Abstract:
BACKGROUND:Paradoxical excitement response during sedation consists of loss of affective control and abnormal movements. Chronic alcohol abuse has been proposed as a predisposing factor despite lack of supporting evidence. Because alcohol and propofol have a common site of action, we postulated that paradoxical excitement responses during propofol-induced sedation occur more frequently in hazardous and harmful alcohol drinkers than in social or non-drinkers. METHODS:One hundred and ninety patients undergoing orthopaedic knee joint surgery were enrolled in this prospective and observational study. Subjects were divided into Group HD (hazardous and harmful drinkers) or Group NHD (no hazardous drinkers) according to the alcohol use disorder identification test (AUDIT). In study 1, propofol infusion was adjusted to achieve the bispectral index at 70-80 using target-controlled infusion. In study 2, the target concentration of propofol was fixed at 0.8 (study 2/Low) or 1.4 μg ml(-1) (study 2/High). Paradoxical excitement responses were categorized by intensity into mild, moderate, or severe. RESULTS:The overall incidence of paradoxical excitement response was higher in Group HD than in Group NHD in study 1 (71.4% vs 43.8%; P=0.022) and study 2/High (70.0% vs 34.5%; P=0.006) but not in study 2/Low. The incidence of moderate-to-severe response was significantly higher in Group HD of study 1 (28.6% vs 3.1%; P=0.0005) and study 2/High (23.3% vs 3.4%; P=0.029) with no difference in study 2/Low. Severe excitement response occurred only in Group HD of study 1 and study 2/High. CONCLUSIONS:Paradoxical excitement occurred more frequently and severely in hazardous and harmful alcohol drinkers than in social drinkers during propofol-induced moderate-to-deep sedation, but not during light sedation.
journal_name
Br J Anaesthjournal_title
British journal of anaesthesiaauthors
Jeong S,Lee HG,Kim WM,Jeong CW,Lee SH,Yoon MH,Choi JIdoi
10.1093/bja/aer275subject
Has Abstractpub_date
2011-12-01 00:00:00pages
930-3issue
6eissn
0007-0912issn
1471-6771pii
S0007-0912(17)32571-0journal_volume
107pub_type
杂志文章abstract:BACKGROUND:State entropy (SE) is a newly available monitor for depth of anaesthesia. We investigated whether the relationship between predicted effect-site propofol concentration and Bispectral Index (BIS) and SE values is useful for predicting loss of verbal contact and loss of consciousness during steady-state condit...
journal_title:British journal of anaesthesia
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abstract::We have estimated the effect of omitting antagonism of neuromuscular block on postoperative nausea and vomiting. A systematic search (MEDLINE, EMBASE, Biological Abstracts, Cochrane library, reference lists and hand searching; no language restriction, up to March 1998) was performed for relevant randomized controlled ...
journal_title:British journal of anaesthesia
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journal_title:British journal of anaesthesia
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更新日期:1998-11-01 00:00:00
abstract::We have compared bupivacaine 5 mg ml-1, either isobaric in saline 0.9% or hyperbaric in 8% glucose, for spinal anaesthesia in 100 children, aged 2-115 months, in a double-blind, randomized, parallel group, prospective study. Children were premedicated with diazepam 0.5 mg kg-1 orally. Seventy-two children were sedated...
journal_title:British journal of anaesthesia
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journal_title:British journal of anaesthesia
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abstract::It is known that propofol can have effects on atrioventricular node conduction. We report a case where administration of propofol was associated with termination of supraventricular tachycardia. Although a similar phenomenon has been reported in children, this is the first such case in an adult. ...
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journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
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abstract::The neuromuscular blocking effect of repeated bolus administration of suxamethonium 1 mg/kg was observed in 10 healthy surgical patients under enflurane-nitrous oxide-oxygen anaesthesia. Tachyphylaxis and slow recovery of the thumb twitch occurred in close dose-relationships with transition of Phase I block to Phase I...
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journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
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pub_type: 临床试验,杂志文章,随机对照试验
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journal_title:British journal of anaesthesia
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journal_title:British journal of anaesthesia
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更新日期:2014-04-01 00:00:00
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pub_type: 杂志文章,评审
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journal_title:British journal of anaesthesia
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pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:2000-08-01 00:00:00
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journal_title:British journal of anaesthesia
pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2010-05-01 00:00:00