Abstract:
:The anaesthetist's work, aimed at giving safe anaesthesia to patients, can do both harm and good to the anaesthetist. Research on stress in anaesthesia has traditionally focused on how the negative effects of stress can be avoided and much effort has been put into improving anaesthetists' work environment to reduce the level of stress. In this review, however, we give attention instead to what the individual anaesthetist can do to improve his or her well-being at work. Stress is, and will remain, an inevitable aspect of the anaesthetist's occupation but, as for any professional working in a stressful environment, adaptive coping can make a big difference in outcome. The choice between construing a difficult clinical situation as threat or challenge is important here because of the difference in the resulting stress response. The anaesthetist can reduce the stress effect of a potentially stressful situation by thinking of it in a new way, by redefining it through reappraisal. We describe here some lines of thought that experienced anaesthetists use to buffer the effects of work stress on physical health and mental well-being. By reframing a situation, they can reduce its stress content even if the problem at hand cannot be successfully solved. Trainee anaesthetists, who experience much stress at work and are at risk of burnout, would benefit from learning about these coping strategies.
journal_name
Br J Anaesthjournal_title
British journal of anaesthesiaauthors
Larsson J,Sanner Mdoi
10.1093/bja/aeq125subject
Has Abstractpub_date
2010-07-01 00:00:00pages
34-7issue
1eissn
0007-0912issn
1471-6771pii
S0007-0912(17)33563-8journal_volume
105pub_type
杂志文章,评审abstract:BACKGROUND:Intubation of a patient with limited cervical spine movement or in whom movement of the cervical spine is not desirable is always a challenge even to the most experienced anaesthesiologist. The intubating laryngeal mask airway (ILMA) and the Bullard laryngoscope (BL) are two instruments recommended for endot...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aem127
更新日期:2007-08-01 00:00:00
abstract::Development targets in anaesthetic pharmacology have evolved from minimizing harm caused by unwanted effects through an era in which rapid onset and offset of drug effect were prioritised. Today's anaesthetists have access to a library of effective drugs whose characteristics offer controllable hypnosis, analgesia and...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/aex328
更新日期:2017-12-01 00:00:00
abstract::In the dog, pancuronium 0.2 mg/kg increased left ventricular systolic pressure and systemic arterial pressure, but did not change central venous pressure. Repeated doses produced diminishing responses and eventually no change in arterial pressure. After tachyphylaxis was established, a pressor response to pancuronium ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/48.12.1143
更新日期:1976-12-01 00:00:00
abstract:BACKGROUND:The aim of this study is to test the hypothesis that a standard 30-min break in a routine 7.5 h period of work makes a difference in cognitive function. METHODS:In a double-blinded, cross-over trial 30 residents in anaesthesia were randomized to receive or not to receive a 30-min break between the assessmen...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/ael151
更新日期:2006-09-01 00:00:00
abstract::We have compared the effects of progressive (30% and 60%) in vitro haemodilution with hydroxyethyl starch (HES), gelatin (GEL) and albumin (ALB) with haemodilution using 0.9% saline in 96 patients by thrombelastography. Haemodilution with HES, GEL and ALB significantly (P < 0.05) compromised coagulation time (k), angl...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/78.6.684
更新日期:1997-06-01 00:00:00
abstract::In the postoperative period fifty-six healthy patients undergoing cholecystectomy or operations for duodenal ulcer, received, in a randomized order, i.m., "high-level" or "low-level" extradural morphine. Thirty-five per cent in the i.m. group, 33% in the high-level group and 50% in the low-level group suffered urinary...
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/54.11.1175
更新日期:1982-11-01 00:00:00
abstract:BACKGROUND:During normothermic cardiopulmonary bypass (CPB), the effect on propofol pharmacokinetics of changes in its binding to plasma proteins is consistent with the predictions of the well-stirred model of hepatic elimination for nonrestrictively cleared drug. However, whether changes in binding lead to clinically ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aei293
更新日期:2006-02-01 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::The possibility of an interaction between diazepam and pancuronium bromide was investigated in six patients undergoing general anaesthesia maintained with fentanyl, droperidol and nitrous oxide. Neuromuscular blockade was controlled using a feedback mechanism which automatically adjusted the rate of injection of pancu...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/53.8.859
更新日期:1981-08-01 00:00:00
abstract::The effect of diluting propofol in 5% dextrose on the incidence of i.v. injection pain was studied in 100 adult patients. Severe injection pain occurred in 32% (16 patients) who received undiluted propofol, compared with 10% (five patients) who received dilute propofol. We concluded that the dilution of propofol signi...
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/62.2.202
更新日期:1989-02-01 00:00:00
abstract:BACKGROUND:A significantly increased risk of acute kidney injury (AKI) with the prophylactic use of aprotinin has been reported in adults undergoing cardiac surgery, but not in children. Blood product transfusions have also been shown to carry an independent risk of AKI. The present study assessed associations between ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aes002
更新日期:2012-05-01 00:00:00
abstract:BACKGROUND:Cardiac output (CO) monitoring by uncalibrated arterial pressure waveform analysis (APCO) using the FloTrac/Vigileo™ is feasible in patients with intracranial haemorrhage, but the results of validation studies are contradictory. The aim of the present study was to analyse the clinical agreement between the i...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aer170
更新日期:2011-10-01 00:00:00
abstract:BACKGROUND:Anaesthetics blunt neuronal responses to noxious stimulation, including effects on electroencephalographic (EEG) responses. It is unclear how anaesthetics differ in their ability to modulate noxious stimulation-evoked EEG activation. We investigated the actions of propofol and halothane on EEG responses to n...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aei208
更新日期:2005-10-01 00:00:00
abstract:BACKGROUND:This study was undertaken to compare the effects of general anaesthesia (GA) and spinal anaesthesia (SA) on the need for postoperative hospitalization and early postoperative comfort in patients undergoing fast-track total knee arthroplasty (TKA). METHODS:One hundred and twenty subjects were randomly alloca...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aet104
更新日期:2013-09-01 00:00:00
abstract::Nociceptin/orphanin FQ, N/OFQ, and its receptor NOP represent a non-opioid branch of the opioid superfamily that were first studied for their effects on pain responses. Both N/OFQ and NOP are involved in a wide range of 'non-pain' responses including immunomodulation and cardiovascular control. There is now growing in...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/aeq337
更新日期:2011-01-01 00:00:00
abstract::The neuromuscular and cardiovascular effects of atracurium were compared during nitrous oxide-isoflurane and nitrous oxide-fentanyl anaesthesia in healthy surgical patients. The dose-response curve was shifted significantly to the left during nitrous oxide-isoflurane anaesthesia (ED50 0.068 mg kg-1) as compared with n...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:
更新日期:1983-01-01 00:00:00
abstract::An analysis of neuromuscular transmission has been made in phrenic nerve/diaphragm preparations from male rats aged 30 days or 110 days. The amplitude of miniature end-plate potentials was found to decrease with age, being 0.969 +/- SEM 0.058 mV at 30 days and 0.510 +/- SEM 0.031 mV at 110 days. Over the same period, ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/49.3.217
更新日期:1977-03-01 00:00:00
abstract:BACKGROUND:Cut-off points (CPs) of the numeric rating scale (NRS 0-10) are regularly used in postoperative pain treatment. However, there is insufficient evidence to identify the optimal CP between mild and moderate pain. METHODS:A total of 435 patients undergoing general, trauma, or oral and maxillofacial surgery wer...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aer195
更新日期:2011-10-01 00:00:00
abstract:BACKGROUND:The analgesia/nociception index (ANI), a 0-100 non-invasive index calculated from heart rate variability, reflects the analgesia/nociception balance during general anaesthesia. The aim of this study was to evaluate the ANI in the assessment of immediate postoperative pain in adult patients undergoing general...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aet110
更新日期:2013-09-01 00:00:00
abstract::Following antagonism of tubocurarine block with a mixture of atropine 20 microgram/kg and neostigmine 50 microgram/kg in 20 children, heart rate decreased from a control value of 110.4 beat/min to 90.1 at 5 min and 89.2 at 6 min (P less than 0.02). Stroke volume index did not change during the first 5 min from a contr...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/49.9.901
更新日期:1977-09-01 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::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
abstract::Five-year survival following cardiac transplantation approaches 50% and such patients occasionally present for non-cardiac surgery. The application of a simple general anaesthetic technique is described in a patient undergoing minor surgery, and the problems involved in managing heart transplant recipients are discuss...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/57.6.634
更新日期:1985-06-01 00:00:00
abstract::Cardioventilatory coupling (CVC) is the temporal coherence of respiratory and cardiac rhythms. We have suggested that this coherence is the result of triggering of inspiratory onset by a preceding cardiovascular afferent. One implication of this triggering hypothesis is that coupling should only exist under conditions...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/82.4.546
更新日期:1999-04-01 00:00:00
abstract:BACKGROUND:Dexmedetomidine is an α-2-receptor agonist which might be used as an additive to local anaesthetics for various regional anaesthetic techniques. We therefore designed this prospective, double-blinded, controlled volunteer study to investigate the effects of dexmedetomidine as an adjuvant to ropivacaine on pe...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aes400
更新日期:2013-03-01 00:00:00
abstract:BACKGROUND:The 'cannot intubate cannot oxygenate' (CICO) emergency requires urgent front of neck airway (FONA) access to prevent death. In cases reported to the 4th National Audit Project, the most successful FONA was a surgical technique, almost all of which were performed by surgeons. Subsequently, UK guidelines adop...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1016/j.bja.2019.07.011
更新日期:2019-11-01 00:00:00
abstract::The isolated rat hepatocyte model has been used to assess the hepatotoxicity of a number of i.v. anaesthetic induction agents. Ketamine, Althesin and CCI 12923 (minaxolone) all inhibited gluconeogenesis and urea formation from alanine. There was also a decrease in the cell ATP concentration, and a dose-related increas...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/51.8.733
更新日期:1979-08-01 00:00:00
abstract:BACKGROUND:To study adequate antinociception during general anaesthesia, tetanic stimulus of 5-10 s duration has been used previously as a standardized nociceptive stimulus. However, such stimuli have been found to correlate poorly with intraoperative nociception. We hypothesized that an electrical tetanic stimulus of ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aem200
更新日期:2007-10-01 00:00:00
abstract::We have documented the changes in gas exchange, haemodynamic state and associated physiological variables which occurred after graft reperfusion in 20 patients undergoing uncomplicated orthotopic liver transplantation. Gas exchange was measured during constant ventilation using a metabolic monitor. After reperfusion, ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/81.3.311
更新日期:1998-09-01 00:00:00
abstract:BACKGROUND:Signalling of several G-protein-coupled receptors of the Gq/11 family is time-dependently inhibited by local anaesthetics (LAs). Since LA-induced modulation of muscarinic m1 and m3 receptor function may explain their beneficial effects in clinical practice, such as decreased postoperative cognitive dysfuncti...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aet299
更新日期:2014-02-01 00:00:00