Abstract：
BACKGROUND:The properties of methadone suggest a potential advantage for epidural over i.v. administration for pain relief, but little supportive evidence exists. METHODS:To investigate the pharmacokinetic and the pharmacodynamic properties of epidural and i.v. methadone, four doses of methadone (0.1, 0.25, 0.5, and 0.75 mg kg(-1)) were investigated by each route in a rat model. The tail-flick and hot water tail immersion test were used for thermal nociception. The magnitude of antinociceptive efficacy was expressed as per cent maximal possible effect (%MPE) of tail withdrawal latency, and the area under the %MPE vs time curve indicated the cumulative antinociceptive effect. A pharmacokinetic model describing the disposition and elimination of methadone was established. RESULTS:The pharmacokinetic profiles of methadone were not significantly different after epidural and i.v. administration. A two-compartment model with saturable elimination provided a good fit of the experimental data. At equivalent doses, epidural methadone produced higher cumulative antinociceptive effect in both thermal models. Supraspinal opioid effect, assessed by pinna reflex presence, was significantly lower with epidural methadone at equivalent doses. The duration of antinociceptive effect was longer with epidural administration of 0.5 and 0.75 mg kg(-1) doses. CONCLUSIONS:Epidural administration of methadone in rats resulted in systemic exposure similar to that after i.v. administration, but improved thermal antinociceptive efficacy, and reduced supraspinal undesired effects. The findings suggest the presence of local effect at the spinal cord level, in addition to the systemic effect produced by epidural methadone.
journal_name
Br J Anaesthjournal_title
British journal of anaesthesiaauthors
Haroutiunian S,Kagan L,Yifrach-Damari I,Davidson E,Ratz Y,Hoffman Adoi
10.1093/bja/aet234subject
Has Abstractpub_date
2014-01-01 00:00:00pages
150-8issue
1eissn
0007-0912issn
1471-6771pii
S0007-0912(17)31981-5journal_volume
112pub_type
杂志文章abstract：:This paper describes the use of solenoid valves for the production of binary gas mixtures. The system is controlled by a microprocessor and is capable of delivering accurate flows and concentrations of gases over the ranges commonly used in anaesthesia. Since the flow produced by the valves is pulsatile, a system for ...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/58.9.1041
更新日期：1986-09-01 00:00:00
abstract：:Intraoperative awareness, with or without recall, continues to be a topic of clinical significance and neurobiological interest. In this article, we review evidence pertaining to the incidence, sequelae, and prevention of intraoperative awareness. We also assess which aspects of the complication are well understood (i...
journal_title：British journal of anaesthesia
pub_type： 杂志文章,评审
doi：10.1093/bja/aev034
更新日期：2015-07-01 00:00:00
abstract：:We have studied in eight rabbits the cardiovascular effects of midazolam, propofol and alfentanil with graded hypoxia. Central blood volume was reduced progressively by gradual inflation of a thoracic vena cava cuff so that cardiac index (CI) decreased at a constant rate. Under control conditions the haemodynamic resp...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/75.5.610
更新日期：1995-11-01 00:00:00
abstract：:Three anaesthetic techniques based on isoflurane were compared in outpatients undergoing laparoscopy. Sixty healthy patients were randomly allocated to receive isoflurane via mask (spontaneous respiration), via tracheal tube (spontaneous respiration) or via tracheal tube with controlled ventilation. Moderate hypercarb...
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/59.2.189
更新日期：1987-02-01 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：:Purified serum cholinesterase 90 mg was administered to a patient with cholinesterase deficiency. The effect on the action of suxamethonium was studied. The half-life (44.7 h), time constant (64.5 h), rate constant (0.0155 h-1) and distribution volume (2740 ml) of the cholinesterase activity were determined. ...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/49.3.269
更新日期：1977-03-01 00:00:00
abstract：:We have examined the effect of isoflurane, halothane and fentanyl on heart rate variability (HRV) using power spectral analysis (PSA). Forty patients were allocated randomly to receive one of four anaesthetic techniques. Anaesthesia was induced with propofol 2 mg kg-1 and all patients breathed a mixture of 66% nitrous...
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：BACKGROUND:Early tracheostomy may decrease the duration of mechanical ventilation, sedation exposure, and intensive care stay, possibly resulting in improved clinical outcomes, but the evidence is conflicting. METHODS:Systematic review and meta-analysis of randomized trials in patients allocated to tracheostomy within...
journal_title：British journal of anaesthesia
pub_type： 杂志文章,meta分析,评审
doi：10.1093/bja/aeu440
更新日期：2015-03-01 00:00:00
abstract：:Ropivacaine is considered safer than bupivacaine, on the basis of experimental and human data that indicate a lower systemic toxicity. Here we report the occurrence of a single seizure after i.v. administration of ropivacaine 120 mg intended for extradural block in a patient having postpartum, tubal ligation. The only...
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：BACKGROUND:Propofol use during sedation for colonoscopy can result in cardiopulmonary complications. Intravenous lidocaine can alleviate visceral pain and decrease propofol requirements during surgery. We tested the hypothesis that i.v. lidocaine reduces propofol requirements during colonoscopy and improves post-colono...
journal_title：British journal of anaesthesia
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.bja.2018.06.019
更新日期：2018-11-01 00:00:00
abstract：:A method for the assessment and management of factors both causing and maintaining a primary metabolic alkalosis is presented. During a 2-year period 65 patients with metabolic alkalosis were treated with saline and potassium chloride infusions. In four patients the alkalosis was refractory and required additional the...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/49.8.811
更新日期：1977-08-01 00:00:00
abstract：BACKGROUND:The surgical pleth index (SPI) is a measurement of intraoperative nociception. Evidence of its usability in children is limited. Given that the autonomic nervous system is still developing during the first years of life, the performance of the SPI on small children cannot be concluded from studies carried ou...
journal_title：British journal of anaesthesia
pub_type： 杂志文章,随机对照试验
doi：10.1093/bja/aew215
更新日期：2016-09-01 00:00:00
abstract：:Since 1972, 367 patients with chronic low-back pain have been treated by electrical stimulation (e.s.). Patients with herniated disc lesions and spondylitis and allied conditions were included. Following e.s. 75-100% pain relief was obtained by 53% of the patients 50% pain relief by 27% and there was no improvement in...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/49.6.629
更新日期：1977-06-01 00:00:00
abstract：:As constant hypoxaemia itself may trigger development of apnoea and periodic breathing, we have studied the effect of oxygen therapy on the occurrence of late postoperative episodic hypoxaemia. Thirty-five patients without cardiopulmonary disease and undergoing elective total hip replacement were monitored with a puls...
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/68.1.18
更新日期：1992-01-01 00:00:00
abstract：BACKGROUND:Opioids can increase sensitivity to noxious stimuli and cause opioid-induced hyperalgesia. We performed a systematic review to evaluate the clinical consequences of intra-operative doses of opioid. METHODS:We identified randomized controlled trials which compared intra-operative opioid to lower doses or pla...
journal_title：British journal of anaesthesia
pub_type： 杂志文章,meta分析,评审
doi：10.1093/bja/aeu137
更新日期：2014-06-01 00:00:00
abstract：:We have performed a prospective, randomized, double-blind clinical study to assess the efficacy of ondansetron, droperidol, or both, in preventing postoperative emesis. We studied 242 patients undergoing biliary or gynaecological surgery under general anaesthesia. Shortly before induction of anaesthesia, patients rece...
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/83.5.813
更新日期：1999-11-01 00:00:00
abstract：:Control measurements of blood flow through and cefoxitin extraction ratios across heart and lungs, liver, kidneys and gut were made under steady-state conditions in awake unrestrained sheep. The studies then were repeated with the same animals anaesthetized with 1.5% halothane or whilst undergoing high thoracic (to ap...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/57.12.1239
更新日期：1985-12-01 00:00:00
abstract：BACKGROUND:Mechanosensory thalamocortical relay neurones (TCNs) receive glutamatergic excitatory input and are subjected to gamma-aminobutyric acid (GABA)Aergic inhibitory input. This study assessed the effects of an increase in concentration of isoflurane on thalamic excitatory and inhibitory mechanisms. METHODS:TCNs...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/aef170
更新日期：2002-08-01 00:00:00
abstract：:We studied the effects of minor surgery and endotracheal intubation on postoperative breathing patterns. We measured breathing patterns and laryngeal resistance during the periods immediately before intubation (preoperative) and immediately after extubation following minor surgery (postoperative) in eight patients ana...
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/87.5.706
更新日期：2001-11-01 00:00:00
abstract：BACKGROUND:After cardiac surgery adequate postoperative analgesia is necessary. We assessed analgesia using intrathecal morphine and clonidine. METHODS:In a double-blind randomized study, 45 patients having coronary artery bypass graft surgery were allocated randomly to receive i.v. 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/aeg070
更新日期：2003-03-01 00:00:00
abstract：BACKGROUND:We measured the effect of two weight adjusted i.v. doses (0.2 mg per 70 kg and 0.4 mg per 70 kg) of the potent opioid buprenorphine on analgesia and respiratory depression in healthy volunteers. The aim of the study was to compare buprenorphine's behaviour with respect to the occurrence of ceiling (or appare...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/ael051
更新日期：2006-05-01 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：:Most human phenotypic characteristics are determined by the interplay of environmental factors (whether external, or related to the internal milieu) with the unique genetic attributes of the individual. The same is true for predisposition to and outcome from most disease states, with acute brain injury being no except...
journal_title：British journal of anaesthesia
pub_type： 杂志文章,评审
doi：10.1093/bja/aem142
更新日期：2007-07-01 00:00:00
abstract：:We have developed a simple, reliable method for rapid analysis of the partial pressure of volatile anaesthetic agents, based on a two-stage, head-space analysis. It is designed to solve the problems associated with reduced solubility of modern anaesthetics. After equilibration and analysis of a 2-ml sample of blood at...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/78.4.449
更新日期：1997-04-01 00:00:00
abstract：BACKGROUND:Pressure recording analytical method (PRAM) is a novel, arterial pulse contour-based method for measuring cardiac output (CO). Validation studies of PRAM in children are few, and have not assessed both absolute accuracy and ability to track changes in CO across a broad case mix. We aimed to compare CO as mea...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/aes420
更新日期：2013-03-01 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：: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：:Mean venous pressures were measured in 20 patients in whom a catheter, inserted via the external jugular vein, failed to pass centrally. The catheter used had a rounded end and two side holes. Pressures were measured with the patient's head in three different positions. The pressures were compared with the central ven...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/58.12.1384
更新日期：1986-12-01 00:00:00
abstract：:We have investigated 296 inpatients in a single-blind observer study to determine the incidence, degree and duration of hypoxaemia during anaesthesia. The clinical recognition of hypoxaemia, period of time until recognition and risk factors were studied. Oxygen saturation (Spo2) was monitored continuously with a pulse...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/66.4.437
更新日期：1991-04-01 00:00:00
abstract：BACKGROUND:It was hypothesized that xenon would stabilize mean arterial pressure (MAP) in haemorrhagic shock, recovery, and volume resuscitation, because a higher MAP has been observed with xenon, when compared with isoflurane anaesthesia. The responses to haemorrhage and subsequent volume replacement were therefore co...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/aei127
更新日期：2005-06-01 00:00:00
