Abstract:
BACKGROUND:Propofol and sevoflurane are suitable agents for maintenance of anaesthesia during neurosurgical procedures. We have prospectively compared these agents in combination with the short-acting opioid, remifentanil. METHODS:Fifty unpremedicated patients undergoing elective craniotomy received remifentanil 1 microg kg(-1) followed by an infusion commencing at 0.5 microg kg(-1) min(-1) reducing to 0.25 microg kg(-1) min(-1) after craniotomy. Anaesthesia was induced with propofol, and maintained with either a target-controlled infusion of propofol, minimum target 2 microg ml(-1) or sevoflurane, initial concentration 2%(ET). Episodes of mean arterial pressure (MAP) more than 100 mm Hg or less than 60 mm Hg for more than 1 min were defined as hypertensive or hypotensive events, respectively. A surgical assessment of operating conditions and times to spontaneous respiration, extubation, obey commands and eye opening were recorded. Drug acquisition costs were calculated. RESULTS:Twenty-four and twenty-six patients were assigned to propofol (Group P) and sevoflurane anaesthesia (Group S), respectively. The number of hypertensive events was comparable, whilst more hypotensive events were observed in Group S than in Group P (P=0.053, chi-squared test). As rescue therapy, more labetolol [45 (33) vs 76 (58) mg, P=0.073] and ephedrine [4.80 (2.21) vs 9.78 (5.59) mg, P=0.020] were used in Group S. Between group differences in recovery times were small and clinically unimportant. The combined hourly acquisition costs of hypnotic, analgesic, and vasoactive drugs appeared to be lower in patients maintained with sevoflurane than with propofol. CONCLUSION:Propofol/remifentanil and sevoflurane/remifentanil both provided satisfactory anaesthesia for intracranial surgery.
journal_name
Br J Anaesthjournal_title
British journal of anaesthesiaauthors
Sneyd JR,Andrews CJ,Tsubokawa Tdoi
10.1093/bja/aei141subject
Has Abstractpub_date
2005-06-01 00:00:00pages
778-83issue
6eissn
0007-0912issn
1471-6771pii
S0007-0912(17)36032-4journal_volume
94pub_type
临床试验,杂志文章,随机对照试验abstract::A new prototype of the laryngeal mask airway (LMA), the intubating laryngeal mask airway (ILMA), was used to facilitate tracheal intubation in 100 fasted patients presenting for elective surgery. Alignment of the ILMA with the larynx was assessed fibreoptically before intubation without the investigator performing the...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/79.6.710
更新日期:1997-12-01 00:00:00
abstract::In 105 patients undergoing day-case surgery recovery of consciousness was significantly faster after enfluane compared with halothane anaesthesia. There was no difference in postoperative morbidity between the two anaesthetic groups. ...
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/51.12.1143
更新日期:1979-12-01 00:00:00
abstract::Systolic pressure variation (SPV) and its dDown component have been shown to be sensitive factors in estimating intravascular volume in patients undergoing mechanical ventilation. In this study, ventilation-induced changes in pulse oximeter plethysmographic waveform were evaluated after removal and after reinfusion of...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/82.2.178
更新日期:1999-02-01 00:00:00
abstract::The time course of the plasma lignocaine concentration, following caudal anaesthesia, was studied in 11 healthy children (3.5-9 yr). Plasma lignocaine concentrations were measured for up to 6 h after administration (5 mg kg-1). Peak plasma concentration was 2.05 +/- 0.08 micrograms ml-1 and occurred at 28.2 +/- 2.9 mi...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/56.12.1399
更新日期:1984-12-01 00:00:00
abstract::Six male patients were studied on the morning following upper abdominal surgery for highly selective vagotomy. Nalbuphine hydrochloride was infused i.v. at different rates that increased progressively in each hour over a 4-h period. In the last 15 min of each hour, the plasma nalbuphine concentrations were almost stea...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/59.11.1356
更新日期:1987-11-01 00:00:00
abstract::Plasma concentrations of pancuronium were measured in nine patients undergoing surgery because of total biliary obstruction. When compared with the averaged model-independent pharmacokinetic parameters obtained for normal patients, the terminal half-life of 270 min was more than twice normal (132 min, P less than 0.00...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/49.11.1103
更新日期:1977-11-01 00:00:00
abstract::In order to evaluate the use of the post-tetanic count (PTC) method during repetitive administration of vecuronium, we studied 20 patients allocated randomly to one of two groups: 10 patients received droperidol-fentanyl anaesthesia (control group); 10 other patients were given droperidol-fentanyl anaesthesia modified...
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/65.4.487
更新日期:1990-10-01 00:00:00
abstract:BACKGROUND:This study was undertaken to compare the effects of general anaesthesia (GA) and spinal anaesthesia (SA) on the need for postoperative hospitalization and early postoperative comfort in patients undergoing fast-track total knee arthroplasty (TKA). METHODS:One hundred and twenty subjects were randomly alloca...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aet104
更新日期:2013-09-01 00:00:00
abstract::We report a case of lumbar extradural abscess that presented 9 days after an elective Caesarean section performed under combined spinal-extradural anaesthesia. This was successfully treated conservatively with full recovery. The clinical course included development, and then resolution, of mild paraparesis. Conservati...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/78.5.591
更新日期:1997-05-01 00:00:00
abstract::We compared psychomotor recovery after total intravenous anaesthesia (TIVA) with remifentanil/propofol and balanced anaesthesia (BAL) with etomidate/fentanyl/isoflurane in 40 patients, ASA I-III, aged > or =80 yr undergoing elective cataract surgery. Recovery times were recorded and psychomotor recovery was assessed 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/86.2.203
更新日期:2001-02-01 00:00:00
abstract::A high degree of safety from fires and explosions exists in operating theatres in the U.K. and this is reflected in the extremely low number of fatal and non-fatal accidents which occur. This has been achieved by safety precautions which in some respects have been over-careful and overexpensive. Antistatic precautions...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/50.7.659
更新日期:1978-07-01 00:00:00
abstract::Haemodynamic changes (supraventricular tachycardia, decreases in arterial pressure) were observed during laryngoscopy and intubation of the trachea in a patient receiving nifedipine and verapamil. Before the induced stresses of laryngoscopy and tracheal intubation, these drugs had controlled the patient's arterial pre...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/58.3.357
更新日期:1986-03-01 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::The ventilatory effects of single i.v. doses of morphine 0.1 mg kg-1, pethidine 0.67 mg kg-1 and methadone 0.1 mg kg-1 were compared after ophthalmic surgery in an open, randomized study in 30 children aged 3-8 yr. Ventilatory changes after each drug had distinctive profiles, with appreciable individual variation. Acu...
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/70.4.414
更新日期:1993-04-01 00:00:00
abstract::The new emulsion formulation of di-isopropyl phenol (propofol) was compared with methohexitone and thiopentone for induction of anaesthesia in day cases. Propofol produced significantly smoother induction of anaesthesia, but caused more cardiovascular and respiratory depression. Pain on injection was significantly les...
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/57.8.725
更新日期:1985-08-01 00:00:00
abstract::We have assessed a prototype laryngeal mask airway (pLMA) in 50 anaesthetized children for ease of insertion, oropharyngeal leak pressures, gastric insufflation and fibreoptic position. The pLMA has a second smaller mask, which rests against the upper oesophageal sphincter, and a second cuff to increase the seal press...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/82.1.132
更新日期:1999-01-01 00:00:00
abstract:BACKGROUND:The immobilizing effects of volatile anaesthetics are primarily mediated at the spinal level. A suppression of recurrent spinal responses (F-waves), which reflect spinal excitability, has been shown for propofol. We have assessed the concentration-dependent F-wave suppression by propofol and related it to th...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aei283
更新日期:2006-01-01 00:00:00
abstract::The effect of prostaglandin E1 (PGE1) on local cerebral blood flow (LCBF) and carbon dioxide reactivity (CO2R) was studied during cerebral aneurysm surgery for subarachnoid haemorrhage in 24 patients under neuroleptanaesthesia. Eleven patients had good neurological status (Hunt and Kosnik grade I: group A) and 13 pati...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/68.3.268
更新日期:1992-03-01 00:00:00
abstract:BACKGROUND:Improvement of postoperative pain and other perioperative outcomes remain a significant challenge and a matter of debate among perioperative clinicians. This systematic review aims to evaluate the effects of perioperative i.v. lidocaine infusion on postoperative pain and recovery in patients undergoing vario...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,meta分析,评审
doi:10.1093/bja/aew101
更新日期:2016-06-01 00:00:00
abstract:BACKGROUND:Pulse pressure variation (PPV) and stroke volume variation (SVV) are robust indicators of fluid responsiveness in mechanically ventilated supine patients. The aim of the study was to evaluate the ability of PPV and SVV to predict fluid responsiveness in mechanically ventilated patients in the prone position ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aeq031
更新日期:2010-04-01 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::A patient with Ebstein's anomaly undergoing anaesthesia for the operation of hysterectomy is reported. The considerations relating to the risk of an increased right-to-left intracardiac shunt are discussed. The patient was anaesthetized successfully with a combination of nitrous oxide, droperidol and fentanyl. ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/49.5.501
更新日期:1977-05-01 00:00:00
abstract:BACKGROUND:Phonomyography (PMG) is a novel method to monitor neuromuscular block. It is non-invasive and can be applied to any muscle. It can be used interchangeably with mechanomyography (MMG). The staircase phenomenon has not been investigated for this method or at the corrugator supercilii muscle. The purpose of thi...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aei183
更新日期:2005-09-01 00:00:00
abstract:BACKGROUND:Recent studies have concluded that i.v. dexamethasone can prolong the duration of peripheral nerve blockade. We hypothesized that a 4 mg dose would equally prolong the duration of psoas compartment blocks (PCBs) when compared with 8 mg, and that both doses would prolong the duration when compared with placeb...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.bja.2017.11.073
更新日期:2018-02-01 00:00:00
abstract::Perioperative risk of death after general surgery is quoted as overall less than 1%. However, each individual's risk varies widely according to many identified factors with some having a significantly increased risk of a worse outcome. The observation that manipulating and targeting certain physiological parameters in...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/ael102
更新日期:2006-07-01 00:00:00
abstract::We have performed a prospective, randomized, double-blind clinical study to assess the efficacy of ondansetron, droperidol, or both, in preventing postoperative emesis. We studied 242 patients undergoing biliary or gynaecological surgery under general anaesthesia. Shortly before induction of anaesthesia, patients rece...
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/83.5.813
更新日期:1999-11-01 00:00:00
abstract::We have investigated the incidence of regurgitation of gastric contents during general anaesthesia administered via a laryngeal mask airway (LMA) or face mask and Guedel airway in 56 patients with no risk factors for regurgitation. Patients swallowed a gelatin capsule containing methylene blue 10 min before induction ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/69.3.314
更新日期:1992-09-01 00:00:00
abstract::The haemodynamic effects of diltiazem were studied in six dogs during fentanyl-nitrous oxide (in oxygen) anaesthesia. A bolus of diltiazem 300 micrograms kg-1 was given, followed by infusions at 30, 60 and 90 micrograms kg-1 min-1 which produced plasma diltiazem concentrations of 392 +/- 30, 908 +/- 54 and 1483 +/- 13...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/60.6.655
更新日期:1988-05-01 00:00:00
abstract:Background:Retrospective clinical studies suggest there is a risk for neurodevelopmental impairment following early childhood exposure to anaesthesia. In the developing animal brain, including those of non-human primates (NHPs), anaesthetics induce apoptotic cell death. We previously reported that a 5 h isoflurane (ISO...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aex123
更新日期:2017-09-01 00:00:00
abstract::We evaluated the use of an inexpensive trans-illuminating light wand for tracheal intubation. Expertise in its use was acquired quickly, thereby providing successful per-oral intubation in all patients who were able to open the mouth, irrespective of the view obtained of the epiglottis and larynx. ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/62.5.494
更新日期:1989-05-01 00:00:00