Abstract：
:The face-grafting techniques are innovative and highly complex, requiring well-defined organization of all the teams involved. Subsequent to the first report in France in 2005, there have been 17 facial allograft transplantations performed worldwide. We describe anaesthesia and postoperative management, and the problems encountered, during the course of seven facial composite tissue grafts performed between 2007 and 2011 in our hospital. The reasons for transplantation were ballistic trauma in four patients, extensive neurofibromatosis in two patients, and severe burns in one patient. Anaesthesia for this long procedure involves advanced planning for airway management, vascular access, technique of anaesthesia, and fluid management. Preparation and grafting phases were highly haemorrhagic (>one blood volume), requiring massive transfusion. Median (range) volumes given for packed red cell (PRC) and fresh-frozen plasma (FFP) were 64.2 ml kg(-1) (35.5-227.5) and 46.2 ml kg(-1) (6.3-173.7), respectively. Blood loss quantification was difficult because of diffuse bleeding to the drapes. The management of patients with neurofibromatosis or burns involving the whole face was more difficult and haemorrhagic than the patients with lower face transplantation. Average surgical duration was 19.1 h (15-28 h). Postoperative severe graft oedema was present in most patients. Most patients encountered complications in ICU, such as renal insufficiency, acute respiratory distress syndrome, and jugular thrombosis. Opportunistic bacterial infections were a feature during the postoperative period in these highly immunosuppressed patients.
journal_name
Br J Anaesthjournal_title
British journal of anaesthesiaauthors
Sedaghati-nia A,Gilton A,Liger C,Binhas M,Cook F,Ait-Mammar B,Scherrer E,Hivelin M,Lantieri L,Marty J,Plaud Bdoi
10.1093/bja/aet159subject
Has Abstractpub_date
2013-10-01 00:00:00pages
600-6issue
4eissn
0007-0912issn
1471-6771pii
S0007-0912(17)32353-Xjournal_volume
111pub_type
杂志文章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：BACKGROUND:The pathophysiology of the serotoninergic system in malignant hyperthermia (MH) is not completely understood. The serotonin-2 (5HT(2A)) receptor agonist 1-(2,5-dimethoxy-4-iodophenyl)-2-aminopropane hydrochloride (DOI) induces typical MH symptoms, including skeletal muscle rigidity, an increase in body tempe...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/aeg172
更新日期：2003-08-01 00:00:00
abstract：BACKGROUND:The 15-item Quality of Recovery (QoR-15) scale is a validated patient-reported outcome questionnaire that measures the quality of postoperative recovery. This study aimed to validate a translated Korean version of QoR-15 (QoR-15K) in a broad range of surgical patients. METHODS:After Korean translation of th...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1016/j.bja.2020.06.040
更新日期：2020-10-01 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：:Intravenous doses of 0.3 mg/kg dimethyl tubocurarine were required for consistent and adequate surgical relaxation in patients during nitrous oxide anaesthesia and produced virtually complete neuromuscular paralysis (96-100%) of the tetanic and twitch responses of the adductor pollicis muscle. The duration of action o...
journal_title：British journal of anaesthesia
pub_type： 临床试验,杂志文章
doi：10.1093/bja/48.10.969
更新日期：1976-10-01 00:00:00
abstract：:One hundred and eighty-five patients were allocated at random to receive pethidine with diazepam (in an emulsion), or pethidine with midazolam i.v. as sedation for upper gastrointestinal endoscopy. Sedation and conditions for examination were comparable and satisfactory in both groups. Midazolam produced more amnesia ...
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/55.11.1095
更新日期：1983-11-01 00:00:00
abstract：BACKGROUND:Anterograde, but not retrograde, amnesia has been demonstrated following midazolam administration. However, there have been no studies investigating whether or not immediate retrograde amnesia can be produced with midazolam. METHODS:After ethics committee approval and consent, 40 adult patients undergoing s...
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/aei040
更新日期：2005-03-01 00:00:00
abstract：BACKGROUND:Improvement of postoperative pain and other perioperative outcomes remain a significant challenge and a matter of debate among perioperative clinicians. This systematic review aims to evaluate the effects of perioperative i.v. lidocaine infusion on postoperative pain and recovery in patients undergoing vario...
journal_title：British journal of anaesthesia
pub_type： 杂志文章,meta分析,评审
doi：10.1093/bja/aew101
更新日期：2016-06-01 00:00:00
abstract：:We have examined the role of benzodiazepine receptors in nitrous oxide-induced neuronal depression in rats. The changes in neuronal excitability induced by nitrous oxide and the benzodiazepine inverse agonist, Ro15-4513, were monitored by measurement of visual evoked potentials (VEP). Administration of Ro15-4513 10 mg...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/77.4.522
更新日期：1996-10-01 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：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：:The insufflation of oxygen at 1 litre kg-1 min-1 via two endobronchial catheters (called continuous flow ventilation (CFV)) maintained a normal PaCO2 and a constant PaO2 in anaesthetized paralysed dogs and in five out of seven cats. In two cats with a high carbon dioxide production, CFV failed to maintain carbon dioxi...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/58.5.544
更新日期：1986-05-01 00:00:00
abstract：:We investigated whether low-dose erythromycin (200 mg) given as an oral premedicant altered the residual gastric volume and its acidity in fasted patients at induction of anaesthesia in a single-blinded study. Sixty patients were allocated randomly to receive either an erythromycin tablet (200 mg) or nothing with 10 m...
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/85.6.861
更新日期：2000-12-01 00:00:00
abstract：:In 10 dogs, one carotid sinus was isolated from the systemic circulation without disturbing its sympathetic innervation. The isolated sinus was connected to a servo-controlled pressure generator which kept mean intrasinus pressure, pulse pressure, and frequency of pulsation constant. The carotid sinus baroreceptor ner...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/59.4.489
更新日期：1987-04-01 00:00:00
abstract：:We conducted a prospective, randomized, double-blind study to compare analgesia obtained by wound infiltration using 29 ml of 0.25% bupivacaine alone, or with the addition of clonidine hydrochloride 150 micrograms. A third group received bupivacaine wound infiltration with clonidine 150 micrograms i.m. to control for ...
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/79.4.446
更新日期：1997-10-01 00:00:00
abstract：BACKGROUND:The molecular actions underlying the clinical effects of inhaled anaesthetics such as sevoflurane and isoflurane are not fully understood. Unexpected observations in positron emission tomography (PET) studies with [11C]AZD9272, a metabotropic glutamate receptor 5 (mGluR5) radioligand with possible affinity f...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1016/j.bja.2020.08.052
更新日期：2021-01-01 00:00:00
abstract：BACKGROUND:Dexmedetomidine (DEX) is increasingly used intraoperatively in infants undergoing cardiac surgery. This phase 1 multicentre study sought to: (i) determine the safety of DEX for cardiac surgery with cardiopulmonary bypass; (ii) determine the pharmacokinetics (PK) of DEX; (iii) create a PK model and dosing for...
journal_title：British journal of anaesthesia
pub_type： 杂志文章,多中心研究
doi：10.1016/j.bja.2019.06.026
更新日期：2019-12-01 00:00:00
abstract：:The use of atracurium in 25 patients undergoing general surgical procedures is described, neuromuscular function being monitored by the "train-of-four" stimuli. An initial dose of atracurium 0.5 mg kg-1 proved to be clinically acceptable, giving good conditions for endotracheal intubation and adequate muscle relaxatio...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/54.12.1243
更新日期：1982-12-01 00:00:00
abstract：:The protein binding of four non-depolarizing neuromuscular blocking drugs-tubocurarine, fazadinium, pancuronium and Org NC45-was measured, in serum from normal patients and from patients with cirrhosis of the liver, by an ultracentrifugation method. The fraction bound to serum protein in normal patients was 56% for tu...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/54.5.513
更新日期：1982-05-01 00:00:00
abstract：BACKGROUND:Individual patient information from clinical trials is infrequently available, but can provide insights for clinical trials and practice. METHODS:We analysed individual patient information from five randomized trials (913 patients) of i.v. patient-controlled analgesia (IVPCA) plus epidural placebo, morphine...
journal_title：British journal of anaesthesia
pub_type： 杂志文章,meta分析
doi：10.1093/bja/aep300
更新日期：2009-12-01 00:00:00
abstract：:The safety of aspirin therapy in neuraxial anaesthesia has been historically questioned, and the current recommendations are still heterogeneous. A comprehensive review of clinical evidence and a comparative analysis of European and American guidelines were performed. Low-dose aspirin produces a selective, complete an...
journal_title：British journal of anaesthesia
pub_type： 杂志文章,评审
doi：10.1093/bja/aev348
更新日期：2015-11-01 00:00:00
abstract：:Bispectral index (BIS) was assessed as a monitor of depth of anaesthesia during fentanyl and midazolam anaesthesia for coronary bypass surgery. In 10 patients given morphine premedication, anaesthesia was induced with a combination of midazolam and fentanyl and thereafter maintained with a continuous infusion of a mix...
journal_title：British journal of anaesthesia
pub_type： 临床试验,杂志文章
doi：10.1093/oxfordjournals.bja.a013587
更新日期：2000-06-01 00:00:00
abstract：:The evidence for an association between hypertensive disease, elevated admission arterial pressure, and perioperative cardiac outcome is reviewed. A systematic review and meta-analysis of 30 observational studies demonstrated an odds ratio for the association between hypertensive disease and perioperative cardiac outc...
journal_title：British journal of anaesthesia
pub_type： 杂志文章,meta分析,评审
doi：10.1093/bja/aeh091
更新日期：2004-04-01 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
abstract：:Infusion thrombophlebitis is a common complication of i.v. infusions. Many factors appear to be involved in its aetiology, of which the duration of infusion, the drugs infused and the solution(s) infused are the most important. Effective prophylaxis should be based on an understanding of the possible pathophysiology. ...
journal_title：British journal of anaesthesia
pub_type： 杂志文章,评审
doi：10.1093/bja/57.2.220
更新日期：1985-02-01 00:00:00
abstract：BACKGROUND:Arousal after sevoflurane anaesthesia has been detectable by monitoring changes in skin conductance (SC) with similar accuracy as monitoring Bispectral Index (BIS). As SC monitoring detects changes in sympathetic tone, the measurements might be confounded by the sympatholytic properties of propofol, a compon...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/ael278
更新日期：2006-12-01 00:00:00
abstract：BACKGROUND:The optimal dose of oxytocin at Caesarean section is unclear. Oxytocin may cause adverse cardiovascular effects, including tachycardia and hypotension, whereas an inadequate dose can result in increased uterine bleeding. We compared the effects of two doses of oxytocin in a randomized double-blind trial. ME...
journal_title：British journal of anaesthesia
pub_type： 杂志文章,随机对照试验
doi：10.1093/bja/aen273
更新日期：2008-12-01 00:00:00
abstract：:Cholinesterase phenotyping studies have been carried out in two laboratories on blood specimens from 28 patients shown to be susceptible to malignant hyperpyrexia. In contrast to previously published reports, no evidence could be found for an increase in the frequency of the E1u E1f genotype above that known to occur ...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/53.3.245
更新日期：1981-03-01 00:00:00
abstract：:Plain bupivacaine 0.5% or 0.75% was injected intrathecally in four groups of 10 patients. Group A received 0.75% bupivacaine 2.7 ml at L3/4, group B 0.5% bupivacaine 4 ml at L3/4, group C 0.75% bupivacaine 2.7 ml at L2/3 and group D 0.75% bupivacaine 2 ml at L3/4. A very wide range of height of block was found in each...
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/58.3.292
更新日期：1986-03-01 00:00:00
abstract：BACKGROUND:Blood flow patterns are important modifiers of platelet interactions with plasma coagulation factors. However, it is not feasible to evaluate rheological effects of haemodilution on coagulation using conventional coagulation testing. METHODS:We evaluated thrombus formation with a microchip-based flow-chambe...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/aet229
更新日期：2013-12-01 00:00:00
