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 the logistic regression curve for suppression of movement to noxious stimuli and the effect on the bispectral index (BIS). The predictive power of drug effects on F-waves and BIS for movement responses to noxious stimuli was tested. METHODS:In 24 patients anaesthesia was induced and maintained with propofol infused by a target controlled infusion pump at stepwise increasing and decreasing plasma concentrations between 0.5 and 4.5 mg litre(-1). The F-waves of the abductor hallucis muscle were recorded at a frequency of 0.2 Hz. BIS values were recorded continuously. Calculated propofol concentrations and F-wave amplitude and persistence were analyzed in terms of a pharmacokinetic-pharmacodynamic (PK/PD) model with a simple sigmoid concentration-response function. Motor responses to tetanic electrical stimulation (50 Hz, 60 mA, 5 s, volar forearm) were tested and the EC(50tetanus) was calculated using logistic regression. RESULTS:For slowly increasing propofol concentrations, computer fits of the PK/PD model for the suppression by propofol yielded a median EC50 of 1.26 (0.4-2.3) and 1.9 (1.0-2.8) mg litre(-1) for the F-wave amplitude and persistence, respectively. These values are far lower than the calculated EC(50) for noxious electrical stimulation of 3.75 mg litre(-1). This difference results in a poor prediction probability of movement to noxious stimuli of 0.59 for the F-wave amplitude. CONCLUSIONS:F-waves are almost completely suppressed at subclinical propofol concentrations and they are therefore not suitable for prediction of motor responses to noxious stimuli under propofol mono-anaesthesia.
journal_name
Br J Anaesthjournal_title
British journal of anaesthesiaauthors
Baars JH,Tas S,Herold KF,Hadzidiakos DA,Rehberg Bdoi
10.1093/bja/aei283subject
Has Abstractpub_date
2006-01-01 00:00:00pages
118-26issue
1eissn
0007-0912issn
1471-6771pii
S0007-0912(17)35274-1journal_volume
96pub_type
杂志文章abstract::Fentanyl or alfentanil, in doses approximating to those used in clinical practice, was added to the priming fluid of an extracorporeal circuit before the institution of cardiopulmonary bypass (CPB). The concentrations of both drugs in the priming fluid were measured over a 20-min period. The concentration of fentanyl ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/58.9.947
更新日期:1986-09-01 00:00:00
abstract::Chlorhexidine allergy has been described in the literature, mainly in Japanese individuals. Most reactions have been limited to the skin, mild in severity and a result of chlorhexidine containing solutions such as 'Savlon' (Novartis Consumer Health, Horesham, UK). We describe what we believe is the first reported case...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/87.2.306
更新日期:2001-08-01 00:00:00
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::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:BACKGROUND:Hydroxyethyl starch (HES) may affect blood coagulation. We studied the effects of a modified, balanced, high-molecular weight [mean molecular weight (MW) 550 kDa], high-substituted [degree of substitution (DS) 0.7] HES preparation (Hextend) on coagulation in patients undergoing major abdominal surgery. METH...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验,收录出版
doi:10.1093/bja/aef242
更新日期:2002-11-01 00:00:00
abstract::The neuromuscular and cardiovascular effects of atracurium were compared during nitrous oxide-isoflurane and nitrous oxide-fentanyl anaesthesia in healthy surgical patients. The dose-response curve was shifted significantly to the left during nitrous oxide-isoflurane anaesthesia (ED50 0.068 mg kg-1) as compared with n...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:
更新日期:1983-01-01 00:00:00
abstract::We have compared bupivacaine 5 mg ml-1, either isobaric in saline 0.9% or hyperbaric in 8% glucose, for spinal anaesthesia in 100 children, aged 2-115 months, in a double-blind, randomized, parallel group, prospective study. Children were premedicated with diazepam 0.5 mg kg-1 orally. Seventy-two children were sedated...
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/81.4.502
更新日期:1998-10-01 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:Cerebral state index (CSI) has recently been introduced as an intra-operative monitor of anaesthetic depth. We compared the performance of the CSI to the bispectral index (BIS) in measuring depth of anaesthesia during target-controlled infusion (TCI) of propofol. METHODS:Twenty Chinese patients undergoing g...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aei253
更新日期:2005-12-01 00:00:00
abstract::The activity of a new i.v. anesthetic agent ICI 35 868, a compound unrelated to currently used barbiturate, eugenol or steroid agents, has been examined in a range of animal species. Some of the properties of ICI 35 868 resemble those of thiopentone in that it is a rapidly acting agent which produces anaesthesia of sh...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/52.8.731
更新日期:1980-08-01 00:00:00
abstract::We have measured in 38 patients the plasma concentration profile of atracurium and its effect on the electromyographic first response of the train-of-four. One of three techniques was used to supplement anaesthesia with 66% nitrous oxide in oxygen, 0.9% isoflurane (end-tidal), 0.5% halothane (end-tidal) or midazolam 3...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/70.1.38
更新日期:1993-01-01 00:00:00
abstract::We have studied the effects of alcuronium in 10 healthy, non-anaesthetized volunteers after they had been taking oral pyridostigmine 30 mg 8 hourly. The responses of adductor pollicis were recorded using an isolated forearm procedure (IFP) during onset and recovery of neuromuscular block produced by 1.5 mg of relaxant...
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/66.3.365
更新日期:1991-03-01 00:00:00
abstract::We have studied post-tetanic count (PTC) and single twitch height at the onset of reflex movement to carinal stimulation after administration of vecuronium with five different types of anaesthesia. Seventy-five adult patients were allocated randomly to five groups of 15 patients each, to receive one of the following a...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验,收录出版
doi:10.1093/bja/72.6.688
更新日期:1994-06-01 00:00:00
abstract:BACKGROUND:There have been few studies comparing the response to asphyxia and the effectiveness of typical cardiopulmonary resuscitation (CPR) using exogenous epinephrine administration and manual closed-chest compression between total intravenous anaesthesia (TIVA) and inhalational anaesthesia. METHODS:Twenty pigs we...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aeg259
更新日期:2003-12-01 00:00:00
abstract:BACKGROUND:Rapid, preoperative identification of patients with the highest risk for medical complications is necessary to ensure that limited infrastructure and human resources are directed towards those most likely to benefit. Existing risk scores either lack specificity at the patient level or utilise the American So...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1016/j.bja.2019.07.030
更新日期:2019-12-01 00:00:00
abstract::Advances in cannabis research have paralleled developments in opioid pharmacology whereby a psychoactive plant extract has elucidated novel endogenous signalling systems with therapeutic significance. Cannabinoids (CBs) are chemical compounds derived from cannabis. The major psychotropic CB delta-9-tetrahydrocannabino...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/aen119
更新日期:2008-07-01 00:00:00
abstract:BACKGROUND:The effects of thoracic epidural anaesthesia (TEA) on gastric mucosal microvascular haemoglobin oxygenation (microHbO(2)) are unclear. At the splanchnic level, reduction of sympathetic tone may promote vasodilation and increase microHbO(2). However, these splanchnic effects are counteracted by systemic effec...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aeh235
更新日期:2004-10-01 00:00:00
abstract::Delirium commonly manifests in the postoperative period as a clinical syndrome resulting from acute brain dysfunction or encephalopathy. Delirium is characterized by acute and often fluctuating changes in attention and cognition. Emergence delirium typically presents and resolves within minutes to hours after terminat...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aew475
更新日期:2017-08-01 00:00:00
abstract:BACKGROUND:Capnography may provide useful non-invasive bedside information concerning heterogeneity in lung ventilation, ventilation-perfusion mismatching and metabolic status. Although the capnogram may be recorded by mainstream and sidestream techniques, the capnogram indices furnished by these approaches have not pr...
journal_title:British journal of anaesthesia
pub_type: 评论,杂志文章
doi:10.1093/bja/aew127
更新日期:2016-07-01 00:00:00
abstract::Recommendations for resuscitation of patients in early haemorrhagic shock, with active ongoing bleeding, have evolved in recent years. This review covers current theories of the pathophysiology of shock and recommended treatments, including damage control surgery, deliberate hypotensive management, administration of a...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/aes389
更新日期:2012-12-01 00:00:00
abstract::The aim of this study was to find, using modern techniques, any histological differences in muscle biopsies between malignant hyperthermia (MH) susceptible (MHS), MH equivocal (MHE) and MH negative (MHN) patients. On the basis of the European MH contracture test carried out in 83 patients, 23 were shown to be MHS, nin...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/79.3.327
更新日期:1997-09-01 00:00:00
abstract:BACKGROUND:There has been a renewed interest in nitric oxide donor drugs, such as nitroglycerin, delivered by the inhalational route for treatment of pulmonary arterial hypertension (PAH). We investigated the acute effects of inhaled nitroglycerin on pulmonary and systemic haemodynamics in children with PAH associated ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/ael112
更新日期:2006-08-01 00:00:00
abstract:BACKGROUND:Abnormal serum sodium concentrations are common in patients presenting for surgery. It remains unclear whether these abnormalities are independent risk factors for postoperative mortality. METHODS:This is a secondary analysis of the European Surgical Outcome Study (EuSOS) that provided data describing 46 53...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aev373
更新日期:2016-01-01 00:00:00
abstract::We have assessed neuromuscular block electromyographically at the gastrocnemius muscle and compared it with that at the abductor digiti minimi muscle in 60 adult patients undergoing cervical spine surgery under general anaesthesia. All patients were in the prone position. After vecuronium 0.2 mg kg-1, times to onset o...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,收录出版
doi:10.1093/bja/82.3.329
更新日期:1999-03-01 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:In critically ill children, monitoring of cardiac output (CO) is essential to guide haemodynamic management and facilitate cardiovascular therapy. The ultrasound dilution technique (UDT), a novel minimally invasive indicator method, was recently introduced to determine CO. We validated UDT against the 'gold ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aet382
更新日期:2014-03-01 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::The effect of diluting propofol in 5% dextrose on the incidence of i.v. injection pain was studied in 100 adult patients. Severe injection pain occurred in 32% (16 patients) who received undiluted propofol, compared with 10% (five patients) who received dilute propofol. We concluded that the dilution of propofol signi...
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/62.2.202
更新日期:1989-02-01 00:00:00
abstract:BACKGROUND:Postoperative non-cardiac complication rates are as high as 11-28% after high-risk abdominal procedures. Emerging evidence indicates that postoperative cardiac troponin T elevations are associated with adverse outcome in non-cardiac surgery. The aim of this study was to determine the relationship between pos...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/aev027
更新日期:2015-06-01 00:00:00
abstract::General anaesthesia for emergency surgery in a pressurized habitat is likely to involve the use of i.v. agents. The anaesthetic property of such agents is known to be antagonized by pressure, but the effect on their duration of action is not easily predicted. The recovery of mice from a single i.v. dose of Althesin, k...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/53.5.455
更新日期:1981-05-01 00:00:00