Abstract:
BACKGROUND:One major risk factor of the sitting position for neurosurgery is air embolism, especially in patients with persistent foramen ovale (PFO). The first aim of this prospective study was to evaluate a bedside method for detecting PFO using transcranial Doppler sonography (TCD) with contrast medium. A second aim was to address intraoperative monitoring, patient positioning and the occurrence and clinical relevance of air embolism. METHODS:Ninety patients with a mean age of 56.5 yr (range 14-81 yr) undergoing surgery in sitting position were investigated by TCD with contrast agent to detect functional PFO, that is PFO that can be provoked with a Valsalva manoeuvre. In patients in whom TCD was not possible, transcranial duplex sonography, duplex sonography of the carotid artery at the neck or transoesophageal ECG was performed. RESULTS:In 26 patients PFO was detected. Thirteen of them presented a persistent PFO with high-intensity transient signal in both middle cerebral arteries without Valsalva manoeuvre. The intraoperative positioning in these patients was adapted to the risk for a paradoxical air embolism, although, after surgical recommendations, three patients with a persistent PFO underwent surgery in sitting position. Intraoperative air embolisms were seen in 8 of 80 patients in sitting or semi-sitting position with air aspirable through the central venous catheter. CONCLUSION:To address the risk of a paradoxical air embolism, especially in patients undergoing surgery in sitting position, preoperative detection of PFO is advisable. If surgery is performed in seated PFO patients, additional monitoring and special care are warranted.
journal_name
Br J Anaesthjournal_title
British journal of anaesthesiaauthors
Engelhardt M,Folkers W,Brenke C,Scholz M,Harders A,Fidorra H,Schmieder Kdoi
10.1093/bja/ael015subject
Has Abstractpub_date
2006-04-01 00:00:00pages
467-72issue
4eissn
0007-0912issn
1471-6771pii
S0007-0912(17)35153-Xjournal_volume
96pub_type
杂志文章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:Recent investigations showed that isoflurane can induce pharmacological preconditioning. The present study aimed to compare the potency of four different halogenated anaesthetics to induce preconditioning. METHODS:Anaesthetized open-chest rabbits underwent 30 min of coronary artery occlusion followed by 3 h...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:
更新日期:2002-09-01 00:00:00
abstract:BACKGROUND:The perioperative period may be associated with a marked neurohumoral stress response, significant fluid losses, and varied fluid replacement regimes. Acute changes in serum sodium concentration are therefore common, but predictors and outcomes of these changes have not been investigated in a large surgical ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aeu409
更新日期:2015-04-01 00:00:00
abstract:BACKGROUND:Dexmedetomidine (DEX) has been shown to provide good perioperative haemodynamic stability with decreased intraoperative opioid requirements. It may have neural protective effects, and thus may be a suitable anaesthetic adjuvant to neurosurgical anaesthesia. METHODS:Fifty-four patients scheduled for elective...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/ael220
更新日期:2006-11-01 00:00:00
abstract::Patients receiving opioids report feeling sleepy, but opioids actually inhibit the rapid eye movement phase of sleep (REM). Inhibition of REM sleep is followed by a rebound increase in REM sleep associated with cardiopulmonary complications. The medial pontine reticular formation (mPRF) is a brain region from which mo...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/74.2.188
更新日期:1995-02-01 00:00:00
abstract::Spinal anaesthesia is the preferred anaesthetic technique for elective Caesarean deliveries. Hypotension is the most common side-effect and has both maternal and neonatal consequences. Different strategies have been attempted to prevent spinal-induced hypotension, including the use of low-dose bupivacaine. We conducte...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,meta分析,评审
doi:10.1093/bja/aer200
更新日期:2011-09-01 00:00:00
abstract:BACKGROUND:Miller laryngoscope blades are preferred for laryngoscopy in infants and children <2 yr of age. Despite their long history, the laryngeal view with the Miller blade size 1 has never been compared with that with the Macintosh (MAC) blade in children. This prospective, single-blinded, randomized study was desi...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aeu228
更新日期:2014-11-01 00:00:00
abstract:BACKGROUND:The esCCO monitor (ECG- estimated Continuous Cardiac Output, Nihon Kohden(®)) is a new non-invasive tool for estimating cardiac output (CO). It derives CO from the pulse wave transit time (PWTT) estimated by the ECG and the plethysmographic wave. An initial calibration is needed to refine the relation linkin...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aes298
更新日期:2012-12-01 00:00:00
abstract:BACKGROUND:Restrictive transfusion triggers are safe for most critically ill patients, but doubts exist for patients with ischaemic heart disease (IHD). We investigated the prevalence of reported IHD at admission to the intensive care unit (ICU) and investigated how this influenced red cell transfusion triggers. We als...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,多中心研究
doi:10.1093/bja/aei073
更新日期:2005-04-01 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::The respiratory effects of a new strong analgesic, meptazinol, were compared with a placebo and with equianalgesic doses of morphine and pentazocine in a double-blind crossover trial in seven healthy volunteers. No significant change in the ventilatory response to rebreathing carbon dioxide was observed after meptazin...
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/51.6.497
更新日期:1979-06-01 00:00:00
abstract:BACKGROUND:Multiple cognitive and psychiatric disorders are associated with an increased tonic inhibitory conductance that is generated by α5 subunit-containing γ-aminobutyric acid type A (α5 GABAA) receptors. Negative allosteric modulators that inhibit α5 GABAA receptors (α5-NAMs) are being developed as treatments for...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1016/j.bja.2020.11.032
更新日期:2020-12-30 00:00:00
abstract:BACKGROUND:Paravertebral regional anaesthesia is used to treat pain after several surgical procedures. This study aimed to improve on our first published ultrasound-guided approach to the paravertebral space (PVS) and to investigate a possible discrepancy between the needle, catheter, and contrast dye position. METHOD...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aeq309
更新日期:2011-02-01 00:00:00
abstract::Isolated, cultured rat pancreatic islets of Langerhans were incubated in medium containing glucose 2 or 20 mmol litre-1 and with glucose supplemented with midazolam 10, 100 or 1000 ng ml-1. Glucose 20 mmol litre-1 with the addition of noradrenaline 10 mumol litre-1 was used as a control. In contrast with noradrenaline...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/70.2.221
更新日期:1993-02-01 00:00:00
abstract::Plain bupivacaine 0.5% or 0.75% was injected intrathecally in four groups of 10 patients. Group A received 0.75% bupivacaine 2.7 ml at L3/4, group B 0.5% bupivacaine 4 ml at L3/4, group C 0.75% bupivacaine 2.7 ml at L2/3 and group D 0.75% bupivacaine 2 ml at L3/4. A very wide range of height of block was found in each...
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/58.3.292
更新日期:1986-03-01 00:00:00
abstract::Seventy-two adult surgical patients were studied to compare neuromuscular and cardiovascular effects of mivacurium chloride during nitrous oxide-fentanyl-thiopentone (BAL group) or nitrous oxide-halothane (HAL group) anaesthesia. Eighteen patients in the BAL group received an initial bolus of mivacurium, either the ED...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/64.2.193
更新日期:1990-02-01 00:00:00
abstract::We have compared the ability of naïve intubators to intubate the trachea using a laryngoscope and an intubating laryngeal mask airway (ILMA) after receiving basic training, in a randomized, prospective, crossover study in 60 patients. Ventilation of the lungs via the ILMA was also compared with ventilation with a face...
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/83.4.615
更新日期:1999-10-01 00:00:00
abstract::The concept of rapid delivery of multiple blood products to the bedside of a massively haemorrhaging patient seems to be a logical approach to the management of the massively bleeding patient. However, controversy exists in the use of fixed blood component ratios. Assessing the extent of the coagulopathy through point...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/aeu379
更新日期:2014-12-01 00:00:00
abstract:BACKGROUND:The oesophageal leak pressure is defined as the pressure which breaks the seal between the cuff of a supraglottic airway and the peri-cuff mucosa, allowing penetration of fluid into the pharynx and the oral cavity. As a consequence, a decrease in this variable increases the risk of reflux and can lead to pul...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aev435
更新日期:2016-02-01 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::Clinicians inevitably encounter patients who meet the diagnostic criteria for the metabolic syndrome (MetS); these criteria include central obesity, hypertension, atherogenic dyslipidaemia, and hyperglycaemia. Regardless of the variations in its definition, MetS may be associated with adverse outcomes in patients unde...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/aev199
更新日期:2015-08-01 00:00:00
abstract::Bilateral superior laryngeal nerve block was combined with topical application of local anaesthetic 140 times in 135 patients to anaesthetize the upper airway and facilitate tracheal intubation, laryngeal instrumentation, or to diminish the response to the endotracheal tube, in a patient already intubated. The techniq...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/53.10.1055
更新日期:1981-10-01 00:00:00
abstract::Visceromotor responses and vasopressin release before and after colonic visceral distension were compared between male (n=5 (n=4 for vasopressin)) and female rats and between females during the oestrous cycle (proestrus n=6, oestrus n=5, metestrus n=5, diestrus n=6) at a controlled depth of anaesthesia. Pre-stimulatio...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/85.6.907
更新日期:2000-12-01 00:00:00
abstract:BACKGROUND:Cyclic redistribution of air within the cuff during respiratory pressure changes creates a self-sealing mechanism which allows tracheal sealing, despite tracheal airway pressure being above baseline cuff inflation pressure. The aim of the present study was to investigate the effect of continuous automated cu...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aen355
更新日期:2009-02-01 00:00:00
abstract::Arterial pressure is still one of the most important measures in estimating the required dose of inhaled anaesthetics. It is measured easily and reacts rapidly which makes it suitable as a variable for feedback control of depth of anaesthesia. Fuzzy logic, a novel approach to feedback control, was used to control arte...
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/74.1.66
更新日期:1995-01-01 00:00:00
abstract::We have investigated the incidence of regurgitation of gastric contents during general anaesthesia administered via a laryngeal mask airway (LMA) or face mask and Guedel airway in 56 patients with no risk factors for regurgitation. Patients swallowed a gelatin capsule containing methylene blue 10 min before induction ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/69.3.314
更新日期:1992-09-01 00:00:00
abstract::We have compared the effects of sevoflurane and halothane on the discharge frequencies of 19 slowly adapting and four rapidly adapting lung receptors in the rabbit by recording from single vagal fibres. Both agents reduced the discharge frequency of slowly adapting receptors during expiration (P < 0.0005), halothane h...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/80.2.257
更新日期:1998-02-01 00:00:00
abstract:BACKGROUND:Robotic-assisted laparoscopic radical prostatectomy (RALRP) is gaining popularity as a less traumatic and minimally invasive alternative to open radical retropubic prostatectomy (RRP). The aim of this study was to evaluate the incidence and grade of venous gas embolism (VGE) during RALRP compared with those ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aeq247
更新日期:2010-12-01 00:00:00
abstract::The evidence for an association between hypertensive disease, elevated admission arterial pressure, and perioperative cardiac outcome is reviewed. A systematic review and meta-analysis of 30 observational studies demonstrated an odds ratio for the association between hypertensive disease and perioperative cardiac outc...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,meta分析,评审
doi:10.1093/bja/aeh091
更新日期:2004-04-01 00:00:00
abstract::We report a case of improved cardiopulmonary exercise (CPX) test outcomes measured 48 h after initial CPX testing and immediately after alterations were made to the settings of a dual chamber, dual sensing pacemaker with exercise detection. The changes allowed successful abdominal surgery to be completed. ...
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