Abstract:
BACKGROUND:The influence of changes in body position relevant to neuraxial blockade on the location of the spinal cord and related neural structures has not been fully quantified. Our aim was to determine the changes, if any, that occur in the location of the spinal cord tip [equivalent to the tip of the conus medullaris (CM)] and nerve roots when an individual moves from the supine to the left lateral position with knees and hips flexed. METHODS:We used magnetic resonance imaging to determine movement of the spinal cord tip and associated structures in 30 adult volunteers. RESULTS:The tip shifted both anteriorly [average 6.3 mm, standard deviation (sd) 2.15 mm; P<0.001] and laterally towards the dependent side (average 1.63 mm, sd 1.19 mm; P<0.001). Although we observed anterior shift in all 30 volunteers, lateral movement did not occur in seven. Movement along the cranio-caudal axis was not statistically significant. CONCLUSIONS:Both the CM and associated nerve roots shift consistently and significantly anteriorly when moving from the supine to the lateral position with knees and hips flexed, which may provide a greater margin of safety during neuraxial blockade than might be predicted. However, the absence of significant cranial movement of the CM along the cranio-caudal axis still makes the spinal cord vulnerable to injury during lumbar neuraxial blockade.
journal_name
Br J Anaesthjournal_title
British journal of anaesthesiaauthors
Ranger MR,Irwin GJ,Bunbury KM,Peutrell JMdoi
10.1093/bja/aen295subject
Has Abstractpub_date
2008-12-01 00:00:00pages
804-9issue
6eissn
0007-0912issn
1471-6771pii
S0007-0912(17)34101-6journal_volume
101pub_type
杂志文章abstract:BACKGROUND:We investigated the effects of total i.v. anaesthesia (TIVA) and balanced anaesthesia (BAL) with sevoflurane on postoperative lung function in patients undergoing surgery in the prone position. METHODS:Sixty patients, aged 21-60 yr, undergoing elective lumbar disc surgery in the prone position were randomly...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aeq321
更新日期:2011-02-01 00:00:00
abstract::The processed electroencephalogram (pEEG) was monitored in eight patients undergoing gynaecological laparotomy under combined extradural and nitrous oxide-isoflurane anaesthesia. Pre-incisional mean spectral edge frequency 95 percentile (SEF95) and median frequency (MF) were 11.67 (SD 1.63) Hz and 3.74 (0.24) Hz, resp...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/78.6.751
更新日期:1997-06-01 00:00:00
abstract::Transoesophageal echocardiography (TOE) is valuable for perioperative monitoring in patients at risk from haemodynamic disturbance. However, its use is not practicable in patients undergoing surgical procedures under regional anaesthesia. We describe two cases showing that transthoracic echocardiography (TTE) has the ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/oxfordjournals.bja.a013596
更新日期:2000-06-01 00:00:00
abstract:BACKGROUND:Restrictive transfusion triggers are safe for most critically ill patients, but doubts exist for patients with ischaemic heart disease (IHD). We investigated the prevalence of reported IHD at admission to the intensive care unit (ICU) and investigated how this influenced red cell transfusion triggers. We als...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,多中心研究
doi:10.1093/bja/aei073
更新日期:2005-04-01 00:00:00
abstract::We have compared the viability criteria of muscle bundles used in the in vitro contracture test for susceptibility to malignant hyperthermia (MH) in a group of 28 patients with various neuromuscular diseases (NMD) and 93 MH-related family patients. In the patients with NMD, this standard test gave one positive, six eq...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/72.1.93
更新日期:1994-01-01 00:00:00
abstract:BACKGROUND:The purpose of this prospective study was to assess the blood-sparing effect, the quality of analgesia, and the incidence of side-effects of a low-dose regime of intrathecal opioids (ITO) when compared with those of a high-dose regime in scoliosis surgery in children. METHODS:Forty-six children were randoml...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aen025
更新日期:2008-04-01 00:00:00
abstract::The anaesthetic and surgical problems associated with Caesarean section in eight grossly obese patients (weight 150-204 kg) are described. In addition to an increase in the frequency and severity of the complications of obesity, those weighing more than 150 kg present a panniculus which may weigh 70 kg. Extradural ana...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/52.9.919
更新日期:1980-09-01 00:00:00
abstract::In theory, setting an infrared multi-gas analyser to measure a volatile anaesthetic different from that in the sampled gas mixture may cause interference with carbon dioxide and nitrous oxide readings. The theory was investigated during evaluation of the Dräger Cicero EM anaesthetic workstation for the Medical Devices...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/76.5.737
更新日期:1996-05-01 00:00:00
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:BACKGROUND:Age and diabetes mellitus have been identified as independent risk factors for cognitive decline after cardiac surgery with cardiopulmonary bypass (CPB). We tested the effects of CPB on cognitive function in aged and diabetic rats utilizing the Morris water maze (MWM). METHODS:Aged rats (26 months) were ran...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aem116
更新日期:2007-08-01 00:00:00
abstract::We have investigated the effect of volatile anaesthetics on protein synthesis and secretion in Hartley male guinea pig liver slices. The slices (250-300 microns thick) were incubated in sealed roller vials containing Krebs-Henseleit buffer at 37 degrees C under 95% oxygen. Volatile anaesthetics were vaporized in the v...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/68.2.172
更新日期:1992-02-01 00:00:00
abstract::A mathematical model of a subject breathing from a circle system has been used to follow the course of anaesthetic uptake during the simulated administration of 60% nitrous oxide, 2% halothane and 2% methoxyflurane, under non-rebreathing conditions and with fresh gas flows to the circle system of between 8 and 0.25 li...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/58.10.1167
更新日期:1986-10-01 00:00:00
abstract:BACKGROUND:Intraneural injection of local anaesthetic agents carries a risk of neurological complications. Early detection of intraneural needle-tip position is very important in the initial phase of injection. Ultrasound (US) characteristics for real-time detection of intraneural injections have been described, but on...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aes208
更新日期:2012-09-01 00:00:00
abstract::We have investigated the value of lower oesophageal contractility (LOC) in detecting awareness during anaesthesia in 20 human volunteer patients. LOC was measured either with subjects awake or after induction with propofol, during induction with propofol, and then as consciousness returned. Statistically significant c...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/65.3.319
更新日期:1990-09-01 00:00:00
abstract::The activity of the enzyme methionine synthase in fetal and maternal liver was investigated before and after exposure to nitrous oxide. Timed-pregnant rats on day 19 of gestation were exposed to either 10% or 50% nitrous oxide for various times up to 240 min. After exposure, fetal and maternal livers were removed and ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/56.5.523
更新日期:1984-05-01 00:00:00
abstract::Data from two published and one new meta-analysis were reviewed to compare the antiemetic efficacy of three different anaesthetic regimens: (i) propofol anaesthesia compared with another anaesthetic (control); (ii) anaesthesia without nitrous oxide compared with the same anaesthetic with nitrous oxide (control); (iii)...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,meta分析
doi:10.1093/bja/78.3.256
更新日期:1997-03-01 00:00:00
abstract::We have studied the effects of alfentanil administered intrathecally on somatosympathetic reflexes evoked by stimulation of radial and tibial nerves in 10 anaesthetized and paralysed dogs. In five animals, alfentanil was administered in doses of 100, 100, 200 and 400 micrograms in 0.8 ml and 800 micrograms in 1.6 ml p...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/68.5.503
更新日期:1992-05-01 00:00:00
abstract:BACKGROUND:Arousal after sevoflurane anaesthesia has been detectable by monitoring changes in skin conductance (SC) with similar accuracy as monitoring Bispectral Index (BIS). As SC monitoring detects changes in sympathetic tone, the measurements might be confounded by the sympatholytic properties of propofol, a compon...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/ael278
更新日期:2006-12-01 00:00:00
abstract::Midazolam 0.3 mg kg-1 was given as a single dose to three groups of children undergoing cardiac surgery to determine its pharmacokinetic profile in this situation. The first group, undergoing closed heart surgery, received the midazolam during the operation. The other groups underwent cardiopulmonary bypass (CPB) with...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/61.3.302
更新日期:1988-09-01 00:00:00
abstract::The water soluble benzodiazepine midazolam was compared with diazepam, in doses of 0.07 mg kg-1 and 0.15 mg kg-1 respectively, administered i.v. to 100 patients undergoing gastroscopy. The degree of sedation, ease of endoscopy and recovery were comparable in the two groups. The effects of both drugs on arterial pressu...
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/55.8.773
更新日期:1983-08-01 00:00:00
abstract:Background:Experimental studies suggest that mechanical cell washing to remove pro-inflammatory components that accumulate in the supernatant of stored donor red blood cells (RBCs) might reduce inflammation and organ injury in transfused patients. Methods:Cardiac surgery patients at increased risk of large-volume RBC ...
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/aex083
更新日期:2017-05-01 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:Preoperative anaemia affects one third of patients undergoing cardiac surgery and is associated with increased mortality and morbidity. Although it is recommended that perioperative teams should identify and treat patients with preoperative anaemia before surgery, introducing new treatment protocols can be c...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,多中心研究
doi:10.1016/j.bja.2019.11.023
更新日期:2020-03-01 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:Cyclic redistribution of air within the cuff during respiratory pressure changes creates a self-sealing mechanism which allows tracheal sealing, despite tracheal airway pressure being above baseline cuff inflation pressure. The aim of the present study was to investigate the effect of continuous automated cu...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aen355
更新日期:2009-02-01 00:00:00
abstract::We have studied post-tetanic count (PTC) and single twitch height at the onset of reflex movement to carinal stimulation after administration of vecuronium with five different types of anaesthesia. Seventy-five adult patients were allocated randomly to five groups of 15 patients each, to receive one of the following a...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验,收录出版
doi:10.1093/bja/72.6.688
更新日期:1994-06-01 00:00:00
abstract:BACKGROUND:Weaning from mechanical ventilation is a challenging step during recovery from critical illness. Weaning failure or early reintubation are associated with increased morbidity and mortality, exposing patients to life-threatening complications. Cardiac dysfunction represents the most common cause of weaning fa...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,meta分析
doi:10.1016/j.bja.2020.07.059
更新日期:2021-01-01 00:00:00
abstract::Many indices are used to quantify pulmonary oxygen transfer. Indices that use only measurements from arterial blood and inspired gas assume a constant C(a-v)O2. Though variations in C(a-v)O2 are recognized, indices such as PaO2/FIO2 remain popular and are often considered the best measure of pulmonary oxygen transfer ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/86.4.477
更新日期:2001-04-01 00:00:00
abstract:BACKGROUND:Tetrodotoxin (TTX) is a powerful sodium channel blocker extracted from the puffer fish. The analgesic effects of TTX were investigated in different animal pain models. METHODS:Wistar rats were submitted to the formalin test and to partial ligation of the sciatic nerve (Seltzer's model). Swiss Webster mice w...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/ael096
更新日期:2006-06-01 00:00:00
abstract::This study was designed to investigate if propofol produced cardiovascular effects by direct actions or by indirect actions secondary to depression of the central nervous system. Experiments were performed on chloralose anaesthetized dogs in which all neurogenic cardiovascular reflexes were abolished by bilateral vago...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/63.1.87
更新日期:1989-07-01 00:00:00