Abstract:
BACKGROUND:The objective of the present study was to investigate sublingual microvascular blood flow and microcirculatory haemoglobin oxygen saturation (Smc(O(2))) during cardiopulmonary bypass (CPB) using constant systemic blood flow but different perfusion pressures achieved by phenylephrine administration. METHODS:Fifteen patients undergoing coronary artery bypass grafting were enrolled in this pilot study. Systemic haemodynamics, oxygen transport variables, arterial and mixed venous blood gas analysis, and microcirculatory variables were determined after initiation of general anaesthesia, during CPB (systemic blood flow=2.4 litre m(-2)), after increasing perfusion pressure by 20 mm Hg with a continuous infusion of phenylephrine, and after termination of phenylephrine infusion. RESULTS:CPB immediately resulted in a significant (P<0.05) decrease in systemic oxygen transport without alterations in sublingual microcirculatory blood flow and Smc(O(2)). Increasing perfusion pressure from 47 (SD 9) to 68 (7) mm Hg using phenylephrine=1.4 (1.0) microg kg(-1) min(-1) resulted in a significant decrease in sublingual small vessel blood flow (from median 2.5 to 1.8 arbitrary units) representing mostly capillary blood flow, but not in medium-sized vessels (median 3 to 2.8 arbitrary units). Concurrently, global tissue blood flow from 110 (54) to 197 (100) perfusion units and Smc(O(2)) increased from 72 (11)% to 84 (7)%, suggesting significant microcirculatory blood flow shunting in vessels with diameters >25 microm. CONCLUSIONS:Our data demonstrate that an increased perfusion pressure produced by phenylephrine at constant CPB flow may decrease microcirculatory blood flow in the sublingual mucosal microcirculation due to microvascular blood flow shunting.
journal_name
Br J Anaesthjournal_title
British journal of anaesthesiaauthors
Maier S,Hasibeder WR,Hengl C,Pajk W,Schwarz B,Margreiter J,Ulmer H,Engl J,Knotzer Hdoi
10.1093/bja/aep018subject
Has Abstractpub_date
2009-04-01 00:00:00pages
485-91issue
4eissn
0007-0912issn
1471-6771pii
S0007-0912(17)34470-7journal_volume
102pub_type
杂志文章abstract:BACKGROUND:Patient dissatisfaction has been previously associated with motor block in shoulder surgery patients receiving brachial plexus block. For elective minor wrist and hand surgery, we tested whether a regional block accelerating the early return of upper extremity motor function would improve patient satisfactio...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aes266
更新日期:2012-11-01 00:00:00
abstract::Fires and explosions have occurred in the operating theatre for many years. Flammable inhalation anaesthetic agents were responsible for many incidents in the past, but these are no longer available in many countries. Other causes of fires and explosions still exist in the operating theatre and, from time to time, res...
journal_title:British journal of anaesthesia
pub_type: 历史文章,杂志文章
doi:10.1093/bja/73.6.847
更新日期:1994-12-01 00:00:00
abstract::Thirteen of 31 Belgian Landrace pigs developed malignant hyperthermia (MH) after breathing halothane. A short period of exercise 1 h before the administration of the triggering agent increased the incidence of the syndrome to 100% in eight similar pigs. Clinical symptoms were more marked and developed more rapidly in ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/48.9.821
更新日期:1976-09-01 00:00:00
abstract:BACKGROUND:Clonidine is a useful analgesic-sedative agent; however, few data exist regarding its use in infants after congenital heart disease surgery. We thus aimed to assess the absorption and safety of enterally administered clonidine in this setting. METHODS:Sixteen infants (median age 6.7 months) received a singl...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aeu258
更新日期:2014-12-01 00:00:00
abstract::The effects of age on the dose of Org NC 45 were studied in 24 healthy, anaesthetized patients using an on-demand infusion of the drug which produced a stable twitch height of 10% of its initial value. The patients were allocated as follows: group I = age less than 40 yr; group II = 40-60 yr and group III = age greate...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/54.6.653
更新日期:1982-06-01 00:00:00
abstract::Skills related to driving, the ability to discriminate the fusion of flickering light, and hand and foot proprioception, were measured double-blind in 34 healthy volunteers before and after three doses of i.v. diazepam. The effects of diazepam were most harmful to co-ordination. With 0.15 mg/kg, 0.30 mg/kg and 0.45 mg...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/47.4.457
更新日期:1975-04-01 00:00:00
abstract:BACKGROUND:Muscle relaxants facilitate tracheal intubation, but they are often not used for short peripheral surgical procedures. The consequences of this practice on the upper airway are still a matter of controversy. We therefore compared the incidence of post-intubation symptoms in a randomized study comparing patie...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aem147
更新日期:2007-08-01 00:00:00
abstract:BACKGROUND:Individual patient information from clinical trials is infrequently available, but can provide insights for clinical trials and practice. METHODS:We analysed individual patient information from five randomized trials (913 patients) of i.v. patient-controlled analgesia (IVPCA) plus epidural placebo, morphine...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,meta分析
doi:10.1093/bja/aep300
更新日期:2009-12-01 00:00:00
abstract::The neuromuscular blocking effects of Org 9426, the 2-morpholino, 16-allyl-pyrrolidino derivative of the 3-desacetoxy analogue of vecuronium have been investigated in anaesthetized patients. Based on data from a pilot study, two doses, 250 and 500 micrograms kg-1 (estimated as the ED90 and 2 x ED90, respectively) were...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/64.4.521
更新日期:1990-04-01 00:00:00
abstract:BACKGROUND:This study compared the efficacy of topical anaesthesia with levobupivacaine 0.75% vs lidocaine 2% during cataract surgery by phacoemulsification. METHODS:A prospective, randomized, double-blind study comparing two agents for topical anaesthesia in cataract surgery. Two hundred and forty-six consecutive pat...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aen369
更新日期:2009-02-01 00:00:00
abstract::Diltiazem inhibited and antagonized the abnormal contractures induced by halothane, caffeine and potassium chloride in isolated skeletal muscle from pigs susceptible to malignant hyperpyrexia (MHS). Contractile responses to caffeine and electrical stimulation also were suppressed by diltiazem in control tissue. Simila...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/62.5.566
更新日期:1989-05-01 00:00:00
abstract::General anaesthesia for emergency surgery in a pressurized habitat is likely to involve the use of i.v. agents. The anaesthetic property of such agents is known to be antagonized by pressure, but the effect on their duration of action is not easily predicted. The recovery of mice from a single i.v. dose of Althesin, k...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/53.5.455
更新日期:1981-05-01 00:00:00
abstract::A 24-yr-old male presented after a fishing accident in which he was pulled underwater by a rope attached to a crayfish pot. He was winched out of the water with the rope still around his neck, sustaining serious neck injuries that ultimately led to his death. After initial resuscitation, he remained fully conscious fo...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/oxfordjournals.bja.a013484
更新日期:2000-04-01 00:00:00
abstract::A 38-yr-old woman with an atrial septum defect and Eisenmenger syndrome was scheduled for a lung biopsy via thoracoscopy during one-lung ventilation. Fluids were given to increase central venous pressure to 8 mm Hg, an epidural catheter was inserted at the sixth thoracic intervertebral space and ropivacaine 0.3%, 6 ml...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aeh104
更新日期:2004-04-01 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::Temazepam elixir 30 mg by mouth was compared with i.v. Diazemuls titrated to a maximum dose of 20 mg in a double-blind study of 50 patients undergoing elective minor oral surgery. The treatments produced a similar reduction in anxiety score and similar degrees of patient relaxation and co-operation. The diazepam group...
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/60.1.18
更新日期:1988-01-01 00:00:00
abstract::We have examined the effects of bupivacaine and lignocaine on myocardial metabolism in the rat isolated heart-lung preparation. Bupivacaine 1, 5 or 25 micrograms ml-1 or lignocaine 4, 20 or 100 micrograms ml-1 was administered 5 min after the start of perfusion. Both bupivacaine 25 micrograms ml-1 and lignocaine 100 m...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/65.4.521
更新日期:1990-10-01 00:00:00
abstract::Intragastric pressure was measured in 20 patients before, and immediately after, the induction of anaesthesia with thiopentone. Intragastric pressure decreased in patients whose weights were the same as or less than expected, and increased in five of seven patients whose weights were greater than expected (P = 0.0013)...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/56.8.873
更新日期:1984-08-01 00:00:00
abstract:BACKGROUND:The observation that patients presenting for bariatric surgery had a high incidence of neuromuscular blocking agent (NMBA) anaphylaxis prompted this restricted case-control study to test the hypothesis that obesity is a risk factor for NMBA anaphylaxis, independent of differences in pholcodine consumption. ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1016/j.bja.2020.12.018
更新日期:2021-01-13 00:00:00
abstract::We investigated the effect of incision and sternotomy on the auditory evoked potential (AEP) and EEG, to try to predict a haemodynamic response to incision or sternotomy using the AEP and EEG in 41 patients undergoing cardiac surgery during propofol and alfentanil anaesthesia. The AEP and EEG were recorded before inci...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/76.5.685
更新日期:1996-05-01 00:00:00
abstract::The safety of aspirin therapy in neuraxial anaesthesia has been historically questioned, and the current recommendations are still heterogeneous. A comprehensive review of clinical evidence and a comparative analysis of European and American guidelines were performed. Low-dose aspirin produces a selective, complete an...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/aev348
更新日期:2015-11-01 00:00:00
abstract::Progressive obstruction of an axillary vein following an axillary approach to brachial plexus blockade is described. At surgical exploration, the axillary vein was narrowed with an aneurysm of its wall. It is likely that, during the performance of the block, the needle penetrated the adventitia of the vein, causing a ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/56.9.1051
更新日期:1984-09-01 00:00:00
abstract::Mice, previously immunized with sheep erythrocytes, were anaesthetized with halothane and the splenic lymphoid cells were incubated with 3H-thymidine at 1-h intervals. Abiphasic response was observed; 0.9 and 1.5% halothane reduced 3H-thymidine incorporation into the primed lymphoid cells by 83 and 94% respectively, w...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/48.12.1129
更新日期:1976-12-01 00:00:00
abstract::Patients are at risk for several types of lung injury in the perioperative period including atelectasis, pneumonia, pneumothorax, acute lung injury, and acute respiratory distress syndrome. Anaesthetic management can cause, exacerbate, or ameliorate these injuries. This review examines the effects of perioperative mec...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/aeq299
更新日期:2010-12-01 00:00:00
abstract::This paper reports three investigations of the suggested relationship between sudden infant death syndrome (SIDS) and malignant hyperpyrexia (MH). In the first study 151 MH-susceptible families completed a questionnaire designed to identify the incidence of SIDS within their own pedigree. In the second study 106 SIDS ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/60.1.28
更新日期:1988-01-01 00:00:00
abstract::Units for the investigation of susceptibility to malignant hyperthermia (MH) were set up in Denmark in 1977 and in Sweden in 1981. Two hundred and ten patients from 76 families have been investigated. The diagnosis of MH susceptibility (MHS) was made by in vitro exposure of muscle from vastus medialis to halothane and...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/56.11.1183
更新日期:1984-11-01 00:00:00
abstract:BACKGROUND:Guidelines recommend discontinuation of clopidogrel for 7 days before a neuraxial injection, while other directives suggest that 5 days might be adequate. We examined the time course of antiplatelet activity after clopidogrel discontinuation in patients undergoing epidural injections. METHODS:Thirteen patie...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aer298
更新日期:2011-12-01 00:00:00
abstract::Two techniques for endotracheal anaesthesia in dental outpatients have been compared: a spontaneous ventilation technique using nitrous oxide, oxygen and halothane, and a controlled ventilation technique using nitrous oxide and oxygen, with tubocurarine and fentanyl. The latter technique has several advantages: abolit...
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/48.9.919
更新日期:1976-09-01 00:00:00
abstract::Bilateral superior laryngeal nerve block was combined with topical application of local anaesthetic 140 times in 135 patients to anaesthetize the upper airway and facilitate tracheal intubation, laryngeal instrumentation, or to diminish the response to the endotracheal tube, in a patient already intubated. The techniq...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/53.10.1055
更新日期:1981-10-01 00:00:00
abstract:BACKGROUND:There have been few studies comparing the response to asphyxia and the effectiveness of typical cardiopulmonary resuscitation (CPR) using exogenous epinephrine administration and manual closed-chest compression between total intravenous anaesthesia (TIVA) and inhalational anaesthesia. METHODS:Twenty pigs we...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aeg259
更新日期:2003-12-01 00:00:00