Abstract：
:Etomidate is an imidazole-derived hypnotic agent preferentially used for rapid sequence induction of anaesthesia because of its favourable haemodynamic profile. However, 11β-hydroxylase inhibition causes adrenal insufficiency with potentially fatal consequences in specific populations. We review the arguments against the liberal administration of etomidate in critically ill, and especially septic, patients. This review considered only high-quality and prospective studies with a low risk of bias. Three major effects have been observed with the clinical use of a single dose of etomidate. First, independent of the clinical setting, etomidate causes adrenal dysfunction via 11β-hydroxylase inhibition ranging from 12 to 48 h, making the drug unsuitable for use in elective interventions. Second, in a systematic review with meta-analyses, including 3715 septic patients, the relative risk of death with etomidate was 1.22 (95% confidence interval 1.11 to 1.35). Based on this statistically significant and clinically relevant increase in mortality, a single dose of etomidate has to be avoided in patients with septic shock. Third, in small randomised controlled trials, a single dose of etomidate in trauma patients was associated with an increased incidence of pneumonia (56.7 vs. 25.9% in controls), prolonged intensive care stay (6.3 vs. 1.5 days) and prolonged hospital stay (11.6 vs. 6.4 days). Based on these randomised controlled trials, the use of etomidate should be avoided in unstable trauma patients. Midazolam and ketamine are two valid alternatives with similar intubation and haemodynamic conditions as etomidate but without its adverse effects. Therefore, for safety reasons, etomidate should be avoided in the critical conditions of sepsis and trauma.
journal_name
Eur J Anaesthesioljournal_title
European journal of anaesthesiologyauthors
de la Grandville B,Arroyo D,Walder Bdoi
10.1097/EJA.0b013e32835819casubject
Has Abstractpub_date
2012-11-01 00:00:00pages
511-4issue
11eissn
0265-0215issn
1365-2346journal_volume
29pub_type
评论,杂志文章abstract：:The analgesic, respiratory and haemodynamic effects of epidural sufentanil 75 micrograms (Group 1) or sufentanil 75 micrograms with adrenaline 75 micrograms (Group 2) were studied in 20 patients following abdominal surgery in a double-blind randomized trial. Pain relief, assessed on a linear analogue scale, sedation, ...
journal_title：European journal of anaesthesiology
pub_type： 临床试验,杂志文章,随机对照试验
doi：
更新日期：1988-05-01 00:00:00
abstract：BACKGROUND:Many trauma centres have adopted the administration of fixed ratios of packed red blood cells (PRBCs), platelet concentrates and fresh frozen plasma (FFP) for bleeding patients. However, the haemostatic efficacy of this concept is not well proven. OBJECTIVE:Our objective was to characterise the haemostatic ...
journal_title：European journal of anaesthesiology
pub_type： 杂志文章
doi：10.1097/EJA.0000000000001202
更新日期：2020-10-01 00:00:00
abstract：BACKGROUND AND OBJECTIVE:To evaluate the efficacy of 0.1% ropivacaine with fentanyl 2 microg mL(-1) via epidural for analgesia in labour. METHODS:In a randomized study, 80 nulliparous parturients in labour had epidural analgesia initiated with 0.2% ropivacaine and fentanyl and were then randomized to receive either 0....
journal_title：European journal of anaesthesiology
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1017/s0265021504000031
更新日期：2004-10-01 00:00:00
abstract：:The benefits of epidural anaesthesia combined with general anaesthesia were studied in young children scheduled for major abdominal surgical procedure (pull-through for Hirschsprung's disease). Two groups of nine children were studied receiving, respectively, general anaesthesia or general anaesthesia plus epidural an...
journal_title：European journal of anaesthesiology
pub_type： 杂志文章
doi：
更新日期：1987-09-01 00:00:00
abstract：BACKGROUND AND OBJECTIVE:Adding opioid to spinal anaesthetic provides additional analgesia during the postoperative period. The purpose of this study was to determine the dose of intrathecal hydromorphone necessary to achieve postoperative pain relief after arthroscopic knee surgery. METHODS:In a prospective, double-b...
journal_title：European journal of anaesthesiology
pub_type： 杂志文章,随机对照试验
doi：10.1097/EJA.0b013e3283476055
更新日期：2012-01-01 00:00:00
abstract：BACKGROUND AND OBJECTIVES:To determine the visibility of pleural lung sliding in alveolar-interstitial syndrome (AIS) in patients on mechanical ventilation at two different time points, as a confirmatory ultrasonographic method for excluding pneumothorax. METHODS:Fifty-two mechanically ventilated patients in the semir...
journal_title：European journal of anaesthesiology
pub_type： 杂志文章
doi：10.1097/EJA.0b013e32833feb40
更新日期：2011-04-01 00:00:00
abstract：BACKGROUND AND OBJECTIVE:The present randomized, safety-assessor blinded, placebo-controlled trial was designed to assess safety and efficacy of sugammadex, a novel selective relaxant-binding agent, in patients with underlying cardiovascular disease undergoing noncardiac surgery. METHODS:Overall, 116 patients (New Yor...
journal_title：European journal of anaesthesiology
pub_type： 杂志文章,多中心研究,随机对照试验
doi：10.1097/EJA.0b013e32832c605b
更新日期：2009-10-01 00:00:00
abstract：BACKGROUND AND OBJECTIVE:Hypotension, the commonest side-effect of spinal anaesthesia, results from sympathetic denervation. This study compared patient positioning (supine vs. decubitus) on haemodynamic variables during spinal anaesthesia. METHODS:After intravenous crystalloid preloading with 5 mL kg(-1), hyperbaric ...
journal_title：European journal of anaesthesiology
pub_type： 杂志文章,随机对照试验
doi：10.1017/s0265021505001183
更新日期：2005-09-01 00:00:00
abstract：BACKGROUND AND OBJECTIVE:Volatile anaesthetics inhibit nicotinic acetylcholine receptors at clinically relevant concentrations with higher affinity for the neuronal nicotinic receptor. The inhibitory effects of propofol on nicotinic receptors have only been documented at supraclinical concentrations. The aim of this st...
journal_title：European journal of anaesthesiology
pub_type： 临床试验,杂志文章,随机对照试验
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更新日期：2005-04-01 00:00:00
abstract：BACKGROUND AND OBJECTIVE:Hypoxia-reperfusion injury is an important determinant of secondary brain injury. In the acute phase of cerebral reperfusion, pro-inflammatory events enhance expression of cerebral endothelial (intercellular adhesion molecule-1 and P-selectin) adhesion molecules, which play an important role in...
journal_title：European journal of anaesthesiology
pub_type： 杂志文章
doi：10.1017/S0265021507003018
更新日期：2008-03-01 00:00:00
abstract：BACKGROUND AND OBJECTIVES:This study compares three modes of patient-controlled epidural analgesia in parturients during labour. METHODS:Eighty-four women were randomized to one of three groups. The epidural solution used in all the three groups was 0.1% bupivacaine with fentanyl 2 microg mL(-1). Patients were able to...
journal_title：European journal of anaesthesiology
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1017/s0265021505000074
更新日期：2005-01-01 00:00:00
abstract：:One hundred patients undergoing scheduled upper limb orthopaedic surgery were studied to determine if the speed of injection of the local anaesthetic solution could modify the extent and depth of anaesthesia with the axillary approach to the brachial plexus. The blocks were performed using the 'orthogonal two-needle t...
journal_title：European journal of anaesthesiology
pub_type： 临床试验,杂志文章,随机对照试验
doi：
更新日期：1995-09-01 00:00:00
abstract：BACKGROUND AND OBJECTIVE:We compared the effects of sub-Tenon's local anaesthetic block and placebo on peri-operative opioid requirement and cardiovascular stability and on postoperative pain, nausea and vomiting in patients undergoing vitreo-retinal surgery under general anaesthesia. METHODS:We studied 43 patients un...
journal_title：European journal of anaesthesiology
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1017/s0265021503001571
更新日期：2003-12-01 00:00:00
abstract：BACKGROUND AND OBJECTIVE:The kneeling prone position is often used for low back surgery in order to decrease intraoperative bleeding and increase the surgical exposure of the vertebral canal. The aim of this study was to assess effects of the kneeling prone position on respiratory gas exchange focusing on oxygen consum...
journal_title：European journal of anaesthesiology
pub_type： 杂志文章
doi：10.1017/s0265021504004053
更新日期：2004-04-01 00:00:00
abstract：BACKGROUND AND OBJECTIVE:Lipid peroxidation plays an important role during liver ischaemia-reperfusion injury. Pentane in breath is often used as an index of lipid peroxidation. We observed the changes in levels of breath pentane during the lipid peroxidation process caused by liver ischaemia-reperfusion injury. METHO...
journal_title：European journal of anaesthesiology
pub_type： 杂志文章
doi：10.1097/eja.0b013e328326f7b7
更新日期：2009-06-01 00:00:00
abstract：BACKGROUND:When airway management is difficult, various measures can be taken to facilitate tracheal intubation. The Bullard and Airtraq laryngoscopes were developed for this purpose. We hypothesised that the Bullard and Airtraq laryngoscopes would perform better than a conventional laryngoscope in the management of a ...
journal_title：European journal of anaesthesiology
pub_type： 杂志文章,随机对照试验
doi：10.1097/EJA.0b013e328354b22c
更新日期：2012-07-01 00:00:00
abstract：BACKGROUND AND OBJECTIVE:Most therapeutic options for postoperative delirium are only symptom oriented; therefore, the best approach remains prevention. The aim of this study was to identify predisposing and precipitating factors for early postoperative delirium. METHODS:A total of 1002 patients were screened for deli...
journal_title：European journal of anaesthesiology
pub_type： 杂志文章
doi：10.1097/EJA.0b013e3283335cee
更新日期：2010-05-01 00:00:00
abstract：BACKGROUND:Ischaemia/reperfusion injury is a common problem in hepatic surgery. An appreciation of the role of sevoflurane dose in preconditioning and subsequent hepatoprotection against ischaemia/reperfusion injury would be useful. OBJECTIVE:The aim of current study was to investigate the protective effect of sevoflu...
journal_title：European journal of anaesthesiology
pub_type： 杂志文章
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abstract：BACKGROUND:Propofol may help to protect against ischaemic acute kidney injury (AKI); however, research on this topic is sparse. OBJECTIVE:The current study aimed to investigate whether there were differences in the incidence of postoperative AKI after lung resection surgery between patients who received propofol-based...
journal_title：European journal of anaesthesiology
pub_type： 杂志文章
doi：10.1097/EJA.0000000000001020
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journal_title：European journal of anaesthesiology
pub_type： 杂志文章,随机对照试验
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journal_title：European journal of anaesthesiology
pub_type： 临床试验,杂志文章
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更新日期：2017-05-01 00:00:00
abstract：BACKGROUND AND OBJECTIVE:Primary brain tumours may be associated with coagulation disorders, which can pose intraoperative and postoperative management difficulties. Thromboelastography is a useful technique for evaluating coagulability. In this study, we evaluated the perioperative coagulation profile using both stand...
journal_title：European journal of anaesthesiology
pub_type： 杂志文章
doi：10.1097/EJA.0b013e32831c8b5f
更新日期：2009-04-01 00:00:00
abstract：:A 6-month-old boy with Sturge-Weber syndrome was scheduled for congenital glaucoma and left buphthalmus surgery. Physical examination revealed haemangioma throughout the right trigeminal nerve, congenital glaucoma, left megalocornea and bilateral buphthalmus. Examination of the eye was performed under general anaesthe...
journal_title：European journal of anaesthesiology
pub_type： 杂志文章
doi：10.1046/j.1365-2346.1999.00472.x
更新日期：1999-05-01 00:00:00
abstract：BACKGROUND AND OBJECTIVE:The effects of bicarbonated Ringer's solution were evaluated and compared with those of acetated Ringer's, lactated Ringer's and Ringer's solutions in partially hepatectomized rabbits. METHOD:Animals were randomly divided into six groups (n = 6 in each group): a sham-operated group, an operate...
journal_title：European journal of anaesthesiology
pub_type： 杂志文章
doi：10.1017/s0265021505001043
更新日期：2005-08-01 00:00:00
abstract：:Sixty patients, ASA I-III, presenting for elective colonic surgery were studied to assess the stability of blood pressure and heart rate during anaesthesia with three equally potent anaesthetic techniques. Patients in group I (n = 20) received thiopentone induction, isoflurane and nitrous oxide; patients in group II (...
journal_title：European journal of anaesthesiology
pub_type： 临床试验,杂志文章,随机对照试验
doi：
更新日期：1995-05-01 00:00:00
abstract：BACKGROUND AND OBJECTIVE:It has been demonstrated that volatile anaesthetics have cardioprotective properties during open-heart procedures, especially when administered continuously. European Council Directive 93/42/EEC concerning medical devices bans the supplementary incorporation of anaesthetic vaporizers in the byp...
journal_title：European journal of anaesthesiology
pub_type： 杂志文章,随机对照试验
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更新日期：2008-02-01 00:00:00
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journal_title：European journal of anaesthesiology
pub_type： 杂志文章
doi：10.1017/s0265021502000352
更新日期：2002-03-01 00:00:00
abstract：:Diabetes mellitus is the most common metabolic disease and its incidence is increasing. New classifications have been recently proposed based upon a better knowledge of pathogenesis, mechanisms of glucose transport and insulin resistance. The perioperative care of diabetic patients is less dependent on blood-glucose c...
journal_title：European journal of anaesthesiology
pub_type： 杂志文章,评审
doi：10.1046/j.0265-0215.2001.00876.x
更新日期：2001-05-01 00:00:00
abstract：BACKGROUND:Myocardial injury after noncardiac surgery (MINS) is a major contributor to peri-operative morbidity and mortality with a reported incidence of about 8%. Tachycardia increases myocardial oxygen demand, and decreases oxygen supply, and is therefore a potential cause of MINS. OBJECTIVE:We tested the hypothesi...
journal_title：European journal of anaesthesiology
pub_type： 杂志文章
doi：10.1097/EJA.0000000000000925
更新日期：2019-02-01 00:00:00
abstract：BACKGROUND AND OBJECTIVE:Continuous spinal analgesia (CSA) offers considerable pain relief, and has been used in various procedures such as for surgery and cancer pain control. In Japan, portable and disposable infusion kits are increasingly employed for continuous epidural analgesia and CSA. In CSA, the use of a micro...
journal_title：European journal of anaesthesiology
pub_type： 杂志文章
doi：10.1017/s0265021504000183
更新日期：2004-11-01 00:00:00
