Abstract：
:One explanation for diminished opioid analgesic efficacy is opioid-induced hyperalgesia (OIH). We report a case of OIH in an infant with gastroschisis, requiring multiple surgical interventions and prolonged sedation for ventilation. This is the first report of OIH in an infant. On day 41 of life after nine separate surgical interventions, the patient's pain scores increased and remained elevated, despite increasing opioid administration. The patient also developed hyperalgesia, allodynia, and photophobia and became extremely irritable upon handling. Other possible causes were excluded, including interruption to opioid delivery, sepsis, acid-base and electrolyte disturbance, and ongoing surgical pathology. An opioid rotation to hydromorphone was initiated and ketamine was commenced. Sedation for ventilation was achieved with dexmedetomidine and midazolam infusions. Over a period of 24 h after opioid de-escalation, pain scores reduced rapidly and the patient became significantly less irritable with handling. All infusions were gradually weaned and eventually ceased.
journal_name
Br J Anaesthjournal_title
British journal of anaesthesiaauthors
Hallett BR,Chalkiadis GAdoi
10.1093/bja/aer332subject
Has Abstractpub_date
2012-01-01 00:00:00pages
116-8issue
1eissn
0007-0912issn
1471-6771pii
S0007-0912(17)32522-9journal_volume
108pub_type
杂志文章abstract：:Frailty is a syndrome of cumulative decline across multiple physiological systems, which predisposes vulnerable adults to adverse events. Assessing vulnerable patients can potentially lead to interventions that improve surgical outcomes. Anaesthesiologists who care for older patients can identify frailty to improve pr...
journal_title：British journal of anaesthesia
pub_type： 杂志文章,评审
doi：10.1016/j.bja.2019.03.034
更新日期：2019-07-01 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：BACKGROUND:Increasing fresh gas flow (FGF) to a circle breathing system reduces carbon dioxide (CO2) absorbent consumption. We assessed the environmental and economic impacts of this trade-off between gas flow and absorbent consumption when no inhalational anaesthetic agent is used. METHODS:A test lung with fixed CO2 ...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1016/j.bja.2020.07.043
更新日期：2020-11-01 00:00:00
abstract：:Clinicians inevitably encounter patients who meet the diagnostic criteria for the metabolic syndrome (MetS); these criteria include central obesity, hypertension, atherogenic dyslipidaemia, and hyperglycaemia. Regardless of the variations in its definition, MetS may be associated with adverse outcomes in patients unde...
journal_title：British journal of anaesthesia
pub_type： 杂志文章,评审
doi：10.1093/bja/aev199
更新日期：2015-08-01 00:00:00
abstract：:Chinese hamster fibroblast cells in stirred suspension cultures were exposed to volatile anaesthetic agents for 3 hr or for 24 hr. Cell viability was measured as colony forming ability and was found to be reduced, in a dose related manner, by halothane, chloroform, methoxyflurane, trichloroetheylene and diethyl ether....
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/47.8.831
更新日期：1975-08-01 00:00:00
abstract：:Anaesthetic and sedative drugs transiently disrupt normal neural activity to facilitate healthcare procedures in children, but they can also cause long-term brain injury in experimental animal models. The US Food and Drug Administration (FDA) has recently advised that repeated or lengthy exposures to anaesthetic and s...
journal_title：British journal of anaesthesia
pub_type： 杂志文章,评审
doi：10.1093/bja/aex141
更新日期：2017-09-01 00:00:00
abstract：:A 55-yr-old man received a left supraclavicular brachial plexus block with 0.42% bupivacaine; he had profound motor and sensory block 26 h after injection; complete recovery occurred at 40 h. ...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/63.5.604
更新日期：1989-11-01 00:00:00
abstract：BACKGROUND:Tracheal tube tip and cuff positions of different cuffed paediatric tracheal tube brands in the trachea can vary with design. METHODS:Data from three clinical studies with measured tracheal lengths were pooled in a database including 422 children aged from birth to 16 yr. Dimensional data of seven cuffed pa...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1016/j.bja.2018.05.002
更新日期：2018-08-01 00:00:00
abstract：:Gastric pH and volume were measured in 87 patients who had received i.v. omeprazole (a new gastric antisecretory agent) 40 mg or placebo 1 or 3 h before surgery. Omeprazole increased the pH of gastric contents in the majority of patients. Administration 1 h before surgery produced greater gastric pH and smaller volume...
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/63.5.536
更新日期：1989-11-01 00:00:00
abstract：:The experimental effort that has been expended in investigating the effects of general anaesthetics on LGICs has been enormous over the past decade. Members of all three LGIC superfamilies have been examined using electrophysiological techniques. Anaesthetics that have been examined include volatile anaesthetics, gase...
journal_title：British journal of anaesthesia
pub_type： 杂志文章,评审
doi：10.1093/bja/aef161
更新日期：2002-07-01 00:00:00
abstract：:We determined in 51 healthy patients undergoing body surface surgery the dose requirements for propofol, as part of a total i.v. anaesthesia technique with an alfentanil infusion. After premedication with temazepam, patients received alfentanil 50 micrograms kg-1 followed by an infusion of 50 micrograms kg-1 h-1. Pati...
journal_title：British journal of anaesthesia
pub_type： 临床试验,杂志文章
doi：10.1093/bja/65.2.157
更新日期：1990-08-01 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：BACKGROUND:Microalbuminuria, often referred to as the urinary albumin-creatinine ratio (ACR), is thought to be a reflection of increased capillary permeability associated with the systemic inflammatory response syndrome, and has been found to be predictive of outcome in several studies. Therefore, we explored the usefu...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/ael211
更新日期：2006-10-01 00:00:00
abstract：BACKGROUND:An important cause of coagulopathy in cardiac surgery is impaired thrombin generation. While plasma is often used to correct this element of the coagulopathy, studies in vitro suggest that prothrombin complex concentrates (PCCs) might be more effective. Comparative data, however, are scant. METHODS:We compa...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1016/j.bja.2018.02.017
更新日期：2018-05-01 00:00:00
abstract：BACKGROUND:The ilioinguinal/iliohypogastric nerve block is a popular regional anaesthetic technique for children undergoing inguinal surgery. The success rate is only 70-80% and complications may occur. A prospective randomized double-blinded study was designed to compare the use of ultrasonography with the conventiona...
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/aei157
更新日期：2005-08-01 00:00:00
abstract：:Acute perioperative changes in arterial pressure occur frequently, particularly in patients with cardiovascular disease or those receiving vasoactive medications, or in relation to certain cardiovascular surgical procedures. Both hypo- and hypertension are common in patients undergoing carotid surgery because of uniqu...
journal_title：British journal of anaesthesia
pub_type： 杂志文章,评审
doi：10.1093/bja/aep012
更新日期：2009-04-01 00:00:00
abstract：:We have studied the use of intra-vas deferens local anaesthesia in 70 patients undergoing vasectomy as day-case patients. Patients were allocated randomly to either a control or treatment group. In the treatment group, 0.5% bupivacaine 1 ml or 0.9% saline 1 ml was injected into the lumen of the right or left vas defer...
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/74.5.612
更新日期：1995-05-01 00:00:00
abstract：BACKGROUND:The inhibitory effect of anaesthetic agents on hypoxic pulmonary vasoconstriction may depend upon their dose, especially when using a volatile agent. The aim of this randomized open study was to compare the effects of sevoflurane and propofol, as primary anaesthetic agents, on oxygenation during one-lung ven...
journal_title：British journal of anaesthesia
pub_type： 杂志文章,随机对照试验
doi：10.1093/bja/aem039
更新日期：2007-04-01 00:00:00
abstract：:The concept of rapid delivery of multiple blood products to the bedside of a massively haemorrhaging patient seems to be a logical approach to the management of the massively bleeding patient. However, controversy exists in the use of fixed blood component ratios. Assessing the extent of the coagulopathy through point...
journal_title：British journal of anaesthesia
pub_type： 杂志文章,评审
doi：10.1093/bja/aeu379
更新日期：2014-12-01 00:00:00
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
pub_type： 杂志文章
doi：10.1093/bja/aei075
更新日期：2005-04-01 00:00:00
abstract：BACKGROUND:Multiple cognitive and psychiatric disorders are associated with an increased tonic inhibitory conductance that is generated by α5 subunit-containing γ-aminobutyric acid type A (α5 GABAA) receptors. Negative allosteric modulators that inhibit α5 GABAA receptors (α5-NAMs) are being developed as treatments for...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1016/j.bja.2020.11.032
更新日期：2020-12-30 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
abstract：BACKGROUND:It is believed that the severely disturbed night-time sleep architecture after surgery is associated with increased cardiovascular morbidity with rebound of rapid eye movement (REM). The daytime sleep pattern of patients after major general surgery has not been investigated before. We decided to study the ci...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/aem340
更新日期：2008-01-01 00:00:00
abstract：:The value of the continuous monitoring of end-tidal carbon dioxide concentration as an indicator of the acute intraoperative interruption of pulmonary blood flow, in patients with pre-existing restrictions of pulmonary blood flow undergoing closed heart surgery, is illustrated by two case reports. Decreases in end-tid...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/57.12.1257
更新日期：1985-12-01 00:00:00
abstract：BACKGROUND:Even mild perioperative hypothermia is associated with several severe adverse effects. Resistive heating has possible advantages compared with other active warming systems because it can heat several fields independently. To assess this new warming system, we measured core temperature in patients during surg...
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/aeg106
更新日期：2003-05-01 00:00:00
abstract：:Placental transfer of 14C-dimethyltubocurarine (14C-dmtc) was studied during Caesarean section. Liquid scintillation counting was used for determination of 14C activity from the maternal and foetal blood samples. Paper chromatography was used to confirm the stability of 14C-dmtc. In all cases 14C-dmtc was able to cros...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/48.3.239
更新日期：1976-03-01 00:00:00
abstract：:Seventy-two adult surgical patients were studied to compare neuromuscular and cardiovascular effects of mivacurium chloride during nitrous oxide-fentanyl-thiopentone (BAL group) or nitrous oxide-halothane (HAL group) anaesthesia. Eighteen patients in the BAL group received an initial bolus of mivacurium, either the ED...
journal_title：British journal of anaesthesia
pub_type： 临床试验,杂志文章
doi：10.1093/bja/64.2.193
更新日期：1990-02-01 00:00:00
abstract：:We have compared, in a double-blind study, the efficacy of flumazenil with that of aminophylline in antagonizing the effects of midazolam in 60 patients (ASA I-II, mean age 66 yr) undergoing transurethral resection of prostate under spinal anaesthesia. All patients received midazolam 0.075 mg kg-1 i.v. and the test dr...
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/66.5.591
更新日期：1991-05-01 00:00:00
abstract：BACKGROUND:Capnography may provide useful non-invasive bedside information concerning heterogeneity in lung ventilation, ventilation-perfusion mismatching and metabolic status. Although the capnogram may be recorded by mainstream and sidestream techniques, the capnogram indices furnished by these approaches have not pr...
journal_title：British journal of anaesthesia
pub_type： 评论,杂志文章
doi：10.1093/bja/aew127
更新日期：2016-07-01 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
