Abstract:
BACKGROUND:Use of dipyrone (metamizole) in perioperative and ICU pain therapy remains controversial due to a lack of solid evidence weighing dipyrone benefit against its potential life-threatening complications. Although dipyrone has known analgesic and antipyretic properties, its mechanisms of actions are incompletely understood. Although dipyrone effects on renal vasodilator prostaglandin synthesis are documented, little is known about its potential renal side effects, especially in the critical care environment. OBJECTIVE:Investigation of the perioperative nephrotoxic potential of dipyrone in patients prone to acute kidney injury (AKI). DESIGN:Retrospective cohort study. SETTING:Single centre study in a tertiary referral hospital from January 2013 until June 2013. PATIENTS:A total of 500 consecutive patients aged 18 years and older referred to the anaesthesia ICU. Patients were excluded if admitted from or discharged to other ICUs, if referred for post resuscitation care, or if repeatedly admitted to the ICU. MAIN OUTCOME MEASURES:Incidence of AKI, as defined by the Kidney Disease: Improving Global Outcomes Acute Kidney Injury Work Group criteria, and duration of vasopressor therapy. RESULTS:Use of dipyrone was associated with an increased incidence of AKI in a dose-dependent manner with a 1.6-fold increase in the incidence of AKI with each additional gram of intravenous dipyrone per day. Dipyrone dose of more than 2.5 g day was the best risk predictive cut-off for AKI. Patients receiving dipyrone on the ICU presented with a prolonged duration of vasopressor therapy. CONCLUSION:Increasing dipyrone dosage is a potential independent risk factor for AKI in adult ICU patients and may prolong vasopressor therapy. Clinical evidence for a benefit of dipyrone therapy in the ICU is insufficient and needs further critical evaluation.
journal_name
Eur J Anaesthesioljournal_title
European journal of anaesthesiologyauthors
Stueber T,Buessecker L,Leffler A,Gillmann HJdoi
10.1097/EJA.0000000000000627subject
Has Abstractpub_date
2017-10-01 00:00:00pages
673-680issue
10eissn
0265-0215issn
1365-2346journal_volume
34pub_type
杂志文章abstract::We have examined the effect of propofol on the neutrophil respiratory burst. Chemiluminescence was used as a measure of the respiratory burst following stimulation with 10(-5) M N-formyl-L-methionyl-L-leucyl-L-phenylalanine. Propofol 1.25, 2.5 and 5.0 x 10(-5) M inhibited neutrophil chemiluminescence by 29.6, 43.0 and...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1046/j.1365-2346.1996.00003.x
更新日期:1996-09-01 00:00:00
abstract::Patients about to undergo a suspension laryngoscopy were randomly assigned to one of two groups (n = 10). They were given either etomidate 1 mg kg-1 followed by 1 mg kg-1 h-1, or propofol 2.5 mg kg-1 followed by 9 mg kg-1 h-1. Alfentanil 10 micrograms kg-1 was given to provide analgesia with a further half dose if nec...
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:1991-03-01 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:BACKGROUND AND OBJECTIVE:The quality of combined spinal-epidural anaesthesia mainly depends on accurate identification of the epidural space. The real-time ultrasound control of the procedure for puncture was therefore evaluated. METHODS:Thirty parturients scheduled for Caesarean section were randomized to three equal...
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/s026502150400105x
更新日期:2004-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:The effects of bicarbonated Ringer's solution were evaluated and compared with those of acetated Ringer's, lactated Ringer's and Ringer's solutions in partially hepatectomized rabbits. METHOD:Animals were randomly divided into six groups (n = 6 in each group): a sham-operated group, an operate...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1017/s0265021505001043
更新日期:2005-08-01 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::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:Continuous spinal analgesia (CSA) offers considerable pain relief, and has been used in various procedures such as for surgery and cancer pain control. In Japan, portable and disposable infusion kits are increasingly employed for continuous epidural analgesia and CSA. In CSA, the use of a micro...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1017/s0265021504000183
更新日期:2004-11-01 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:The objective of this study was to determine the intracranial, cardiovascular and respiratory changes induced by conversion to high-frequency oscillator ventilation from conventional mechanical ventilation at increasing airway pressures. METHODS:In this study, 11 anaesthetized sheep had invasive cardiovascu...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1017/S0265021506002006
更新日期:2007-05-01 00:00:00
abstract:BACKGROUND:Acute neuropathic pain can occur in the postoperative period but any link with persistent post-surgical neuropathic pain remains unclear. OBJECTIVES:The objectives of this study were to prospectively describe the incidence of acute post-surgical neuropathic pain in a large population using the DN4 (clinicia...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1097/EJA.0000000000000634
更新日期:2017-10-01 00:00:00
abstract::Fourteen fit young patients undergoing body surface surgery received an infusion of alfentanil at either 50 or 100 micrograms kg-1 hr-1 to supplement nitrous oxide anaesthesia. The alfentanil infusion was continued for two hours post-operatively at the lower rate of 20 micrograms kg-1 hr-1. Resting ventilation, carbon...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章
doi:
更新日期:1987-05-01 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:In this prospective, randomized, double-blind, controlled study, we investigated the sensory, motor and analgesic block characteristics of S(+) ketamine, fentanyl and saline given intrathecally (IT) in addition to 0.5% plain bupivacaine (10 mg) for spinal analgesia. METHODS:Ninety ASA I or II adult patients...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1017/S0265021506000950
更新日期:2006-12-01 00:00:00
abstract:BACKGROUND:Better understanding of risk factors for adverse events during monitored anaesthesia care (MAC) for paediatric gastrointestinal endoscopy may improve outcome in children. OBJECTIVES:To identify the prevalence and predictors of adverse events during MAC for paediatric endoscopy. DESIGN:An observational stud...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1097/EJA.0000000000000995
更新日期:2019-06-01 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:BACKGROUND AND OBJECTIVE:the objective of this study was to assess whether antiemetic drugs metoclopramide and diphenhydramine, administered together as opposed to alone, can have better efficacy in preventing postoperative nausea and vomiting when added to patient-controlled morphine analgesia. PATIENTS AND METHODS:d...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/EJA.0b013e32833f53b8
更新日期:2010-12-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:The aim of this prospective study was to compare the effect of the administration of desflurane or sevoflurane to a fixed neuromuscular block. METHODS:After written consent, 12 patients were anaesthetized with propofol and sufentanil. Atracurium was administered via a continuous infusion in or...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1017/S0265021506000706
更新日期:2006-09-01 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
abstract:BACKGROUND:Stress in anaesthesiologists is a common and multifactorial problem related to patients, colleagues and organisations. The consequences of stress include depression, work-home conflicts and burnout. Reduction in stress can be achieved by reducing the number and magnitude of stressors or by increasing resilie...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1097/EJA.0000000000000518
更新日期:2016-11-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:It has been demonstrated that volatile anaesthetics have cardioprotective properties during open-heart procedures, especially when administered continuously. European Council Directive 93/42/EEC concerning medical devices bans the supplementary incorporation of anaesthetic vaporizers in the byp...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1017/S0265021507001330
更新日期:2008-02-01 00:00:00
abstract:BACKGROUND:Near-infrared spectroscopy estimates cerebral regional tissue oxygen saturation (rSO2), which may decrease under hyperventilation. Propofol and sevoflurane act differently on cerebral blood vessels. Consequently, cerebral blood flow during hyperventilation with propofol and sevoflurane anaesthesia may differ...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/EJA.0000000000000507
更新日期:2016-12-01 00:00:00
abstract:BACKGROUND:Pulse pressure variation (PPV) is a well known dynamic preload indicator of fluid responsiveness. However, its usefulness in open-chest conditions remains controversial. OBJECTIVE:We evaluated whether augmented PPV during a Valsalva manoeuvre can predict fluid responsiveness after sternotomy. DESIGN:A pros...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章
doi:10.1097/EJA.0000000000000613
更新日期:2017-05-01 00:00:00
abstract::This paper focuses on the potential role of second messenger systems as general anaesthetic targets. Intracellular free calcium, cyclic nucleotides (cAMP, cGMP), inositol polyphosphates, the protein kinase-activating second messenger diacylglycerol, and the transducing G proteins involved in receptor-coupled second me...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,评审
doi:
更新日期:1995-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:We investigated the following aspects of pharmacokinetic-guided total intravenous anaesthesia with remifentanil and propofol in patients undergoing surgical myocardial revascularization: anaesthetic efficacy, haemodynamic effects, impact on extubation of the trachea and analgesia after operatio...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1017/s0265021503000589
更新日期:2003-05-01 00:00:00
abstract:BACKGROUND:The use of noradrenaline to enable a restrictive approach to intra-operative fluid therapy to avoid salt and water overload has gained increasing acceptance. However, concerns have been raised about the impact of this approach on renal function. OBJECTIVES:To identify risk factors for acute kidney injury (A...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1097/EJA.0000000000000808
更新日期:2018-09-01 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:Intrathecal ketamine produces a short period of analgesia with stable haemodynamics. Midazolam with bupivacaine prolongs the duration of analgesia when administered intrathecally but does not prevent hypotension. The objective of this study was to assess the effect of a combination of intrathecal bupivacaine...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1017/S0265021507002645
更新日期:2008-04-01 00:00:00
abstract::The effect of the duration of stabilization of control responses on the onset and duration of clinical relaxation of suxamethonium 1 mg kg-1 and rocuronium 0.6 mg kg-1 were investigated in 90 patients. The control responses were allowed to stabilize for 1, 5, 10, 15 or 20 min prior to administration of rocuronium and ...
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.1365-2346.1996.d01-379.x
更新日期:1996-07-01 00:00:00
abstract:BACKGROUND:Minimising rocuronium administration during paediatric surgery helps to reduce the incidence of residual muscular blockade. OBJECTIVE:To determine whether intermittent bolus injection (Bolus group) or continuous infusion (group) requires the lesser amount of rocuronium. DESIGN:A randomised, single-blind co...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/EJA.0000000000000934
更新日期:2019-03-01 00:00:00