Abstract:
BACKGROUND:This study evaluated the A-Line Autoregressive Index (AAI) response to surgical stimulation during lumbar arthrodesis, as an estimate of the anti-nociceptive component of a Bispectral Index (BIS) guided anaesthesia combined with epidural analgesia. METHODS:An epidural catheter was inserted in 23 patients allocated randomly to receive ropivacaine plus clonidine (Group R) or normal saline (Group S) epidurally. General anaesthesia was induced with propofol, cis-atracurium and a remifentanil infusion that was stopped 3 min after tracheal intubation, and maintained using sevoflurane to keep BIS at 50 (range 40-60). Mean arterial pressure, heart rate, end-tidal sevoflurane, BIS and AAI were analysed from 2 min before to 17 min after surgical incision. RESULTS:While BIS was maintained at 50, AAI significantly increased from a 2 min averaged value of 12 (4) to 21 (7) in Group S within the first 5 min after surgical incision, but did not change in Group R. Maximum AAI values reached during the study period were significantly higher in Group S than in Group R [38 (12) and 27 (10), respectively]. Binary logistic regression analysis allowed the calculation of AAI threshold values above which the probability of predominant nociception over anti-nociception was higher than 95%. At 1 MAC sevoflurane concentration, a 2 min averaged AAI of 35 or an AAI peak value of 62 were associated with such a probability. CONCLUSIONS:During a BIS-guided constant level of hypnosis, AAI response to the onset of surgical stimulation significantly differs according to the analgesic regimen. Further studies are needed to refine the estimation of sensitivity and specificity of this variable in assessing the balance between nociception and anti-nociception during general anaesthesia.
journal_name
Br J Anaesthjournal_title
British journal of anaesthesiaauthors
Bonhomme V,Llabres V,Dewandre PY,Brichant JF,Hans Pdoi
10.1093/bja/ael004subject
Has Abstractpub_date
2006-03-01 00:00:00pages
353-60issue
3eissn
0007-0912issn
1471-6771pii
S0007-0912(17)35208-Xjournal_volume
96pub_type
杂志文章,随机对照试验abstract:BACKGROUND:Individual patient information from clinical trials is infrequently available, but can provide insights for clinical trials and practice. METHODS:We analysed individual patient information from five randomized trials (913 patients) of i.v. patient-controlled analgesia (IVPCA) plus epidural placebo, morphine...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,meta分析
doi:10.1093/bja/aep300
更新日期:2009-12-01 00:00:00
abstract::Postoperative management following major surgery in patients with neuromuscular disorders associated with scoliosis is frequently complicated by sputum retention and ventilatory failure. This report demonstrates the successful perioperative management of an 11-yr-old boy with type II spinal muscular atrophy undergoing...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aef227
更新日期:2002-10-01 00:00:00
abstract::Interest in the use of psychosocial interventions to help older adults manage pain is growing. In this article, we review this approach. The first section reviews the conceptual background for psychosocial interventions with a special emphasis on the biopsychosocial model of pain. The second section highlights three p...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/aet129
更新日期:2013-07-01 00:00:00
abstract::The induction dose requirements of propofol were compared in three age groups in 300 unpremedicated healthy Chinese children: group A, younger than 2 yr (n = 48); group B, 2-5 yr (n = 117); group C, 6-12 yr (n = 135). Patients in each group were allocated randomly to receive one of eight doses of propofol (1.2, 1.4, 1...
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/68.1.64
更新日期:1992-01-01 00:00:00
abstract::Nociceptin/orphanin FQ, N/OFQ, and its receptor NOP represent a non-opioid branch of the opioid superfamily that were first studied for their effects on pain responses. Both N/OFQ and NOP are involved in a wide range of 'non-pain' responses including immunomodulation and cardiovascular control. There is now growing in...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/aeq337
更新日期:2011-01-01 00:00:00
abstract::Thirty mothers undergoing elective Caesarean section received thiopentone 3.5 mg kg-1 and 30 received etomidate 0.3 mg kg-1 for induction of anaesthesia. Subsequent management of anaesthesia was identical in both groups. Maternal to fetal base excess differences and the degree of biochemical correlation between mother...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/51.2.135
更新日期:1979-02-01 00:00:00
abstract::A new anaesthetic gas scavenging system is described. The resistance of the system appears to be low. When input gas flow rate in the system was zero or 150 litre min-1, misuse of the system produced pressure changes at its collecting points of 26 Pa subatmospheric and 630 Pa above atmospheric pressure, respectively. ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/55.7.681
更新日期:1983-07-01 00:00:00
abstract:Background.:Compromised tissue oxygenation is one of the root causes of dysfunction of various organs and postoperative complications. Oxygenation of different tissue beds may follow different patterns of change during physiological derangement. Methods.:Patients undergoing elective major posterior spine surgery parti...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aex008
更新日期:2017-04-01 00:00:00
abstract::A blood-gas study of the respiratory effects of sodium nitroprusside during anaesthesia has shown a marked reduction in PaO2 when the drug was administered. After nitroprusside PaO2 returned to the previous values. It is suggested that the reduction in PaO2 is a result of an increased scatter of ventilation/perfusion ...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/47.11.1205
更新日期:1975-11-01 00:00:00
abstract:BACKGROUND:In this randomized, double-blind study, the effects of thoracic and lumbar epidural anaesthesia on the induction doses (IDs) and maintenance doses (MDs) of propofol during bispectral index (BIS) guided total i.v. anaesthesia were compared. METHODS:Fifty-four patients (three groups, n=18 each) undergoing uro...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aen160
更新日期:2008-08-01 00:00:00
abstract::Closed-loop control of neuromuscular blockade, using a semi-continuous infusion of vecuronium, is described. In 28 patients, the average neuromuscular transmission was between 13 and 17% of control. Requirements for vecuronium averaged 1.1 micrograms kg-1 min-1 (0.8-1.5 micrograms kg-1 min-1), being in the same range ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/58.10.1100
更新日期:1986-10-01 00:00:00
abstract::We describe an obstetric patient who developed incapacitating headache after inadvertent dural tap and was treated with repeated blood patching. She subsequently developed severe lumbar back pain which, after exclusion of suspected extradural abscess, was treated successfully with simple analgesics and physiotherapy. ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/78.3.334
更新日期:1997-03-01 00:00:00
abstract::We report the safe use of remifentanil as part of the anaesthetic technique in a patient undergoing major head and neck surgery who was being treated for depressive illness with the non-specific monoamine oxidase inhibitor (MAOI) phenelzine. ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/oxfordjournals.bja.a013453
更新日期:2000-03-01 00:00:00
abstract::Patients with Munchausen's syndrome often undergo multiple surgical operations under general anaesthesia. They tend to have multiple exposures to routinely used anaesthetic agents. A patient with Munchausen's syndrome who developed an anaphylactoid reaction to thiopentone is described and the importance of obtaining p...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/59.11.1472
更新日期:1987-11-01 00:00:00
abstract:BACKGROUND:Brachytherapy presents the anaesthetist with unique problems. Information on anaesthesia for brachytherapy, however, is limited. The aim of this paper is to report on our experience involving a large number of brachytherapy procedures. METHODS:A retrospective analysis of records of 1622 anaesthetic procedur...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aei301
更新日期:2006-02-01 00:00:00
abstract:BACKGROUND:We used an automated bispectral index (BIS)-guided dual-loop controller to determine propofol and remifentanil requirements during general anaesthesia in obese and lean surgical patients. METHODS:Obese patients, BMI>35 kg m(-2), and lean patients (<25 kg m(-2)) having laparoscopic procedures were prospectiv...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1093/bja/aeu401
更新日期:2015-04-01 00:00:00
abstract::Summary While complex physiological mechanisms exist to regulate and optimize tissue oxygenation under various conditions, clinical and experimental evidence indicates that anaemia, unchecked, is associated with organ injury and unfavourable outcomes. More data (especially from human studies) are needed to answer ques...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/aer350
更新日期:2011-12-01 00:00:00
abstract:BACKGROUND:In 2016, the World Health Organization (WHO) strongly recommended the use of a high fraction of inspired oxygen (FiO2) in adult patients undergoing general anaesthesia to reduce the risk of surgical site infection (SSI). Since then, further trials have been published, trials included previously have come und...
journal_title:British journal of anaesthesia
pub_type: meta分析
doi:10.1016/j.bja.2018.11.024
更新日期:2019-03-01 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:BACKGROUND:Propofol can scavenge free radicals because it has a chemical structure similar to antioxidants. METHODS:We examined if free radical scavenging occurs with propofol during CABG operations. We studied 24 patients undergoing CABG surgery for triple vessel disease, randomized into two groups. After induction o...
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/aef173
更新日期:2002-08-01 00:00:00
abstract::To understand the cellular and molecular basis of the anaesthetic state, it is important to remember that, in the intact CNS, synapses operate within elaborate nerve networks. From the data presented above, it is evident that block of impulse conduction in presynaptic fibres does not explain the effects of most anesth...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/71.1.134
更新日期:1993-07-01 00:00:00
abstract::One hundred and eighty-five patients were allocated at random to receive pethidine with diazepam (in an emulsion), or pethidine with midazolam i.v. as sedation for upper gastrointestinal endoscopy. Sedation and conditions for examination were comparable and satisfactory in both groups. Midazolam produced more amnesia ...
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/55.11.1095
更新日期:1983-11-01 00:00:00
abstract::This communication presents evidence in support of a neuropathic basis for the myopathy associated with malignant hyperpyrexia (MH). Muscle from MH susceptible individuals showed a reduced calcium uptake by the sarcoplasmic reticulum. There was a reduced concentration of phosphocreatine and ATP and an increased concen...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/47.4.475
更新日期:1975-04-01 00:00:00
abstract:Background:Kidney transplantation is associated with harmful processes affecting the viability of the graft. One of these processes is associated with the phenomenon of ischaemia-reperfusion injury. Anaesthetic conditioning is a widely described strategy to attenuate ischaemia-reperfusion injury. We therefore conducted...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aex057
更新日期:2017-05-01 00:00:00
abstract::The role of endothelin-1, a potent vasoconstrictor released by vascular endothelium, in the vasoconstriction that develops after prolonged operations is not clear. This study was performed in order to determine if there was any relationship between endothelin-1 and the degree of vasoconstriction during prolonged plast...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/74.6.661
更新日期:1995-06-01 00:00:00
abstract::In obstetric patients undergoing postpartum tubal ligation, we found that metoclopramide produced dose-dependent prolongation of suxamethonium-induced neuromuscular block. Mean block times after suxamethonium 1 mg kg-1 were 8.0 min, 9.83 min and 12.45 min for control and metoclopramide 10 mg and metoclopramide 20 mg g...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/65.2.220
更新日期:1990-08-01 00:00:00
abstract::The relationship between maternal FIO2 and umbilical venous PO2, PCO2, pH and neonatal Apgar and TSR (time to sustained respiration) scores was studied in 35 patients undergoing Caesarean section under general anaesthesia. Patients were allocated randomly to breathe an FIO2 of either 0.5 or 0.33. Umbilical venous bloo...
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/61.3.250
更新日期:1988-09-01 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::Abnormal oxygen use and organ failure in the critically ill may result from 'poisoning' of mitochondrial function. Measurement of arterial ketone body ratio (AKBR) has been proposed to reflect mitochondrial redox state and may provide a useful marker to monitor mitochondrial function in the critically ill. We measured...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/83.2.325
更新日期:1999-08-01 00:00:00
abstract:BACKGROUND:Interscalene brachial plexus block (ISBPB) is an effective nerve block for shoulder surgery. However, a 100% incidence of phrenic nerve palsy limits the application of ISBPB for patients with limited pulmonary reserve. We examined the incidence of phrenic nerve palsy with a low-volume ISBPB compared with a s...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aen229
更新日期:2008-10-01 00:00:00