Abstract:
BACKGROUND:We used an automated bispectral index (BIS)-guided dual-loop controller to determine propofol and remifentanil requirements during general anaesthesia in obese and lean surgical patients. METHODS:Obese patients, BMI>35 kg m(-2), and lean patients (<25 kg m(-2)) having laparoscopic procedures were prospectively evaluated in this multicentre single-blind study. The automated controller targeted BIS between 40 and 60 by adjusting propofol and remifentanil administration. Propofol and remifentanil consumptions were calculated using both total body weight (TBW) and ideal body weight (IBW). Results are expressed as medians (inter-quartile range). RESULTS:Thirty obese [BMI=43 (40-49) kg m(-2)] and 29 lean [BMI=23 (21-25) kg m(-2)] patients completed the study. BIS was between 40 and 60 during 84 (69-91)% vs 85 (78-92)% of the anaesthetic time, P=0.46. The amount of propofol given during induction [1.2 (1.1-1.6) vs 1.3 (1.0-1.7) mg kg(-1), P=0.47] and maintenance [5.2 (4.1-6) vs 5.3 (4.7-6.4) mg kg(-1) h(-1), P=0.39] calculated using TBW was similar between the two groups. The dual-loop controller delivered half as much remifentanil to the obese patients during induction [1.0 (0.8-1.6) vs 2.2 (1.5-2.7) µg kg(-1), P<0.001] and maintenance [0.12 (0.07-0.16) vs 0.25 (0.17-0.29) µg kg(-1) min(-1), P<0.001] calculated using TBW. But when remifentanil consumption was calculated using IBW, the amounts were similar during induction at 2.2 (1.6-3.5) vs 2.0 (1.6-3.0) µg kg(-1) IBW, P=0.48, and during maintenance at 0.26 (0.16-0.34) vs 0.27 (0.18-0.33 ) µg kg(-1) min(-1), P=0.50. CONCLUSIONS:The amount of propofol-remifentanil administered by the controller is consistent with current knowledge, propofol is best dosed using TBW whereas remifentanil is best dosed using IBW. CLINICAL TRIAL REGISTRATION:NCT00779844.
journal_name
Br J Anaesthjournal_title
British journal of anaesthesiaauthors
Liu N,Lory C,Assenzo V,Cocard V,Chazot T,Le Guen M,Sessler DI,Journois D,Fischler Mdoi
10.1093/bja/aeu401subject
Has Abstractpub_date
2015-04-01 00:00:00pages
605-14issue
4eissn
0007-0912issn
1471-6771pii
S0007-0912(17)31673-2journal_volume
114pub_type
临床试验,杂志文章,多中心研究abstract:BACKGROUND:The incidence of pain on injection of propofol remains unacceptably high in children, despite various strategies to reduce it. A new drug formulation of propofol has, in adult studies, been reported to cause less injection pain compared with other propofol solutions. The aim of the present prospective random...
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/aei156
更新日期:2005-08-01 00:00:00
abstract::We have compared the postoperative morphine requirements and analgesic efficacy of four doses of i.m. ketorolac 30 mg administered 6-hourly with placebo in a double-blind study of patients undergoing major or minor orthopaedic surgery. During the 24-h postoperative study period which began at the end of surgery, 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/69.1.19
更新日期:1992-07-01 00:00:00
abstract::Profound postoperative respiratory depression after larger doses of fentanyl was partially reversed by 4-aminopyridine. This reversal was independent of FIO2' suggesting that the response was not dependent upon peripheral chemoreceptor-mediated drive. Similar reversal of fentanyl-induced depression by 4-aminopyridine ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/53.4.373
更新日期:1981-04-01 00:00:00
abstract::Patients receiving opioids report feeling sleepy, but opioids actually inhibit the rapid eye movement phase of sleep (REM). Inhibition of REM sleep is followed by a rebound increase in REM sleep associated with cardiopulmonary complications. The medial pontine reticular formation (mPRF) is a brain region from which mo...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/74.2.188
更新日期:1995-02-01 00:00:00
abstract::This study was designed to determine whether dextran, gelatin or hydroxyethyl starch-based colloidal resuscitation fluids (CRF) are inhibitory to T lymphocyte activation and mitogenesis in vitro. Isolated peripheral blood lymphocytes from normal donors were activated with mitogen (PHA) and cultured in up to 50% v:v CR...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/81.2.242
更新日期:1998-08-01 00:00:00
abstract:BACKGROUND:High-frequency oscillation (HFO) is a widely used lung-protective ventilatory strategy in paediatric and neonatal acute lung injury. Its safe and effective use has been hindered by inadequate recruitment of the lung during oscillation and, until recently, the lack of an adequately powered oscillator for use ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/88.5.708
更新日期:2002-05-01 00:00:00
abstract::Zomepirac 100 mg and dihydrocodeine 30 mg were compared with placebo in a controlled randomized, double-blind, single-dose postoperative study. Patients continued to receive either zomepirac or dihydrocodeine for pain relief for 5 days at home in a double-blind study, being allowed to titrate the consumption of tablet...
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/57.4.412
更新日期:1985-04-01 00:00:00
abstract::The study was performed to determine the ED50 and ED95 of a continuous infusion of the emulsion formulation of propofol during 67% nitrous oxide anaesthesia in 57 patients premedicated with morphine sulphate 0.15 mg kg-1. Anaesthesia was induced with propofol 2 mg kg-1, and maintained before incision with a fixed-rate...
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/58.10.1080
更新日期:1986-10-01 00:00:00
abstract::In a randomized study of patients undergoing Caesarean section, either enflurane (mean 0.24 MAC-h) or halothane (mean 0.23 MAC-h) and 50% nitrous oxide in oxygen were administered to women (n = 12) with severe pre-eclampsia-eclampsia and to 16 healthy pregnant patients with normal renal and hepatic function. No eviden...
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/56.6.587
更新日期:1984-06-01 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::Forty-five patients undergoing circumcision were allocated randomly to one of three study groups to compare topical analgesia with dorsal nerve block using the midline or lateral approach. Pain scores, side effects and analgesic requirements were recorded after surgery. Patients who received topical analgesia required...
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/73.4.437
更新日期:1994-10-01 00:00:00
abstract::We have studied the effect of clonidine, dexmedetomidine and morphine on gastric emptying and gastrointestinal transit in the rat. In one group, each agonist was injected i.p. in 6-12 male Wistar rats. In another group of rats, yohimbine, naloxone or saline was injected with an agonist. At 30 min, radiolabelled saline...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/78.3.301
更新日期:1997-03-01 00:00:00
abstract:BACKGROUND:Double-lumen tubes (DLTs) are frequently used to establish one-lung ventilation (OLV). Their correct placement is crucial. We hypothesized that electrical impedance tomography (EIT) reliably displays distribution of ventilation between left and right lung and may thus be used to verify correct DLT placement ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aen166
更新日期:2008-09-01 00:00:00
abstract:BACKGROUND:Patient dissatisfaction has been previously associated with motor block in shoulder surgery patients receiving brachial plexus block. For elective minor wrist and hand surgery, we tested whether a regional block accelerating the early return of upper extremity motor function would improve patient satisfactio...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aes266
更新日期:2012-11-01 00:00:00
abstract::The speeds of onset of pancuronium, atracurium and vecuronium are increased by prior administration of magnesium sulphate. A prospective, randomized, double-blind, controlled, clinical study was performed to examine the effects of prior i.v. administration of magnesium sulphate 60 mg kg-1 on the neuromuscular blocking...
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/79.1.122
更新日期:1997-07-01 00:00:00
abstract::In a double-blind, randomized study, we have compared the efficacy of transdermal hyoscine in the prevention of nausea and vomiting with placebo in 60 young, ASA I-II patients after middle ear surgery during general anaesthesia. In the placebo group, 27% and 43% of patients suffered from nausea and vomiting, respectiv...
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/73.6.763
更新日期:1994-12-01 00:00:00
abstract::Interest in the use of psychosocial interventions to help older adults manage pain is growing. In this article, we review this approach. The first section reviews the conceptual background for psychosocial interventions with a special emphasis on the biopsychosocial model of pain. The second section highlights three p...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/aet129
更新日期:2013-07-01 00:00:00
abstract:BACKGROUND:Tracheal tube tip and cuff positions of different cuffed paediatric tracheal tube brands in the trachea can vary with design. METHODS:Data from three clinical studies with measured tracheal lengths were pooled in a database including 422 children aged from birth to 16 yr. Dimensional data of seven cuffed pa...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1016/j.bja.2018.05.002
更新日期:2018-08-01 00:00:00
abstract::The effect of the topical application of a lignocaine-prilocaine cream (EMLA) on the pain of venous cannulation was tested in a double-blind manner. Sixty boys and girls between the ages of 4 and 10 yr who were to undergo surgery participated in the study. No analgesic premedication was given and the venous cannulatio...
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/58.11.1242
更新日期:1986-11-01 00:00:00
abstract::Neurone specific enolase (NSE) and S-100 beta protein have been used as markers of brain damage. We hypothesized that blood concentrations of NSE and S-100 beta protein reflect cognitive dysfunction after abdominal surgery. We studied 65 elderly patients in whom neuropsychological testing was performed before abdomina...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/oxfordjournals.bja.a013410
更新日期:2000-02-01 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::We have studied the effects of alcuronium in 10 healthy, non-anaesthetized volunteers after they had been taking oral pyridostigmine 30 mg 8 hourly. The responses of adductor pollicis were recorded using an isolated forearm procedure (IFP) during onset and recovery of neuromuscular block produced by 1.5 mg of relaxant...
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/66.3.365
更新日期:1991-03-01 00:00:00
abstract::Atropine and glycopyrronium are frequently used for premedication to reduce oral and respiratory secretions and prevent bradycardia. Glycopyrronium is said to have similar antisialagogue effects, but is less likely to cause significant tachycardia than atropine. Different antimuscarinic receptor selectivity patterns c...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/74.5.549
更新日期:1995-05-01 00:00:00
abstract::Cryoprecipitate, originally developed as a therapy for patients with antihaemophilic factor deficiency, or haemophilia A, has been in use for almost 50 yr. However, cryoprecipitate is no longer administered according to its original purpose, and is now most commonly used to replenish fibrinogen levels in patients with...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/aeu158
更新日期:2014-12-01 00:00:00
abstract::Using in vivo microdialysis, we have investigated the effects of propofol on acetylcholine (ACh) release from various regions of the rat brain. Propofol 25 and 50 mg kg-1 i.p. decreased basal ACh release from the frontal cortex by 70% and 85%, respectively. Propofol 25 and 50 mg kg-1 i.p. decreased basal ACh release f...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/80.5.644
更新日期:1998-05-01 00:00:00
abstract::We have investigated the effect of dopamine and dopexamine on the isolated perfused rat kidney. After an equilibration period of 20 min and two control periods of 10 min, dopexamine 1.0, 2.5 or 4.0 micrograms kg-1 min-1 or dopamine 2.0 micrograms kg-1 min-1 were perfused for a further 40 min in random order. Renal blo...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/83.6.898
更新日期:1999-12-01 00:00:00
abstract::Spinal anaesthesia is the preferred anaesthetic technique for elective Caesarean deliveries. Hypotension is the most common side-effect and has both maternal and neonatal consequences. Different strategies have been attempted to prevent spinal-induced hypotension, including the use of low-dose bupivacaine. We conducte...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,meta分析,评审
doi:10.1093/bja/aer200
更新日期:2011-09-01 00:00:00
abstract:BACKGROUND:Circadian variation may affect many biological and pharmacological phenomena. METHODS:To assess circadian variations in labour pain perception, 222 consecutive nulliparous women with uncomplicated pregnancy, spontaneous labour, cervical dilatation (3-5 cm), ruptured membranes and normal fetal heart rate tra...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aeh223
更新日期:2004-09-01 00:00:00
abstract:BACKGROUND:Abnormal serum sodium concentrations are common in patients presenting for surgery. It remains unclear whether these abnormalities are independent risk factors for postoperative mortality. METHODS:This is a secondary analysis of the European Surgical Outcome Study (EuSOS) that provided data describing 46 53...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aev373
更新日期:2016-01-01 00:00:00
abstract::Ketamine, as the sole anaesthetic agent, was assessed in a double-blind study of 135 female patients who underwent laparoscopic sterilization. The patients were allocated randomly to one of four groups according to the type (pentobarbitone or droperidol) and route (i.v. or i.m.) of premedication. In addition all the p...
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/49.11.1159
更新日期:1977-11-01 00:00:00