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 allocated to receive either intrathecal bupivacaine (SA group) or GA with target controlled infusion of propofol and remifentanil (GA group). Primary outcome was length of hospital stay (LOS) defined as time from end of surgery until the subject met the hospital discharge criteria. Secondary outcome parameters included actual time of discharge, postoperative pain, intraoperative blood loss, length of stay in the Post Anaesthesia Care Unit, dizziness, postoperative nausea and vomiting, need for urinary catheterization and subject satisfaction. RESULTS:GA resulted in shorter LOS (46 vs 52 h, P<0.001), and less nausea and vomiting (4 vs 15, P<0.05) and dizziness (VAS 0 mm vs 20 mm, P<0.05) compared with SA. During the first 2 postoperative hours, GA patients had higher pain scores (P<0.001), but after 6 h the SA group had significantly higher pain scores (P<0.001). Subjects in the GA group used fewer patient-controlled analgesia doses and less morphine (P<0.01), and were able to walk earlier compared with the SA group (P<0.001). Subjects receiving SA would request a change in the method of anaesthesia in the event of a subsequent operation more often than the GA subjects (P<0.05). CONCLUSION:GA had more favourable recovery effects after TKA compared with SA.
journal_name
Br J Anaesthjournal_title
British journal of anaesthesiaauthors
Harsten A,Kehlet H,Toksvig-Larsen Sdoi
10.1093/bja/aet104subject
Has Abstractpub_date
2013-09-01 00:00:00pages
391-9issue
3eissn
0007-0912issn
1471-6771pii
S0007-0912(17)32396-6journal_volume
111pub_type
杂志文章,随机对照试验abstract:BACKGROUND:Investigators planning dose-response studies of neuromuscular blockers have rarely used a priori power analysis to determine the minimal sample size their protocols require. Institutional Review Boards and peer-reviewed journals now generally ask for this information. This study outlines a proposed method fo...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aeq310
更新日期:2011-02-01 00:00:00
abstract::The analgesic effects and bioavailability of a slow-release preparation of morphine (Duromorph) were studied in 12 patients with acute postoperative pain. Duromorph produced significant analgesia within 1-2 h of administration i.m., and there was a progressive decrease in the mean pain score for at least 8 h. None of ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/57.10.949
更新日期:1985-10-01 00:00:00
abstract::In 40 patients anaesthetized with thiopentone, 66% nitrous oxide and 1% halothane, the effects of a single i.v. dose of nalbuphine 4.5, 8, 15, 25 or 50 mg/70 kg or morphine 3, 5, 10 or 17.5 mg/70 kg on total ventilation and end-tidal carbon dioxide concentration have been measured. Depression of respiration occurred w...
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/58.6.625
更新日期:1986-06-01 00:00:00
abstract::Plasma diazepam concentrations were determined following oral, i.m. and i.v. administration to a group of pregnant women with pre-eclampsia and a group of normal pregnant women. Diazepam concentrations were greater following oral as compared with i.m. administration in the control group, who received a single 5-mg dos...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/48.11.1091
更新日期:1976-11-01 00:00:00
abstract::We have compared the viability criteria of muscle bundles used in the in vitro contracture test for susceptibility to malignant hyperthermia (MH) in a group of 28 patients with various neuromuscular diseases (NMD) and 93 MH-related family patients. In the patients with NMD, this standard test gave one positive, six eq...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/72.1.93
更新日期:1994-01-01 00:00:00
abstract::We carried out a randomized prospective study in 60 patients who had undergone major abdominal surgery for cancer. For postoperative pain control, 30 patients received continuous extradural infusion of 0.125% bupivacaine 12.5 mg h-1 and morphine 0.25 mg h-1 (EXI group) and 30 received patient-controlled analgesia (PCA...
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/80.6.742
更新日期:1998-06-01 00:00:00
abstract::Thirteen of 31 Belgian Landrace pigs developed malignant hyperthermia (MH) after breathing halothane. A short period of exercise 1 h before the administration of the triggering agent increased the incidence of the syndrome to 100% in eight similar pigs. Clinical symptoms were more marked and developed more rapidly in ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/48.9.821
更新日期:1976-09-01 00:00:00
abstract::A new design of tracheal tube cuff was compared with two types of high-volume, low-pressure (HVLP) cuffed tracheal tube for leakage of fluid from the subglottic space into the trachea. Spontaneous and positive-pressure ventilation were simulated using a mechanical lung, an intubated model trachea and a ventilator. Exc...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/80.6.796
更新日期:1998-06-01 00:00:00
abstract::We have determined the effect of pretreatment with mivacurium on the potency of suxamethonium and the effect of prior administration of suxamethonium on the potency of mivacurium. We studied 100 ASA I or II patients during thiopentone-fentanyl-nitrous oxide-isoflurane anaesthesia. Neuromuscular block was recorded as t...
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/74.1.26
更新日期:1995-01-01 00:00:00
abstract::Blood samples were obtained from a radial artery cannula in a 60-yr-old man during coronary artery surgery. Serum potassium concentrations of 9.3, 8.4, and 7.4 mmol litre(-1) were obtained. A simultaneous venous blood sample gave a serum potassium concentration of 4.4 mmol litre(-1). The ECG was unchanged. After the a...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aeh199
更新日期:2004-09-01 00:00:00
abstract::We have studied post-tetanic count (PTC) and single twitch height at the onset of reflex movement to carinal stimulation after administration of vecuronium with five different types of anaesthesia. Seventy-five adult patients were allocated randomly to five groups of 15 patients each, to receive one of the following a...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验,收录出版
doi:10.1093/bja/72.6.688
更新日期:1994-06-01 00:00:00
abstract::The ventilatory effects of single i.v. doses of morphine 0.1 mg kg-1, pethidine 0.67 mg kg-1 and methadone 0.1 mg kg-1 were compared after ophthalmic surgery in an open, randomized study in 30 children aged 3-8 yr. Ventilatory changes after each drug had distinctive profiles, with appreciable individual variation. Acu...
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/70.4.414
更新日期:1993-04-01 00:00:00
abstract::Muscle fasciculations and pain following the administration of suxamethonium were assessed in a group of patients who performed a series of stretch exercises approximately 1 h before operation. Comparison was made with a group who received suxamethonium but no pretreatment. Fasciculations were significantly reduced in...
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/59.5.596
更新日期:1987-05-01 00:00:00
abstract::The trachea of a man who had cut his own throat was successfully intubated using a fibreoptic laryngoscope after attempts at conventional oral intubation had failed. The advantages of the fibreoptic instrument and the method of use in such an injury are discussed. ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/50.5.511
更新日期:1978-05-01 00:00:00
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 s...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aer332
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND:Miller laryngoscope blades are preferred for laryngoscopy in infants and children <2 yr of age. Despite their long history, the laryngeal view with the Miller blade size 1 has never been compared with that with the Macintosh (MAC) blade in children. This prospective, single-blinded, randomized study was desi...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aeu228
更新日期:2014-11-01 00:00:00
abstract:BACKGROUND:The purpose of this observational study was to investigate the relationship between splanchnic and renal blood flow during infrarenal aortic cross-clamp (XC) and postoperative gastrointestinal perfusion and function. METHODS:Descending aortic blood flow (DABF) was continuously monitored with an oesophageal ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aes095
更新日期:2012-06-01 00:00:00
abstract:BACKGROUND:Anaesthetic drugs act at sites within the brain that undergo profound changes during typical ageing. We postulated that anaesthesia-induced brain dynamics observed in the EEG change with age. METHODS:We analysed the EEG in 155 patients aged 18-90 yr who received propofol (n=60) or sevoflurane (n=95) as the ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aev213
更新日期:2015-07-01 00:00:00
abstract:BACKGROUND:Dexmedetomidine is an α-2-receptor agonist which might be used as an additive to local anaesthetics for various regional anaesthetic techniques. We therefore designed this prospective, double-blinded, controlled volunteer study to investigate the effects of dexmedetomidine as an adjuvant to ropivacaine on pe...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
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更新日期:2013-03-01 00:00:00
abstract::We have compared the antagonism of neuromuscular block produced by pipecuronium with pancuronium in 80 anaesthetized surgical patients using mechanomyography and electromyography. Pancuronium 0.1 mg kg-1 or pipecuronium 0.07 mg kg-1 was given after induction of anaesthesia and neuromuscular block was adjusted to 75% t...
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:1995-04-01 00:00:00
abstract::The pharmaceutical formulation of Althesin was shown to have a weak allergenic potential in the guinea pig maximization test. Alphadolone and alphaxalone acetate were found to be devoid of such potential, while the status of Cremophor EL remained equivocal. ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/55.8.715
更新日期:1983-08-01 00:00:00
abstract::A retrospective study was carried out to determine analgesic requirements in a group of orthopaedic outpatients (n = 145) and oral surgery inpatients (n = 172). The orthopaedic patients received a codeine-paracetamol premedication, an opioid during operation, or no analgesic. Less than 50% of the orthopaedic patients ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/64.5.617
更新日期:1990-05-01 00:00:00
abstract:BACKGROUND:The effect of anaesthetic drugs on long-term oncological outcomes after cancer surgery is an area of current interest. Dexamethasone is widely used in anaesthetic practice; however, its effect on long-term survival and cancer outcomes is not known. This study presents the results of a 5-yr follow-up of patie...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aet577
更新日期:2014-07-01 00:00:00
abstract::The anaesthetist's work, aimed at giving safe anaesthesia to patients, can do both harm and good to the anaesthetist. Research on stress in anaesthesia has traditionally focused on how the negative effects of stress can be avoided and much effort has been put into improving anaesthetists' work environment to reduce th...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
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更新日期:2010-07-01 00:00:00
abstract::We have examined interactions between midazolam, propofol and alfentanil using two end-points of light sedation (hypnosis) and anaesthesia. Quantal dose-response curves were determined in 400 female patients for the drugs individually and in combination. At the hypnotic end-point, interactions were analysed by fitting...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
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更新日期:1992-08-01 00:00:00
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journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
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更新日期:1992-02-01 00:00:00
abstract:BACKGROUND:The use of lipid emulsions to reduce cardiac toxicity of local anaesthetics (LAs) has shown success in experimental studies and some clinical cases, and thus has been implemented in clinical practice. However, lipid treatment is usually given after the occurrence of neurological or cardiovascular symptoms of...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
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更新日期:2014-04-01 00:00:00
abstract::Although most local anaesthetic drugs are generally regarded as vasodilators at their site of injection, they produce systemic effects characterized by increases in peripheral resistance, cardiac output, arterial pressure heart rate. The direct depressive effects of the drugs are counterbalanced by increased sympathet...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:
更新日期:1975-02-01 00:00:00
abstract::The effects of bolus doses of phenoperidine 1-2 mg i.v. either alone, or combined with pancuronium 2-4 mg, were investigated in seven patients in traumatic coma. Phenoperidine alone significantly reduced mean arterial pressure (MAP) by a mean (+/- SEM) of 13.2 (+/- 2.8) mm Hg. Overall there was no significant change i...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/59.5.592
更新日期:1987-05-01 00:00:00
abstract::One hundred and six former or current flexible trainees in anaesthesia responded to a questionnaire evaluating their part-time training (a response rate of 71%). They were compared with a group of 32 flexible trainees in obstetrics and gynaecology. Anaesthetists were more satisfied than obstetricians and gynaecologist...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/81.2.268
更新日期:1998-08-01 00:00:00