Abstract:
:Several observational and objective methods are available to assess sedation depth; however, data regarding their accuracy in differentiating deep sedation are limited. In this study we compared 3 sedation tools in children from birth to 18 yr of age and determined their relative value in detecting deep levels of sedation. Bispectral index monitoring (BIS), Modified Maintenance of Wakefulness Tests (MMWT), and the University of Michigan Sedation Scale (UMSS) were used to assess sedation. Three-hundred-twenty-seven observations were recorded in 39 children. The overall validity of each measure was supported by appropriate changes after sedation administration through the observation period. There were moderate to high correlations between UMSS and BIS (rho = -0.73) and UMSS and MMWT (rho = -0.59; P < 0.01). The correlation between BIS and MMWT was significant but low (r = 0.36; P < 0.01). Measures of exact agreement supported the reliability of the UMSS and MMWT across the sedation continuum. There were significant decreases in BIS across UMSS scores except from scores 2-3. ROC curves suggested that BIS < or = 80 and MMWT < or = 14 min were most sensitive in delineating deep sedation. Our findings demonstrate the overall validity of these observational and objective measures of sedation depth in children <18 yr of age but show ongoing limitations distinguishing moderate from deep sedation.
journal_name
Anesth Analgjournal_title
Anesthesia and analgesiaauthors
Malviya S,Voepel-Lewis T,Tait ARdoi
10.1213/01.ANE.0000184045.01780.73subject
Has Abstractpub_date
2006-02-01 00:00:00pages
389-94issue
2eissn
0003-2999issn
1526-7598pii
102/2/389journal_volume
102pub_type
杂志文章abstract:BACKGROUND:In cardiac surgery, pulmonary hypertension is an important prognostic factor for which several treatments have been suggested over time. In this systematic review and meta-analysis, we compared the efficacy of inhaled aerosolized vasodilators to intravenously administered agents and to placebo in the treatme...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,meta分析,评审
doi:10.1213/ANE.0000000000002138
更新日期:2017-08-01 00:00:00
abstract:BACKGROUND:Hypothermia may be accidental or therapeutic. Therapeutic hypothermia is increasingly used as treatment for various conditions, e.g., neuroprotection after cardiac arrest. Hypothermia leads to an impairment of the coagulation system, but the degree of impairment has been difficult to determine. Most studies ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ane.0b013e31817ee955
更新日期:2008-11-01 00:00:00
abstract::The purpose of this study was to compare meperidine to meperidine with bupivacaine when used for patient-controlled epidural analgesia (PCEA) after thoracotomy. For 3 days after thoracotomy patients received thoracic PCEA with meperidine 0.1% plain or with added bupivacaine 0.1% or 0.01%. No background infusion was us...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000539-199607000-00014
更新日期:1996-07-01 00:00:00
abstract::The acute central nervous and cardiovascular effects of the local anesthetics ropivacaine and bupivacaine were compared in 12 volunteers in a randomized double-blind manner with use of intravenous infusions at a rate of 10 mg/min up to a maximal dose of 150 mg. The volunteers were all healthy men. They were familiariz...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1989-11-01 00:00:00
abstract:UNLABELLED:Morbidly obese (MO) patients undergoing laparoscopy have lower PaO(2) compared with normal-weight (NW) patients. We hypothesized that increases in tidal volume (V(T)) or respiratory rate (RR) would improve oxygenation. All measurements were performed at: 1) baseline: V(T) 600-700 mL and 10 breaths/min, 2) do...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章
doi:10.1213/01.ane.0000067409.33495.1f
更新日期:2003-07-01 00:00:00
abstract:BACKGROUND:Atelectasis occurs regularly after induction of general anesthesia, persists postoperatively, and may contribute to significant postoperative morbidity and additional health care costs. Laparoscopic surgery has been reported to be associated with an increased incidence of postoperative atelectasis. It has be...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/ANE.0b013e3181ba7945
更新日期:2009-11-01 00:00:00
abstract::High blood concentrations of local anesthetics are cardiotoxic. The aim of this study was to compare the effects of lidocaine and bupivacaine on the intrinsic pacemaker activity of in vitro sinoatrial nodal cells of the adult and neonatal guinea pig in the presence and absence of hypoxia and acidosis. Fifteen pairs of...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1986-09-01 00:00:00
abstract:UNLABELLED:With pressure support ventilation (PSV), each PSV breath is flow-cycled, and the breath termination criterion (TC) is usually nonadjustable. When TC does not match the interaction between the patient's inspiratory-expiratory efforts to the opening and closing of the inspiratory and expiratory valves, patient...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章
doi:10.1097/00000539-200101000-00031
更新日期:2001-01-01 00:00:00
abstract:BACKGROUND:A decremental positive end-expiratory pressure (PEEP) trial after full lung recruitment allows for the adjustment of the lowest PEEP that prevents end-expiratory collapse (open-lung PEEP). For a tidal volume (Vt) approaching zero, the PEEP of minimum respiratory system elastance (PEEP(minErs)) is theoretical...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0b013e31824a95ca
更新日期:2013-03-01 00:00:00
abstract::The effects of nitrous oxide-oxygen plus small doses of fentanyl with (N = 7) and without (N = 15) naloxone and the effects of nitrous oxide-oxygen plus halothane (N = 13) on plasma concentration of arginine vasopressin (AVP) and cortisol were studied in normal patients before and during gynecologic laparotomies. Pati...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1984-01-01 00:00:00
abstract:BACKGROUND:Nicotine has an antinociceptive effect in animal models. The analgesic effect in humans has been examined, but studies have had mixed results. A proposed etiology is variability in chronic nicotine exposure because of differences in tobacco smoking rates and second-hand smoke exposure. In this study, we exam...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/ANE.0b013e3181bd1612
更新日期:2009-12-01 00:00:00
abstract:UNLABELLED:Reports of transient neurological symptoms with the use of subarachnoid lidocaine has generated interest in alternate local anesthetics of intermediate duration, such as mepivacaine. This prospective randomized, double-blinded, dose-response study examined the anesthetic and recovery profiles of 60- and 80-m...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000539-200009000-00015
更新日期:2000-09-01 00:00:00
abstract::It is not uncommon to observe prolonged CNS depression for several hours following controlled hypotension and halothane anesthesia for neurosurgery. The present study evaluates possible contribution of large doses of trimethaphan to CNS depression. Four adult sheep were placed on transapical left ventricular bypass (T...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-197701000-00005
更新日期:1977-01-01 00:00:00
abstract::Rifampin is commonly used for the treatment of tuberculosis and staphylococcal infections, as well as for prevention of infection in cardiac valve and bone surgeries. We report a case of profound hypotension after anesthesia induction with propofol in a patient who was treated with two 600 mg doses of rifampin for pro...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0b013e318292cbd0
更新日期:2013-07-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to identify optimal target propofol and remifentanil concentrations to avoid a gag reflex in response to insertion of an upper gastrointestinal endoscope. METHODS:Patients presenting for endoscopy received target-controlled infusions (TCI) of both propofol and remifentanil for ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/ANE.0000000000000756
更新日期:2015-07-01 00:00:00
abstract::Quantitative Sensory Testing (QST) is a psycho-physiological test used to identify dysfunction of individual nerve fiber types. In the present study, we investigated whether selective nerve fiber dysfunction, as assessed by QST, correlates with the effectiveness of epidural steroid injections (ESI) in patients with lu...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章
doi:10.1213/01.ane.0000078583.47735.69
更新日期:2003-09-01 00:00:00
abstract::The ideal choice of a priming solution of the cardiopulmonary bypass (CPB) and its influence on the hemostatic system are not clear. Addition of albumin was reported to inhibit platelet damaging by blood-surface interactions ("coating"). To explore this possibility in 60 consecutive male patients undergoing elective a...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验,收录出版
doi:10.1213/00000539-199202000-00008
更新日期:1992-02-01 00:00:00
abstract::This study documented gastric fluid acidity in ambulatory surgical patients 30-120 min after they had taken a 300-mg tablet of ranitidine, as changes specific to this relatively brief dose-to-sampling interval previously had not been delineated. At 20-120 min before outpatient surgery, ranitidine was given with 15 mL ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-199112000-00018
更新日期:1991-12-01 00:00:00
abstract:BACKGROUND:Signal transduction cascade of anesthetic-induced preconditioning has been extensively studied, yet many aspects of it remain unsolved. Here, we investigated the roles of reactive oxygen species (ROS) and mitochondrial uncoupling in cardiomyocyte preconditioning by two modern volatile anesthetics: desflurane...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ane.0b013e3181a93ad9
更新日期:2009-08-01 00:00:00
abstract::For the past 25 years, halothane has been the primary anesthetic agent at Children's Hospital, Columbus, Ohio. To confirm our impression that adverse reactions to halothane are rarely a problem in children, we examined the records of 200,311 cases conducted with halothane from June 1, 1958, through May 31, 1983. Life-...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1984-09-01 00:00:00
abstract::Virchow's triad is traditionally invoked to explain pathophysiologic mechanisms leading to thrombosis, alleging concerted roles for abnormalities in blood composition, vessel wall components, and blood flow in the development of arterial and venous thrombosis. Given the tissue-specific bleeding observed in hemophilia ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,评审
doi:10.1213/ANE.0b013e31823a088c
更新日期:2012-02-01 00:00:00
abstract::The relative safety of epidural catheter placement with subsequent heparinization has been well documented. However, what is the risk of neurologic sequelae in such patients who receive warfarin perioperatively? This study retrospectively evaluates the risk of spinal hematoma in patients receiving postoperative epidur...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-199407000-00017
更新日期:1994-07-01 00:00:00
abstract:UNLABELLED:The transient hyperemic response (THR) in the middle cerebral artery (MCA) after the release of brief compression of the ipsilateral common carotid artery has been used to study cerebral autoregulation. We conducted the present study to evaluate the reliability of THR to detect changes in cerebral autoregula...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-199810000-00018
更新日期:1998-10-01 00:00:00
abstract:UNLABELLED:Clinical and basic science studies suggest that spinal alpha-2-adrenergic receptor agonists and local anesthetics produce analgesia, but interaction between alpha-2-adrenergic receptor agonists and local anesthetics in the persistent pain model has not been examined. In the present study, using isobolographi...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-200103000-00034
更新日期:2001-03-01 00:00:00
abstract:BACKGROUND:Paravertebral analgesia is useful for breast surgery. Patient controlled analgesia by IV or epidural routes is well established for delivering postoperative analgesia. Our objective was to apply patient control to paravertebral analgesia and evaluate the efficacy and tolerability of two distinct dosing regim...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/ane.0b013e31817b7f01
更新日期:2008-08-01 00:00:00
abstract:UNLABELLED:A microscope will be used for the first case of the day in operating room (OR) 1 and then may be used in the second case of the day by a different surgeon in a different OR, OR 2. Provided that the probability is reasonably high that the first case of the day in OR 2 will last longer than the first case in O...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-200004000-00037
更新日期:2000-04-01 00:00:00
abstract:INTRODUCTION:During magnetic resonance imaging (MRI), children are at risk for body temperature variations. The cold MRI environment that preserves the MRI magnet can cause serious hypothermia. On the other hand, hyperthermia may also develop because of radiofrequency-induced heating of the tissues, particularly in pro...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0b013e31824b003e
更新日期:2012-06-01 00:00:00
abstract:BACKGROUND:We studied the effects of isoflurane on hippocampal synaptic transmission and paired-pulse plasticity, under in vivo intact interneuron circuitry. METHODS:Using rats chronically implanted with electrodes, excitatory postsynaptic potential (EPSP) and population spike amplitude (PSA) were measured in the hipp...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ane.0000281433.73260.8d
更新日期:2007-10-01 00:00:00
abstract:UNLABELLED:We tested the ability of electroconvulsive treatment (ECT) to block thermal hyperalgesia and mechanical allodynia in rats with peripheral neuropathy. Repeated ECT (six times daily) significantly reduced thermal hyperalgesia 48 h after the end of the final treatment but had no significant effects on mechanica...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-199803000-00028
更新日期:1998-03-01 00:00:00
abstract:UNLABELLED:We investigated the physiological reaction to mobilization the first and second day after aortic valve replacement in an open, prospective study. Hemodynamic and oxygenation variables were recorded in 15 patients using a pulmonary artery oximetry catheter and bench oximetry. Serious intraoperative events occ...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章
doi:10.1213/01.ane.0000096194.10459.7e
更新日期:2004-02-01 00:00:00