Abstract:
BACKGROUND:During normothermic cardiopulmonary bypass (CPB), the effect on propofol pharmacokinetics of changes in its binding to plasma proteins is consistent with the predictions of the well-stirred model of hepatic elimination for nonrestrictively cleared drug. However, whether changes in binding lead to clinically significant changes in the drug effect remains unclear. The purpose of this study was to assess changes in the drug effect of propofol in response to altered plasma binding using quantitative EEG measurements. METHODS:Thirty patients undergoing cardiac surgery were assigned randomly to receive propofol infusions at 4 (Group P-4) or 6 (Group P-6) mg kg(-1) h(-1) during surgery. The concentration of propofol in blood samples, collected from the radial artery at predetermined intervals, was determined by HPLC. The unbound fraction of drug in plasma was estimated using equilibrium dialysis. Bispectral index (BIS) and burst suppression ratio (BSR) were measured at the time blood samples were collected. RESULTS:The total concentration of propofol in blood was unchanged during CPB relative to the pre-CPB value in both groups. However, the fraction of unbound propofol in blood increased by 2-fold during CPB. While BIS values were unchanged during CPB in Group P-4, there was a slight, but significant, decrease in Group P-6. In both groups, BSR significantly increased during CPB. BIS values showed a weak correlation with the concentration of unbound propofol (r(2)=0.19, P<0.001). BSR showed a moderate correlation with the concentration of unbound propofol (r(2)=0.56, P<0.001). CONCLUSIONS:The anaesthetic effect of propofol significantly increased during CPB without any alteration in the total drug concentration. The enhanced efficacy may be caused by a reduction in plasma binding of the drug.
journal_name
Br J Anaesthjournal_title
British journal of anaesthesiaauthors
Takizawa E,Hiraoka H,Takizawa D,Goto Fdoi
10.1093/bja/aei293subject
Has Abstractpub_date
2006-02-01 00:00:00pages
179-85issue
2eissn
0007-0912issn
1471-6771pii
S0007-0912(17)35229-7journal_volume
96pub_type
杂志文章,随机对照试验abstract:BACKGROUND:Entrustable professional activities (EPAs) are commonly developed by senior clinicians and education experts. However, if postgraduate training is conceptualised as an educational alliance, the perspective of trainees should be included. This raises the question as to whether the views of trainees and superv...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1016/j.bja.2020.04.009
更新日期:2020-07-01 00:00:00
abstract:BACKGROUND:Pressures (Pe) exerted by bronchial blockers on the inner wall of the bronchi may cause mucosal ischaemia. Our aims were as follows: (i) to compare the intracuff pressure (Pi) and Pe exerted by commercially available bronchial blockers in an in vitro and an ex vivo model; (ii) to investigate the influence of...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aew120
更新日期:2016-09-01 00:00:00
abstract::Thoracic imaging is regularly performed on the majority of critical care patients. Conventionally, this uses a combination of plain radiography and computed tomography. There is growing enthusiasm for the use of ultrasound to replace much of this radiology and provide more immediate, point-of-care imaging with reducti...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/aet076
更新日期:2013-08-01 00:00:00
abstract:BACKGROUND:Evidence-based international expert consensus regarding anaesthetic practice in hip/knee arthroplasty surgery is needed for improved healthcare outcomes. METHODS:The International Consensus on Anaesthesia-Related Outcomes after Surgery group (ICAROS) systematic review, including randomised controlled and ob...
journal_title:British journal of anaesthesia
pub_type: 共识发展会议,杂志文章,meta分析
doi:10.1016/j.bja.2019.05.042
更新日期:2019-09-01 00:00:00
abstract::Six patients with airway stenosis were submitted to bronchoscopy under general anaesthesia. Each was ventilated with a gas mixture of 50% oxygen and nitrogen using successively manual jet insufflation (JV) using the Sanders technique at 20 b.p.m., and high frequency jet ventilation (HFJV) at rates of 150, 300 and 500 ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/55.10.969
更新日期:1983-10-01 00:00:00
abstract::The central venous catheter (CVC) is associated with numerous complications more so during the process of insertion. We report for the first time how an indwelling catheter was entrapped by a replacement catheter on the same side, after being speared by the introducer needle and guidewire. The diagnosis was made when ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/ael286
更新日期:2007-01-01 00:00:00
abstract::In this study, we simultaneously evaluated the spasmolytic effects of prostaglandin E1 (PGE1) on serotonin-induced bronchoconstriction and pulmonary hypertension. Eleven mongrel dogs (8-12 kg) anaesthetized with pentobarbital were assigned to two groups: saline (n = 4) and PGE1 (n = 7). Bronchoconstriction and pulmona...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/85.3.460
更新日期:2000-09-01 00:00:00
abstract::This paper reports three investigations of the suggested relationship between sudden infant death syndrome (SIDS) and malignant hyperpyrexia (MH). In the first study 151 MH-susceptible families completed a questionnaire designed to identify the incidence of SIDS within their own pedigree. In the second study 106 SIDS ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/60.1.28
更新日期:1988-01-01 00:00:00
abstract::Maternal and umbilical venous serum naloxone concentrations were measured after the i.v. (30 mothers) or i.m. (seven mothers) injection of naloxone 400 micrograms. Following i.v. naloxone there was rapid transfer to the fetus and therapeutic plasma concentrations could be expected in 1 or 2 min. However, following i.m...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/58.1.45
更新日期:1986-01-01 00:00:00
abstract:BACKGROUND:Malposition of tracheostomy tubes is difficult to detect at the bedside and may contribute to eventual device misplacement. Endoscopic examination can be undertaken via tracheoscopic (T-view) or trans-laryngeal (L-view) approach, offering more precise detail regarding positioning within the airway. The aims ...
journal_title:British journal of anaesthesia
pub_type: 评论,信件
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更新日期:2017-01-01 00:00:00
abstract:BACKGROUND:Plethysmographic variability index (PVI) is an accurate predictor of fluid responsiveness in mechanically ventilated patients. However, the site of measurement of the plethysmographic waveform impacts its morphology and its respiratory variation. The goal of this study was to investigate the ability of PVI t...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aer165
更新日期:2011-09-01 00:00:00
abstract::We have studied 13 patients with diabetic nephropathy and 13 patients with uraemia of other origin undergoing renal transplantation, and 12 control patients undergoing general surgery. QTc dispersion and maximum QTc interval were calculated from the 12-lead ECG, and cardiovascular autonomic function tests were perform...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/73.6.801
更新日期:1994-12-01 00:00:00
abstract:BACKGROUND:The pharmacokinetic profile of local anaesthetics is influenced by the mode of administration. We sought to compare the pharmacokinetics of two doses of ropivacaine after fascia iliaca compartment (FIC) block in children. METHODS:In this prospective, double-blind study, children received an FIC block as a p...
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/aeh066
更新日期:2004-03-01 00:00:00
abstract::One hundred and forty male rats received a cryoinjury to a segment of the exposed sciatic nerve. A variety of temperatures and freeze patterns was used and the recovery of function was monitored. Where obvious nerve freezing occurred, the cryoinjury caused complete loss of function in the limb. The return of motor act...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/53.11.1121
更新日期:1981-11-01 00:00:00
abstract::Blood flow to functionally different vascular beds was examined during a sodium nitroprusside infusion in 10 dogs anaesthetized with halothane (1 MAC) in oxygen. Blood flows were measured in the ascending aorta, and the coeliac, superior mesenteric, renal and iliac arteries. In two dogs, regional vascular impedance an...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/49.8.735
更新日期:1977-08-01 00:00:00
abstract::Although most local anaesthetic drugs are generally regarded as vasodilators at their site of injection, they produce systemic effects characterized by increases in peripheral resistance, cardiac output, arterial pressure heart rate. The direct depressive effects of the drugs are counterbalanced by increased sympathet...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:
更新日期:1975-02-01 00:00:00
abstract:BACKGROUND:Some patients have features that indicate possible difficulty with direct laryngoscopy for tracheal intubation. Prediction of the likely outcome and selection of patients for an enhanced management algorithm would reduce the possible harm from failed intubation attempts. METHODS:Adult elective patients were...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1016/j.bja.2018.09.021
更新日期:2019-02-01 00:00:00
abstract::We have compared, in a randomized study in 26 patients, immediate and late postoperative recovery after elective laparoscopic cholecystectomy using the gasless, mechanical abdominal wall lift method with conventional carbon dioxide pneumoperitoneum. After the gasless method, tracheal extubation was performed significa...
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
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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::In 1849 John Snow, already the leading anaesthetic practitioner and innovator of his day, made a historic contribution to the epidemiology of infectious disease by his famous study of the distribution of cholera around the area of Broad Street in London. We report on our experience as anaesthetists in a field hospital...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
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abstract::Thirty patients for elective lower segment Caesarean section were randomly divided into two groups. One group received 50 mulitre/kg of Althesin for induction of anaesthesia and the other, 100 mulitre/kg. The two maternal groups were similar. There was no significant difference in the clinical or biochemical status of...
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:1975-11-01 00:00:00
abstract:Background:. Missense variants in the ryanodine receptor 1 gene ( RYR1 ) are associated with malignant hyperthermia but only a minority of these have met the criteria for use in predictive DNA diagnosis. We examined the utility of a simplified method of segregation analysis and a functional assay for determining the pa...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aex042
更新日期:2017-04-01 00:00:00
abstract::Forty-five patients undergoing circumcision were allocated randomly to one of three study groups to compare topical analgesia with dorsal nerve block using the midline or lateral approach. Pain scores, side effects and analgesic requirements were recorded after surgery. Patients who received topical analgesia required...
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/73.4.437
更新日期:1994-10-01 00:00:00
abstract::The activity of the enzyme methionine synthase in fetal and maternal liver was investigated before and after exposure to nitrous oxide. Timed-pregnant rats on day 19 of gestation were exposed to either 10% or 50% nitrous oxide for various times up to 240 min. After exposure, fetal and maternal livers were removed and ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/56.5.523
更新日期:1984-05-01 00:00:00
abstract::This study was designed to determine whether dextran, gelatin or hydroxyethyl starch-based colloidal resuscitation fluids (CRF) are inhibitory to T lymphocyte activation and mitogenesis in vitro. Isolated peripheral blood lymphocytes from normal donors were activated with mitogen (PHA) and cultured in up to 50% v:v CR...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/81.2.242
更新日期:1998-08-01 00:00:00
abstract::Metoclopramide hastens emptying of the stomach. Since it may be given to patients before operation, the sedative and toxic effects of 10- and 20-mg does given i.m. were studied in patients and student volunteers. Saline and diazepam 10 mg were used as placebo and reference drugs. Neither dose of metoclopramide had as ...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/46.7.509
更新日期:1974-07-01 00:00:00
abstract:BACKGROUND:Tracheal tube tip and cuff positions of different cuffed paediatric tracheal tube brands in the trachea can vary with design. METHODS:Data from three clinical studies with measured tracheal lengths were pooled in a database including 422 children aged from birth to 16 yr. Dimensional data of seven cuffed pa...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1016/j.bja.2018.05.002
更新日期:2018-08-01 00:00:00
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journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aet587
更新日期:2014-06-01 00:00:00
abstract::Patients with metastatic carcinoid tumours often undergo surgical procedures to reduce the tumour burden and associated debilitating symptoms. These procedures and anaesthesia can precipitate a life-threatening carcinoid crisis. To assess perioperative outcomes, we studied retrospectively the medical records of adult ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/87.3.447
更新日期:2001-09-01 00:00:00
abstract::Ketamine, as the sole anaesthetic agent, was assessed in a double-blind study of 135 female patients who underwent laparoscopic sterilization. The patients were allocated randomly to one of four groups according to the type (pentobarbitone or droperidol) and route (i.v. or i.m.) of premedication. In addition all the p...
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/49.11.1159
更新日期:1977-11-01 00:00:00