Abstract:
BACKGROUND:Parecoxib, a cyclo oxygenase-2 inhibiting non-steroidal anti-inflammatory drug, has been widely used for postoperative analgesia. Our aim was to quantify the benefit of a single dose after coronary artery bypass grafting. METHODS:The investigation was carried out as a randomized double blind placebo controlled study. A single i.v. dose of parecoxib 40 mg or placebo was given at closure of sternotomy. No opioid other than morphine was given in the first 24 postoperative hours. Pain was assessed using both a Visual Analogue Score (1-10), and the amount of morphine used via a morphine patient controlled analgesia pump. Creatinine clearance was measured before and after operation from 24 h urine collections. After a global announcement by Pfizer that paracoxib was 'contraindicated in patients with ischaemic heart disease' further recruitment was suspended and the collected data from 40 patients were analysed. RESULTS:Twenty-one patients received parecoxib and 19 received placebo. Amongst those who received parecoxib, there was a highly significant sparing of rescue medication before tracheal extubation (P=0.004) compared with placebo, and an overall 35% morphine sparing effect during the first 6 h post extubation after correction for the variability in extubation time (P=0.037). Respiration, as measured by arterial carbon dioxide tension at the time of extubation, was significantly better in the parecoxib group (P=0.045). Significantly more furosemide was given for postoperative oliguria in those patients who received parecoxib (P=0.036). After correcting for differences in diuretic usage and fluid balance, parecoxib was associated with a significant increase in plasma creatinine (P=0.041). CONCLUSION:A single dose of parecoxib has a significant opioid sparing effect in the first 6 h after coronary artery bypass grafting which resulted in significantly improved ventilation with mild elevation of plasma creatinine within normal limits.
journal_name
Br J Anaesthjournal_title
British journal of anaesthesiaauthors
Khalil MW,Chaterjee A,Macbryde G,Sarkar PK,Marks RRdoi
10.1093/bja/aei298subject
Has Abstractpub_date
2006-02-01 00:00:00pages
171-8issue
2eissn
0007-0912issn
1471-6771pii
S0007-0912(17)35228-5journal_volume
96pub_type
杂志文章,随机对照试验abstract::We prospectively studied spontaneous recovery from cisatracurium-induced neuromuscular block in 18 patients scheduled for cardiac surgery, and its suitability for fast-track cardiac surgery. Neuromuscular block was induced by an i.v. bolus (range 0.15-0.3 mg kg(-1)) and maintained by a continuous infusion (range 1.1-3...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/86.1.130
更新日期:2001-01-01 00:00:00
abstract:Background:Blood lactate is a strong predictor of mortality, and repeated blood lactate assays are recommended during surgery in high-risk patients. We hypothesized that the use of intravascular microdialysis incorporated in a central venous catheter would be interchangeable with the reference blood gas technique to mo...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aex338
更新日期:2017-12-01 00:00:00
abstract::One hundred patients presenting for surgical treatment of fractured neck of femur were allocated to receive either spinal (SAB) or general (GA) anaesthesia. Before operation, the mean PaO2 was 9.04 kPa. There was a significant decrease in PaO2 of 0.68 kPa in GA group at 1 h after operation, while blood-gas values were...
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/52.1.49
更新日期:1980-01-01 00:00:00
abstract:BACKGROUND:The memory effect of dexmedetomidine has not been prospectively evaluated in children. We evaluated the feasibility of measuring memory and sedation responses in children during dexmedetomidine sedation for non-painful radiological imaging studies. Secondarily, we quantified changes in memory in relation to ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aew421
更新日期:2017-02-01 00:00:00
abstract::In a randomized study of patients undergoing Caesarean section, either enflurane (mean 0.24 MAC-h) or halothane (mean 0.23 MAC-h) and 50% nitrous oxide in oxygen were administered to women (n = 12) with severe pre-eclampsia-eclampsia and to 16 healthy pregnant patients with normal renal and hepatic function. No eviden...
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/56.6.587
更新日期:1984-06-01 00:00:00
abstract:BACKGROUND:The debate on lung-protective ventilation strategies for surgical patients is ongoing. Evidence suggests that the use of low tidal volume VT improves clinical outcomes. However, the optimal levels of PEEP and recruitment manoeuvre (RM) strategies incorporated into low VT ventilation remain unclear. METHODS:...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,meta分析
doi:10.1016/j.bja.2019.10.024
更新日期:2020-03-01 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...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/80.1.63
更新日期:1998-01-01 00:00:00
abstract::Healthcare litigation in the UK continues to grow at an alarming rate, with claims against anaesthetists and critical care physicians increasing each year. This has led to a huge financial burden for the taxpayer and a sharp increase in professional indemnity fees for individual doctors. Although such litigation shoul...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aes188
更新日期:2012-07-01 00:00:00
abstract::We investigated the effects of anaesthesia on dynamic nitric oxide production, concentrations of tetrahydrobiopterin and the accumulation of cyclic GMP (cGMP) in the rat central nervous system (CNS). Rats were assigned to anaesthesia with halothane, isoflurane, pentobarbital, diazepam, ketamine or xenon (n=6 per group...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/86.3.388
更新日期:2001-03-01 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 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: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::The pharmaceutical formulation of Althesin was shown to have a weak allergenic potential in the guinea pig maximization test. Alphadolone and alphaxalone acetate were found to be devoid of such potential, while the status of Cremophor EL remained equivocal. ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/55.8.715
更新日期:1983-08-01 00:00:00
abstract::In a randomized, double-blind study, we have examined the stereoselective disposition and pharmacodynamic characteristics of ketamine in surgical patients after i.v. administration of S(+)-ketamine 1 mg/kg body weight (25 patients) or racemic ketamine 2 mg/kg body weight (25 patients). S(+)-Ketamine was not inverted t...
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/70.6.666
更新日期:1993-06-01 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::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::We describe the anaesthetic management of a patient who underwent transthoracic endoscopic vagotomy. One-lung ventilation was necessary to provide adequate surgical access. Potential intraoperative problems involved arterial oxygen saturation during one-lung ventilation, unequal intrathoracic pressures causing mediast...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/68.3.318
更新日期:1992-03-01 00:00:00
abstract::We have investigated 60 patients in a prospective double-blind, placebo-controlled study to assess the efficacy of EMLA (Eutectic Mixture of Local Anaesthetics) cream to provide analgesia during extracorporeal shock wave lithotripsy (ESWL) with a second generation lithotriptor. Before operation, EMLA or placebo cream ...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/69.4.399
更新日期:1992-10-01 00:00:00
abstract::Three anaesthetic techniques based on isoflurane were compared in outpatients undergoing laparoscopy. Sixty healthy patients were randomly allocated to receive isoflurane via mask (spontaneous respiration), via tracheal tube (spontaneous respiration) or via tracheal tube with controlled ventilation. Moderate hypercarb...
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/59.2.189
更新日期:1987-02-01 00:00:00
abstract:BACKGROUND:To study adequate antinociception during general anaesthesia, tetanic stimulus of 5-10 s duration has been used previously as a standardized nociceptive stimulus. However, such stimuli have been found to correlate poorly with intraoperative nociception. We hypothesized that an electrical tetanic stimulus of ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aem200
更新日期:2007-10-01 00:00:00
abstract::We studied cardiovascular and catecholamine responses for 3 days in three groups of patients undergoing abdominal hysterectomy. The night before surgery and again 2 h before induction of anaesthesia, patients received the ACE inhibitor, ramipril, the beta 1 blocker, metoprolol, or placebo. In the actively treated grou...
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/72.6.633
更新日期:1994-06-01 00:00:00
abstract::Since 1972, 367 patients with chronic low-back pain have been treated by electrical stimulation (e.s.). Patients with herniated disc lesions and spondylitis and allied conditions were included. Following e.s. 75-100% pain relief was obtained by 53% of the patients 50% pain relief by 27% and there was no improvement in...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/49.6.629
更新日期:1977-06-01 00:00:00
abstract::Conventional extradural analgesia during labour with 0.25-0.375% bupivacaine may induce motor weakness and subjective sensory deficit, reducing maternal satisfaction. Even in a regimen for ambulatory extradural analgesia (0.1% bupivacaine-fentanyl 2 micrograms ml-1), a potential for proprioreception impairment exists,...
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/76.2.319
更新日期:1996-02-01 00:00:00
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...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aeh104
更新日期:2004-04-01 00:00:00
abstract::We studied 325 patients undergoing elective noncardiac surgery who had preoperative ambulatory ECG monitoring performed for a duration of 5130 h (range 8-24 h; mean 15.8 h). Sixty-four subjects (20%) had one or more episodes of ST segment depression consistent with myocardial ischaemia. Of all preoperative cardiovascu...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/73.5.574
更新日期:1994-11-01 00:00:00
abstract::A patient with a tracheostomy and an iatrogenic tracheo-oesophageal fistula presented for diagnostic bronchoscopy and right upper lobectomy. The anaesthetic management is discussed with reference to the options available and, in particular, the use of a Brompton Pallister single lumen endobronchial tube. ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/74.4.461
更新日期:1995-04-01 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::Midazolam 0.3 mg kg-1 was given as a single dose to three groups of children undergoing cardiac surgery to determine its pharmacokinetic profile in this situation. The first group, undergoing closed heart surgery, received the midazolam during the operation. The other groups underwent cardiopulmonary bypass (CPB) with...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/61.3.302
更新日期:1988-09-01 00:00:00
abstract:BACKGROUND:General anaesthesia is a balance between hypnosis and analgesia. We investigated whether an increase in remifentanil blood concentration would reduce the amount of propofol required to maintain a comparable level of anaesthesia in 60 patients undergoing ambulatory surgery. METHODS:Patients were allocated ra...
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/aeg115
更新日期:2003-05-01 00:00:00
abstract:BACKGROUND:A significantly increased risk of acute kidney injury (AKI) with the prophylactic use of aprotinin has been reported in adults undergoing cardiac surgery, but not in children. Blood product transfusions have also been shown to carry an independent risk of AKI. The present study assessed associations between ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aes002
更新日期:2012-05-01 00:00:00