Abstract:
Background:Kidney transplantation is associated with harmful processes affecting the viability of the graft. One of these processes is associated with the phenomenon of ischaemia-reperfusion injury. Anaesthetic conditioning is a widely described strategy to attenuate ischaemia-reperfusion injury. We therefore conducted the Volatile Anaesthetic Protection of Renal Transplants-1 trial, a pilot project evaluating the influence of two anaesthetic regimens, propofol- vs sevoflurane-based anaesthesia, on biochemical and clinical outcomes in living donor kidney transplantation. Methods:Sixty couples were randomly assigned to the following three groups: PROP (donor and recipient propofol), SEVO (donor and recipient sevoflurane), and PROSE (donor propofol and recipient sevoflurane). The primary outcome was renal injury reflected by urinary biomarkers. The follow-up period was 2 yr. Results:Three couples were excluded, leaving 57 couples for analysis. Concentrations of kidney injury molecule-1 (KIM-1), N -acetyl-β- d -glucosaminidase (NAG), and heart-type fatty acid binding protein (H-FABP) in the first urine upon reperfusion showed no differences. On day 2, KIM-1 concentrations were higher in SEVO [952.8 (interquartile range 311.8-1893.0) pg mmol -1 ] compared with PROP [301.2 (202.0-504.7) pg mmol -1 ]. This was the same for NAG: SEVO, 1.835 (1.162-2.457) IU mmol -1 vs PROP, 1.078 (0.819-1.713) IU mmol -1 . Concentrations of H-FABP showed no differences. Measured glomerular filtration rate at 3, 6, and 12 months showed no difference. After 2 yr, there was a difference in the acute rejection rate ( P =0.039). Post hoc testing revealed a difference between PROP (35%) and PROSE (5%; P =0.020). The difference between PROP and SEVO (11%) was not significant ( P =0.110). Conclusions:The SEVO group showed higher urinary KIM-1 and NAG concentrations in living donor kidney transplantation on the second day after transplantation. This was not reflected in inferior graft outcome. Clinical trial registration:NCT01248871.
journal_name
Br J Anaesthjournal_title
British journal of anaesthesiaauthors
Nieuwenhuijs-Moeke GJ,Nieuwenhuijs VB,Seelen MAJ,Berger SP,van den Heuvel MC,Burgerhof JGM,Ottens PJ,Ploeg RJ,Leuvenink HGD,Struys MMRFdoi
10.1093/bja/aex057subject
Has Abstractpub_date
2017-05-01 00:00:00pages
720-732issue
5eissn
0007-0912issn
1471-6771pii
S0007-0912(17)31332-6journal_volume
118pub_type
杂志文章,随机对照试验abstract:BACKGROUND:Paravertebral regional anaesthesia is used to treat pain after several surgical procedures. This study aimed to improve on our first published ultrasound-guided approach to the paravertebral space (PVS) and to investigate a possible discrepancy between the needle, catheter, and contrast dye position. METHOD...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aeq309
更新日期:2011-02-01 00:00:00
abstract::We describe an obstetric patient who presented for removal of a retained placenta. After insertion of the spinal anaesthetic, she developed a severe headache, and a subarachnoid haemorrhage was diagnosed. We discuss the differential diagnosis of the headache, the occurrence of intracranial haemorrhages after dural pun...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/86.3.442
更新日期:2001-03-01 00:00:00
abstract:BACKGROUND:State entropy (SE) is a newly available monitor for depth of anaesthesia. We investigated whether the relationship between predicted effect-site propofol concentration and Bispectral Index (BIS) and SE values is useful for predicting loss of verbal contact and loss of consciousness during steady-state condit...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aei075
更新日期:2005-04-01 00:00:00
abstract::The effects of different premedication (i.m. and i.v.) on the usefulness of midazolam or thiopentone as induction agents for minor surgery was studied in 194 women undergoing either dilatation and curettage or explorative fractionate curettage. Midazolam appeared to produce light sedation which required powerful preme...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/54.5.507
更新日期:1982-05-01 00:00:00
abstract::Thirty mothers undergoing elective Caesarean section received thiopentone 3.5 mg kg-1 and 30 received etomidate 0.3 mg kg-1 for induction of anaesthesia. Subsequent management of anaesthesia was identical in both groups. Maternal to fetal base excess differences and the degree of biochemical correlation between mother...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/51.2.135
更新日期:1979-02-01 00:00:00
abstract::We have compared, in a randomized study in 26 patients, immediate and late postoperative recovery after elective laparoscopic cholecystectomy using the gasless, mechanical abdominal wall lift method with conventional carbon dioxide pneumoperitoneum. After the gasless method, tracheal extubation was performed significa...
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/77.5.576
更新日期:1996-11-01 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:Identification of statistically reliable outcomes for comparison among anaesthetists is challenging. Time-weighted intraoperative mean arterial pressure <65 mm Hg (AUC 65 ) is associated with increased odds for myocardial damage. We explored retrospectively whether such hypotension before incision was statis...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aex153
更新日期:2017-07-01 00:00:00
abstract:BACKGROUND:Prediction models to identify parturients who experience protracted pain, prolonged opioid use, and delayed self-assessed functional recovery are currently inadequate. METHODS:For this study, 213 nulliparous women who planned vaginal delivery were enrolled and assessed daily until they completed three outco...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1016/j.bja.2018.04.033
更新日期:2018-08-01 00:00:00
abstract::In nine patients, undergoing repeat operations because of severe intra-abdominal infection developing after major abdominal surgery, serum potassium concentrations were monitored during induction of anaesthesia. Four patients showed an increase of serum potassium ranging from 2.5 to 3.1 mmol/litre above baseline value...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/48.6.557
更新日期:1976-06-01 00:00:00
abstract:BACKGROUND:The use of lipid emulsions to reduce cardiac toxicity of local anaesthetics (LAs) has shown success in experimental studies and some clinical cases, and thus has been implemented in clinical practice. However, lipid treatment is usually given after the occurrence of neurological or cardiovascular symptoms of...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aet353
更新日期:2014-04-01 00:00:00
abstract::We have studied the effect of tropisetron, a 5-HT3-receptor antagonist, on postoperative nausea, vomiting and pain in 54 patients, aged 50-83 yr, after major hip or knee surgery. The patients were given subarachnoid injection of plain 0.5% bupivacaine, mixed with preservative-free morphine 0.3 mg, for surgical and pos...
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/71.5.681
更新日期:1993-11-01 00:00:00
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-cardia...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,多中心研究
doi:10.1093/bja/aew179
更新日期:2016-08-01 00:00:00
abstract::Percutaneous dilatational tracheostomy (PDT) is associated with a number of life-threatening complications. We present a case of massive and fatal arterial haemorrhage that occurred in the intensive care unit during an elective PDT on an 86-year-old woman following earlier evacuation of a traumatic subdural haematoma....
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aeg074
更新日期:2003-04-01 00:00:00
abstract::Six male patients were studied on the morning following upper abdominal surgery for highly selective vagotomy. Nalbuphine hydrochloride was infused i.v. at different rates that increased progressively in each hour over a 4-h period. In the last 15 min of each hour, the plasma nalbuphine concentrations were almost stea...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/59.11.1356
更新日期:1987-11-01 00:00:00
abstract::We gave either midazolam or propofol for induction of anaesthesia to 140 ASA I or II female patients (18-60 yr). ED50 values were obtained by probit analysis for three clinical end-points: loss of response to command; loss of eyelash reflex; failure to respond to application of an anaesthetic face mask delivering 1% i...
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/69.3.240
更新日期:1992-09-01 00:00:00
abstract::Bupivacaine 2.5 mg kg-1 (0.5 ml kg-1 of 0.5% solution), with or without adrenaline 5 micrograms ml-1, was administered by interpleural injection to 12 patients after elective cholecystectomy. Noncompartmental analysis indicated that the addition of adrenaline had no effect on total body clearance, apparent volume of d...
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/64.6.662
更新日期:1990-06-01 00:00:00
abstract::We report a case of lumbar radiculopathy after zygapophyseal joint injections for chronic low back pain. The management of the patient and potential causes for the radiculopathy are discussed. The case acts as a reminder that the spinal nerve roots should be considered when performing intra-articular facet joint injec...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aem178
更新日期:2007-09-01 00:00:00
abstract::We describe the management of three patients undergoing awake carotid surgery who developed signs of cerebral ischaemia after carotid cross-clamping. Drug treatment to increase arterial blood pressure above baseline reversed the neurological deficit and an internal carotid artery shunt was not needed. Shunt insertion ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/87.4.641
更新日期:2001-10-01 00:00:00
abstract::There is compelling evidence that preconditioning occurs in humans. Experimental studies with potential clinical implications as well as clinical studies evaluating ischaemic, pharmacological and anaesthetic cardiac preconditioning in the perioperative setting are reviewed. These studies reveal promising results. Howe...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/aeg206
更新日期:2003-10-01 00:00:00
abstract::The use of di-isopropyl phenol (Diprivan) for induction of anaesthesia was assessed in doses ranging from 1 to 3 mg kg-1. With less than 1.75mg kg-1 not all patients were anaesthetized; 2.0 mg kg-1 appeared to be a satisfactory induction dose. Involuntary muscle movement, cough and hiccup at induction were rare with a...
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/53.11.1197
更新日期:1981-11-01 00:00:00
abstract::In a random, double-blind crossover trial using an ischaemic limb pain model we have assessed the speed of onset of analgesia after an i.v. bolus of equipotent doses of diamorphine and morphine in 12 healthy male volunteers. Pain and its subsequent relief were assessed by means of a visual analogue scale. Two of the s...
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/66.6.656
更新日期:1991-06-01 00:00:00
abstract::We studied 20 patients undergoing thoracotomy, in a double-blind, placebo-controlled crossover trial of intercostal bupivacaine. Bupivacaine 0.25% was infused at 5 ml h-1 through each of two catheters placed in the intercostal space at operation. Mean (95% confidence limits) 24-h requirements for morphine from a patie...
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/70.5.508
更新日期:1993-05-01 00:00:00
abstract::A simple mathematical model of the chest wall was constructed so that during tidal breathing the relative volume contributions of the rib cage and abdomen/diaphragm could be measured in man, using four mercury-in-rubber strain gauges around the trunk. From the dimensions of the trunk and the change in circumference de...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/51.5.391
更新日期:1979-05-01 00:00:00
abstract::Blood samples were obtained from a radial artery cannula in a 60-yr-old man during coronary artery surgery. Serum potassium concentrations of 9.3, 8.4, and 7.4 mmol litre(-1) were obtained. A simultaneous venous blood sample gave a serum potassium concentration of 4.4 mmol litre(-1). The ECG was unchanged. After the a...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aeh199
更新日期:2004-09-01 00:00:00
abstract:BACKGROUND:The pharmacokinetic profile of local anaesthetics is influenced by the mode of administration. We sought to compare the pharmacokinetics of two doses of ropivacaine after fascia iliaca compartment (FIC) block in children. METHODS:In this prospective, double-blind study, children received an FIC block as a p...
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/aeh066
更新日期:2004-03-01 00:00:00
abstract::Ketamine, as the sole anaesthetic agent, was assessed in a double-blind study of 135 female patients who underwent laparoscopic sterilization. The patients were allocated randomly to one of four groups according to the type (pentobarbitone or droperidol) and route (i.v. or i.m.) of premedication. In addition all the p...
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/49.11.1159
更新日期:1977-11-01 00:00:00
abstract::Using human nasal cytological brushings, we have investigated the effects of morphine on ciliary function by measurement of cilia beat frequency in vitro, and we have also determined opioid receptor binding in these specimens. We obtained ciliated samples from seven volunteers, and measured cilia beat frequency using ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/76.2.274
更新日期:1996-02-01 00:00:00
abstract::The face-grafting techniques are innovative and highly complex, requiring well-defined organization of all the teams involved. Subsequent to the first report in France in 2005, there have been 17 facial allograft transplantations performed worldwide. We describe anaesthesia and postoperative management, and the proble...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aet159
更新日期:2013-10-01 00:00:00
abstract::Frailty is a syndrome of cumulative decline across multiple physiological systems, which predisposes vulnerable adults to adverse events. Assessing vulnerable patients can potentially lead to interventions that improve surgical outcomes. Anaesthesiologists who care for older patients can identify frailty to improve pr...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1016/j.bja.2019.03.034
更新日期:2019-07-01 00:00:00