Abstract:
BACKGROUND:The revised cardiac risk index (RCRI) is associated strongly with increased cardiac ischaemic risk and perioperative death. Associations with non-cardiac morbidity in non-cardiac surgery have not been explored. In the elective orthopaedic surgical population, morbidity is common but preoperative predictors are unclear. We hypothesized that RCRI would identify individuals at increased risk of non-cardiac morbidity in this surgically homogenous population. METHODS:Five hundred and sixty patients undergoing elective primary (>90%) and revision hip and knee procedures were studied. A modified RCRI (mRCRI) score was calculated, weighting intermediate and low risk factors. The primary endpoint was the development of morbidity, collected prospectively using the Postoperative Morbidity Survey, on postoperative day (POD) 5. RESULTS:Morbidity on POD 5 was more frequent in patients with mRCRI ≥ 3 {relative risk 1.7, [95% confidence interval (CI): 1.4-2.1]; P<0.001}. Time to hospital discharge was delayed in patients with mRCRI score ≥ 3 (log-rank test, P=0.0002). Pulmonary (P<0.001), infectious (P=0.001), cardiovascular (P=0.0003), renal (P<0.0001), wound (P=0.02), and neurological (P=0.002) morbidities were more common in patients with mRCRI score ≥ 3. Pre/postoperative haematocrit, anaesthetic/analgesic technique, and postoperative temperature were similar across mRCRI groups. There were significant associations with hospital stay, as measured by the area under the receiver-operating characteristic curves for mRCRI 0.64 (95% CI: 0.58-0.70) and POSSUM 0.70 (95% CI: 0.63-0.75). CONCLUSIONS:mRCRI score ≥ 3 is associated with increased postoperative non-cardiac morbidity and prolonged hospital stay after elective orthopaedic procedures. mRCRI can contribute to objective risk stratification of postoperative morbidity.
journal_name
Br J Anaesthjournal_title
British journal of anaesthesiaauthors
Ackland GL,Harris S,Ziabari Y,Grocott M,Mythen M,SOuRCe Investigators.doi
10.1093/bja/aeq245subject
Has Abstractpub_date
2010-12-01 00:00:00pages
744-52issue
6eissn
0007-0912issn
1471-6771pii
S0007-0912(17)33402-5journal_volume
105pub_type
杂志文章,多中心研究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:BACKGROUND:Pain on injection of propofol is unpleasant. We hypothesized that propofol infusion pain might be prevented by infusing remifentanil before starting the propofol infusion in a clinical setting where target-controlled infusions (TCI) of both drugs were used. A prospective, randomized, double-blind, placebo-co...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aem293
更新日期:2007-12-01 00:00:00
abstract::To understand the cellular and molecular basis of the anaesthetic state, it is important to remember that, in the intact CNS, synapses operate within elaborate nerve networks. From the data presented above, it is evident that block of impulse conduction in presynaptic fibres does not explain the effects of most anesth...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/71.1.134
更新日期:1993-07-01 00:00:00
abstract:BACKGROUND:The elderly are perceived as a high-risk group for procedural sedation. Concern exists regarding the safety of sedation of this patient group by emergency physicians, particularly when using propofol. METHODS:We analysed prospectively collected data on patients aged 75 yr or older undergoing sedation betwee...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1016/j.bja.2018.07.038
更新日期:2018-12-01 00:00:00
abstract::We have compared the efficacy of patient-controlled interscalene analgesia (PCIA) using ropivacaine with patient-controlled analgesia (PCA) using nicomorphine in 60 patients (n = 30 in each group), in a prospective, randomized study. In both groups, all patients received interscalene block with 0.75% ropivacaine befor...
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/81.4.603
更新日期:1998-10-01 00:00:00
abstract:BACKGROUND:We defined the nature of the pharmacological interaction after intrathecal co-administration of ginsenosides with clonidine, and clarified the contribution of the α-2 adrenoceptors on the effect of ginsenosides. METHODS:Pain was evoked by injection of a formalin solution (5%, 50 μl) into the hindpaw of male...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aeq367
更新日期:2011-03-01 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::Buprenorphine 0.3 mg or fentanyl 0.125 mg i.v. were used to supplement nitrous oxide anaesthesia in a double-blind investigation of 40 patients undergoing major abdominal surgery. Initially both narcotics appeared to suppress tachycardia and increased arterial pressure in response to surgery, but 80% of the patients w...
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/52.4.453
更新日期:1980-04-01 00:00:00
abstract::We present a new pattern of nerve stimulation--double burst stimulation (DBS)--to detect residual neuromuscular block manually. The DBS consists of two short lasting, 50-Hz tetanic stimuli or bursts separated by a 750-ms interval. The response to this pattern of stimulation is two single separated muscle contractions ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/62.3.274
更新日期:1989-03-01 00:00:00
abstract::Isolated, cultured rat pancreatic islets of Langerhans were incubated in medium containing glucose 2 or 20 mmol litre-1 and with glucose supplemented with midazolam 10, 100 or 1000 ng ml-1. Glucose 20 mmol litre-1 with the addition of noradrenaline 10 mumol litre-1 was used as a control. In contrast with noradrenaline...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/70.2.221
更新日期:1993-02-01 00:00:00
abstract::An oxygen consuming lung model was used for evaluation and validation of a technique for metabolic gas exchange measurements during controlled ventilation. The technique comprised a Servo 900 C ventilator (Siemens) and separate oxygen and carbon dioxide analysers (Beckman). Measurements of oxygen consumption and carbo...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/64.3.311
更新日期:1990-03-01 00:00:00
abstract:BACKGROUND:Days alive and out of hospital (DAH) has been proposed as a pragmatic outcome measure of surgical quality. However, there is a lack of procedure specific data or data within an optimised fast-track protocol. Furthermore, information about influence of follow-up duration and types of complications on DAH is l...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,多中心研究
doi:10.1016/j.bja.2019.07.022
更新日期:2019-11-01 00:00:00
abstract:BACKGROUND:LMA CTrach (CT), a modified version of the intubating LMA Fastrach, allows continuous video-endoscopy of the tracheal intubation procedure. We tested the hypothesis that the CT is efficient for tracheal intubation of morbidly obese patients who are at risk of a difficult airway. METHODS:After Ethics' Commit...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/ael219
更新日期:2006-11-01 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::We have recently reported that continuous administration of butorphanol into the brachial plexus neurovascular sheath provided superior analgesia compared with that obtained with continuous i.v. administration. Furthermore, we found that analgesia was most pronounced when a mixture of mepivacaine and butorphanol was g...
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/78.1.83
更新日期:1997-01-01 00:00:00
abstract:BACKGROUND:Chronic pain is no longer an effective warning system, but a syndrome with co-morbidities and many causes, needing a careful evaluation. Questions remain about the pain behaviour of chronic pain patients compared with patients with acute pain, or healthy subjects that we investigated. METHODS:We compared th...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1016/j.bja.2018.04.042
更新日期:2018-09-01 00:00:00
abstract::We have compared the efficacy of adding varying concentrations of hyaluronidase to a standard mixture of 2% lidocaine and 1% ropivacaine to provide peribulbar anaesthesia for cataract surgery. We used (i) the time to adequate anaesthesia for surgery and (ii) ocular and eyelid movement scores at 8 min after block as cl...
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/86.6.876
更新日期:2001-06-01 00:00:00
abstract:BACKGROUND:We describe a practical method of training anaesthetists in the technique of awake fibreoptic intubation. This is performed on a training course using the delegates as subjects. METHODS:The first 15 subjects underwent cardiovascular monitoring during airway fibreoptic endoscopy performed by other course mem...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aef226
更新日期:2002-10-01 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::This article has been retracted: please see Elsevier Policy on Article Withdrawal (https://www.elsevier.com/about/our-business/policies/article-withdrawal). This article has been retracted at the request of the Editor-in-Chief, Professor Hugh Hemmings, based on the recommendations of Justus-Liebig-University Giessen f...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,撤回出版物
doi:10.1016/j.bja.2020.07.036
更新日期:2020-09-01 00:00:00
abstract::We have studied the relationship between gas exchange and mechanical frequency response during high frequency jet ventilation (HFJV) at 0.5-5.0 Hz in anaesthetized pigs. The mechanical gain curve showed a minimal "anti-resonant" response at 0.8 Hz (f1) and a maximal "resonant" response at 5.0 Hz (f2). This finding may...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/64.4.453
更新日期:1990-04-01 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::The cardiorespiratory effects of increasing respiratory frequency were investigated in two groups of dogs ventilated mechanically with a system which minimized apparatus and anatomical deadspace. In one group minute volume was constant whilst frequency was increased; in the second group minute volume was increased to ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/52.5.475
更新日期:1980-05-01 00:00:00
abstract:BACKGROUND:The effect of anaesthesia on postoperative outcome is unclear. Cardioprotective properties of volatile anaesthetics have been demonstrated experimentally and in haemodynamically stable patients undergoing coronary artery bypass grafting. Their effects in patients undergoing high-risk cardiac surgery have not...
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/aeu290
更新日期:2014-12-01 00:00:00
abstract:BACKGROUND:Although opioids are widely used as analgesics in general anaesthesia, they have unpleasant side-effects and can delay postoperative recovery. Acupuncture and related techniques are effective for acute and chronic pain, and reduces some side-effects. We assessed the effect of transcutaneous electric acupoint...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aeu001
更新日期:2014-06-01 00:00:00
abstract::In our daily anaesthetic practice, we are confronted with an increasing number of patients treated with either antiplatelet or anticoagulant agents. During the last decade, changes have occurred that make the handling of antithrombotic medication a challenging part of anaesthetic perioperative management. In this revi...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aew214
更新日期:2016-09-01 00:00:00
abstract::We have studied the effect of tropisetron, a 5-HT3-receptor antagonist, on postoperative nausea, vomiting and pain in 54 patients, aged 50-83 yr, after major hip or knee surgery. The patients were given subarachnoid injection of plain 0.5% bupivacaine, mixed with preservative-free morphine 0.3 mg, for surgical and pos...
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/71.5.681
更新日期:1993-11-01 00:00:00
abstract::Falls are a known public health problem, and there is increasing recognition of the importance of perioperative falls for risk prediction and quality assessment. Our objective was to review existing literature regarding the occurrence, injuries, and risk factors of preoperative and postoperative falls. A systematized ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/aew377
更新日期:2016-12-01 00:00:00
abstract::We studied a cat model simulating laudanosine accumulation in the "anephric" patient. Cardiovascular effects were seen only with the bolus doses of laudanosine 2 mg kg-1, and at plasma laudanosine concentrations unlikely to be achieved clinically. Similarly, EEG and power spectra analysis showed no evidence of epilept...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/58.suppl_1.14s
更新日期:1986-01-01 00:00:00
abstract:BACKGROUND:Isoflurane and other volatile anaesthetics have a cardioprotective effect and limit myocardial infarct size to the same extent as ischaemic preconditioning. Phosphatidylinositol-3-kinase (PI3K) was found to play a key role in myocardial protection by ischaemic preconditioning. The aim of the present investig...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aei264
更新日期:2005-12-01 00:00:00