Abstract:
BACKGROUND:Isoflurane has shown better control of intensive care sedation than propofol or midazolam and seems to be a useful alternative. However, its effect on survival remains unclear. OBJECTIVE:The objective of this study is to compare mortality after sedation with either isoflurane or propofol/midazolam. DESIGN:A retrospective analysis of data in a hospital database for a cohort of consecutive patients. SETTING:Sixteen-bed interdisciplinary surgical ICU of a German university hospital. PATIENTS:Consecutive cohort of 369 critically ill surgical patients defined within the database of the hospital information system. All patients were continuously ventilated and sedated for more than 96 h between 1 January 2005 and 31 December 2010. After excluding 169 patients (93 >79 years old, 10 <40 years old, 46 mixed sedation, 20 lost to follow-up), 200 patients were studied, 72 after isoflurane and 128 after propofol/midazolam. INTERVENTIONS:Sedation with isoflurane using the AnaConDa system compared with intravenous sedation with propofol or midazolam. MAIN OUTCOME MEASURES:Hospital mortality (primary) and 365-day mortality (secondary) were compared with the Kaplan-Meier analysis and a log-rank test. Adjusted odds ratios (ORs) [with 95% confidence interval (95% CI)] were calculated by logistic regression analyses to determine the risk of death after isoflurane sedation. RESULTS:After sedation with isoflurane, the in-hospital mortality and 365-day mortality were significantly lower than after propofol/midazolam sedation: 40 versus 63% (P = 0.005) and 50 versus 70% (P = 0.013), respectively. After adjustment for potential confounders (coronary heart disease, chronic obstructive pulmonary disease, acute renal failure, creatinine, age and Simplified Acute Physiology Score II), patients after isoflurane were at a lower risk of death during their hospital stay (OR 0.35; 95% CI 0.18 to 0.68, P = 0.002) and within the first 365 days (OR 0.41; 95% CI 0.21 to 0.81, P = 0.010). CONCLUSION:Compared with propofol/midazolam sedation, long-term sedation with isoflurane seems to be well tolerated in this group of critically ill patients after surgery.
journal_name
Eur J Anaesthesioljournal_title
European journal of anaesthesiologyauthors
Bellgardt M,Bomberg H,Herzog-Niescery J,Dasch B,Vogelsang H,Weber TP,Steinfort C,Uhl W,Wagenpfeil S,Volk T,Meiser Adoi
10.1097/EJA.0000000000000252subject
Has Abstractpub_date
2016-01-01 00:00:00pages
6-13issue
1eissn
0265-0215issn
1365-2346journal_volume
33pub_type
杂志文章abstract::Dynamic hyperinflation, also called intrinsic PEEP (PEEPi,) occurs particularly when high tidal volumes or high respiratory rates are used during mechanical ventilation, although the phenomenon does occur at normal tidal volumes. It is not identified using existing monitoring such as the airway pressure but can be ide...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,评审
doi:
更新日期:1994-01-01 00:00:00
abstract:BACKGROUND:Comparisons of peri-operative complications associated with paediatric (≤16 years) and adult anaesthesia are poorly available, especially in which cardiac surgery, organ transplantation and neurosurgery are involved. OBJECTIVE:The aim of this study was to evaluate the nature and incidence of peri-operative ...
journal_title:European journal of anaesthesiology
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doi:10.1097/EJA.0000000000000769
更新日期:2018-04-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:It has been reported that the left molar approach of laryngoscopy can make difficult intubation easier. The aim of this study was to investigate whether left molar approach to laryngoscopy provided a better laryngeal view in cases of unexpected difficult intubation. METHODS:Following the appro...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1017/S0265021508004110
更新日期:2008-08-01 00:00:00
abstract:BACKGROUND:While videolaryngoscopes help in the management of difficult airways, they remain too expensive for those with limited resources. We have developed a robust, re-usable, low-cost videolaryngoscope at United Mission Hospital Tansen, Nepal, by combining a smartphone-compatible endoscope capable of capturing sti...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1097/EJA.0000000000001264
更新日期:2020-11-01 00:00:00
abstract::Two groups of 25 patients were sedated during neuroradiological investigation. The first group was sedated with fentanyl and midazolam while the other was given fentanyl and a two-stage infusion of propofol in a subanaesthetic dose. Both techniques resulted in satisfactory sedation and recovery, although those who rec...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1989-09-01 00:00:00
abstract::From a family tragedy 20 years ago, ATLS has truly become an international trauma care program. Its success is demonstrated not only in the large number of physicians that have been trained, but also in the appearance of a number of affiliated courses with a similar structure, aimed at training medical, nursing, civil...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,评审
doi:10.1046/j.1365-2346.1996.00939.x
更新日期:1996-03-01 00:00:00
abstract:BACKGROUND:Postoperative cognitive decline (pCD) occurs frequently (6 to 30%) after carotid endarterectomy (CEA), although there are no exact estimates and risk factors are still unclear. OBJECTIVE:The objective of this study was to determine pCD incidence and risk factors in CEA patients. DESIGN:We performed a syste...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1097/EJA.0000000000001130
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abstract:BACKGROUND:Hypoventilation is a major cause of morbidity and mortality in patients having procedures under sedation. Few clinical strategies have been evaluated to reduce intraoperative hypoventilation during surgical procedures under deep sedation. OBJECTIVE:The primary objective of this investigation was to examine ...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/EJA.0000000000000025
更新日期:2014-12-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:We have evaluated the effects of propofol and its relationship with K+ channels on human isolated umbilical vessels. METHODS:Umbilical vessel rings were suspended in isolated organ baths containing Krebs-Ringer solution. In the first series of experiments the effect of propofol (10(-9)-10(-4) ...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1017/S0265021505001924
更新日期:2006-05-01 00:00:00
abstract::The initial disposition of propofol was reported to change when the administration was preceded by fentanyl. The pharmacokinetic profile of the induction dose of propofol (2 mg kg-1 body weight) was studied in 20 ASA I patients randomly allocated to receive fentanyl 1.5 microgram kg-1 (n = 12) or not (n = 8). Anaesthe...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1994-03-01 00:00:00
abstract::The effects of anaesthetic techniques and drugs on 18 neonates born after elective Caesarean section were studied, employing computerized EEG. Three different groups, epidural, spinal and general anaesthesia, were compared with each other and with a control group after normal vaginal delivery. A new computerized EEG m...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:
更新日期:1985-03-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Most therapeutic options for postoperative delirium are only symptom oriented; therefore, the best approach remains prevention. The aim of this study was to identify predisposing and precipitating factors for early postoperative delirium. METHODS:A total of 1002 patients were screened for deli...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1097/EJA.0b013e3283335cee
更新日期:2010-05-01 00:00:00
abstract:BACKGROUND:The respiratory exchange ratio (RER), defined as the ratio of CO2 production (VCO2) to O2 consumption (VO2), is reported to be a noninvasive marker of anaerobic metabolism. The intubated, ventilated patient's inspired and expired fractions of O2 and CO2 (FiO2, FeO2, FiCO2 and FeCO2) are monitored in the oper...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1097/EJA.0000000000001111
更新日期:2020-11-01 00:00:00
abstract::Sixty patients were randomly assigned to two equal groups. Group I received epidural morphine 1 mg after surgery and used a patient-controlled analgesia device programmed to deliver morphine 0. 2 mg h-1, 0.2 mg per bolus. Group II received an epidural loading dose of morphine 1 mg plus ketamine 5 mg and used a patient...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1046/j.1365-2346.1999.00592.x
更新日期:1999-12-01 00:00:00
abstract::We studied the movement response to skin incision in 68 adult (males/females) ASA I-II patients receiving propofol +/- fentanyl intravenous anaesthesia using the bispectral index and 95% spectral edge frequency monitoring with an A-1050 EEG monitor. Following Ethics Committee approval, patients were randomly assigned ...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1046/j.1365-2346.1999.00549.x
更新日期:1999-09-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:The cerebral state index (CSI) is a low-cost and compact electroencephalographic monitor alternative to the bispectral index (BIS). Although both indices are shown as the number between 0 and 100, owing to the different calculation algorithms, both indices might be different during anaesthesia....
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1097/EJA.0b013e328324e946
更新日期:2009-08-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Partial obstruction of endotracheal tubes due to accumulation of secretions and mucus plugs can increase the tube resistance and subsequently impose increased resistive load on the patient. This study was performed to determine the changes in the resistance of endotracheal tubes of sizes 7.5, ...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1017/S0265021507003134
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journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
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journal_title:European journal of anaesthesiology
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journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1046/j.0265-0215.2000.00808.x
更新日期:2001-04-01 00:00:00
abstract::In this review, we shall consider the oral and intravenous fluid management of pregnant women during labour and operative delivery in the context of neuroaxial blockade. We shall also discuss the use of blood transfusion in the peripartum period, especially during postpartum haemorrhage. Current management of military...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,评审
doi:10.1097/EJA.0b013e32833c30e3
更新日期:2010-12-01 00:00:00
abstract::The anti-emetic effects of ondansetron and droperidol were evaluated in 134 ASA Grade I and II female patients, scheduled for laparoscopic cholecystectomy and minor gynaecological laparoscopic surgery, who were randomly assigned to receive ondansetron 4 mg or droperidol 75 micrograms kg-1 intravenously immediately aft...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1046/j.1365-2346.1999.00581.x
更新日期:1999-11-01 00:00:00
abstract:BACKGROUND:Magnesium potentiates the effects of nondepolarising muscle relaxants. However, few studies have used magnesium chloride (MgCl2). Sugammadex reverses neuromuscular block by steroidal nondepolarising muscle relaxants. OBJECTIVES:To assess the effects of MgCl2 on rocuronium-induced neuromuscular blockade and ...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1097/EJA.0000000000000714
更新日期:2018-03-01 00:00:00
abstract::Seventy women who requested epidural pain relief in labour received a continuous epidural infusion at 8 ml h-1, which contained either 0.25% bupivacaine (n = 29), or a mixture of 0.125% bupivacaine and 0.005% alfentanil (n = 31), assigned randomly. Increments of 4 ml 0.25% bupivacaine were given on demand to prevent r...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1993-05-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:The study compared the analgesic efficacy and safety of two preoperatively administered cyclo-oxygenase-2 inhibitors, celecoxib and rofecoxib. METHODS:Ninety adult patients undergoing thyroid surgery were divided into three groups (each n = 30). They were given a single oral dose of placebo, c...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1017/s0265021503000796
更新日期:2003-06-01 00:00:00
abstract:BACKGROUND:Magnesium sulphate is an important adjuvant drug in multimodal anaesthesia. In combination with rocuronium it can enhance neuromuscular blockade (NMB). Limited data exist concerning the effect of magnesium sulphate on the duration of deep or intense NMB and the period of no response. OBJECTIVE(S):To determi...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/EJA.0000000000001003
更新日期:2019-07-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Hypotension, the commonest side-effect of spinal anaesthesia, results from sympathetic denervation. This study compared patient positioning (supine vs. decubitus) on haemodynamic variables during spinal anaesthesia. METHODS:After intravenous crystalloid preloading with 5 mL kg(-1), hyperbaric ...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1017/s0265021505001183
更新日期:2005-09-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Adding various opioids to the local anaesthetic solution administrated intrathecally improves the analgesic potency of spinal analgesia. The purpose of this study was to evaluate the efficacy and safety of intrathecal fentanyl 10 microg added to 15 mg hyperbaric ropivacaine in patients undergoi...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1017/s0265021505000785
更新日期:2005-06-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:We assessed the intraoperative haemodynamic responses and recovery profiles of total intravenous anaesthesia with remifentanil and alfentanil for outpatient surgery. METHODS:Patients in Group 1 (n = 20) received alfentanil 20 microg kg(-1) followed by 2 microg kg(-1) min(-1) intravenously; pat...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1017/s0265021503000115
更新日期:2003-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Low-dose mixture of hyperbaric bupivacaine and fentanyl is commonly used in day-case spinal anaesthesia. Using hyperbaric articaine, the onset may be faster and duration more predictable than with bupivacaine-fentanyl. We compared these two spinal anaesthetics for inguinal herniorrhaphy. METHO...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/EJA.0b013e32834a11be
更新日期:2012-01-01 00:00:00