Abstract:
BACKGROUND:Overt stroke after non-cardiac surgery has a substantial impact on the duration and quality of life. Covert stroke in the non-surgical setting is much more common than overt stroke and is associated with an increased risk of cognitive decline and dementia. Little is known about covert stroke after non-cardiac, non-carotid artery surgery. METHODS:We undertook a prospective, international cohort study to determine the incidence of covert stroke after non-cardiac, non-carotid artery surgery. Eligible patients were ≥65 yr of age and were admitted to hospital for at least three nights after non-cardiac, non-carotid artery surgery. Patients underwent a brain magnetic resonance study between postoperative days 3 and 10. The main outcome was the incidence of perioperative covert stroke. RESULTS:We enrolled a total of 100 patients from six centres in four countries. The incidence of perioperative covert stroke was 10.0% (10/100 patients, 95% confidence interval 5.5-17.4%). Five of the six centres that enrolled patients reported an incident covert stroke, and covert stroke was found in patients undergoing major general (3/27), major orthopaedic (3/41), major urological or gynaecological (3/22), and low-risk surgery (1/12). CONCLUSIONS:This international multicentre study suggests that 1 in 10 patients ≥65 yr of age experiences a perioperative covert stroke. A larger study is required to determine the impact of perioperative covert stroke on patient-important outcomes. CLINICAL TRIAL REGISTRATION:NCT01369537.
journal_name
Br J Anaesthjournal_title
British journal of anaesthesiaauthors
Mrkobrada M,Hill MD,Chan MT,Sigamani A,Cowan D,Kurz A,Sessler DI,Jacka M,Graham M,Dasgupta M,Dunlop V,Emery DJ,Gulka I,Guyatt G,Heels-Ansdell D,Murkin J,Pettit S,Sahlas DJ,Sharma M,Sharma M,Srinathan S,St John Pdoi
10.1093/bja/aew179subject
Has Abstractpub_date
2016-08-01 00:00:00pages
191-7issue
2eissn
0007-0912issn
1471-6771pii
S0007-0912(17)33834-5journal_volume
117pub_type
杂志文章,多中心研究abstract:BACKGROUND:Moderate to deep sedation has been recommended during endoscopic submucosal dissection (ESD). However, it is often accompanied by adverse events such as respiratory depression or aspiration pneumonia. This study investigated the respiratory complications and ESD outcomes of two sedation protocols: moderate s...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aeu555
更新日期:2015-07-01 00:00:00
abstract::The analgesic effects of buprenorphine 2 microgram/kg--1 and 8 microgram. kg--1 were compared with those of pethidine 1 mg. kg--1 and pentazocine 0.6 mg.kg--1 in 172 patients recovering from surgery. The drugs were given by i.m. injection in the period immediately after operation and the quality of pain relief was ass...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/49.9.913
更新日期:1977-09-01 00:00:00
abstract:BACKGROUND:The second gas effect (SGE) is considered to be significant only during periods of large volume N(2)O uptake (VN(2)O); however, the SGE of small VN(2)O has not been studied. We hypothesized that the SGE of N(2)O on sevoflurane would become less pronounced when sevoflurane administration is started 60 min aft...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/ael008
更新日期:2006-03-01 00:00:00
abstract::Several risk scores have been developed to calculate the probability of postoperative nausea and vomiting (PONV). However, the power to discriminate which individual will suffer from PONV is still limited. Thus, we wondered how the number of predictors in a score affects the discriminating power and how the characteri...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/86.6.822
更新日期:2001-06-01 00:00:00
abstract::Abnormal oxygen use and organ failure in the critically ill may result from 'poisoning' of mitochondrial function. Measurement of arterial ketone body ratio (AKBR) has been proposed to reflect mitochondrial redox state and may provide a useful marker to monitor mitochondrial function in the critically ill. We measured...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/83.2.325
更新日期:1999-08-01 00:00:00
abstract:BACKGROUND:Intraperitoneal insufflation of carbon dioxide (CO2) may promote collapse of dependent lung regions. The present study was undertaken to study the effects of CO2-pneumoperitoneum (CO2-PP) on atelectasis formation, arterial oxygenation, and arterial to end-tidal PCO2-gradient (Pa-E'(CO2)). METHODS:Fifteen an...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aep102
更新日期:2009-08-01 00:00:00
abstract::We have compared the anaesthetic and analgesic efficacy of levobupivacaine with that of racemic bupivacaine in 66 male patients undergoing ambulatory primary inguinal herniorrhaphy. Patients were allocated randomly in a double-blind manner to local infiltration anaesthesia (0.25% w/v 50 ml) with either racemic bupivac...
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/82.2.280
更新日期:1999-02-01 00:00:00
abstract:BACKGROUND:We investigated the extent and frequency of dose errors and treatment delays made as a consequence of preparing drug infusions at the bedside, rather than using pre-filled syringes. METHODS:Forty-eight nurses with critical care experience volunteered to take part in this randomized, blinded, controlled stud...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aes257
更新日期:2012-11-01 00:00:00
abstract::We describe a six-compartment physiological model of the kinetics and dynamics of induction of anaesthesia with propofol in sheep. It includes a faithful description of initial bolus kinetics caused by accurate representations of the inter-relationships between initial vascular mixing, lung kinetics and cardiac output...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/79.4.497
更新日期:1997-10-01 00:00:00
abstract:BACKGROUND:Axillary vein catheterization via a distal approach is an alternative to the proximal approach to axillary/subclavian vein catheterization under ultrasound (US) guidance. The aim of this trial was to compare the two approaches. METHODS:In a randomized single-centre study, all patients requiring central vein...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aev458
更新日期:2016-02-01 00:00:00
abstract::Cobra venom consists of a neurotoxin which is responsible for respiratory paralysis simulating that associated with a non-depolarizing muscle relaxant. A combination of artificial respiration and neostigmine has been useful in resuscitating a child bitten by a snake. ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/49.10.1065
更新日期:1977-10-01 00:00:00
abstract:BACKGROUND:The significance of IgE antibodies to neuromuscular blocking agent (NMBA)-induced anaphylactic reactions during anaesthesia is unclear. We investigated the relevance of IgE to rocuronium using an in vitro technique. METHODS:Serum samples from 61 patients with anaphylactic reactions during anaesthesia were i...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aer028
更新日期:2011-05-01 00:00:00
abstract:BACKGROUND:Microalbuminuria, often referred to as the urinary albumin-creatinine ratio (ACR), is thought to be a reflection of increased capillary permeability associated with the systemic inflammatory response syndrome, and has been found to be predictive of outcome in several studies. Therefore, we explored the usefu...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/ael211
更新日期:2006-10-01 00:00:00
abstract::We have studied haemodynamic responses to 0, 0.25, 0.5, 0.75 and 1 MAC isoflurane administration in 10 patients during a zero-order propofol infusion and normocapnia. Isoflurane reduced mean arterial pressure (MAP), systemic vascular resistance and left ventricular stroke work in a dose-dependent manner (29%, 38% and ...
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/69.1.36
更新日期:1992-07-01 00:00:00
abstract::A series of 443 spinal anaesthetics is described. The procedures included operative vaginal delivery, removal of retained placenta and a miscellaneous group common to most obstetric units. Failure to provide effective relief of pain occurred in 5.2% of patients. There was one potentially serious complication, but with...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/51.6.531
更新日期:1979-06-01 00:00:00
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journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/58.9.947
更新日期:1986-09-01 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::The arterial to end-tidal PCO2 difference (PaCO2-PE'CO2) was measured in five anaesthetized dogs during controlled ventilation at 0.25 Hz (15 b.p.m.) and during high frequency jet ventilation at 1, 3 and 5 Hz. Because of the slow response of the infra-red carbon dioxide analyser, satisfactory recordings of end-tidal c...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/59.2.240
更新日期:1987-02-01 00:00:00
abstract::A new anaesthetic gas scavenging system is described. The resistance of the system appears to be low. When input gas flow rate in the system was zero or 150 litre min-1, misuse of the system produced pressure changes at its collecting points of 26 Pa subatmospheric and 630 Pa above atmospheric pressure, respectively. ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/55.7.681
更新日期:1983-07-01 00:00:00
abstract::The effect of ketamine analgesia on gastric emptying was assessed in five healthy volunteers. Gastric emptying, estimated indirectly by the absorption of orally administered paracetamol, was not significantly delayed following administration of i.m. ketamine when compared with placebo. ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/53.12.1321
更新日期:1981-12-01 00:00:00
abstract::An extradural catheter was inserted at the third lumbar interspace for relief of pain during labour in a 21-year-old gravid patient. Attempts to withdraw the catheter met with resistance and produced severe pain in the distribution of the second left lumbar nerve. Radiography revealed an acutely angled loop of the cat...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/55.5.473
更新日期:1983-05-01 00:00:00
abstract:BACKGROUND:Mechanosensory thalamocortical relay neurones (TCNs) receive glutamatergic excitatory input and are subjected to gamma-aminobutyric acid (GABA)Aergic inhibitory input. This study assessed the effects of an increase in concentration of isoflurane on thalamic excitatory and inhibitory mechanisms. METHODS:TCNs...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aef170
更新日期:2002-08-01 00:00:00
abstract::The effects of i.m. dexmedetomidine 1.0 micrograms kg-1, a new alpha 2-adrenoceptor agonist, were compared with those of i.m. midazolam 0.08 mg kg-1 and placebo on vigilance, anaesthetic requirements, haemodynamic state and plasma catecholamine concentrations in a double-blind placebo-controlled study in 107 healthy (...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1991-10-01 00:00:00
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journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aew421
更新日期:2017-02-01 00:00:00
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journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aer162
更新日期:2011-10-01 00:00:00
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journal_title:British journal of anaesthesia
pub_type: 杂志文章,多中心研究
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更新日期:2020-02-01 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
abstract::A simple method of adapting a pressure-cycled ventilator of the flow generator type to ventilate patients on a circle-absorber anaesthetic system is described. Standard lengths of corrugated black rubber tubing are placed between the ventilator and the circle-absorber is deadspace, replacing the reservoir bag. The per...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/49.3.273
更新日期:1977-03-01 00:00:00
abstract:BACKGROUND:Inconsistent and poorly coordinated systems of tracheostomy care commonly result in frustrations, delays, and harm. Quality improvement strategies described by exemplar hospitals of the Global Tracheostomy Collaborative have potential to mitigate such problems. This 3 yr guided implementation programme inves...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,多中心研究
doi:10.1016/j.bja.2020.04.064
更新日期:2020-07-01 00:00:00
abstract:BACKGROUND:High-dose glucocorticoid may reduce postsurgical pain and improve recovery. We hypothesized that 125 mg methylprednisolone (MP) would reduce time to meet functional discharge criteria after total hip arthroplasty (THA). METHODS:Forty-eight patients undergoing unilateral THA under spinal anaesthesia were con...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aes345
更新日期:2013-01-01 00:00:00