Abstract:
BACKGROUND:The ilioinguinal/iliohypogastric nerve block is a popular regional anaesthetic technique for children undergoing inguinal surgery. The success rate is only 70-80% and complications may occur. A prospective randomized double-blinded study was designed to compare the use of ultrasonography with the conventional ilioinguinal/iliohypogastric nerve block technique. METHODS:One hundred children (age range, 1 month-8 years) scheduled for inguinal hernia repair, orchidopexy or hydrocele repair were included in the study. Following induction of general anaesthesia, the children received an ilioinguinal/iliohypogastric block performed either under ultrasound guidance using levobupivacaine 0.25% until both nerves were surrounded by the local anaesthetic or by the conventional 'fascial click' method using levobupivacaine 0.25% (0.3 ml kg(-1)). Additional intra- and postoperative analgesic requirements were recorded. RESULTS:Ultrasonographic visualization of the ilioinguinal/iliohypogastric nerves was possible in all cases. The amount of local anaesthetic used in the ultrasound group was significantly lower than in the 'fascial click' group (0.19 (SD 0.05) ml kg(-1) vs 0.3 ml kg(-1), P<0.0001). During the intraoperative period 4% of the children in the ultrasound group received additional analgesics compared with 26% in the fascial click group (P=0.004). Only three children (6%) in the ultrasound-guided group needed postoperative rectal acetaminophen compared with 20 children (40%) in the fascial click group (P<0.0001). CONCLUSIONS:Ultrasound-guided ilioinguinal/iliohypogastric nerve blocks can be achieved with significantly smaller volumes of local anaesthetics. The intra- and postoperative requirements for additional analgesia are significantly lower than with the conventional method.
journal_name
Br J Anaesthjournal_title
British journal of anaesthesiaauthors
Willschke H,Marhofer P,Bösenberg A,Johnston S,Wanzel O,Cox SG,Sitzwohl C,Kapral Sdoi
10.1093/bja/aei157subject
Has Abstractpub_date
2005-08-01 00:00:00pages
226-30issue
2eissn
0007-0912issn
1471-6771pii
S0007-0912(17)34938-3journal_volume
95pub_type
临床试验,杂志文章,随机对照试验abstract::The effects of i.m. dexmedetomidine 1.0 micrograms kg-1, a new alpha 2-adrenoceptor agonist, were compared with those of i.m. midazolam 0.08 mg kg-1 and placebo on vigilance, anaesthetic requirements, haemodynamic state and plasma catecholamine concentrations in a double-blind placebo-controlled study in 107 healthy (...
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/67.4.402
更新日期:1991-10-01 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::The fresh gas flow rate necessary to prevent rebreathing in T-piece anaesthesia is well established at twice total ventilation. The minimum reservoir volume to avoid air dilution of anaesthetic gases in the alveolus at this flow rate is, however, undecided. A lung model was constructed to represent spontaneous respira...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/57.8.803
更新日期:1985-08-01 00:00:00
abstract:BACKGROUND:Perioperative neurocognitive disorders (PND) result in long-term morbidity and mortality with no effective interventions available. Because interleukin-6 (IL-6), a pro-inflammatory cytokine, is consistently up-regulated by trauma, including after surgery, we determined whether IL-6 is a putative therapeutic ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1016/j.bja.2017.11.096
更新日期:2018-03-01 00:00:00
abstract::The relative sensitivity of sympathetic preganglionic and postganglionic axons, B and C fibres, respectively, to two structurally dissimilar local anaesthetics was examined. The concentration of amethocaine (ester-linked tertiary amine) or prilocaine (amide-linked secondary amine) required to reduce the B fibre compou...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/47.11.1135
更新日期:1975-11-01 00:00:00
abstract:BACKGROUND:Tapentadol is an analgesic agent for treatment of acute and chronic pain that activates the µ-opioid receptor combined with inhibition of neuronal norepinephrine reuptake. Both mechanisms are implicated in activation of descending inhibitory pain pathways. In this study, we investigated the influence of tape...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aeu056
更新日期:2014-07-01 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:Muscle relaxants facilitate tracheal intubation, but they are often not used for short peripheral surgical procedures. The consequences of this practice on the upper airway are still a matter of controversy. We therefore compared the incidence of post-intubation symptoms in a randomized study comparing patie...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aem147
更新日期:2007-08-01 00:00:00
abstract::Cardioventilatory coupling (CVC) is the temporal coherence of respiratory and cardiac rhythms. We have suggested that this coherence is the result of triggering of inspiratory onset by a preceding cardiovascular afferent. One implication of this triggering hypothesis is that coupling should only exist under conditions...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/82.4.546
更新日期:1999-04-01 00:00:00
abstract::Quality of recovery after anaesthesia is an important measure of the early postoperative health status of patients. We attempted to develop a valid, reliable and responsive measure of quality of recovery after anaesthesia and surgery. We studied 160 patients and asked them to rate postoperative recovery using three me...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/oxfordjournals.bja.a013366
更新日期:2000-01-01 00:00:00
abstract::Isolated, cultured rat pancreatic islets of Langerhans were incubated in medium containing glucose 2 or 20 mmol litre-1 and with glucose supplemented with midazolam 10, 100 or 1000 ng ml-1. Glucose 20 mmol litre-1 with the addition of noradrenaline 10 mumol litre-1 was used as a control. In contrast with noradrenaline...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/70.2.221
更新日期:1993-02-01 00:00:00
abstract::We have studied the incidence of respiratory complications and hypoxic episodes during inhalation induction with isoflurane in 75 healthy unpremedicated children. Problems occurred less frequently when 4% isoflurane in oxygen was used from the outset than with traditional techniques using nitrous oxide and a gradually...
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/66.3.327
更新日期:1991-03-01 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::This article briefly reviews psychological aspects of pain, paying special attention to chronic pain. The review considers the interruptive and interference effects of pain and its impact on a person's identity. The importance of processes related to interruption, interference, and identity will vary across people and...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/aen123
更新日期:2008-07-01 00:00:00
abstract::We have compared the effects of sevoflurane and halothane on the discharge frequencies of 19 slowly adapting and four rapidly adapting lung receptors in the rabbit by recording from single vagal fibres. Both agents reduced the discharge frequency of slowly adapting receptors during expiration (P < 0.0005), halothane h...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/80.2.257
更新日期:1998-02-01 00:00:00
abstract:BACKGROUND:The efficacy of opioids typically decreases after long-term use owing to the development of tolerance. Glial activation and the upregulation of proinflammatory cytokines are related to the induction of tolerance. We investigated the effect of leukemia inhibitory factor (LIF) on morphine analgesia and toleran...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aew247
更新日期:2016-10-01 00:00:00
abstract::We studied the interactive effect of dexmedetomidine and morphine on gastric emptying and gastrointestinal transit in the rat. In one group of rats, to examine the interactive effect on gastrointestinal transit, the two drugs were injected i.p. in a fixed ratio (30: 1)--that of their ED50 values--in six doses (0.062-1...
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pub_type: 杂志文章
doi:10.1093/bja/80.1.63
更新日期:1998-01-01 00:00:00
abstract::We studied the elimination rate of nitrous oxide in 36 patients undergoing orthopaedic surgery. They were allocated randomly to one of six groups which differed in time of nitrous oxide exposure and mode of ventilation. In order to simulate recovery conditions, nitrous oxide administration was discontinued after 30, 6...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
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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
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更新日期:1992-02-01 00:00:00
abstract:BACKGROUND:Lower thoracic epidural anaesthesia and analgesia (EDA) has gained increasing importance in perioperative pain therapy. The loss-of-resistance technique used to identify the epidural space is thought to rely on the penetration of the ligamentum flavum. Investigations at the cervical and lumbar regions have d...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
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更新日期:2005-06-01 00:00:00
abstract:BACKGROUND:Anaesthetic drugs act at sites within the brain that undergo profound changes during typical ageing. We postulated that anaesthesia-induced brain dynamics observed in the EEG change with age. METHODS:We analysed the EEG in 155 patients aged 18-90 yr who received propofol (n=60) or sevoflurane (n=95) as the ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aev213
更新日期:2015-07-01 00:00:00
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journal_title:British journal of anaesthesia
pub_type: 杂志文章
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更新日期:1988-12-01 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...
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pub_type: 杂志文章
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更新日期:2007-08-01 00:00:00
abstract:Background:The influence of different head and neck positions on the effectiveness of ventilation with the air-Q® self-pressurizing airway remains unevaluated. This study aimed to evaluate the influence of different head and neck positions on ventilation with the air-Q® SP airway. Methods:In this prospective, randomiz...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
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更新日期:2017-03-01 00:00:00
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journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1996-11-01 00:00:00
abstract::We studied a cat model simulating laudanosine accumulation in the "anephric" patient. Cardiovascular effects were seen only with the bolus doses of laudanosine 2 mg kg-1, and at plasma laudanosine concentrations unlikely to be achieved clinically. Similarly, EEG and power spectra analysis showed no evidence of epilept...
journal_title:British journal of anaesthesia
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更新日期:1986-01-01 00:00:00
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journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1996-09-01 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
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更新日期:1982-05-01 00:00:00
abstract::This review looks at the challenges faced when monitoring patients in the field environment. It is considered from the perspective of the UK Defence Medical Services and their experiences over the past 20 yr. The lessons learned are applicable to many other circumstances where a high standard of care, for a large spec...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
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更新日期:2006-07-01 00:00:00
abstract::By analysing the EEG, reticular multi-unit activity and behavioural changes, we have classified general anaesthetics into three groups: central nervous system (CNS) depressant, CNS excitant and epileptogenic agents. Changes in CNS neural activity are associated with alteration in transmitter release. We have attempted...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/80.3.365
更新日期:1998-03-01 00:00:00