Abstract:
:Carotid endarterectomy is commonly conducted under regional (deep, superficial, intermediate, or combined) cervical plexus block, but it is not known if complication rates differ. We conducted a systematic review of published papers to assess the complication rate associated with superficial (or intermediate) and deep (or combined deep plus superficial/intermediate). The null hypothesis was that complication rates were equal. Complications of interest were: (1) serious complications related to the placement of block, (2) incidence of conversion to general anaesthesia, and (3) serious systemic complications of the surgical-anaesthetic process. We retrieved 69 papers describing a total of 7558 deep/combined blocks and 2533 superficial/intermediate blocks. Deep/combined block was associated with a higher serious complication rate related to the injecting needle when compared with the superficial/intermediate block (odds ratio 2.13, P = 0.006). The conversion rate to general anaesthesia was also higher with deep/combined block (odds ratio 5.15, P < 0.0001), but there was an equivalent incidence of other systemic serious complications (odds ratio 1.13, P = 0.273; NS). We conclude that superficial/intermediate block is safer than any method that employs a deep injection. The higher rate of conversion to general anaesthesia with the deep/combined block may have been influenced by the higher incidence of direct complications, but may also suggest that the superficial/combined block provides better analgesia during surgery.
journal_name
Br J Anaesthjournal_title
British journal of anaesthesiaauthors
Pandit JJ,Satya-Krishna R,Gration Pdoi
10.1093/bja/aem160subject
Has Abstractpub_date
2007-08-01 00:00:00pages
159-69issue
2eissn
0007-0912issn
1471-6771pii
S0007-0912(17)34751-7journal_volume
99pub_type
杂志文章,meta分析,评审abstract::Sickle cell disease is a congenital haemoglobinopathy with a high incidence of perioperative complications. Traditional anaesthetic management, based largely on extrapolation from biochemical models, has emphasized avoidance of red cell sickling to prevent exacerbations of the disease. This historical review outlines ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/aei129
更新日期:2005-09-01 00:00:00
abstract::In the prone knee-chest position the spread of plain 0.5% bupivacaine in the cerebrospinal fluid and associated haemodynamic changes may be different compared with the horizontal position. A randomized comparison was performed in 40 ASA I-II patients, aged 24-61 yr, undergoing lumbar disc surgery. Subarachnoid injecti...
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/79.5.609
更新日期:1997-11-01 00:00:00
abstract::We have investigated the effect of dopamine and dopexamine on the isolated perfused rat kidney. After an equilibration period of 20 min and two control periods of 10 min, dopexamine 1.0, 2.5 or 4.0 micrograms kg-1 min-1 or dopamine 2.0 micrograms kg-1 min-1 were perfused for a further 40 min in random order. Renal blo...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/83.6.898
更新日期:1999-12-01 00:00:00
abstract::We studied 133 women given a combined spinal-epidural for analgesia in labour. The initial intrathecal dose contained bupivacaine 2.5 mg with fentanyl 25 micrograms. When the mothers were comfortable, they were allocated randomly to one of three groups: continuous infusion (group Cl, n = 46), midwife top-ups (group MW...
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/82.2.233
更新日期:1999-02-01 00:00:00
abstract:BACKGROUND:Cut-off points (CPs) of the numeric rating scale (NRS 0-10) are regularly used in postoperative pain treatment. However, there is insufficient evidence to identify the optimal CP between mild and moderate pain. METHODS:A total of 435 patients undergoing general, trauma, or oral and maxillofacial surgery wer...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aer195
更新日期:2011-10-01 00:00:00
abstract::The use of atracurium during major abdominal surgery was assessed in 20 infants with hepatic dysfunction caused by biliary atresia. An initial dose of 0.6 mg kg-1 provided excellent intubating conditions in all patients. Subsequent neuromuscular blockade was monitored with a peripheral nerve stimulator and incremental...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/58.11.1214
更新日期:1986-11-01 00:00:00
abstract::We report the successful preoperative control and anaesthetic management of severe hypertension in a 7-month-old baby with nephroblastoma and increased renin activity. The strategy for selection of appropriate antihypertensive pharmacological agents and the anaesthetic implications and management of the condition are ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/69.2.206
更新日期:1992-08-01 00:00:00
abstract::The effects of Org NC 45 and pancuronium bromide on heart rate and arterial pressure were studied in anaesthetized man. A bolus of either Org NC 45 0.1 mg kg-1 or pancuronium 0.1 mg kg-1 was administered to lightly anaesthetized unstimulated subjects. Following Org NC 45 heart rate decreased in the majority of subject...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/54.4.435
更新日期:1982-04-01 00:00:00
abstract::Development targets in anaesthetic pharmacology have evolved from minimizing harm caused by unwanted effects through an era in which rapid onset and offset of drug effect were prioritised. Today's anaesthetists have access to a library of effective drugs whose characteristics offer controllable hypnosis, analgesia and...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/aex328
更新日期:2017-12-01 00:00:00
abstract:BACKGROUND:The aim of this study was to test if intraoperative administration of N(2)O during propofol-remifentanil anaesthesia prevented the onset of postoperative opioid-induced hyperalgesia (OIH). METHODS:Fifty adult ASA I-II patients undergoing elective open septorhinoplasty under general anaesthesia were studied....
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aer323
更新日期:2011-12-01 00:00:00
abstract::The value of the continuous monitoring of end-tidal carbon dioxide concentration as an indicator of the acute intraoperative interruption of pulmonary blood flow, in patients with pre-existing restrictions of pulmonary blood flow undergoing closed heart surgery, is illustrated by two case reports. Decreases in end-tid...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/57.12.1257
更新日期:1985-12-01 00:00:00
abstract::Six patients with airway stenosis were submitted to bronchoscopy under general anaesthesia. Each was ventilated with a gas mixture of 50% oxygen and nitrogen using successively manual jet insufflation (JV) using the Sanders technique at 20 b.p.m., and high frequency jet ventilation (HFJV) at rates of 150, 300 and 500 ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/55.10.969
更新日期:1983-10-01 00:00:00
abstract::Healthcare litigation in the UK continues to grow at an alarming rate, with claims against anaesthetists and critical care physicians increasing each year. This has led to a huge financial burden for the taxpayer and a sharp increase in professional indemnity fees for individual doctors. Although such litigation shoul...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aes188
更新日期:2012-07-01 00:00:00
abstract::We have studied the effect of milrinone on pulmonary vascular resistance (PVR) in dogs with hypoxic pulmonary vasoconstriction (HPV). Using a pulmonary arterial occlusion method, we measured effective pulmonary capillary pressure (Pcap) by which total PVR was partitioned into arterial (PVRa) and venous (PVRv) componen...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/81.6.920
更新日期:1998-12-01 00:00:00
abstract::We have evaluated the effect of delivering nitric oxide using a continuous flow system (CFS) or two commercially available proportional gas injection systems (PGIS), Nodomo (Dräger, Lübeck, Germany) and Pulmonox-Mini (Messer Griesheim Austria, Gumpoldskirchen, Austria) on measured and simulated concentrations of nitri...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/81.4.544
更新日期:1998-10-01 00:00:00
abstract::Human plasma cholinesterase (E.C. 3.1.1.8) was shown to be inhibited by physiological concentrations of propanidid and suxamethonium using a colourimetric assay at 25 degrees C and pH 7.2 unit with butyrylthiocholine as substrate. Propanidid inhibited the enzyme in a non-competitive manner (I50 = 2.0 mmol litre-1; app...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/51.3.181
更新日期:1979-03-01 00:00:00
abstract::Ropivacaine is considered safer than bupivacaine, on the basis of experimental and human data that indicate a lower systemic toxicity. Here we report the occurrence of a single seizure after i.v. administration of ropivacaine 120 mg intended for extradural block in a patient having postpartum, tubal ligation. The only...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/80.6.843
更新日期:1998-06-01 00:00:00
abstract::We have investigated 296 inpatients in a single-blind observer study to determine the incidence, degree and duration of hypoxaemia during anaesthesia. The clinical recognition of hypoxaemia, period of time until recognition and risk factors were studied. Oxygen saturation (Spo2) was monitored continuously with a pulse...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/66.4.437
更新日期:1991-04-01 00:00:00
abstract::The haemodynamic effects of diltiazem were studied in six dogs during fentanyl-nitrous oxide (in oxygen) anaesthesia. A bolus of diltiazem 300 micrograms kg-1 was given, followed by infusions at 30, 60 and 90 micrograms kg-1 min-1 which produced plasma diltiazem concentrations of 392 +/- 30, 908 +/- 54 and 1483 +/- 13...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/60.6.655
更新日期:1988-05-01 00:00:00
abstract::We studied 100 healthy women undergoing outpatient gynaecological laparoscopy in a randomized, double-blind and placebo-controlled study to evaluate the effect of neostigmine on postoperative nausea and vomiting (PONV). After induction of anaesthesia with propofol, anaesthesia was maintained with sevoflurane and 66% n...
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/81.5.757
更新日期:1998-11-01 00:00:00
abstract::Plasma concentrations of pancuronium were measured using a fluorimetric method in six patients with normal renal function and seven patients in chronic renal failure. A tow-compartment open model was used in the pharmacokinetic analysis of the data. With this model, the clearance of pancuronium was found to be reduce...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/48.4.341
更新日期:1976-04-01 00:00:00
abstract::Standard methods for accurate intraoperative measurement of neuromuscular block are either expensive or inconvenient and are not used widely. We have evaluated a new method of monitoring neuromuscular block using a low-frequency microphone. The method is based on the phenomenon of low-frequency sound emission by contr...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/83.3.405
更新日期:1999-09-01 00:00:00
abstract::We randomized women having elective Caesarean section to receive either no preload (control group, n=33) or 4% gelatin solution (Gelofusine) 15 ml kg(-1) (colloid group, n=35) i.v. before spinal anaesthesia. Intravenous metaraminol was titrated at 0.25-0.75 mg min(-1) to maintain systolic arterial pressure (SAP) in th...
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/87.5.772
更新日期:2001-11-01 00:00:00
abstract:BACKGROUND:Balloon dilatational tracheostomy using the Ciaglia Blue Dolphin device has recently been introduced as a modification of the Ciaglia technique. The aim of this study was to compare the new Dolphin system with the single-step dilatational tracheostomy (Ciaglia Blue Rhino) in intensive care unit (ICU) patient...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aeq087
更新日期:2010-06-01 00:00:00
abstract::We have tested the hypothesis that intradermal testing is a more effective method for determining the drug responsible for anaesthetic anaphylactic reactions than prick testing in 212 consecutive patients, aged more than 10 yr, referred to an anaesthetic allergy clinic over a 4-yr period. The study was a prospective, ...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/79.1.59
更新日期:1997-07-01 00:00:00
abstract::This study has examined the effect of hydration on immediate recovery from anaesthesia in two groups of 15 patients undergoing therapeutic abortion. A standard anaesthetic technique was administered. Patients in group I received no preoperative fluid; those in group II received, before anaesthesia, 20 ml kg-1 of 4% gl...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/68.6.576
更新日期:1992-06-01 00:00:00
abstract:BACKGROUND:Early clot amplitudes measured on thromboelastometry (ROTEM®) predict maximum clot firmness (MCF) in adults. In this multicentre, retrospective study, we aimed to confirm the suspected relationship between early ROTEM® variables and MCF, in children undergoing cardiac or non-cardiac surgery. METHODS:4762 RO...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,多中心研究
doi:10.1093/bja/aev369
更新日期:2015-12-01 00:00:00
abstract:BACKGROUND:Blood flow patterns are important modifiers of platelet interactions with plasma coagulation factors. However, it is not feasible to evaluate rheological effects of haemodilution on coagulation using conventional coagulation testing. METHODS:We evaluated thrombus formation with a microchip-based flow-chambe...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aet229
更新日期:2013-12-01 00:00:00
abstract::It is generally accepted that halothane reduces airway and tissue resistance in lungs with preexisting airway tone. However, under conditions of resting airway tone, pulmonary resistance remains unaltered. In this study, we have determined the effects of halothane on respiratory system, pulmonary and chest wall resist...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/oxfordjournals.bja.a013443
更新日期:2000-03-01 00:00:00
abstract::Studies with an emulsion formulation of ICI 35 868 (2,6- diisopropylphenol ) indicate that this new formulation has anaesthetic properties in rats and mice, and haemodynamic effects in the mini-pig which are similar to those of the previously available Cremophor formulation. Administration of the emulsion formulation ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/56.6.617
更新日期:1984-06-01 00:00:00