relationship between lung volume and duration of inspiration. Ten patients breath...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/56.3.215
更新日期：1984-03-01 00:00:00
abstract：:We have investigated 60 patients in a prospective double-blind, placebo-controlled study to assess the efficacy of EMLA (Eutectic Mixture of Local Anaesthetics) cream to provide analgesia during extracorporeal shock wave lithotripsy (ESWL) with a second generation lithotriptor. Before operation, EMLA or placebo cream ...
journal_title：British journal of anaesthesia
pub_type： 临床试验,杂志文章
doi：10.1093/bja/69.4.399
更新日期：1992-10-01 00:00:00
abstract：BACKGROUND:Current guidelines for perioperative management of coronavirus disease 19 (COVID-19) are mainly based on extrapolated evidence or expert opinion. We aimed to systematically investigate how COVID-19 affects perioperative management and clinical outcomes, to develop evidence-based guidelines. METHODS:First, w...
journal_title：British journal of anaesthesia
pub_type： 杂志文章,评审
doi：10.1016/j.bja.2020.08.049
更新日期：2020-12-01 00:00:00
abstract：:In an open study we have investigated the efficacy of 20 ml of 0.75% ropivacaine (7.5 mg ml-1) to provide extradural anaesthesia for elective Caesarean section. Plasma concentrations (total and free) were estimated in the mother and neonate. Anaesthesia was effective and safe. Plasma concentrations of ropivacaine in t...
journal_title：British journal of anaesthesia
pub_type： 临床试验,杂志文章
doi：10.1093/bja/79.1.3
更新日期：1997-07-01 00:00:00
abstract：BACKGROUND:Postoperative cognitive dysfunction (POCD) is a common complication in elderly patients after major surgery. An association between POCD and the development of dementia has been suspected. In this study, we assessed if POCD was a risk factor for the occurrence of dementia. METHODS:Danish patients enrolled b...
journal_title：British journal of anaesthesia
pub_type： 杂志文章,多中心研究
doi：10.1093/bja/aes466
更新日期：2013-06-01 00:00:00
abstract：:We have examined the effects of two types of insulin therapy (continuous i.v. infusion (group A: 1.25 u. h-1) and direct i.v. bolus administration of 10 u. every 2 h (group B: 10 u./2 h)) on the metabolic and endocrine responses to surgery in 60 adult diabetic patients undergoing general anaesthesia for elective proce...
journal_title：British journal of anaesthesia
pub_type： 临床试验,杂志文章
doi：10.1093/bja/72.1.5
更新日期：1994-01-01 00:00:00
abstract：:We have measured plasma concentrations of bupivacaine after ilioinguinal block in children of different sizes. We studied 14 children with weights 10-15 kg and 17 children with weights 15-30 kg. Each child received 0.5% bupivacaine 0.25 ml kg-1 (1.25 mg kg-1) (Carbostesin, Astra, Germany). Venous blood was obtained be...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/76.3.452
更新日期：1996-03-01 00:00:00
abstract：:We have investigated the effect of a bolus injection of atracurium 0.6 mg kg-1 on the cardiovascular system in 16 patients undergoing aortocoronary bypass surgery. H1- and H2-receptor antagonists were administered to eight patients before the neuromuscular blocker. A standard anaesthetic was used comprising fentanyl, ...
journal_title：British journal of anaesthesia
pub_type： 临床试验,杂志文章
doi：10.1093/bja/68.2.155
更新日期：1992-02-01 00:00:00
abstract：:One hundred patients presenting for surgical treatment of fractured neck of femur were allocated to receive either spinal (SAB) or general (GA) anaesthesia. Before operation, the mean PaO2 was 9.04 kPa. There was a significant decrease in PaO2 of 0.68 kPa in GA group at 1 h after operation, while blood-gas values were...
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/52.1.49
更新日期：1980-01-01 00:00:00
abstract：:Arterial blood and expired gas samples were taken from 20 patients before operation and on the first day after upper abdominal surgery. After operation the patients were studied breathing air and also breathing 35% oxygen from a venturi-type mask. Preoperative Pao2 with age was exaggerated by operation. Pao2 after ope...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/47.4.491
更新日期：1975-04-01 00:00:00
abstract：:When using endobronchial anaesthesia for the management of transthoracic endoscopic sympathectomy (TES), excessive insufflation of carbon dioxide into the pleural space may cause haemodynamic instability, hypoxaemia and tension pneumothorax. We prospectively studied an alternative technique using a tracheal tube, i.v....
journal_title：British journal of anaesthesia
pub_type： 临床试验,杂志文章
doi：10.1093/bja/74.2.141
更新日期：1995-02-01 00:00:00
abstract：BACKGROUND:The aim of this study was to determine the prevalence of postoperative nausea and vomiting (PONV) after fast-track cardiac anaesthesia, risk factors for PONV and its influence on the length of stay in the intensive care unit (ICU). METHODS:A prospective study was performed in the cardiothoracic ICU (CTICU) ...
journal_title：British journal of anaesthesia
pub_type： 临床试验,杂志文章
doi：10.1093/bja/aeg166
更新日期：2003-08-01 00:00:00
abstract：BACKGROUND:Propofol is used during living-related donor liver transplantation because its metabolism is not greatly affected by liver failure. However, the pharmacokinetics of propofol during liver transplantation have not been fully defined. The purpose of this study was to evaluate the apparent systemic clearance of ...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/aei243
更新日期：2005-11-01 00:00:00
abstract：:We describe a case of a 9-yr-old child with sickle cell disease complicated by abdominal vaso-occlusive crisis and priapism. Both complications were successfully treated with a combination of epidural local anesthetics and morphine. ...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/87.6.935
更新日期：2001-12-01 00:00:00
abstract：:We tested the hypothesis that premedication with i.m. midazolam decreases core temperature dose-dependently. We studied six male volunteers, in random order, on 3 days: (1) no midazolam administration (control day), (2) midazolam 0.025 mg kg-1 i.m., (3) midazolam 0.075 mg kg-1 i.m. On the first day, subjects were main...
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/78.4.396
更新日期：1997-04-01 00:00:00
