Abstract:
BACKGROUND:We measured the effect of two weight adjusted i.v. doses (0.2 mg per 70 kg and 0.4 mg per 70 kg) of the potent opioid buprenorphine on analgesia and respiratory depression in healthy volunteers. The aim of the study was to compare buprenorphine's behaviour with respect to the occurrence of ceiling (or apparent maximum) in these typical micro-opioid protein-(MOP) receptor effects. METHODS:Ten subjects (5 males) received 0.2 mg per 70 kg, 10 others (5 males) 0.4 mg per 70 kg i.v. buprenorphine. Steady-state inspired minute ventilation at a fixed end-tidal Pco(2) of 7 kPa was measured before drug infusion and at regular intervals after drug infusion. Experimental pain was induced using transcutaneous electrical stimulation and a gradually increasing current. Pain tolerance was measured at regular intervals before and after drug infusion. The studies lasted 8 h. RESULTS:After infusion of the drug ventilation showed a rapid decline and reached peak depression between 150 and 180 min after drug administration. This effect was dose-independent with respect to timing and magnitude. At peak respiratory depression minute ventilation was 13.1 (sd 1.8) litre min(-1) in the 0.2 mg group vs 12.0 (sd 1.3) litre min(-1) in the 0.4 mg group (n.s.). At buprenorphine 0.2 mg a small short-lived analgesic effect was observed with a maximum increase in pain tolerance current of 6.7 (sd 2.8) mA occurring at 75 min after drug administration. Peak analgesic effect was 29% above baseline current. In contrast, buprenorphine 0.4 mg caused a large and long-lived analgesic effect with a maximum increase in pain tolerance current of 23.8 (sd 7.4) mA occurring at 130 min after drug administration. Peak analgesic effect was 160% above baseline current (0.4 vs 0.2 mg, P<0.01). CONCLUSIONS:While buprenorphine's analgesic effect increased significantly, respiratory depression was similar in magnitude and timing for the two doses tested. We conclude that over the dose range tested buprenorphine displays ceiling in respiratory effect but none in analgesic effect.
journal_name
Br J Anaesthjournal_title
British journal of anaesthesiaauthors
Dahan A,Yassen A,Romberg R,Sarton E,Teppema L,Olofsen E,Danhof Mdoi
10.1093/bja/ael051subject
Has Abstractpub_date
2006-05-01 00:00:00pages
627-32issue
5eissn
0007-0912issn
1471-6771pii
S0007-0912(17)35069-9journal_volume
96pub_type
杂志文章abstract::Seventeen patients received morphine 0.2 mgkg-1 in a 10% dextrose solution i.m. (n = 5), extradurally (n = 6) and intrathecally (n = 6) for pain after operation. Morphine was measured in plasma by radioimmunoassay. Plasma immunoreactive morphine concentration was significantly less after intrathecal administration aft...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/53.9.911
更新日期:1981-09-01 00:00:00
abstract:BACKGROUND:The AirWay Scope (AWS) is a fibreoptic device that allows for intubation without alignment of the oral, pharyngeal, and tracheal axes. It may be useful for patients with an unstable cervical-spine (C-spine) or when C-spine movement is undesirable. This study was conducted to fluoroscopically evaluate upper C...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aen207
更新日期:2008-10-01 00:00:00
abstract:BACKGROUND:A multidisciplinary approach to improve postoperative outcomes in frail elderly patients is gaining interest. Multidisciplinary team care should be targeted at complex patients at high risk for adverse postoperative outcome to limit the strain on available resources and to prevent an unnecessary increase in ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1016/j.bja.2019.12.042
更新日期:2020-02-14 00:00:00
abstract::The pressor and catecholamine responses to laryngoscopy and intubation were studied in nine patients with pregnancy-induced hypertension (PIH) and in eight normotensive controls. Five of the PIH patients had received oral labetalol as antihypertensive therapy. Mean arterial pressure (MAP) increased significantly from ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/63.4.429
更新日期:1989-10-01 00:00:00
abstract::The performance of a fuzzy controller for atracurium-induced neuromuscular block was assessed. Ten ASA I or II patients undergoing surgery anticipated to last at least 120 min were studied. A Datex Relaxograph was used to monitor neuromuscular block. Initially the T1 set point was set at 10% of baseline for at least 3...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/76.3.396
更新日期:1996-03-01 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::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::The effect of ketamine analgesia on gastric emptying was assessed in five healthy volunteers. Gastric emptying, estimated indirectly by the absorption of orally administered paracetamol, was not significantly delayed following administration of i.m. ketamine when compared with placebo. ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/53.12.1321
更新日期:1981-12-01 00:00:00
abstract:BACKGROUND:There is considerable evidence that the use of tidal volumes <6 ml kg(-1) predicted body weight (PBW) reduces mortality in mechanically ventilated patients. We evaluated the effectiveness of using a large screen displaying delivered tidal volume in ml kg(-1) (PBW) for reducing tidal volumes. METHODS:We asse...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aev110
更新日期:2015-08-01 00:00:00
abstract::We have measured in a double-blind study the changes in intraocular pressure (IOP) in 40 consecutive patients (pretreated with fentanyl or alfentanil) who received suxamethonium and tracheal intubation. Although IOP increased significantly following administration of suxamethonium, mean IOP in both groups remained sig...
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/63.6.688
更新日期:1989-12-01 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::We studied two groups of six patients scheduled for gastrointestinal surgery; they were allocated randomly to receive high- or low-dose fentanyl anaesthesia. The confounding effect of protein balance, before the trauma of surgery, on postoperative nitrogen excretion was controlled by standardized protein intake before...
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/72.6.697
更新日期:1994-06-01 00:00:00
abstract::A modification of an i.v. regional anaesthesia (IVRA) technique is described in which the arm is re-exsanguinated before surgery (re-IVRA). IVRA and re-IVRA were compared for quality of operative field, sensory and motor block, quality of analgesia and blood concentrations of prilocaine, lignocaine and mepivacaine in ...
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/70.3.280
更新日期:1993-03-01 00:00:00
abstract::An investigation was carried out into the relationship between the inflation pressures of normally compliant lungs and the airways pressure necessary to produce the insufflation of gas to the stomach. This relationship was examined during manual ventilation with a mask, using a rapid sequence induction technique. In t...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/59.3.315
更新日期:1987-03-01 00:00:00
abstract::We have compared the effects of the anaesthetic gases nitrogen and argon on adenosine diphosphate (ADP)-induced human blood platelet aggregation with the effects of the non-anaesthetic gas helium. All three gases showed dose-dependent inhibition of platelet aggregation. For nitrogen and argon there was a linear relati...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/64.1.77
更新日期:1990-01-01 00:00:00
abstract::We investigated whether low-dose erythromycin (200 mg) given as an oral premedicant altered the residual gastric volume and its acidity in fasted patients at induction of anaesthesia in a single-blinded study. Sixty patients were allocated randomly to receive either an erythromycin tablet (200 mg) or nothing with 10 m...
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/85.6.861
更新日期:2000-12-01 00:00:00
abstract:BACKGROUND:The role of repeated prone positioning in intubated subjects with acute respiratory distress syndrome caused by COVID-19 remains unclear. METHODS:We conducted a retrospective observational cohort study of critically ill intubated patients with COVID-19 who were placed in the prone position between March 18,...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1016/j.bja.2020.09.042
更新日期:2021-01-01 00:00:00
abstract::In a prospective study, patients undergoing abdominal surgery were allocated randomly to receive intermittent morphine 10 mg i.m. (n = 41) or a single injection of buprenorphine 0.3 mg i.m. followed by sublingual buprenorphine 0.4 mg every 6 h (n = 39) for 3 days following operation. Patients receiving buprenorphine w...
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/56.8.855
更新日期:1984-08-01 00:00:00
abstract::Progressive obstruction of an axillary vein following an axillary approach to brachial plexus blockade is described. At surgical exploration, the axillary vein was narrowed with an aneurysm of its wall. It is likely that, during the performance of the block, the needle penetrated the adventitia of the vein, causing a ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/56.9.1051
更新日期:1984-09-01 00:00:00
abstract:BACKGROUND:There have been few studies comparing the response to asphyxia and the effectiveness of typical cardiopulmonary resuscitation (CPR) using exogenous epinephrine administration and manual closed-chest compression between total intravenous anaesthesia (TIVA) and inhalational anaesthesia. METHODS:Twenty pigs we...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aeg259
更新日期:2003-12-01 00:00:00
abstract::Prolongation of the QT interval of the ECG represents an imbalance in cardiac autonomic function and may predict cardiac arrhythmia. Vagal activity protects against prolongation of the QT interval which may be associated with flattening of the T-wave of the ECG. The changes in QT interval, T-wave amplitude and respira...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/71.5.736
更新日期:1993-11-01 00:00:00
abstract::We have studied the efficacy of i.v. clonidine to suppress post-extradural shivering in parturients. Forty healthy parturients who received extradural block for labour (n = 20) or for Caesarean section (n = 20) and who required treatment for shivering after delivery were allocated randomly to two groups. Group I recei...
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/71.2.294
更新日期:1993-08-01 00:00:00
abstract::Liver/gas partition coefficients for isoflurane, enflurane, halothane and methoxyflurane increased two-fold in rats killed 16 h after a single injection of 15% ethanol 7 g kg-1. In contrast, blood/gas and brain/gas partition coefficients did not change. Chronic (21 days) ingestion of ethanol increased liver/gas partit...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/58.5.551
更新日期:1986-05-01 00:00:00
abstract::We have studied 14 female patients undergoing elective laparoscopy under general anaesthesia with peritoneal insufflation of carbon dioxide in order to examine changes in physiological deadspace (VDphys), arterial to end-tidal carbon dioxide partial pressure difference (PaCO2-PE' CO2) and PaCO2. VCO2 increased after i...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/68.2.211
更新日期:1992-02-01 00:00:00
abstract::The effects of doxacurium chloride, a new long-acting non-depolarizing neuromuscular blocking drug, on cardiac performance were studied in 45 patients undergoing high-dose fentanyl-diazepam-oxygen anaesthesia for cardiac surgery. Data were collected at baseline (10 min after tracheal intubation), and at 2, 5 and 10 mi...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/63.6.675
更新日期:1989-12-01 00:00:00
abstract::Cholinesterase phenotyping studies have been carried out in two laboratories on blood specimens from 28 patients shown to be susceptible to malignant hyperpyrexia. In contrast to previously published reports, no evidence could be found for an increase in the frequency of the E1u E1f genotype above that known to occur ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/53.3.245
更新日期:1981-03-01 00:00:00
abstract::Two techniques for endotracheal anaesthesia in dental outpatients have been compared: a spontaneous ventilation technique using nitrous oxide, oxygen and halothane, and a controlled ventilation technique using nitrous oxide and oxygen, with tubocurarine and fentanyl. The latter technique has several advantages: abolit...
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/48.9.919
更新日期:1976-09-01 00:00:00
abstract::The neuromuscular blocking effect of repeated bolus administration of suxamethonium 1 mg/kg was observed in 10 healthy surgical patients under enflurane-nitrous oxide-oxygen anaesthesia. Tachyphylaxis and slow recovery of the thumb twitch occurred in close dose-relationships with transition of Phase I block to Phase I...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/48.2.91
更新日期:1976-02-01 00:00:00
abstract::We have studied the complications associated with three techniques used to maintain extradural analgesia in labour: midwife top-up doses of 0.25% bupivacaine 10 ml, continuous infusion of 0.125% bupivacaine 10 ml h-1 and patient-controlled extradural analgesia (PCEA) with self-administered 3-ml bolus doses of 0.25% bu...
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/73.5.619
更新日期:1994-11-01 00:00:00
abstract::We have investigated the effect of interpleural morphine on postoperative pain and pulmonary function after thoracotomy. At the end of surgery, an interpleural catheter was inserted in 17 patients and, in a double-blind and randomized manner, either a bolus of morphine 2.5 mg interpleurally (i.p.) and normal saline i....
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/69.6.637
更新日期:1992-12-01 00:00:00