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 sulphate (MS) 5 mg, or extended-release epidural morphine (EREM; DepoDur) at doses of 5-30 mg, to explore effects of a range of epidural morphine doses. Pain and opioid requirement on first and second postoperative days, dose-response, clinically relevant comparisons of IVPCA without epidural morphine, 5 mg MS, and 10 mg EREM, and relationship between patient rating and other measures were described. RESULTS:There were three strong findings. Epidural morphine resulted in greater patient satisfaction, despite higher rates of adverse events. Those describing their analgesic medication as 'very good' or 'excellent' used IVPCA opioid less and had pain scores significantly below the global mean, whereas those describing their medication as 'poor' or 'fair' had pain scores significantly above the mean. Epidural morphine meant less need for postoperative IVPCA opioid than epidural placebo. The therapeutic gain with EREM was lower pain scores with less IVPCA opioid. Moderate or severe pruritus was more common with IVPCA plus epidural morphine, whatever the formulation, compared with IVPCA plus placebo. CONCLUSIONS:Analysis of individual patient data from high-quality clinical trials provides important insights into characteristics of new agents not immediately apparent from original trials, and also informing clinical practice. Prophylactic epidural morphine provides a better patient experience than IVPCA alone.
journal_name
Br J Anaesthjournal_title
British journal of anaesthesiaauthors
Mhuircheartaigh RJ,Moore RA,McQuay HJdoi
10.1093/bja/aep300subject
Has Abstractpub_date
2009-12-01 00:00:00pages
874-81issue
6eissn
0007-0912issn
1471-6771pii
S0007-0912(17)33883-7journal_volume
103pub_type
杂志文章,meta分析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
abstract::A randomized, double-blind study of 40 women was performed to compare patient controlled anaesthesia (PCA) morphine requirements after spinal anaesthesia for elective Caesarean section. The women received 0.2 mg of either morphine or diamorphine mixed with 0.5% bupivacaine in 8% dextrose. There were no significant dif...
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/81.2.135
更新日期:1998-08-01 00:00:00
abstract::Three anaesthetic techniques based on isoflurane were compared in outpatients undergoing laparoscopy. Sixty healthy patients were randomly allocated to receive isoflurane via mask (spontaneous respiration), via tracheal tube (spontaneous respiration) or via tracheal tube with controlled ventilation. Moderate hypercarb...
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/59.2.189
更新日期:1987-02-01 00:00:00
abstract:BACKGROUND:Desflurane (DES)-induced preconditioning is mediated by large-conductance calcium-activated potassium channels (BK(Ca)). Whether BK(Ca) are involved in anaesthetic-induced post-conditioning is unknown. We tested the hypothesis that DES-induced post-conditioning is mediated by BK(Ca) upstream of the mitochond...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aer496
更新日期:2012-04-01 00:00:00
abstract::The fresh gas flow rate necessary to prevent rebreathing in T-piece anaesthesia is well established at twice total ventilation. The minimum reservoir volume to avoid air dilution of anaesthetic gases in the alveolus at this flow rate is, however, undecided. A lung model was constructed to represent spontaneous respira...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/57.8.803
更新日期:1985-08-01 00:00:00
abstract::We have evaluated the accuracy and reliability of the Paratrend 7 continuous blood-gas analyser in infants and small children under conditions of severe hypoxaemia admitted to the paediatric intensive care unit in the perioperative period with cyanotic congenital heart disease. PO2, PCO2 and pH (hydrogen ion concentra...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/79.5.665
更新日期:1997-11-01 00:00:00
abstract::We have examined the role of gamma-aminobutyric acid (GABA) neurones in propofol anaesthesia in mice using the righting reflex. Propofol i.p. increased the percentage of loss of the righting reflex in a dose-dependent manner with an ED50 value of 140 (95% confidence limits 123-160) mg kg-1 (n = 40; eight animals per d...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/83.4.665
更新日期:1999-10-01 00:00:00
abstract::We have used the technique of double-blind sequential allocation to quantify the minimum local analgesic concentration (MLAC) of extradural bupivacaine for women in early (median cervical dilatation 2 cm) and late (median cervical dilatation 5 cm) labour. The first bolus was 20 ml of the bupivacaine test solution. The...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/80.1.11
更新日期:1998-01-01 00:00:00
abstract::Critical narrowing of the dependent airways was examined in anaesthetized dogs with closed chests. Two techniques were used, (a) "closing" volume (CV), measured from the expired nitrogen plateau and (b) tantalum bronchography, to measure the calibre of airways of 3-8 mm diameter in the upper (UZ), middle (MZ) and lowe...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/50.8.735
更新日期:1978-08-01 00:00:00
abstract::A patient with a tracheostomy and an iatrogenic tracheo-oesophageal fistula presented for diagnostic bronchoscopy and right upper lobectomy. The anaesthetic management is discussed with reference to the options available and, in particular, the use of a Brompton Pallister single lumen endobronchial tube. ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/74.4.461
更新日期:1995-04-01 00:00:00
abstract::"Priming" with alcuronium has been studied in 72 female patients. Blockade of single twitch responses of the adductor pollicis by alcuronium 0.15, 0.2 or 0.3 mg kg-1 could be accelerated by priming with a suitable priming portion of the total dose. Giving alcuronium 0.04 mg kg-1 30 s after the induction of anaesthesia...
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/58.8.827
更新日期:1986-08-01 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::Muscle fasciculations and pain following the administration of suxamethonium were assessed in a group of patients who performed a series of stretch exercises approximately 1 h before operation. Comparison was made with a group who received suxamethonium but no pretreatment. Fasciculations were significantly reduced in...
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/59.5.596
更新日期:1987-05-01 00:00:00
abstract:BACKGROUND:Midlatency auditory evoked potentials (MLAEP) are a promising tool for monitoring suppression of sensory processing during anaesthesia and might help to avoid awareness. MLAEP in children are different to those in adults and the exact changes during general anaesthesia are unknown. METHODS:In 49 children of...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aem267
更新日期:2007-12-01 00:00:00
abstract::The study of rare families with inherited pain insensitivity can identify new human-validated analgesic drug targets. Here, a 66-yr-old female presented with nil requirement for postoperative analgesia after a normally painful orthopaedic hand surgery (trapeziectomy). Further investigations revealed a lifelong history...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1016/j.bja.2019.02.019
更新日期:2019-08-01 00:00:00
abstract::The concentrations of volatile hydrocarbons were studied in breath samples from patients before and after anaesthesia. In patients to whom halothane was administered, there was a significant increase in the concentration of isobutene (from 0.43 +/- 0.09 to 4.66 +/- 2.22 nmol litre-1). There was no change in the concen...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/52.10.989
更新日期:1980-10-01 00:00:00
abstract::Bispectral index (BIS) was assessed as a monitor of depth of anaesthesia during fentanyl and midazolam anaesthesia for coronary bypass surgery. In 10 patients given morphine premedication, anaesthesia was induced with a combination of midazolam and fentanyl and thereafter maintained with a continuous infusion of a mix...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/oxfordjournals.bja.a013587
更新日期:2000-06-01 00:00:00
abstract::Nausea and vomiting occur commonly during and after Caesarean delivery (CD) performed under neuraxial anaesthesia. Metoclopramide is a prokinetic agent reported to be safe in parturients. This meta-analysis assesses the efficacy of metoclopramide for prophylaxis against intra- and postoperative nausea and vomiting (IO...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,meta分析,评审
doi:10.1093/bja/aer509
更新日期:2012-03-01 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 recently installed anti-pollution system, initially designed to function in a passive mode, was evaluated, but found to be inconstant in its performance. A simple method of making the system active is described and evaluated. ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/49.5.439
更新日期:1977-05-01 00:00:00
abstract::We studied the elimination rate of nitrous oxide in 36 patients undergoing orthopaedic surgery. They were allocated randomly to one of six groups which differed in time of nitrous oxide exposure and mode of ventilation. In order to simulate recovery conditions, nitrous oxide administration was discontinued after 30, 6...
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/71.2.189
更新日期:1993-08-01 00:00:00
abstract::We have examined dimethylthiourea, a potent scavenger of free radicals, for its anaesthetic properties in mice and rats. In mice, dimethylthiourea abolished the righting reflex at intraperitoneal doses greater than 1.5 mg g-1 bodyweight; in rats, it decreased the MAC value for isoflurane in a dose-dependent fashion. D...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/70.4.456
更新日期:1993-04-01 00:00:00
abstract::The effect on intervillous blood flow of lumbar extradural analgesia for Caesarean section was studied in nine healthy women using xenon-133. Extradural anaesthesia was performed with lignocaine 1 1/2% 16--20 ml with adrenaline 5 microgram ml-1. Impairment of placental blood flow during the block was observed in seven...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/50.3.275
更新日期:1978-03-01 00:00:00
abstract::The analgesic effects of buprenorphine 2 microgram/kg--1 and 8 microgram. kg--1 were compared with those of pethidine 1 mg. kg--1 and pentazocine 0.6 mg.kg--1 in 172 patients recovering from surgery. The drugs were given by i.m. injection in the period immediately after operation and the quality of pain relief was ass...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/49.9.913
更新日期:1977-09-01 00:00:00
abstract:BACKGROUND:None of the currently available hypnosis monitoring systems have evaluated balanced xenon anaesthesia. We investigated the performance of the bispectral index (BIS) and the composite A-line autoregressive index (cAAI) while comparing balanced xenon with sevoflurane anaesthesia. METHODS:Sixty patients underg...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aeq163
更新日期:2010-09-01 00:00:00
abstract::Fast inactivation of sodium channel function is modified by anaesthetics. Its quantitative contribution to the overall anaesthetic effect is assessed by removing the fast inactivation mechanism enzymatically. Sodium channels from human brain cortex were incorporated into planar lipid bilayers. After incorporation, cha...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/82.1.74
更新日期:1999-01-01 00:00:00
abstract::We tested the hypothesis that the solvent for etomidate was a factor in the incidence of pain and other side effects after injection, and that these were associated with histamine release. Nine of 10 volunteers who received etomidate in a propylene glycol formulation reported moderate to severe pain on injection; only...
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/83.3.464
更新日期:1999-09-01 00:00:00
abstract:BACKGROUND:There is growing interest in the effect of postoperative analgesics on oncological outcomes after cancer surgery. We investigated the impact of tramadol after breast cancer surgery on recurrence and mortality and explored the mechanism by which tramadol affects cultured breast cancer cells in vitro. METHODS...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1016/j.bja.2019.09.004
更新日期:2019-12-01 00:00:00
abstract:BACKGROUND:Ultrasound-guided internal jugular venous access increases the rate of successful cannulation and reduces the incidence of complications, compared with the landmark technique. Three transducer orientation approaches have been proposed for this procedure: short-axis (SAX), long-axis (LAX) and oblique-axis (OA...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aev399
更新日期:2016-03-01 00:00:00
abstract::Five hundred and seventeen women in labour receiving extradural analgesia, using bupivacaine plain solution, were randomly allocated to one of three groups. Group A received 6-8ml of 0.5% solution, group B 10-14ml of 0.25% solution, and group C 6-8 ml of 0.25% solution. Spontaneous delivery occurred in 31.7% of patien...
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/53.9.933
更新日期:1981-09-01 00:00:00