Abstract:
BACKGROUND:Perioperative beta-blockers are suggested to reduce cardiovascular mortality, myocardial-ischemia/infarction, and supraventricular arrhythmias after surgery. We reviewed the evidence regarding the effectiveness of perioperative beta-blockers for improving patient outcomes after cardiac and noncardiac surgery. METHODS:Eleven large databases were searched from the time of their inception until October 2005. Various online-resources were consulted for the identification of unpublished trials and conference abstracts. We included randomized, controlled trials comparing perioperative beta-blockers with either placebo or the standard-of-care. Of the 3680 retrieved titles, 69 met inclusion criteria for analysis. Odds ratios (OR) assuming random effects were computed in the absence of significant clinical heterogeneity. RESULTS:Beta-blockers reduced the frequency of ventricular tachyarrhythmias [OR (cardiac surgery): 0.28, 95% CI 0.13-0.57; OR (noncardiac surgery): 0.56, 95% CI 0.21-1.45], atrial fibrillation/flutter [OR (cardiac surgery): 0.37, 95% CI 0.28-0.48], other supraventricular arrhythmias [OR (cardiac surgery): 0.25, 95% CI 0.18-0.35; OR (noncardiac surgery): 0.43, 95% CI 0.14-1.37], and myocardial ischemia [OR (cardiac surgery): 0.49, 95% CI 0.17-1.4; OR (noncardiac surgery): 0.38, 95% CI 0.21-0.69]. Length of hospitalization was not reduced [weighted mean difference (cardiac surgery): -0.35 days, 95% CI -0.77-0.07; weighted mean difference (noncardiac surgery): -5.59 days, 95% CI -12.22-1.04] and, in contrast to previous reports, beta-blockers did not reduce mortality [OR (cardiac surgery): 0.55, 95% CI 0.17-1.83; OR (noncardiac surgery): 0.78, 95% CI 0.33-1.87], and they had no influence on the occurrence of perioperative myocardial infarction [OR (cardiac surgery): 0.89, 95% CI 0.53-1.5; OR (noncardiac surgery): 0.59; 0.25-1.39]. CONCLUSIONS:Beta-blockers reduced perioperative arrhythmias and myocardial ischemia, but they had no effect on myocardial infarction, mortality, or length of hospitalization.
journal_name
Anesth Analgjournal_title
Anesthesia and analgesiaauthors
Wiesbauer F,Schlager O,Domanovits H,Wildner B,Maurer G,Muellner M,Blessberger H,Schillinger Mdoi
10.1213/01.ane.0000247805.00342.21subject
Has Abstractpub_date
2007-01-01 00:00:00pages
27-41issue
1eissn
0003-2999issn
1526-7598pii
104/1/27journal_volume
104pub_type
杂志文章abstract:BACKGROUND:Perineural dexamethasone has gained popularity in regional anesthesia to prolong analgesia duration. However, uncertainty remains regarding the optimal perineural dose. Clarification of this characteristic is of significant importance as the administration of dexamethasone may lead to dose-dependent complica...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,meta分析,评审
doi:10.1213/ANE.0000000000002488
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:Sugammadex is the first selective relaxant binding agent that has been studied for reversal of neuromuscular blockade induced by rocuronium and other steroidal non-depolarizing neuromuscular blocking agents (NMBAs). OBJECTIVES:To assess the efficacy and safety of sugammadex in reversing neuromuscular blocka...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,meta分析
doi:10.1213/ANE.0b013e3181ce8d5e
更新日期:2010-04-01 00:00:00
abstract:UNLABELLED:There is concern that the environment in which consent for anesthesia research is sought may be coercive. We therefore designed this study to determine the factors that parents consider in consenting to their child's participation in clinical anesthesia research. The study sample consisted of 246 parents who...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-199801000-00010
更新日期:1998-01-01 00:00:00
abstract:BACKGROUND:Postoperative delirium is an important problem for surgical inpatients and was the target of a multidisciplinary quality improvement project at our institution. We developed and tested a semiautomated delirium risk stratification instrument, Age, WORLD backwards, Orientation, iLlness severity, Surgery-specif...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000005085
更新日期:2020-12-01 00:00:00
abstract:UNLABELLED:We investigated the effect of IV droperidol on the bispectral index (BIS) in conscious and propofol-sedated patients during spinal anesthesia. Thirty minutes after the induction of spinal anesthesia, 20 patients were given 2 mg of droperidol IV without administration of other sedatives (conscious group). Ano...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1213/01.ane.0000048517.98692.53
更新日期:2003-03-01 00:00:00
abstract:UNLABELLED:We tested the hypothesis that routine cleaning and autoclaving does not remove protein deposits from reusable laryngeal mask airways (LMAs). All previously used classic and flexible LMAs from a single hospital were tested. Each LMA was hand-washed in an enzymatic solution for 3 min, machine-washed with a dis...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ane.0000080154.76349.5b
更新日期:2003-10-01 00:00:00
abstract::The value of family-centered care in general and subspecialty pediatrics has been well documented in the literature. Translation of these principles into perioperative medicine has its logistical challenges; however, there are theoretical benefits. Specifically, pediatric patients with psychiatric diagnoses or special...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0b013e31827ab89c
更新日期:2013-06-01 00:00:00
abstract::To test the hypothesis that, after anesthesia for noncardiac surgical procedures, the increased cardiac work during recovery induces wall motion and ejection fraction (EF) abnormalities in patients with mild angina pectoris, gated radionuclide angiography was performed in patients undergoing simple cholecystectomy und...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1986-06-01 00:00:00
abstract:BACKGROUND:Infusion of lipid emulsion has been shown to reverse lipophilic drug-induced cardiovascular collapse in laboratory models and humans. The effect of high dose lipid in nondrug-induced cardiac arrest is, however, uncertain. In a rabbit model of asphyxial pulseless electrical activity (PEA) we compared lipid au...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ane.0b013e31819367ba
更新日期:2009-04-01 00:00:00
abstract::Fentanyl pharmacokinetics was compared in two groups of adult patients, one group (n = 5) aged less than 50 years, and one group (n = 4) aged greater than 60 years. Despite equivalent doses of fentanyl (10 microgram/kg IV), serum drug concentrations were significantly higher in the older patient group. This was reflec...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1982-12-01 00:00:00
abstract:BACKGROUND:Mounting evidence from animal studies shows that anesthetic exposure in early life leads to apoptosis in the developing nervous system. This loss of neurons has functional consequences in adulthood. Clinical retrospective reviews have suggested that multiple anesthetic exposures in early childhood are associ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0b013e31826d37c5
更新日期:2013-01-01 00:00:00
abstract:UNLABELLED:We conducted a randomized, controlled, cross-over cadaver study to test the hypothesis that the efficacy of seal for ventilation and airway protection, anatomic position, and airway patency with the flexible laryngeal mask airway (FLMA) are altered by the application of a Boyle Davis (B-D) gag. We also deter...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000539-199907000-00032
更新日期:1999-07-01 00:00:00
abstract:UNLABELLED:Besides having important hormonal effects, progesterone has depressant and hypnotic effects on the brain. In this study, we compared women in the follicular phase with low progesterone levels and in the luteal phase with high progesterone levels regarding their anesthetic requirements. Twenty patients with m...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ane.0000168271.76090.63
更新日期:2005-10-01 00:00:00
abstract::This study evaluated the role of nitric oxide (NO) in spinal cord nociceptive transmission during peripheral inflammation evoked by formalin injection into the rat paw, using N omega-nitro-L-arginine (N-Arg), an NO synthase inhibitor. Male rats were prepared with intrathecal (IT) catheters. To quantify the formalin re...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-199311000-00003
更新日期:1993-11-01 00:00:00
abstract:BACKGROUND:Bilateral breast augmentation is an increasingly popular day-case procedure. Local infiltration with sedation is routinely used for its ease of application compared with the more complex and potentially riskier paravertebral blockade (PVB). We hypothesized that ropivacaine injected by experienced anesthesia ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/ANE.0b013e318264ba33
更新日期:2012-11-01 00:00:00
abstract:BACKGROUND:Skeletal muscle failure in critical illness (intensive care unit-acquired weakness) is a well-known complication developing early during intensive care unit stay. However, muscle weakness during the perioperative setting has not yet been investigated. METHODS:We performed a subgroup investigation of a prosp...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章
doi:10.1213/ANE.0000000000004068
更新日期:2020-02-01 00:00:00
abstract::Phenomena seen in axons exposed to subblocking doses serve as the basis for interpreting clinical and behavioral observations during onset and recovery of peripheral nerve block. To delineate the changes in excitability and in impulse conduction caused by subblocking concentrations of local anesthetics (LAs) in myelin...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-199212000-00008
更新日期:1992-12-01 00:00:00
abstract:UNLABELLED:In adult patients, the creation of pneumoperitoneum (PP) by means of carbon dioxide (CO(2)) insufflation leads to an increase in cerebral blood flow velocity (CBFV), which is thought to be caused by hypercapnia. We evaluated whether PP leads to an increase of CBFV in children, and whether this increase is di...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-200202000-00005
更新日期:2002-02-01 00:00:00
abstract:BACKGROUND:The electroencephalogram (EEG) measures cerebral activity and, because of its use as an intraoperative monitor, the Accreditation Council for Graduate Medical Education requires EEG monitoring experience during anesthesiology residency. To improve the anesthesiology residents' education at the University of ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ane.0000287666.72775.07
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND:Previous studies demonstrated that MAC for isoflurane directly correlates with the concentration of Na(+) in cerebrospinal fluid surrounding the spinal cord, the primary site for mediation of the immobility produced by inhaled anesthetics. If this correlation resulted from increased irritability of the cord,...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ane.0b013e3181815f2b
更新日期:2008-09-01 00:00:00
abstract:UNLABELLED:The Valsalva maneuver in the awake patient and the ventilation maneuver in the tracheally intubated anesthetized patient are two provocation methods to detect a patent foramen ovale (PFO) by means of contrast transesophageal echocardiography. In 60 patients undergoing posterior fossa surgery, a contrast agen...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-200105000-00006
更新日期:2001-05-01 00:00:00
abstract:BACKGROUND:Obstructive sleep apnea (OSA) patients are at increased risk for pulmonary and cardiovascular complications; perioperative mortality risk is unclear. This report analyzes cases submitted to the OSA Death and Near Miss Registry, focusing on factors associated with poor outcomes after an OSA-related event. We ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000005005
更新日期:2020-10-01 00:00:00
abstract:BACKGROUND:Control of bleeding during laparoscopic liver resection (LLR) is important for patient safety. It remains unknown what the effects of mechanical ventilation with varying tidal volumes on bleeding during LLR. Thus, this study aims to investigate whether mechanical ventilation with low tidal volume (LTV) reduc...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000005242
更新日期:2020-10-14 00:00:00
abstract::To determine the safety, efficacy, and dose response of epidurally administered morphine for analgesia after cesarean delivery, 40 healthy women who underwent cesarean delivery with epidural anesthesia were randomly assigned to receive one of four regimens for relief of postoperative pain: intramuscular administration...
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:1983-07-01 00:00:00
abstract:BACKGROUND:Propofol-evoked injection site pain is not observed with fospropofol. We hypothesized that unlike propofol, fospropofol does not activate the irritant receptor, transient receptor potential 1 (TRPA1). METHODS:We tested the hypothesis using electrophysiology and behavioral studies. RESULTS:Our data demonstr...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0b013e318258b9db
更新日期:2012-10-01 00:00:00
abstract::The efficacy of two dosage regimens of intravenous naloxone were compared to avoid nonrespiratory side effects and respiratory depression and yet to preserve analgesia (maximum tolerance to periostial pressure over the tibia) after administration of 200 micrograms epidural fentanyl. Three groups of eight patients were...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章
doi:
更新日期:1988-01-01 00:00:00
abstract::While a large number of studies has examined the efficacy of opioid-sparing analgesics in adult surgical populations, fewer studies are available to guide postoperative pain treatment in pediatric patients. We systematically reviewed available publications on the use of systemic nonopioid agents for postoperative anal...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,评审
doi:10.1213/ANE.0000000000002434
更新日期:2017-11-01 00:00:00
abstract:UNLABELLED:We studied the effect of fluvoxamine and erythromycin on the pharmacokinetics of ropivacaine in a double-blinded, randomized, four-way cross-over study. Eight healthy volunteers ingested daily 1500 mg erythromycin for 6 days, 100 mg fluvoxamine for 5 days (Days 2-6), both erythromycin and fluvoxamine, or pla...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000539-200011000-00030
更新日期:2000-11-01 00:00:00
abstract::The anesthesia machine check is an integral part of the anesthesiologist's daily routine. It is standard operating procedure to check the high- and low-pressure systems of the machine as well as other integral parts that are accessible. Many new anesthesia machines offer a self-testing capability, but older ones with ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ANE.0000175210.13435.82
更新日期:2005-09-01 00:00:00
abstract:IMPLICATIONS:In this study, although 41%-94% of the patients were fast-track eligible after laparoscopic surgery, only 35%-53% of the patients actually bypassed the postanesthesia care unit (PACU) because of anesthetic-related factors and surgical complications. Residual sedation was the most common anesthetic-related ...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章
doi:10.1097/00000539-200107000-00024
更新日期:2001-07-01 00:00:00