Abstract:
BACKGROUND:Epidural analgesia (EDA) is known to be an independent risk factor for perioperative hypothermia and its many known adverse effects. Combined general and epidural anaesthesia decreases intraoperative core temperature more rapidly than general anaesthesia alone. Hence, adequate warming procedures are needed for these patients. OBJECTIVE:We evaluated the effects of active skin-surface warming before and/or after initiation of EDA during general anaesthesia as a procedure to prevent perioperative hypothermia. DESIGN:A randomised controlled trial. SETTING:Department of Anaesthesiology in a general hospital in Germany from January 2013 until August 2014. PATIENTS:After obtaining written informed consent, we included 99 adult patients undergoing elective major abdominal surgery under combined general anaesthesia and EDA with an expected duration of surgery of at least 120 min. Patients were excluded if they were under 18 years of age, classified as American Society of Anesthesiologists' physical status 4 or higher or if patients refused EDA. INTERVENTIONS:Patients were randomly assigned to one of three groups and received either only passive insulation, 15 min of active air-forced warming after EDA and before induction of general anaesthesia, or two periods, each of 15 min, of active air-forced warming before and after EDA. Core and skin temperatures were measured at several time points throughout the study. MAIN OUTCOME MEASURES:The primary outcome measure was the incidence of hypothermia on arrival in the ICU. The secondary outcome measure was the incidence of postoperative shivering. In addition, the perioperative change in body core temperature was recorded. RESULTS:Without prewarming (n = 32), 72% of patients became hypothermic (<36°C) at the end of anaesthesia. Fifteen minutes of warming after insertion of the epidural catheter and before initiation of general anaesthesia reduced the incidence of postoperative hypothermia to 6% (n = 33). After two periods of 15 min of warming before and after insertion of the epidural catheter, no patient became hypothermic (n = 34). Prewarming in either 'warming' group prevents the initial temperature drop which was observed in the control group. CONCLUSION:Warming for 15 min before and after initiation of EDA in patients receiving combined anaesthesia is effective in preventing postoperative hypothermia. TRIAL REGISTRATION:This trial was registered with ClinicalTrials.gov (identifier: NCT01795482).
journal_name
Eur J Anaesthesioljournal_title
European journal of anaesthesiologyauthors
Horn EP,Bein B,Broch O,Iden T,Böhm R,Latz SK,Höcker Jdoi
10.1097/EJA.0000000000000369subject
Has Abstractpub_date
2016-05-01 00:00:00pages
334-40issue
5eissn
0265-0215issn
1365-2346journal_volume
33pub_type
杂志文章,随机对照试验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::This study was designed to evaluate the metabolic effects of intrathecal morphine in patients undergoing coronary artery surgery. Ten patients received 4 mg preservative-free morphine in 6 ml saline intrathecally before surgery and were compared with 10 patients anaesthetised in a similar manner, though without intrat...
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:1985-09-01 00:00:00
abstract:BACKGROUND:Lidocaine has actions potentially of benefit during ischaemia-reperfusion. Neutrophils and endothelial cells have an important role in ischaemia-reperfusion injury. METHODS:Isolated human neutrophil CD11b and CD18, and human umbilical vein endothelial cell (HUVEC) ICAM-1 expression and supernatant IL-1beta ...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1017/s0265021504000353
更新日期:2004-12-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:To know whether the application of patient-controlled analgesia devices could be avoided if intrathecal morphine is given in combination with spinal anaesthesia. METHODS:In a randomized, double-blind multicentre study, 188 orthopaedic patients were randomized to receive intrathecally placebo, ...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1097/EJA.0b013e328329b045
更新日期:2009-08-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:For cannulation of the internal jugular vein (IJV), ultrasound increases the number of first pass successes and reduces the rate of mechanical complications. A frequent complication of IJV access is the accidental injury of the common carotid artery (CCA), which can be dangerous in some circums...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1097/EJA.0b013e328341a492
更新日期:2011-05-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:The electroencephalographic Narcotrend Index was evaluated as a measure of sedation in mechanically ventilated intensive care unit patients. Narcotrend Index and conventional electroencephalography parameter values were compared to the Richmond Agitation-Sedation Scale and a simplified three-le...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1017/S0265021507001329
更新日期:2008-02-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:It has been hypothesized that combinations of analgesics with different mechanisms of action may reduce or even prevent postoperative pain. We, therefore, investigated the analgesic effect of gabapentin, dexamethasone and low-dose ketamine in combination with paracetamol and ketorolac as compar...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/EJA.0b013e328331c71d
更新日期:2010-04-01 00:00:00
abstract::The effects of laryngeal lignocaine spray and/or lignocaine jelly as lubricants were studied on the incidence of sore throat, hoarseness, or tracheal irritability as evidenced by either a tendency to cough or frank coughing after intubation with a Sensiv tube (Searle Medical Products). Pressure in the medium-volume, l...
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:1988-11-01 00:00:00
abstract::Two patients presented with very different signs of central anticholinergic syndrome following general anaesthesia for which they had received premedication with hyoscine. Both responded dramatically to 1 mg of intravenous (i.v.) physostigmine, which produced a rapid return to a normal level of consciousness. The aeti...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1046/j.1365-2346.1997.00128.x
更新日期:1997-07-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:The aim of this prospective, randomized, double-blind investigation was to assess the dose-effect characteristics of postoperative nausea and vomiting after intrathecal administration of small doses of morphine (from 0.015 to 0.25 mg) in opioid-naïve, non-surgical patients. METHODS:With Ethic ...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1017/S026502150600038X
更新日期:2006-07-01 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::A 6-month-old boy with Sturge-Weber syndrome was scheduled for congenital glaucoma and left buphthalmus surgery. Physical examination revealed haemangioma throughout the right trigeminal nerve, congenital glaucoma, left megalocornea and bilateral buphthalmus. Examination of the eye was performed under general anaesthe...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1046/j.1365-2346.1999.00472.x
更新日期:1999-05-01 00:00:00
abstract:BACKGROUND:Neuropathic pain following surgery could be a useful model for the study of the genetic mechanisms of peripheral neuropathic pain. OBJECTIVE:The aim of this study was to identify genetic predictors of persistent postsurgical neuropathic pain. DESIGN:An ancillary study from a prospective cohort. SETTING:Ei...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,多中心研究
doi:10.1097/EJA.0000000000000986
更新日期:2019-05-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Robot-assisted prostatectomy requires pneumoperitoneum in a steep Trendelenburg position, which may induce endobronchial intubation or accidental extubation. The aim of the study was to evaluate the effect of pneumoperitoneum in 30 degrees Trendelenburg position on the displacement of the trach...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1097/EJA.0b013e328333d587
更新日期:2010-05-01 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::In anaesthetized dogs, stellate ganglion blockade led to a moderate disturbance in left ventricular diastolic function. We investigated the effect of a left-sided block, following injection of 10 mL bupivacaine 0.5%, on echocardiographic variables of ventricular function in eight otherwise healthy patients with sympat...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1046/j.1365-2346.2000.00606.x
更新日期:2000-02-01 00:00:00
abstract:BACKGROUND:Neostigmine is widely used to antagonise residual paralysis. Over the last decades, the benchmark of acceptable neuromuscular recovery has increased progressively to a train-of-four (TOF) ratio of at least 0.9. Raising this benchmark may impact on the efficacy of neostigmine. OBJECTIVE(S):The systematic rev...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1097/EJA.0000000000000741
更新日期:2018-03-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:The anaesthetic method for intracranial neurosurgery must provide haemodynamic stability on emergence and allow early evaluation of the neurological status. In this study, we examined the effects of the alpha-2 agonist dexmedetomidine given at the end of the procedure to prevent hyperdynamic re...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1017/S0265021508004201
更新日期:2008-10-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:General anaesthesia may contribute to postoperative cognitive decline in the elderly. The aim was to determine the effects of repeated pentobarbital anaesthesia throughout life on central cholinergic function in the rat. METHODS:Young Lewis rats were randomly allocated to two groups. The anaes...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1017/s0265021503000176
更新日期:2003-02-01 00:00:00
abstract:BACKGROUND:Pre-operative carbohydrate loading has been shown to reduce pre-operative discomfort and postoperative nausea and vomiting in general surgical patients. Few studies have considered day-case surgery. OBJECTIVE:The aim of this prospective randomised study was to determine whether pre-operative carbohydrate lo...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/EJA.0000000000001002
更新日期:2019-08-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Alpha-2 agonists offer useful effects that make these drugs an interesting alternative for pharmacological premedication. METHODS:In a randomized, double-blind study, effects of clonidine (150 microg orally), midazolam (7.5 mg orally) and placebo administered 60-90 min prior to estimated anae...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/EJA.0b013e32832a0c7c
更新日期:2009-07-01 00:00:00
abstract::The analgesic, respiratory and haemodynamic effects of epidural sufentanil 75 micrograms (Group 1) or sufentanil 75 micrograms with adrenaline 75 micrograms (Group 2) were studied in 20 patients following abdominal surgery in a double-blind randomized trial. Pain relief, assessed on a linear analogue scale, sedation, ...
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:1988-05-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:To determine the visibility of pleural lung sliding in alveolar-interstitial syndrome (AIS) in patients on mechanical ventilation at two different time points, as a confirmatory ultrasonographic method for excluding pneumothorax. METHODS:Fifty-two mechanically ventilated patients in the semir...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1097/EJA.0b013e32833feb40
更新日期:2011-04-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Early recovery after anaesthesia is gaining importance in fast track management. The aim of this study was to quantify psychomotor recovery within the first 24 h after propofol/remifentanil anaesthesia using the Short Performance Test (Syndrom Kurztest (SKT)), consisting of nine subtests. The ...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1017/S0265021506001530
更新日期:2007-04-01 00:00:00
abstract:BACKGROUND:Postoperative pneumonia is associated with increased morbidity, mortality and costs. Prediction models of pneumonia that are currently available are based on retrospectively collected data and administrative coding systems. OBJECTIVE:To identify independent variables associated with the occurrence of postop...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,多中心研究
doi:10.1097/EJA.0000000000000921
更新日期:2019-02-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:The aim of study was to investigate the electron microscopic changes in the medulla of the spinal cord that occur with intrathecal midazolam administration. METHODS:Twenty-eight albino rabbits of New Zealand type were randomized into two groups. Following anaesthesia, 16 rabbits were given 300...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1017/S0265021505001547
更新日期:2005-12-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Astrocytes exposed to hypoxia produce pro-inflammatory cytokines and upregulate intercellular adhesion molecule-1 on cerebral endothelium. This study investigated the effects of midazolam on this response. METHODS:Mouse astrocytes were exposed to 4 h of hypoxia and 24 h of reoxygenation. Astro...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1017/S0265021506000652
更新日期:2006-09-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:The aim of this study was to compare a cerebral oximeter with transcranial Doppler (TCD) as a neurological monitor in patients undergoing carotid endarterectomy under regional anaesthesia. METHODS:Forty patients were enrolled for this prospective study. We recorded every adverse neurological e...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1097/EJA.0b013e32832b89c2
更新日期:2009-08-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Statins are prescribed for patients with hypercholesterolemia. Atorvastatin is metabolized by cytochrome P4503A4 and inhibits P4503A4 activity in vitro. Alfentanil is a potent opioid used in clinical anaesthetic practice and is also metabolized by P4503A4. This study tested the hypothesis that ...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章
doi:10.1017/s0265021503001078
更新日期:2003-08-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:The importance of monitoring the breathing pattern during sedation of children undergoing magnetic resonance scans is indicated in guidelines, but no appropriate magnetic resonance-compatible devices are available. We report preliminary findings from a technique referred to as remote pressure s...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1017/S0265021507000312
更新日期:2007-09-01 00:00:00