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 standard-volume technique both guided by ultrasound. METHODS:Forty patients undergoing shoulder surgery were randomized to receive an ultrasound-guided ISBPB of either 5 or 20 ml ropivacaine 0.5%. General anaesthesia was standardized. Both groups were assessed for respiratory function by sonographic diaphragmatic assessment and spirometry before and after receiving ISBPB, and after surgery. Motor and sensory block, pain, sleep quality, and analgesic consumption were additional outcomes. Statistical comparison of continuous variables was analysed using one-way analysis of variance and Student's t-test. Non-continuous variables were analysed using chi(2) tests. Statistical significance was assumed at P<0.05. RESULTS:The incidence of diaphragmatic paralysis was significantly lower in the low-volume group compared with the standard-volume group (45% vs 100%). Reduction in forced expiratory volume in 1 s, forced vital capacity, and peak expiratory flow at 30 min after the block was also significantly less in the low-volume group. In addition, there was a significantly greater decrease in postoperative oxygen saturation in the standard-volume group (-5.85 vs -1.50, P=0.004) after surgery. There were no significant differences in pain scores, sleep quality, and total morphine consumption up to 24 h after surgery. CONCLUSIONS:The use of low-volume ultrasound-guided ISBPB is associated with fewer respiratory and other complications with no change in postoperative analgesia compared with the standard-volume technique.
journal_name
Br J Anaesthjournal_title
British journal of anaesthesiaauthors
Riazi S,Carmichael N,Awad I,Holtby RM,McCartney CJdoi
10.1093/bja/aen229subject
Has Abstractpub_date
2008-10-01 00:00:00pages
549-56issue
4eissn
0007-0912issn
1471-6771pii
S0007-0912(17)34171-5journal_volume
101pub_type
杂志文章,随机对照试验abstract::We describe the management of three patients undergoing awake carotid surgery who developed signs of cerebral ischaemia after carotid cross-clamping. Drug treatment to increase arterial blood pressure above baseline reversed the neurological deficit and an internal carotid artery shunt was not needed. Shunt insertion ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/87.4.641
更新日期:2001-10-01 00:00:00
abstract::We have examined the role of benzodiazepine receptors in nitrous oxide-induced neuronal depression in rats. The changes in neuronal excitability induced by nitrous oxide and the benzodiazepine inverse agonist, Ro15-4513, were monitored by measurement of visual evoked potentials (VEP). Administration of Ro15-4513 10 mg...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/77.4.522
更新日期:1996-10-01 00:00:00
abstract:BACKGROUND:Clonidine is an alpha 2 adrenergic agonist with analgesic properties. This study aimed to see if the addition of clonidine to morphine when given by patient-controlled analgesia (PCA) would improve analgesia beyond the first 12 h after surgery. METHODS:Sixty patients undergoing lower abdominal surgery were ...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:2002-09-01 00:00:00
abstract::We describe a six-compartment physiological model of the kinetics and dynamics of induction of anaesthesia with propofol in sheep. It includes a faithful description of initial bolus kinetics caused by accurate representations of the inter-relationships between initial vascular mixing, lung kinetics and cardiac output...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/79.4.497
更新日期:1997-10-01 00:00:00
abstract:BACKGROUND:Psychological factors are thought to drive inter-patient variations in anaesthetic and analgesic requirements. This cross-sectional study investigated whether preoperative psychological factors can predict anaesthetic requirements and postoperative pain. METHODS:Before total thyroidectomy, 100 consecutive w...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aer305
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND:The optimal dose of oxytocin at Caesarean section is unclear. Oxytocin may cause adverse cardiovascular effects, including tachycardia and hypotension, whereas an inadequate dose can result in increased uterine bleeding. We compared the effects of two doses of oxytocin in a randomized double-blind trial. ME...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aen273
更新日期:2008-12-01 00:00:00
abstract::Magnesium inhibits the release of acetylcholine from the motor nerve terminal and thus potentiates the action of the non-depolarizing neuromuscular blocking drugs. We have examined the possibility that this effect might enhance the speed of onset of non-depolarizing block with pancuronium. Following the administration...
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/66.2.247
更新日期:1991-02-01 00:00:00
abstract::A variant of a rebreathing/indicator-dilution technique was used to measure lung volume. Two or three indicators, which should have essentially the same pulmonary volume of distribution, were used. Gas compositions were measured by respiratory mass spectrometry and an extrapolation was used to allow for oxygen consump...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/56.3.289
更新日期:1984-03-01 00:00:00
abstract::The use of di-isopropyl phenol (Diprivan) for induction of anaesthesia was assessed in doses ranging from 1 to 3 mg kg-1. With less than 1.75mg kg-1 not all patients were anaesthetized; 2.0 mg kg-1 appeared to be a satisfactory induction dose. Involuntary muscle movement, cough and hiccup at induction were rare with a...
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/53.11.1197
更新日期:1981-11-01 00:00:00
abstract:BACKGROUND:There are no studies comparing local anaesthetic requirements for obese and normal parturients. Obesity has been associated with a higher incidence of Caesarean section and higher levels of epidural block have also been found in obese obstetric patients, suggesting they may require less local anaesthetic. Th...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aei284
更新日期:2006-01-01 00:00:00
abstract::The study was performed to determine the ED50 and ED95 of a continuous infusion of the emulsion formulation of propofol during 67% nitrous oxide anaesthesia in 57 patients premedicated with morphine sulphate 0.15 mg kg-1. Anaesthesia was induced with propofol 2 mg kg-1, and maintained before incision with a fixed-rate...
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/58.10.1080
更新日期:1986-10-01 00:00:00
abstract::Thiopentone 4 mg/kg, Althesin 0.055 ml/kg and ketamine 2 mg/kg were compared in 157 children undergoing minor otolaryngological surgery, mostly adenotonsillectomy. Premedication was with pethidine and atropine and anaesthesia was maintained with nitrous oxide in oxygen and halothane. Tracheal intubation was facilitate...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/49.4.363
更新日期:1977-04-01 00:00:00
abstract::We have studied the effects of stepwise increasing infusion rates of propofol 200-500 micrograms kg-1 min-1 on blood concentrations of propofol and the disposition and clearance of a bolus dose of indocyanine green (ICG) 0.5 mg kg-1 in 10 acutely instrumented dogs. Drug concentrations and ICG clearance were measured 3...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/72.4.451
更新日期:1994-04-01 00:00:00
abstract::A blood-gas study of the respiratory effects of sodium nitroprusside during anaesthesia has shown a marked reduction in PaO2 when the drug was administered. After nitroprusside PaO2 returned to the previous values. It is suggested that the reduction in PaO2 is a result of an increased scatter of ventilation/perfusion ...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/47.11.1205
更新日期:1975-11-01 00:00:00
abstract:BACKGROUND:Propofol and sevoflurane are suitable agents for maintenance of anaesthesia during neurosurgical procedures. We have prospectively compared these agents in combination with the short-acting opioid, remifentanil. METHODS:Fifty unpremedicated patients undergoing elective craniotomy received remifentanil 1 mic...
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/aei141
更新日期:2005-06-01 00:00:00
abstract::We describe a scavenging device, primarily for use during inhalation induction of anaesthesia in children; it was designed to optimize the often conflicting requirements of clinical acceptability and adequate gas collection. The performance was assessed in three ways. The device reduced the nitrous oxide concentration...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/64.1.117
更新日期:1990-01-01 00:00:00
abstract::Thoracic imaging is regularly performed on the majority of critical care patients. Conventionally, this uses a combination of plain radiography and computed tomography. There is growing enthusiasm for the use of ultrasound to replace much of this radiology and provide more immediate, point-of-care imaging with reducti...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/aet076
更新日期:2013-08-01 00:00:00
abstract::The speeds of onset of pancuronium, atracurium and vecuronium are increased by prior administration of magnesium sulphate. A prospective, randomized, double-blind, controlled, clinical study was performed to examine the effects of prior i.v. administration of magnesium sulphate 60 mg kg-1 on the neuromuscular blocking...
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/79.1.122
更新日期:1997-07-01 00:00:00
abstract::Dose-response relationships for the antagonism of intermediate-acting neuromuscular blocking agents have not been evaluated previously in children. We have examined the dose-response relationships for neostigmine antagonism of 90% rocuronium-induced neuromuscular block in children and adults, during nitrous oxide-1 MA...
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/77.6.710
更新日期:1996-12-01 00:00:00
abstract::Although well established in clinical practice, both propofol and midazolam have limitations. New hypnotics with different and potentially superior pharmacokinetics and pharmacodynamics are under development. These include the benzodiazepine receptor agonists CNS7056 and JM-1232 (-), the etomidate-based methoxycarbony...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/aeq190
更新日期:2010-09-01 00:00:00
abstract:BACKGROUND:Propofol use during sedation for colonoscopy can result in cardiopulmonary complications. Intravenous lidocaine can alleviate visceral pain and decrease propofol requirements during surgery. We tested the hypothesis that i.v. lidocaine reduces propofol requirements during colonoscopy and improves post-colono...
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::Simple methods are described for computing the variables derived from the Siggaard-Andersen nomogram, where the in vitro buffer line is either established by direct measurement or calculated from measurements of pH, Pco2 and haemoglobin. Calculations are performed using the equation of the pH-log Pco2 buffer line, the...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/47.4.500
更新日期:1975-04-01 00:00:00
abstract::The metabolic effect of infusing 1.0-1.5 litre of Hartmann's solution to normal subjects and those with maturity onset diabetes has been studied during surgery. It was found that the use of Hartmann's solution after operation was associated with a 7.5 mmol litre-u increase in plasm glucose concentration compared with ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/50.2.185
更新日期:1978-02-01 00:00:00
abstract::Fresh gas flows of nitrous oxide, oxygen and halothane at 6, 3, 2 and 1 litre/min were introduced into a circle absorber system. Spontaneous respiration and IPPV were studied and a regression of inspired on delivered oxygen concentration % was calculated. The difference between delivered and inspired oxygen concentrat...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/48.3.217
更新日期:1976-03-01 00:00:00
abstract::Bupivacaine 2.5 mg kg-1 (0.5 ml kg-1 of 0.5% solution), with or without adrenaline 5 micrograms ml-1, was administered by interpleural injection to 12 patients after elective cholecystectomy. Noncompartmental analysis indicated that the addition of adrenaline had no effect on total body clearance, apparent volume of d...
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/64.6.662
更新日期:1990-06-01 00:00:00
abstract:BACKGROUND:Anterograde, but not retrograde, amnesia has been demonstrated following midazolam administration. However, there have been no studies investigating whether or not immediate retrograde amnesia can be produced with midazolam. METHODS:After ethics committee approval and consent, 40 adult patients undergoing s...
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/aei040
更新日期:2005-03-01 00:00:00
abstract::Since the preoperative administration of water might promote gastric emptying and dilute the remaining gastric contents, 50 patients were investigated before elective surgery. One group was given water 100 ml 2 h before operation; the other group was fasted as usual. Volume and pH of gastric contents were measured imm...
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/60.7.803
更新日期:1988-06-01 00:00:00
abstract::We report the case of a morbidly obese patient who developed rhabdomyolysis with acute renal failure, hepatic dysfunction, and an increase of cardiac troponin-1 after total knee arthroplasty. Postoperative rhabdomyolysis has a wide range of triggers and differential diagnoses that should be considered by the anaesthes...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/ael274
更新日期:2006-12-01 00:00:00
abstract:BACKGROUND:High-frequency oscillation (HFO) is a widely used lung-protective ventilatory strategy in paediatric and neonatal acute lung injury. Its safe and effective use has been hindered by inadequate recruitment of the lung during oscillation and, until recently, the lack of an adequately powered oscillator for use ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/88.5.708
更新日期:2002-05-01 00:00:00
abstract:BACKGROUND:The Bispectral Index (BIS) monitor has been suggested as a potential tool to measure depth of sedation in paediatric intensive care unit (PICU) patients. The primary aim of our observational study was to assess the difference in BIS values between the left and right sides of the brain. Secondary aims were to...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aen035
更新日期:2008-05-01 00:00:00