Abstract:
BACKGROUND:Pain management in craniotomy patients is challenging, with mild-to-moderate pain intensity, moderate-to-high risk of postoperative nausea and vomiting (PONV), and potentially catastrophic consequences of analgesic-related side-effects. The aim of this study was to determine whether i.v. parecoxib administered at dural closure during craniotomy decreased total morphine consumption and morphine-related side-effects compared with placebo. METHODS:One hundred adult patients presenting for supratentorial craniotomy under propofol/remifentanil anaesthesia were randomized to receive parecoxib, 40 mg i.v., or placebo in a double-blind manner. All patients received local anaesthetic scalp infiltration, regular i.v. paracetamol, nurse-administered morphine in the post-anaesthesia care unit (PACU) until verbal analogue pain scores were ≤4/10 and patient-controlled morphine thereafter. Morphine consumption, pain intensity, and analgesia-related side-effects were recorded during the first 24 h after operation. RESULTS:Ninety-six patients (49 control and 47 parecoxib) were included in the analyses. Fifty-nine (61%) patients received morphine in the PACU and only one patient (control) did not receive any morphine in the postoperative period. There were no significant differences between the two groups in morphine consumption [20 (range: 0-102) vs 16 (range: 1-92) mg; P=0.38], pain intensity [excellent/very good pain relief in 78% of parecoxib patients; 74% of control patients (P=0.72)] or analgesia-related side-effects (PONV in 51% of parecoxib patients; 56% of control patients; P=0.55) in the first 24 h after operation. No major morbidity was recorded. CONCLUSIONS:Our study demonstrated no clinical benefit to adding i.v. parecoxib to local anaesthetic scalp infiltration, i.v. paracetamol, and patient-controlled i.v. morphine after supratentorial craniotomy.
journal_name
Br J Anaesthjournal_title
British journal of anaesthesiaauthors
Williams DL,Pemberton E,Leslie Kdoi
10.1093/bja/aer223subject
Has Abstractpub_date
2011-09-01 00:00:00pages
398-403issue
3eissn
0007-0912issn
1471-6771pii
S0007-0912(17)33079-9journal_volume
107pub_type
临床试验,杂志文章,随机对照试验abstract::The anaesthetic risks of acromegaly include difficulties in airway management, hypertension, and cardiac, gastrointestinal and renal problems. To estimate the incidence of major complications in this rare group of patients, we reviewed 28 patients with acromegaly who had pituitary tumour excision over a 10-yr period. ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/oxfordjournals.bja.a013400
更新日期:2000-02-01 00:00:00
abstract:BACKGROUND:Magnesium is a calcium and an NMDA-receptor antagonist and can modify important mechanisms of nociception. We evaluated the co-analgesic effect of magnesium in the postoperative setting after on-pump cardiac surgery. METHODS:Forty patients randomly received either magnesium gluconate as an i.v. bolus of 0.2...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/ael037
更新日期:2006-04-01 00:00:00
abstract:BACKGROUND:Circadian rhythms coordinate almost all physiological functions and are implicated in major disease development. Even though circadian rhythms have a major impact on human health, little is known about how they affect general anaesthesia. The purpose of this study was to understand if the time of day affects...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1016/j.bja.2018.06.027
更新日期:2018-10-01 00:00:00
abstract:BACKGROUND:There are no published data to predict tracheostomy tube size as growth proceeds in children requiring long-term ventilation. METHODS:A retrospective audit was undertaken of children having long-term ventilation, managed from the Southport spinal injuries unit. The dates of step-up in size of tracheostomy t...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aeh296
更新日期:2005-01-01 00:00:00
abstract::The pupils in brainstem-dead patients are classically fixed and dilated. We present a case of a brainstem-dead patient whose pupils displayed persistent asynchronous pupillary constriction and dilatation independent of external physical stimuli. Central causes for the phenomenon were excluded leaving an unexplained pe...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/86.5.717
更新日期:2001-05-01 00:00:00
abstract::To understand the sequential response of the autonomic nervous system to pregnancy, we studied heart rate variability in 23 first trimester, 23 second trimester and 21 third trimester pregnant women. Twenty non-pregnant women were recruited as controls. Time and frequency domain measures of heart rate variability in t...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/oxfordjournals.bja.a013433
更新日期:2000-03-01 00:00:00
abstract::We have studied the effects of flow and dobutamine on systemic haemodynamic variables, oxygen delivery (DO2) and oxygen consumption (VO2) in 20 patients during cardiopulmonary bypass (CPB) with mild hypothermia (34 degrees C). In a subgroup of seven patients, we also studied the effects on gastric microcirculatory blo...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/76.1.5
更新日期:1996-01-01 00:00:00
abstract::An investigation was carried out into the relationship between the inflation pressures of normally compliant lungs and the airways pressure necessary to produce the insufflation of gas to the stomach. This relationship was examined during manual ventilation with a mask, using a rapid sequence induction technique. In t...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/59.3.315
更新日期:1987-03-01 00:00:00
abstract::The oxygen delivery (DO2) and consumption (VO2) relationship in brain-dead organ donors is unknown. Therefore, in a prospective study, we determined the DO2/VO2 relationship in 21 consecutive brain-dead patients. Patients were allocated to one of two groups, according to plasma lactate concentration: normal (group NL,...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/76.6.783
更新日期:1996-06-01 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 investigated the effect of four doses of remifentanil on the incidence of respiratory depression and somatic response at incision. Remifentanil was administered as a loading dose of 0.125, 0.25, 0.375 or 0.5 microgram kg-1 and at a maintenance infusion rate of 0.025, 0.05, 0.075 or 0.1 microgram kg-1 min-1, re...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1093/bja/80.4.509
更新日期:1998-04-01 00:00:00
abstract::In a random, double-blind crossover trial using an ischaemic limb pain model we have assessed the speed of onset of analgesia after an i.v. bolus of equipotent doses of diamorphine and morphine in 12 healthy male volunteers. Pain and its subsequent relief were assessed by means of a visual analogue scale. Two of the s...
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/66.6.656
更新日期:1991-06-01 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::Experiments were performed on 14 anaesthetized, artifically ventilated dogs, in which efferent activity in the phrenic nerve was recorded and blood-gas tensions, arterial pH and core temperature were controlled. Doses of midazolam between 0.2 mg kg-1 and 2 mg kg-1 abolished phrenic nerve activity for periods between 3...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/56.10.1161
更新日期:1984-10-01 00:00:00
abstract::The clinical understanding of the dynamics of myocardial contraction is hampered by an over-simplified interpretation of the intramural pattern of force generation. This limits the anaesthetist's knowledge of the direct effects of commonly used anaesthetics. A discrimination between a negative inotropic effect and cha...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/60.suppl_1.2s
更新日期:1988-01-01 00:00:00
abstract::Thirty mothers undergoing elective Caesarean section received thiopentone 3.5 mg kg-1 and 30 received etomidate 0.3 mg kg-1 for induction of anaesthesia. Subsequent management of anaesthesia was identical in both groups. Maternal to fetal base excess differences and the degree of biochemical correlation between mother...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/51.2.135
更新日期:1979-02-01 00:00:00
abstract:Background:In addition to general anaesthetic effects, sevoflurane can also induce hyperactive behaviours during induction and recovery, which may contribute to neurotoxicity; however, the mechanism of such effects is unclear. Volatile anaesthetics including isoflurane have been found to activate the kainate (GluK2) re...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aex043
更新日期:2017-11-01 00:00:00
abstract::Amethocaine 1% solution was mixed with equal volumes of water, 0.9% saline or 10% dextrose to prepare respectively, hypobaric, isobaric and hyperbaric solutions which were compared for intradural spinal anaesthesia in 60 patients. Thirty patients received 10 mg and 30 patients received 15 mg of amethocaine. Injections...
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/52.6.589
更新日期:1980-06-01 00:00:00
abstract:BACKGROUND:The Alaris AEP monitor(TM) (Alaris, UK, version 1.4) is the first commercially available auditory evoked potential (AEP) monitor designed to estimate the depth of anaesthesia. It generates an "Alaris AEP index" (AAI), which is a dimensionless number scaled from 100 (awake) to 0. This study was designed to co...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aeg189
更新日期:2003-09-01 00:00:00
abstract:BACKGROUND:Medication-related adverse events (MRE) in anaesthesia care are frequent and require a deeper understanding if we are to prevent medication harm. METHODS:We searched for reported MRE from the Spanish Anaesthesia Incident Reporting System (SENSAR) database over a 10-yr period. SENSAR is a cross-national, mul...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,多中心研究
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更新日期:2020-02-01 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::Nicorandil, a nicotinamide nitrate derivative, relaxes vascular smooth muscle and reduces cardiac muscle contractility by increasing membrane potassium conductance, probably by activating ATP-sensitive potassium channels. In this prospective, randomized, double-blind, placebo-controlled clinical study, we examined the...
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/86.3.332
更新日期:2001-03-01 00:00:00
abstract::Fentanyl or alfentanil, in doses approximating to those used in clinical practice, was added to the priming fluid of an extracorporeal circuit before the institution of cardiopulmonary bypass (CPB). The concentrations of both drugs in the priming fluid were measured over a 20-min period. The concentration of fentanyl ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/58.9.947
更新日期:1986-09-01 00:00:00
abstract::Patients receiving opioids report feeling sleepy, but opioids actually inhibit the rapid eye movement phase of sleep (REM). Inhibition of REM sleep is followed by a rebound increase in REM sleep associated with cardiopulmonary complications. The medial pontine reticular formation (mPRF) is a brain region from which mo...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/74.2.188
更新日期:1995-02-01 00:00:00
abstract::Plasma concentrations of amethocaine were measured after topical application of amethocaine cream 2 g (5% w/w) to the dorsum of the right hand of 10 adult volunteers. The cream was applied for 240 min and plasma was assayed for amethocaine and its metabolite p-n-butylaminobenzoic acid at 0, 30, 60, 90, 120 and 240 min...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
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更新日期:1991-10-01 00:00:00
abstract:BACKGROUND:Overt stroke after non-cardiac surgery has a substantial impact on the duration and quality of life. Covert stroke in the non-surgical setting is much more common than overt stroke and is associated with an increased risk of cognitive decline and dementia. Little is known about covert stroke after non-cardia...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,多中心研究
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更新日期:2016-08-01 00:00:00
abstract:BACKGROUND:Intravenous amino acid infusion during general anaesthesia prevents decreases in core temperature resulting from increased energy expenditure and heat accumulation. METHODS:We investigated whether such stimulation also occurs during spinal anaesthesia, which blocks sympathetic nervous activity. We examined ...
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:2003-01-01 00:00:00
abstract::The influence of sodium nitroprusside (SNP) on mitochondrial respiration was examined in rat liver mitochondria. The addition of SNP 1 mmol litre-1 during state 3 respiration inhibited the oxygen uptake by 63.4%. A mixture of SNP 1 mmol litre-1 and glutathione (GSH) 1 mmol litre-1 inhibited the oxygen uptake more mark...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/49.12.1239
更新日期:1977-12-01 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:BACKGROUND:One-lung ventilation (OLV) increases mechanical stress in the lung and affects ventilation and perfusion (V, Q). There are no data on the effects of OLV on postoperative V/Q matching. Thus, this controlled study evaluates the influence of OLV on V/Q distribution in a pig model using a gamma camera technique ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aen021
更新日期:2008-04-01 00:00:00