Abstract:
BACKGROUND:Obstructive sleep apnoea (OSA) affects ~9-24% of the general population, and 90% remain undiagnosed. Those patients with undiagnosed moderate-to-severe OSA may be associated with an increased risk of perioperative complications. Our objective was to evaluate the proportion of surgical patients with undiagnosed moderate-to-severe OSA. METHODS:After research ethics board approval, patients visiting preoperative clinics were recruited over 4 yr and screened with the STOP-BANG questionnaire. The 1085 patients, who consented, subsequently underwent polysomnography (PSG) (laboratory or portable) before operation. Chart review was conducted in this historical cohort to ascertain the clinical diagnosis of OSA by surgeons and anaesthetists, blinded to the PSG results. The PSG study-identified OSA patients were further classified based on severity using the apnoea-hypopnoea index (AHI) cut-offs. RESULTS:Of 819 patients, 111 patients had pre-existing OSA and 58% (64/111) were not diagnosed by the surgeons and 15% (17/111) were not diagnosed by the anaesthetists. Among the 708 study patients, PSG showed that 233 (31%) had no OSA, 218 (31%) patients had mild OSA (AHI: 5-15); 148 (21%) had moderate OSA (AHI: 15-30), and 119 (17%) had severe OSA (AHI>30). Before operation, of the 267 patients with moderate-to-severe OSA, 92% (n=245) and 60% (n=159) were not diagnosed by the surgeons and the anaesthetists, respectively. CONCLUSIONS:We found that anaesthetists and surgeons failed to identify a significant number of patients with pre-existing OSA and symptomatic undiagnosed OSA, before operation. This study may provide an impetus for more diligent case finding of OSA before operation.
journal_name
Br J Anaesthjournal_title
British journal of anaesthesiaauthors
Singh M,Liao P,Kobah S,Wijeysundera DN,Shapiro C,Chung Fdoi
10.1093/bja/aes465subject
Has Abstractpub_date
2013-04-01 00:00:00pages
629-36issue
4eissn
0007-0912issn
1471-6771pii
S0007-0912(17)32732-0journal_volume
110pub_type
杂志文章abstract:BACKGROUND:Postoperative cognitive dysfunction (POCD) is a common complication in elderly patients after major surgery. An association between POCD and the development of dementia has been suspected. In this study, we assessed if POCD was a risk factor for the occurrence of dementia. METHODS:Danish patients enrolled b...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,多中心研究
doi:10.1093/bja/aes466
更新日期:2013-06-01 00:00:00
abstract:BACKGROUND:The oesophageal leak pressure is defined as the pressure which breaks the seal between the cuff of a supraglottic airway and the peri-cuff mucosa, allowing penetration of fluid into the pharynx and the oral cavity. As a consequence, a decrease in this variable increases the risk of reflux and can lead to pul...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aev435
更新日期:2016-02-01 00:00:00
abstract:BACKGROUND:Fluid administration to increase stroke volume index (SVi) is a cornerstone of haemodynamic resuscitation. We assessed the accuracy of SVi variation during a calibrated abdominal compression manoeuvre (ΔSVi-CAC) to predict fluid responsiveness in children. METHODS:Patients younger than 8 yr with acute circu...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1016/j.bja.2018.06.030
更新日期:2018-12-01 00:00:00
abstract::We have studied the cardiovascular effects of equipotent concentrations of halothane or isoflurane, with or without 50% nitrous oxide in oxygen, in 80 patients, aged 60 yr or more, during 20 min of stable equipotent anaesthesia. Non-invasive measurement techniques were used, with suprasternal Doppler ultrasonography f...
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/80.2.169
更新日期:1998-02-01 00:00:00
abstract::We have conducted a randomized, double-blind comparison of 4% and 8% sevoflurane for induction of anaesthesia in unpremedicated patients aged more than 60 yr. Sevoflurane was inhaled in 50% nitrous oxide using a vital capacity breath technique, and mean, systolic and diastolic arterial pressures and heart rate were mo...
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/82.1.20
更新日期:1999-01-01 00:00:00
abstract::The metabolic effect of infusing 1.0-1.5 litre of Hartmann's solution to normal subjects and those with maturity onset diabetes has been studied during surgery. It was found that the use of Hartmann's solution after operation was associated with a 7.5 mmol litre-u increase in plasm glucose concentration compared with ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/50.2.185
更新日期:1978-02-01 00:00:00
abstract::Hypertensive patients were monitored for myocardial ischaemia during anaesthesia and surgery with the V5 lead of a standard electrocardiograph. Myocardial ischaemia was detected in 11 of 39 untreated hypertensive patients and in four of seven receiving therapy with a diuretic, but in none of 44 receiving atenolol. Fou...
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/61.6.675
更新日期:1988-12-01 00:00:00
abstract:BACKGROUND:The observation that patients presenting for bariatric surgery had a high incidence of neuromuscular blocking agent (NMBA) anaphylaxis prompted this restricted case-control study to test the hypothesis that obesity is a risk factor for NMBA anaphylaxis, independent of differences in pholcodine consumption. ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1016/j.bja.2020.12.018
更新日期:2021-01-13 00:00:00
abstract::Loss of resistance dorsal to the ligamentum flavum was recorded in 10 of 16 patients aged 43--75 yr whilst performing extradural anaesthesia at the L2--3 interspace via the midline approach. Degeneration of the interspinous ligament with cavity formation is observed frequently in the elderly and may account for false ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/51.3.253
更新日期:1979-03-01 00:00:00
abstract::A double-blind crossover volunteer trial has been carried out to determine if oral doxapram reduces the respiratory depression caused by morphine 0.12 mg kg-1 i.m. Doxapram was given to the subjects 90 min before the morphine and significantly reduced the displacement of the ventilatory response to carbon dioxide caus...
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/62.2.159
更新日期:1989-02-01 00:00:00
abstract::Closed-loop control of neuromuscular blockade, using a semi-continuous infusion of vecuronium, is described. In 28 patients, the average neuromuscular transmission was between 13 and 17% of control. Requirements for vecuronium averaged 1.1 micrograms kg-1 min-1 (0.8-1.5 micrograms kg-1 min-1), being in the same range ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/58.10.1100
更新日期:1986-10-01 00:00:00
abstract:BACKGROUND:In a series of ex vivo and in vivo studies we investigated the ability of repetitive ketamine administration to alter the metabolism and anaesthetic effect of propofol and the role of ketamine-mediated P-450 2B induction in rats. METHODS:Male Wistar rats were pretreated with 80 mg kg(-1) ketamine i.p. twice...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/ael173
更新日期:2006-09-01 00:00:00
abstract::The effects of the inhalation of 50% nitrous oxide on somatosensory evoked potentials during a fentanyl-oxygen anaesthetic technique for central nervous system surgery were evaluated. The latency and amplitude of the first cortical wave were obtained using conventional somatosensory techniques with median or posterior...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/57.9.849
更新日期:1985-09-01 00:00:00
abstract:BACKGROUND:Psychological factors are thought to drive inter-patient variations in anaesthetic and analgesic requirements. This cross-sectional study investigated whether preoperative psychological factors can predict anaesthetic requirements and postoperative pain. METHODS:Before total thyroidectomy, 100 consecutive w...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aer305
更新日期:2012-01-01 00:00:00
abstract::We studied 20 patients undergoing thoracotomy, in a double-blind, placebo-controlled crossover trial of intercostal bupivacaine. Bupivacaine 0.25% was infused at 5 ml h-1 through each of two catheters placed in the intercostal space at operation. Mean (95% confidence limits) 24-h requirements for morphine from a patie...
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/70.5.508
更新日期:1993-05-01 00:00:00
abstract::Tissue damage during surgery induces coagulation factors and activates platelets. Surgical pain may provoke release of catecholamines, leading to hypercoagulability. We have investigated the effect of surgical pain on blood coagulability and fibrinolysis in orthopaedic operations using tourniquets in 22 patients under...
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/80.4.460
更新日期:1998-04-01 00:00:00
abstract::We tested the hypothesis that the solvent for etomidate was a factor in the incidence of pain and other side effects after injection, and that these were associated with histamine release. Nine of 10 volunteers who received etomidate in a propylene glycol formulation reported moderate to severe pain on injection; only...
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/83.3.464
更新日期:1999-09-01 00:00:00
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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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更新日期:1998-09-01 00:00:00
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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
doi:10.1093/bja/72.2.177
更新日期:1994-02-01 00:00:00
abstract::We have tested the hypothesis that intradermal testing is a more effective method for determining the drug responsible for anaesthetic anaphylactic reactions than prick testing in 212 consecutive patients, aged more than 10 yr, referred to an anaesthetic allergy clinic over a 4-yr period. The study was a prospective, ...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/79.1.59
更新日期:1997-07-01 00:00:00
abstract::We report a case of massive pulmonary embolism occurring at the time of graft reperfusion in a patient undergoing orthotopic liver transplantation. The clinical diagnosis of pulmonary embolus was aided by on-table echocardiography. Cardiopulmonary bypass and surgical embolectomy prevented her death. We discuss the dif...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/80.5.685
更新日期:1998-05-01 00:00:00
abstract::One hundred patients presenting for surgical treatment of fractured neck of femur were allocated to receive either spinal (SAB) or general (GA) anaesthesia. Before operation, the mean PaO2 was 9.04 kPa. There was a significant decrease in PaO2 of 0.68 kPa in GA group at 1 h after operation, while blood-gas values were...
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/52.1.49
更新日期:1980-01-01 00:00:00
abstract::We have studied 14 female patients undergoing elective laparoscopy under general anaesthesia with peritoneal insufflation of carbon dioxide in order to examine changes in physiological deadspace (VDphys), arterial to end-tidal carbon dioxide partial pressure difference (PaCO2-PE' CO2) and PaCO2. VCO2 increased after i...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/68.2.211
更新日期:1992-02-01 00:00:00
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journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/67.3.247
更新日期:1991-09-01 00:00:00
abstract:BACKGROUND:There are no studies comparing local anaesthetic requirements for obese and normal parturients. Obesity has been associated with a higher incidence of Caesarean section and higher levels of epidural block have also been found in obese obstetric patients, suggesting they may require less local anaesthetic. Th...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aei284
更新日期:2006-01-01 00:00:00
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journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/80.6.843
更新日期:1998-06-01 00:00:00
abstract::Local reactions after i.v. injection of diazepam, flunitrazepam and isotonic saline were studied in patients who received extradural analgesia or general anaesthesia. The frequency of thrombophlebitis on the 1st, 3rd and 5th days after the injection of diazepam was 2.1%, 17.0% and 14.9% respectively, after flunitrazep...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/52.8.817
更新日期:1980-08-01 00:00:00
abstract:BACKGROUND:Myocardial potassium channels are complexes formed by different subunits. The subunit composition may influence the cardiotoxic action of local anaesthetics. The effects of amide local anaesthetics on HERG channels co-expressed with the putative subunit MiRP1 have not been established. It is also unclear if ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aeh026
更新日期:2004-01-01 00:00:00
abstract::Haemodynamic changes (supraventricular tachycardia, decreases in arterial pressure) were observed during laryngoscopy and intubation of the trachea in a patient receiving nifedipine and verapamil. Before the induced stresses of laryngoscopy and tracheal intubation, these drugs had controlled the patient's arterial pre...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/58.3.357
更新日期:1986-03-01 00:00:00
abstract:BACKGROUND:The ability of the third-generation FloTrac/Vigileo software to track changes in cardiac index (CI) induced by volume expansion and norepinephrine in critically ill patients is unknown. METHODS:In subjects with circulatory failure, we administered volume expansion (20 subjects) and increased (20 subjects) o...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aer491
更新日期:2012-04-01 00:00:00