Abstract:
:A 38-yr-old woman with an atrial septum defect and Eisenmenger syndrome was scheduled for a lung biopsy via thoracoscopy during one-lung ventilation. Fluids were given to increase central venous pressure to 8 mm Hg, an epidural catheter was inserted at the sixth thoracic intervertebral space and ropivacaine 0.3%, 6 ml were given. Careful balance of systemic and pulmonary vascular resistance is crucial in Eisenmenger syndrome, so norepinephrine (0.14 mg kg(-1) min(-1)) was infused before general anaesthesia was started with fentanyl 4 mg kg(-1), ketamine 2 mg kg(-1), pancuronium 1 mg and succinylcholine 2 mg kg(-1). Anaesthesia was maintained with propofol 4-8 mg kg(-1) h(-1). To control pulmonary artery pressure, ventilation was performed with oxygen 100% and nitric oxide 20 ppm. Surgery and anaesthesia course were uneventful and the patient was extubated. However, pleural haemorrhage required treatment with blood components, re-intubation on the second postoperative day and removal of the haematoma by mini-thoracotomy. A step-by-step approach using a balanced combination of regional and general anaesthesia, controlled fluid administration, norepinephrine and inhaled nitric oxide preserved a stable circulation even during one-lung ventilation. The diagnostic value of lung biopsy must be weighed against the possibility of life-threatening haemorrhage.
journal_name
Br J Anaesthjournal_title
British journal of anaesthesiaauthors
Heller AR,Litz RJ,Koch Tdoi
10.1093/bja/aeh104subject
Has Abstractpub_date
2004-04-01 00:00:00pages
587-90issue
4eissn
0007-0912issn
1471-6771pii
aeh104journal_volume
92pub_type
杂志文章abstract::Hypothermia during prolonged surgery may be prevented by active and passive warming methods. We have compared randomly two types of occlusive body wraps in groups of 20 patients. One wrap had additional reflective properties which, by reducing radiative in addition to convective and evaporative heat loss, was expected...
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/79.6.766
更新日期:1997-12-01 00:00:00
abstract:BACKGROUND:Low bispectral index values frequently reflect EEG suppression and have been associated with postoperative mortality. This study investigated whether intraoperative EEG suppression was an independent predictor of 90 day postoperative mortality and explored risk factors for EEG suppression. METHODS:This obse...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1093/bja/aeu105
更新日期:2014-12-01 00:00:00
abstract::Bispectral index (BIS) was assessed as a monitor of depth of anaesthesia during fentanyl and midazolam anaesthesia for coronary bypass surgery. In 10 patients given morphine premedication, anaesthesia was induced with a combination of midazolam and fentanyl and thereafter maintained with a continuous infusion of a mix...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/oxfordjournals.bja.a013587
更新日期:2000-06-01 00:00:00
abstract::We describe a scavenging device, primarily for use during inhalation induction of anaesthesia in children; it was designed to optimize the often conflicting requirements of clinical acceptability and adequate gas collection. The performance was assessed in three ways. The device reduced the nitrous oxide concentration...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/64.1.117
更新日期:1990-01-01 00:00:00
abstract:BACKGROUND:The analgesic efficacy of continuous transversus abdominis plane (TAP) blocks in comparison with that of single-injection TAP blocks is not clear. This randomized, triple-blind, placebo-controlled trial investigated the benefits of adding continuous TAP blocks to single-injection TAP blocks after a laparotom...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aew339
更新日期:2016-12-01 00:00:00
abstract::We have investigated the effects of 9.5% and 14.1% MAC concentrations of isoflurane on some psychometric measurements. Both concentrations depressed peak saccadic velocity (P < 0.01), choice reaction time (P < 0.05) and visual analogue scores for sedation (P < 0.05), but not the critical flicker fusion threshold. The ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/71.6.839
更新日期:1993-12-01 00:00:00
abstract:BACKGROUND:Balloon dilatational tracheostomy using the Ciaglia Blue Dolphin device has recently been introduced as a modification of the Ciaglia technique. The aim of this study was to compare the new Dolphin system with the single-step dilatational tracheostomy (Ciaglia Blue Rhino) in intensive care unit (ICU) patient...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aeq087
更新日期:2010-06-01 00:00:00
abstract:BACKGROUND:Cardiac surgery with cardiopulmonary bypass (CPB) is commonly perceived as a risk factor for decline in renal function, especially in patients with preoperative renal dysfunction. There are few data on the effects of CPB on renal function in patients with mild preoperative renal dysfunction. The purpose of t...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,多中心研究
doi:10.1093/bja/aen081
更新日期:2008-06-01 00:00:00
abstract::Buprenorphine 0.3 mg or fentanyl 0.125 mg i.v. were used to supplement nitrous oxide anaesthesia in a double-blind investigation of 40 patients undergoing major abdominal surgery. Initially both narcotics appeared to suppress tachycardia and increased arterial pressure in response to surgery, but 80% of the patients w...
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/52.4.453
更新日期:1980-04-01 00:00:00
abstract:BACKGROUND:We studied the potential neuroprotective effects of halothane and desflurane, compared with the awake state, on infarct size following 2 h of intraluminal middle cerebral artery occlusion (MCAo) and 22 h of reperfusion. METHODS:Male Sprague-Dawley rats were anaesthetized with desflurane or halothane, intuba...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aeg186
更新日期:2003-09-01 00:00:00
abstract:BACKGROUND:Short-axis ultrasound-guided placement of central venous catheters (CVCs) is widely accepted as safe practice. However, utilizing the long-axis approach could further improve safety, as it allows for better visualization of the needle as it is advanced to the target vessel. However, the long-axis approach ha...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aer329
更新日期:2012-01-01 00:00:00
abstract::As the physiology of deliberate hypotension has been unravelled, and as each new pharmacological agent has become available which either depresses or blocks peripheral vascular tone, depresses myocardial performance, or interferes with the conducting tissues within the myocardium, its possible incorporation into the a...
journal_title:British journal of anaesthesia
pub_type: 历史文章,杂志文章
doi:10.1093/bja/47.7.745
更新日期:1975-07-01 00:00:00
abstract::We studied the pharmacokinetics of glycopyrronium in 11 uraemic patients undergoing cadaveric renal transplantation and in seven ASA I control patients undergoing general surgery. Glycopyrronium 4 micrograms kg-1 was given i.v. before induction of anaesthesia. Blood and urine samples were collected for up to 24 h for ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/71.3.437
更新日期:1993-09-01 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:BACKGROUND:Even mild perioperative hypothermia is associated with several severe adverse effects. Resistive heating has possible advantages compared with other active warming systems because it can heat several fields independently. To assess this new warming system, we measured core temperature in patients during surg...
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/aeg106
更新日期:2003-05-01 00:00:00
abstract::Eight patients with a history of failed tracheal intubation during pregnancy were investigated by x-ray laryngoscopy after delivery. Partial elevation of the epiglottis with no view of glottic structures was found in five patients who were therefore considered to still present difficulty. In each of these five patient...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/65.6.813
更新日期:1990-12-01 00:00:00
abstract:BACKGROUND:Fibrinolysis contributes to coagulopathy after major trauma and surgery. We hypothesized that progressive haemodilution is responsible, at least in part, for increased fibrinolytic tendency of blood clot. METHODS:The study was performed in two parts. First, whole blood (WB) samples collected from six health...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aeq001
更新日期:2010-03-01 00:00:00
abstract:BACKGROUND:Thermal, mechanical, and electrical stimuli are often used in acute pain studies and cause qualitatively different pain sensations. Yet, the comparative electroencephalogram (EEG) changes caused by these stimuli have not been studied. We hypothesized that because these stimuli cause different pain sensations...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/ael377
更新日期:2007-03-01 00:00:00
abstract::We have measured in a double-blind study the changes in intraocular pressure (IOP) in 40 consecutive patients (pretreated with fentanyl or alfentanil) who received suxamethonium and tracheal intubation. Although IOP increased significantly following administration of suxamethonium, mean IOP in both groups remained sig...
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/63.6.688
更新日期:1989-12-01 00:00:00
abstract::The effects of bolus doses of phenoperidine 1-2 mg i.v. either alone, or combined with pancuronium 2-4 mg, were investigated in seven patients in traumatic coma. Phenoperidine alone significantly reduced mean arterial pressure (MAP) by a mean (+/- SEM) of 13.2 (+/- 2.8) mm Hg. Overall there was no significant change i...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/59.5.592
更新日期:1987-05-01 00:00:00
abstract:BACKGROUND:Myocardial injury after noncardiac surgery is common, although the exact pathophysiology is unknown. It is plausible that hypotension after surgery is relevant for the development of myocardial injury. The authors evaluated whether low mean arterial pressures (MAPs) after surgery are related to an increased ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1016/j.bja.2017.11.002
更新日期:2018-01-01 00:00:00
abstract::The effect of the topical application of a lignocaine-prilocaine cream (EMLA) on the pain of venous cannulation was tested in a double-blind manner. Sixty boys and girls between the ages of 4 and 10 yr who were to undergo surgery participated in the study. No analgesic premedication was given and the venous cannulatio...
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/58.11.1242
更新日期:1986-11-01 00:00:00
abstract::This is the report of a 55-yr-old female who developed severe myotonia and dystonia after general anaesthesia. Before starting on gabapentin therapy for a neuropathic pain condition, she had undergone numerous uneventful general anaesthetics. Since receiving treatment with gabapentin, she has experienced severe moveme...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aem130
更新日期:2007-08-01 00:00:00
abstract::Carbon dioxide laser surgery in the airway presents the anaesthetist with new problems. The mode of action of carbon dioxide lasers and its effects on anaesthetic agents and equipment are described. Complications, especially of fire hazards in the airway, and methods of avoiding them are set out in detail. Various ana...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/59.12.1610
更新日期:1987-12-01 00:00:00
abstract::We have studied in eight rabbits the cardiovascular effects of midazolam, propofol and alfentanil with graded hypoxia. Central blood volume was reduced progressively by gradual inflation of a thoracic vena cava cuff so that cardiac index (CI) decreased at a constant rate. Under control conditions the haemodynamic resp...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/75.5.610
更新日期:1995-11-01 00:00:00
abstract::The processed electroencephalogram (pEEG) was monitored in eight patients undergoing gynaecological laparotomy under combined extradural and nitrous oxide-isoflurane anaesthesia. Pre-incisional mean spectral edge frequency 95 percentile (SEF95) and median frequency (MF) were 11.67 (SD 1.63) Hz and 3.74 (0.24) Hz, resp...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/78.6.751
更新日期:1997-06-01 00:00:00
abstract::Metoclopramide has been used for almost 40 yr to prevent postoperative nausea and vomiting (PONV). We have reviewed the efficacy and safety of metoclopramide for the prevention of PONV. A systematic search (MEDLINE, EMBASE, manufacturers' databases, hand searching, bibliographies, all languages, up to June 1998) was p...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,meta分析
doi:10.1093/bja/83.5.761
更新日期:1999-11-01 00:00:00
abstract::A variant of a rebreathing/indicator-dilution technique was used to measure lung volume. Two or three indicators, which should have essentially the same pulmonary volume of distribution, were used. Gas compositions were measured by respiratory mass spectrometry and an extrapolation was used to allow for oxygen consump...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/56.3.289
更新日期:1984-03-01 00:00:00
abstract:BACKGROUND:Experimental studies and investigations in patients with cardiac diseases suggest that opioids at clinical concentrations have no important direct effect on myocardial relaxation and contractility. In vivo data on the effect of remifentanil on myocardial function in humans are scarce. This study aimed to inv...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aeq414
更新日期:2011-04-01 00:00:00
abstract:BACKGROUND:LMA CTrach (CT), a modified version of the intubating LMA Fastrach, allows continuous video-endoscopy of the tracheal intubation procedure. We tested the hypothesis that the CT is efficient for tracheal intubation of morbidly obese patients who are at risk of a difficult airway. METHODS:After Ethics' Commit...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/ael219
更新日期:2006-11-01 00:00:00