Abstract：
BACKGROUND:Clonidine is a useful analgesic-sedative agent; however, few data exist regarding its use in infants after congenital heart disease surgery. We thus aimed to assess the absorption and safety of enterally administered clonidine in this setting. METHODS:Sixteen infants (median age 6.7 months) received a single nasogastric dose of 3 μg kg(-1) clonidine 2-6 h after surgery. Blood samples were obtained at seven time intervals (up to 480 min). Plasma concentration profiles were obtained, and then pooled with a previous study (137 samples, 30 infants) for estimation of population pharmacokinetic parameters (NONMEM version 7.2). RESULTS:Enteral absorption showed considerable inter-individual variability, with clonidine Cmax ranging from 0.15 to 1.55 ng ml(-1) (median 0.73), and Tmax from 12 to 478 min (median 190). Although therapeutic sedative plasma concentrations were achieved in 94% of patients, only half had attained this by 70 min post-dose. Patients who did not receive inotropes exhibited a positive association between cumulative morphine dose and Tmax (interaction effect P=0.03); this was not seen among those receiving inotropes. The haemodynamic profile was favourable; few patients required fluid boluses, and this bore no relationship to plasma clonidine concentration. Population pharmacokinetic parameter estimation yielded results similar to previous paediatric studies: clearance 13.7 litre h(-1) 70 kg(-1) and Vd 181 litre 70 kg(-1). CONCLUSIONS:Early postoperative enteral clonidine produces favourable haemodynamic profiles and therapeutic plasma concentrations in the majority of cardiac surgical infants; however, the time to achieve this can be erratic. Thus, parenteral administration may be preferable if rapid analgo-sedative effects are needed.
journal_name
Br J Anaesthjournal_title
British journal of anaesthesiaauthors
Arenas-Lopez S,Mulla H,Manna S,Durward A,Murdoch IA,Tibby SMdoi
10.1093/bja/aeu258subject
Has Abstractpub_date
2014-12-01 00:00:00pages
964-9issue
6eissn
0007-0912issn
1471-6771pii
S0007-0912(17)30652-9journal_volume
113pub_type
杂志文章abstract：:This editorial looks at some of the various anesthesias used during pregnancy termination. Trichloroethylene, often a popular substitute for halothane, has been subjected to little evaluation. Only clinical study however, can actually establish the significance of myometrial depressant properties in the pregnant pat...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/52.8.711
更新日期：1980-08-01 00:00:00
abstract：BACKGROUND:Short-axis ultrasound-guided placement of central venous catheters (CVCs) is widely accepted as safe practice. However, utilizing the long-axis approach could further improve safety, as it allows for better visualization of the needle as it is advanced to the target vessel. However, the long-axis approach ha...
journal_title：British journal of anaesthesia
pub_type： 杂志文章,随机对照试验
doi：10.1093/bja/aer329
更新日期：2012-01-01 00:00:00
abstract：:Methodology for assessment of depth of anaesthesia based on analysis of the electroencephalogram (EEG) is controversial. Techniques range from display of single measures, for example median value of the frequency spectrum, to dedicated pattern recognition systems based on measures of several EEG features. We have comp...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/77.2.172
更新日期：1996-08-01 00:00:00
abstract：:We have assessed neuromuscular block electromyographically at the gastrocnemius muscle and compared it with that at the abductor digiti minimi muscle in 60 adult patients undergoing cervical spine surgery under general anaesthesia. All patients were in the prone position. After vecuronium 0.2 mg kg-1, times to onset o...
journal_title：British journal of anaesthesia
pub_type： 临床试验,杂志文章,收录出版
doi：10.1093/bja/82.3.329
更新日期：1999-03-01 00:00:00
abstract：BACKGROUND:The 'cannot intubate cannot oxygenate' (CICO) emergency requires urgent front of neck airway (FONA) access to prevent death. In cases reported to the 4th National Audit Project, the most successful FONA was a surgical technique, almost all of which were performed by surgeons. Subsequently, UK guidelines adop...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1016/j.bja.2019.07.011
更新日期：2019-11-01 00:00:00
abstract：:We have undertaken a prospective, randomized study to determine the incidence of postoperative nausea and vomiting during intensive care stay after cardiac surgery, and to study the effect of addition of droperidol to an infusion of morphine used for postoperative analgesia. Data from 398 patients were examined. The u...
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/77.3.356
更新日期：1996-09-01 00:00:00
abstract：:Use of inhaled nitric oxide for treatment of pulmonary hypertension in adult critical illness is limited by its mode of delivery and high costs, prompting evaluation of alternative therapies. We report the use of oral sildenafil in a patient with severe secondary pulmonary hypertension and right ventricular dysfunctio...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/aei114
更新日期：2005-06-01 00:00:00
abstract：:Alcuronium 0.16 mg kg-1 was used to provide neuromuscular blockade in patients with chronic renal failure undergoing renal transplantation. Relaxation was found to be adequate for intubation and surgery. There were minimal alterations to cardiovascular variables. The dose required was small, and complete reversal occu...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/56.11.1229
更新日期：1984-11-01 00:00:00
abstract：:A blood-gas study of the respiratory effects of sodium nitroprusside during anaesthesia has shown a marked reduction in PaO2 when the drug was administered. After nitroprusside PaO2 returned to the previous values. It is suggested that the reduction in PaO2 is a result of an increased scatter of ventilation/perfusion ...
journal_title：British journal of anaesthesia
pub_type： 临床试验,杂志文章
doi：10.1093/bja/47.11.1205
更新日期：1975-11-01 00:00:00
abstract：BACKGROUND:In critically ill children, monitoring of cardiac output (CO) is essential to guide haemodynamic management and facilitate cardiovascular therapy. The ultrasound dilution technique (UDT), a novel minimally invasive indicator method, was recently introduced to determine CO. We validated UDT against the 'gold ...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/aet382
更新日期：2014-03-01 00:00:00
abstract：:The choice of an i.v. anaesthetic induction poses problems for the anaesthetist confronted with a patient with one of the acute porphyrias. We undertook a prospective clinical trial in 13 variegate porphyric subjects using propofol as an anaesthetic induction agent. Urinary porphyrin precursors and porphyrins were mea...
journal_title：British journal of anaesthesia
pub_type： 临床试验,杂志文章
doi：10.1093/bja/66.1.60
更新日期：1991-01-01 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：:We have examined the effects of bupivacaine and lignocaine on myocardial metabolism in the rat isolated heart-lung preparation. Bupivacaine 1, 5 or 25 micrograms ml-1 or lignocaine 4, 20 or 100 micrograms ml-1 was administered 5 min after the start of perfusion. Both bupivacaine 25 micrograms ml-1 and lignocaine 100 m...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/65.4.521
更新日期：1990-10-01 00:00:00
abstract：BACKGROUND:Paradoxical excitement response during sedation consists of loss of affective control and abnormal movements. Chronic alcohol abuse has been proposed as a predisposing factor despite lack of supporting evidence. Because alcohol and propofol have a common site of action, we postulated that paradoxical excitem...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/aer275
更新日期：2011-12-01 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：:Acetazolamide, a carbonic anhydrase inhibitor, may cause significant disturbances in carbon dioxide transport and elimination. In this study, end-tidal carbon dioxide monitoring has been used to study the correlation between arterial carbon dioxide (PaCO2) and end-tidal carbon dioxide partial pressure (PE'CO2) in rabb...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/73.2.225
更新日期：1994-08-01 00:00:00
abstract：:We studied cardiovascular and catecholamine responses for 3 days in three groups of patients undergoing abdominal hysterectomy. The night before surgery and again 2 h before induction of anaesthesia, patients received the ACE inhibitor, ramipril, the beta 1 blocker, metoprolol, or placebo. In the actively treated grou...
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/72.6.633
更新日期：1994-06-01 00:00:00
abstract：BACKGROUND:The pulmonary artery catheter is invasive and may cause serious complications. A safe method of cardiac output (CO) measurement is needed. We have assessed the accuracy and reliability of a recently marketed self-calibrating arterial pulse contour CO monitoring system (FloTrac/Vigileo) in end-stage liver fai...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/aen343
更新日期：2009-01-01 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：Background.:Compromised tissue oxygenation is one of the root causes of dysfunction of various organs and postoperative complications. Oxygenation of different tissue beds may follow different patterns of change during physiological derangement. Methods.:Patients undergoing elective major posterior spine surgery parti...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/aex008
更新日期：2017-04-01 00:00:00
abstract：:The possibility of an interaction between diazepam and pancuronium bromide was investigated in six patients undergoing general anaesthesia maintained with fentanyl, droperidol and nitrous oxide. Neuromuscular blockade was controlled using a feedback mechanism which automatically adjusted the rate of injection of pancu...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/53.8.859
更新日期：1981-08-01 00:00:00
abstract：:Gastric (GP) and lower oesophageal sphincter pressures (LOSP) were measured in non-pregnant female volunteers (group I) and pregnant women with (group III) or without (group II) heartburn. Patients in early pregnancy had greater gastric pressures than group I. Mean barrier pressure (LOSP-GP) was significantly decrease...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/53.4.381
更新日期：1981-04-01 00:00:00
abstract：:Development targets in anaesthetic pharmacology have evolved from minimizing harm caused by unwanted effects through an era in which rapid onset and offset of drug effect were prioritised. Today's anaesthetists have access to a library of effective drugs whose characteristics offer controllable hypnosis, analgesia and...
journal_title：British journal of anaesthesia
pub_type： 杂志文章,评审
doi：10.1093/bja/aex328
更新日期：2017-12-01 00:00:00
abstract：:Carotid endarterectomy is commonly conducted under regional (deep, superficial, intermediate, or combined) cervical plexus block, but it is not known if complication rates differ. We conducted a systematic review of published papers to assess the complication rate associated with superficial (or intermediate) and deep...
journal_title：British journal of anaesthesia
pub_type： 杂志文章,meta分析,评审
doi：10.1093/bja/aem160
更新日期：2007-08-01 00:00:00
abstract：:We describe the anaesthetic management of a patient undergoing lobectomy for cavitating lung abscess complicated by haemoptysis. Surgery for lung abscess is one of the absolute indications for the use of a double-lumen tube (DLT). Because pus or blood could impede fibreoptic-assisted DLT placement, a traditional, blin...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/85.5.791
更新日期：2000-11-01 00:00:00
abstract：BACKGROUND:This study compares cardiac output (CO) measurements obtained by lithium dilution (LiDCO), pulse power analysis (PulseCO), and continuous thermodilution (CTD) with bolus thermodilution (BTD) in ponies. METHODS:Eight isoflurane-anaesthetized Shetland ponies received xylazine, ketamine, and midazolam infusion...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/aes269
更新日期：2012-12-01 00:00:00
abstract：:Advances in cannabis research have paralleled developments in opioid pharmacology whereby a psychoactive plant extract has elucidated novel endogenous signalling systems with therapeutic significance. Cannabinoids (CBs) are chemical compounds derived from cannabis. The major psychotropic CB delta-9-tetrahydrocannabino...
journal_title：British journal of anaesthesia
pub_type： 杂志文章,评审
doi：10.1093/bja/aen119
更新日期：2008-07-01 00:00:00
abstract：BACKGROUND:While volatile agents have been implicated in metastasis-enhancing effects on cancer cells, the effects of xenon are unknown. We investigated xenon- and sevoflurane-mediated effects on migration and expression of angiogenesis biomarkers in human breast adenocarcinoma cells. METHODS:MDA-MB-231 and MCF-7 cell...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/aeu191
更新日期：2014-07-01 00:00:00
abstract：BACKGROUND:Cerebral state index (CSI) has recently been introduced as an intra-operative monitor of anaesthetic depth. We compared the performance of the CSI to the bispectral index (BIS) in measuring depth of anaesthesia during target-controlled infusion (TCI) of propofol. METHODS:Twenty Chinese patients undergoing g...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/aei253
更新日期：2005-12-01 00:00:00
abstract：BACKGROUND:The objective of this study was to determine whether assessment of stroke volume (SV) and measurement of exhaled end-tidal carbon dioxide [Formula: see text] during an end-expiratory occlusion (EEO) test can predict fluid responsiveness in the operating theatre. METHODS:Forty-two subjects monitored by oesop...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/aet582
更新日期：2014-06-01 00:00:00
