Abstract:
BACKGROUND:Data on contributors to between-individual variability in overall tramadol clearance and O-demethyl tramadol (M1) formation in preterm neonates and young infants are limited. METHODS:A population pharmacokinetic analysis of tramadol and M1 was undertaken using non-linear mixed effects model. Covariate analysis included weight, postmenstrual age (PMA), postnatal age (PNA), creatinaemia, (cardiac) surgery, cardiac defect, and cytochrome (CYP)2D6 polymorphisms, classified by CYP2D6 activity score. RESULTS:In 57 patients (25-54 weeks PMA), 593 observations were collected. Tramadol clearance was described using a two-compartment, zero-order input, first-order elimination linear model. An additional compartment was used to characterize M1. Tramadol clearance at term age was 17.1 litre h(-1) (70 kg)(-1) (CV, 37.2%). Size (37.8%) and PMA (27.3%) contribute to this variability. M1 formation clearance (CL2M1, i.e. the contribution of M1 synthesis to M clearance) was 4.11 litre h(-1) (70 kg)(-1) (CV, 110.9%) at term age. Size and PMA were the major contributors to the variability (52.7%); the CYP2D6 activity score contributes 6.4% to this variability. CONCLUSIONS:Overall tramadol clearance estimates confirm earlier reports while CL2M1 variability is explained by size, PMA, and CYP2D6 polymorphisms. The CL2M1 is very low in preterm neonates, irrespective of the CYP2D6 polymorphism with subsequent rapid maturation. The slope of this increase depends on the CYP2D6 activity score. The current pharmacokinetic observations suggest a limited micro-opioid receptor-mediated analgesic effect of M1 in preterm neonates and a potential CYP2D6 polymorphism-dependent effect beyond term age.
journal_name
Br J Anaesthjournal_title
British journal of anaesthesiaauthors
Allegaert K,van den Anker JN,de Hoon JN,van Schaik RH,Debeer A,Tibboel D,Naulaers G,Anderson BJdoi
10.1093/bja/aen019subject
Has Abstractpub_date
2008-04-01 00:00:00pages
525-32issue
4eissn
0007-0912issn
1471-6771pii
S0007-0912(17)34372-6journal_volume
100pub_type
杂志文章abstract::Eighty-one consenting women undergoing elective Caesarean section under spinal anaesthesia were randomly divided into two groups. In Group O patients, ondansetron 4 mg was given intravenously at the end of the surgery and 8 mg added to the morphine solution in the PCA syringe. Patients in Group P received only morphin...
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/87.3.502
更新日期:2001-09-01 00:00:00
abstract::Patients with renal failure and undergoing a cadaver renal transplant were found to have plasma concentrations of laudanosine, following the administration of a single bolus dose of atracurium 0.5 mg kg-1, higher than those found in patients without renal failure. Since laudanosine is a known central nervous system st...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/57.11.1049
更新日期:1985-11-01 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::A retrospective study was carried out to determine analgesic requirements in a group of orthopaedic outpatients (n = 145) and oral surgery inpatients (n = 172). The orthopaedic patients received a codeine-paracetamol premedication, an opioid during operation, or no analgesic. Less than 50% of the orthopaedic patients ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/64.5.617
更新日期:1990-05-01 00:00:00
abstract::A total of 1442 patients who had major gynaecological surgery were recruited into three multicentre studies using a standard general anaesthetic technique in order to assess the efficacy of various doses of orally administered ondansetron in the prevention of postoperative nausea and vomiting. A total of 1257 patients...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,meta分析,多中心研究,随机对照试验
doi:10.1093/bja/71.4.517
更新日期:1993-10-01 00:00:00
abstract::We have compared, in a double-blind study, the efficacy of flumazenil with that of aminophylline in antagonizing the effects of midazolam in 60 patients (ASA I-II, mean age 66 yr) undergoing transurethral resection of prostate under spinal anaesthesia. All patients received midazolam 0.075 mg kg-1 i.v. and the test dr...
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/66.5.591
更新日期:1991-05-01 00:00:00
abstract::The induction dose requirements of propofol were compared in three age groups in 300 unpremedicated healthy Chinese children: group A, younger than 2 yr (n = 48); group B, 2-5 yr (n = 117); group C, 6-12 yr (n = 135). Patients in each group were allocated randomly to receive one of eight doses of propofol (1.2, 1.4, 1...
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/68.1.64
更新日期:1992-01-01 00:00:00
abstract:BACKGROUND:The effect of anaesthesia on postoperative outcome is unclear. Cardioprotective properties of volatile anaesthetics have been demonstrated experimentally and in haemodynamically stable patients undergoing coronary artery bypass grafting. Their effects in patients undergoing high-risk cardiac surgery have not...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1093/bja/aeu290
更新日期:2014-12-01 00:00:00
abstract::Patients with metastatic carcinoid tumours often undergo surgical procedures to reduce the tumour burden and associated debilitating symptoms. These procedures and anaesthesia can precipitate a life-threatening carcinoid crisis. To assess perioperative outcomes, we studied retrospectively the medical records of adult ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/87.3.447
更新日期:2001-09-01 00:00:00
abstract::In 40 patients anaesthetized with thiopentone, 66% nitrous oxide and 1% halothane, the effects of a single i.v. dose of nalbuphine 4.5, 8, 15, 25 or 50 mg/70 kg or morphine 3, 5, 10 or 17.5 mg/70 kg on total ventilation and end-tidal carbon dioxide concentration have been measured. Depression of respiration occurred 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/58.6.625
更新日期:1986-06-01 00:00:00
abstract::The relationship between maternal FIO2 and umbilical venous PO2, PCO2, pH and neonatal Apgar and TSR (time to sustained respiration) scores was studied in 35 patients undergoing Caesarean section under general anaesthesia. Patients were allocated randomly to breathe an FIO2 of either 0.5 or 0.33. Umbilical venous bloo...
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/61.3.250
更新日期:1988-09-01 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:BACKGROUND:Obstructive sleep apnoea (OSA) affects ~9-24% of the general population, and 90% remain undiagnosed. Those patients with undiagnosed moderate-to-severe OSA may be associated with an increased risk of perioperative complications. Our objective was to evaluate the proportion of surgical patients with undiagnos...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aes465
更新日期:2013-04-01 00:00:00
abstract::As the route of breathing and use of airway apparatus such as mask, mouthpiece and noseclip can alter breathing pattern, this study has used the helium dilution method to estimate the effects of mouthpiece and mask breathing on functional residual capacity (FRC) in the supine position, and the change in FRC that occur...
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/76.4.560
更新日期:1996-04-01 00:00:00
abstract::Changes in intragastric pressure after the administration of suxamethonium 1.5 mg kg-1 i.v. were studied in 32 children (mean age 6.9 yr) pretreated with either physiological saline or alfentanil 50 micrograms kg-1. Anaesthesia was induced with thiopentone 5 mg kg-1. The incidence and intensity of muscle fasciculation...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/60.2.176
更新日期:1988-02-01 00:00:00
abstract::During resection of a Wilms' tumour in a 10-year-old girl, sudden bradycardia, hypotension and cyanosis developed, leading to cardiac arrest. It was thought that part of the tumour had caused a pulmonary embolus. After prompt resuscitation, cardiopulmonary bypass surgery was started within 20 min. At operation the lef...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/53.8.903
更新日期:1981-08-01 00:00:00
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:Interscalene brachial plexus block (ISBPB) is an effective nerve block for shoulder surgery. However, a 100% incidence of phrenic nerve palsy limits the application of ISBPB for patients with limited pulmonary reserve. We examined the incidence of phrenic nerve palsy with a low-volume ISBPB compared with a s...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
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更新日期:2008-10-01 00:00:00
abstract::Atropine and glycopyrrolate were compared in a mixture with neostigmine for reversal of neuromuscular blockade in patients undergoing open heart surgery. In patients not receiving beta-blocking drugs, glycopyrrolate was shown to possess advantages over atropine in terms of a lower initial increase in heart rate, bette...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
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更新日期:1985-02-01 00:00:00
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journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.bja.2018.06.019
更新日期:2018-11-01 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
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journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/aei133
更新日期:2005-06-01 00:00:00
abstract:BACKGROUND:This study aimed to investigate whether reversal of rocuronium-induced neuromuscular blockade with sugammadex reduced the incidence of residual blockade and facilitated operating room discharge readiness. METHODS:Adult patients undergoing abdominal surgery received rocuronium, followed by randomized allocat...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aev104
更新日期:2015-11-01 00:00:00
abstract:BACKGROUND:Current guidelines for perioperative management of coronavirus disease 19 (COVID-19) are mainly based on extrapolated evidence or expert opinion. We aimed to systematically investigate how COVID-19 affects perioperative management and clinical outcomes, to develop evidence-based guidelines. METHODS:First, w...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1016/j.bja.2020.08.049
更新日期:2020-12-01 00:00:00
abstract::We present an unusual case of hypercapnia and surgical emphysema during transanal endoscopic microsurgery, which led to delayed post-operative ventilatory failure. The hypercapnia and surgical emphysema were secondary to rectal insufflation with carbon dioxide used to facilitate visualization and resection of a rectal...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/86.4.586
更新日期:2001-04-01 00:00:00
abstract::The arterial to end-tidal PCO2 difference (PaCO2-PE'CO2) was measured in five anaesthetized dogs during controlled ventilation at 0.25 Hz (15 b.p.m.) and during high frequency jet ventilation at 1, 3 and 5 Hz. Because of the slow response of the infra-red carbon dioxide analyser, satisfactory recordings of end-tidal c...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/59.2.240
更新日期:1987-02-01 00:00:00
abstract:BACKGROUND:The pharmacokinetic profile of local anaesthetics is influenced by the mode of administration. We sought to compare the pharmacokinetics of two doses of ropivacaine after fascia iliaca compartment (FIC) block in children. METHODS:In this prospective, double-blind study, children received an FIC block as a p...
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/aeh066
更新日期:2004-03-01 00:00:00
abstract::Puerperal women are reported to have a rate of cerebral infarction 13 times greater than non-pregnant females. We report a case of cerebral ischaemia in a 30-yr-old healthy parturient after epidural analgesia for labour, complicated by dural puncture treated with two epidural blood patches. Investigations showed the d...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:
更新日期:2003-01-01 00:00:00
abstract::Animal studies suggest that alpha 2 agonists inhibit the chemoreceptor response to hypoxia. We have examined the effect of oral clonidine on the ventilatory response to sustained, isocapnic hypoxia (SpO2 79.7% (SD 1.1%) for 20 min) in eight male subjects. The hypoxic ventilatory response was measured before and after ...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/76.2.214
更新日期:1996-02-01 00:00:00
abstract::The rate of liquid-phase gastric emptying was determined in seven smokers from the rate of paracetamol absorption after abstaining overnight from cigarettes, and again after smoking two cigarettes within 30 min. There were no significant differences between the maximum paracetamol concentration, the time to reach maxi...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/57.11.1104
更新日期:1985-11-01 00:00:00