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 primary anaesthetic. The EEG spectrum and coherence were estimated throughout a 2 min period of stable anaesthetic maintenance. Age-related effects were characterized by analysing power and coherence as a function of age using linear regression and by comparing the power spectrum and coherence in young (18- to 38-yr-old) and elderly (70- to 90-yr-old) patients. RESULTS:Power across all frequency bands decreased significantly with age for both propofol and sevoflurane; elderly patients showed EEG oscillations ∼2- to 3-fold smaller in amplitude than younger adults. The qualitative form of the EEG appeared similar regardless of age, showing prominent alpha (8-12 Hz) and slow (0.1-1 Hz) oscillations. However, alpha band dynamics showed specific age-related changes. In elderly compared with young patients, alpha power decreased more than slow power, and alpha coherence and peak frequency were significantly lower. Older patients were more likely to experience burst suppression. CONCLUSIONS:These profound age-related changes in the EEG are consistent with known neurobiological and neuroanatomical changes that occur during typical ageing. Commercial EEG-based depth-of-anaesthesia indices do not account for age and are therefore likely to be inaccurate in elderly patients. In contrast, monitoring the unprocessed EEG and its spectrogram can account for age and individual patient characteristics.
journal_name
Br J Anaesthjournal_title
British journal of anaesthesiaauthors
Purdon PL,Pavone KJ,Akeju O,Smith AC,Sampson AL,Lee J,Zhou DW,Solt K,Brown ENdoi
10.1093/bja/aev213subject
Has Abstractpub_date
2015-07-01 00:00:00pages
i46-i57eissn
0007-0912issn
1471-6771pii
S0007-0912(17)31009-7journal_volume
115 Suppl 1pub_type
杂志文章abstract::The analgesic effects of an identical inguinal field block, performed before or immediately after inguinal herniorrhaphy, were evaluated in 32 healthy patients in a double-blind, randomized study. During surgery, all patients received a light general anaesthesia with thiopentone, alfentanil and nitrous oxide in oxygen...
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/68.4.344
更新日期:1992-04-01 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:BACKGROUND:Malposition of tracheostomy tubes is difficult to detect at the bedside and may contribute to eventual device misplacement. Endoscopic examination can be undertaken via tracheoscopic (T-view) or trans-laryngeal (L-view) approach, offering more precise detail regarding positioning within the airway. The aims ...
journal_title:British journal of anaesthesia
pub_type: 评论,信件
doi:10.1093/bja/aew336
更新日期:2017-01-01 00:00:00
abstract:BACKGROUND:With the increasing prevalence of children who are overweight and with obesity, anaesthesiologists must determine the optimal dosing of medications given the altered pharmacokinetics and pharmacodynamics in this population. We therefore determined the single dose of dexmedetomidine that provided sufficient s...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1016/j.bja.2020.11.037
更新日期:2021-01-22 00:00:00
abstract::We have compared, in a randomized, double-blind study, the pharmacokinetics of ropivacaine and bupivacaine during labour. Total and free plasma concentrations of ropivacaine and bupivacaine were measured after the first of two extradural doses. The main dose was 20 mg (test dose) and 30 mg, with a top-up dose of 25 mg...
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/79.5.558
更新日期:1997-11-01 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:BACKGROUND:There are no published data to predict tracheostomy tube size as growth proceeds in children requiring long-term ventilation. METHODS:A retrospective audit was undertaken of children having long-term ventilation, managed from the Southport spinal injuries unit. The dates of step-up in size of tracheostomy t...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aeh296
更新日期:2005-01-01 00:00:00
abstract::Skills related to driving, the ability to discriminate the fusion of flickering light, and hand and foot proprioception, were measured double-blind in 34 healthy volunteers before and after three doses of i.v. diazepam. The effects of diazepam were most harmful to co-ordination. With 0.15 mg/kg, 0.30 mg/kg and 0.45 mg...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/47.4.457
更新日期:1975-04-01 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::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:Plethysmographic variability index (PVI) is an accurate predictor of fluid responsiveness in mechanically ventilated patients. However, the site of measurement of the plethysmographic waveform impacts its morphology and its respiratory variation. The goal of this study was to investigate the ability of PVI t...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aer165
更新日期:2011-09-01 00:00:00
abstract::A 39-year-old male suffered a closed chest deceleration injury. He presented with clinical and radiological signs consistent with trauma to the thoracic aorta, but also developed sinus bradycardia which was relieved by drainage of a haemothorax. The possible mechanisms of the changes in heart rate are discussed and di...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/72.3.358
更新日期:1994-03-01 00:00:00
abstract:BACKGROUND:The effect of anaesthetic drugs on long-term oncological outcomes after cancer surgery is an area of current interest. Dexamethasone is widely used in anaesthetic practice; however, its effect on long-term survival and cancer outcomes is not known. This study presents the results of a 5-yr follow-up of patie...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aet577
更新日期:2014-07-01 00:00:00
abstract:BACKGROUND:There has been a renewed interest in nitric oxide donor drugs, such as nitroglycerin, delivered by the inhalational route for treatment of pulmonary arterial hypertension (PAH). We investigated the acute effects of inhaled nitroglycerin on pulmonary and systemic haemodynamics in children with PAH associated ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/ael112
更新日期:2006-08-01 00:00:00
abstract::Relative humidity of air produced by simple compressors used to drive ventilators was measured at different working pressures. At normal working pressures, a relative humidity of 100% was found and condensation occurred, mainly at the high pressure air/oxygen mixer valve. This resulted in blockages and loss of accurac...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/53.5.549
更新日期:1981-05-01 00:00:00
abstract:BACKGROUND:The therapeutic potential of cardiac μ-opioid receptors in ischaemia-reperfusion (I/R) injury during opioid-modulating diseases, such as heart failure, is unknown. We aimed to explore the changes of cardiac μ-opioid receptor expression during heart failure, and its role in opioid-induced cardioprotection. M...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1016/j.bja.2017.11.110
更新日期:2018-07-01 00:00:00
abstract:BACKGROUND:We investigated the effects of total i.v. anaesthesia (TIVA) and balanced anaesthesia (BAL) with sevoflurane on postoperative lung function in patients undergoing surgery in the prone position. METHODS:Sixty patients, aged 21-60 yr, undergoing elective lumbar disc surgery in the prone position were randomly...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aeq321
更新日期:2011-02-01 00:00:00
abstract:BACKGROUND:The aim of this study was to determine the prevalence of postoperative nausea and vomiting (PONV) after fast-track cardiac anaesthesia, risk factors for PONV and its influence on the length of stay in the intensive care unit (ICU). METHODS:A prospective study was performed in the cardiothoracic ICU (CTICU) ...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/aeg166
更新日期:2003-08-01 00:00:00
abstract::In 1849 John Snow, already the leading anaesthetic practitioner and innovator of his day, made a historic contribution to the epidemiology of infectious disease by his famous study of the distribution of cholera around the area of Broad Street in London. We report on our experience as anaesthetists in a field hospital...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/75.6.810
更新日期:1995-12-01 00:00:00
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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:BACKGROUND:Muscle relaxants facilitate tracheal intubation, but they are often not used for short peripheral surgical procedures. The consequences of this practice on the upper airway are still a matter of controversy. We therefore compared the incidence of post-intubation symptoms in a randomized study comparing patie...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aem147
更新日期:2007-08-01 00:00:00
abstract:BACKGROUND:There are regional differences in the effects of anaesthetics agents and perioperative stimuli on the EEG. We studied the topography of the EEG during induction of anaesthesia and intubation in patients receiving thiopental and fentanyl to document regional electrical brain activity. METHODS:EEG was recorde...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aeh020
更新日期:2004-01-01 00:00:00
abstract::The effect of the combination of opiates and hypnotics on bispectral index (BIS) is unclear. This double-blind placebo-controlled trial investigated the effect on BIS and sedation of different infusion doses of remifentanil combined with a steady infusion of propofol. Forty patients initially received a target-control...
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/oxfordjournals.bja.a013474
更新日期:2000-04-01 00:00:00
abstract::We report a case of lumbar extradural abscess that presented 9 days after an elective Caesarean section performed under combined spinal-extradural anaesthesia. This was successfully treated conservatively with full recovery. The clinical course included development, and then resolution, of mild paraparesis. Conservati...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/78.5.591
更新日期:1997-05-01 00:00:00
abstract::We have investigated the value of lower oesophageal contractility (LOC) in detecting awareness during anaesthesia in 20 human volunteer patients. LOC was measured either with subjects awake or after induction with propofol, during induction with propofol, and then as consciousness returned. Statistically significant c...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/65.3.319
更新日期:1990-09-01 00:00:00
abstract::To understand the cellular and molecular basis of the anaesthetic state, it is important to remember that, in the intact CNS, synapses operate within elaborate nerve networks. From the data presented above, it is evident that block of impulse conduction in presynaptic fibres does not explain the effects of most anesth...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/71.1.134
更新日期:1993-07-01 00:00:00
abstract::In obstetric patients undergoing postpartum tubal ligation, we found that metoclopramide produced dose-dependent prolongation of suxamethonium-induced neuromuscular block. Mean block times after suxamethonium 1 mg kg-1 were 8.0 min, 9.83 min and 12.45 min for control and metoclopramide 10 mg and metoclopramide 20 mg g...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/65.2.220
更新日期:1990-08-01 00:00:00
abstract::The problems of selection of tracheal tubes, and the need for a rationale, are outlined. Tracheal tubes of 7.5 mm and 8.5 mm i.d. are recommended for female and male patients, respectively. Tracheal size was determined using high pressure-low volume cuffs as measuring devices. The average diameter of the cuff at seal ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/58.1.111
更新日期:1986-01-01 00:00:00
abstract:BACKGROUND:Positive end-expiratory pressure (PEEP) is widely used to improve oxygenation and prevent alveolar collapse in mechanically ventilated patients with the acute respiratory distress syndrome (ARDS). Although PEEP improves arterial oxygenation predictably, high-PEEP strategies have demonstrated equivocal improv...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aew314
更新日期:2016-11-01 00:00:00
abstract::The 119 patients who had undergone previous Caesarean section lumbar extradural block was administered to 77 (65%); the other 42 (35%) received analgesia with ketobemidone 0.8-1.0 ml i.m. or nitrous oxide in oxygen intermittently, or both. Controlled i.v. infusion of oxytocin for induction or acceleration of labour wa...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/52.8.827
更新日期:1980-08-01 00:00:00