Abstract:
:Anaesthetic and sedative drugs transiently disrupt normal neural activity to facilitate healthcare procedures in children, but they can also cause long-term brain injury in experimental animal models. The US Food and Drug Administration (FDA) has recently advised that repeated or lengthy exposures to anaesthetic and sedative drugs prior to 3 yr of age have the potential to harm the development of children's brains and added warnings to these drug labels. Paediatric anaesthesia toxicity could represent a significant public health issue, and concern about this potential injury in children has become an important issue for families, paediatric clinicians and healthcare regulators. Since late 2015, important new data from five major clinical studies have been published. This narrative review aims to provide a brief overview of the preclinical and clinical literature, including a comprehensive review of these recent additions to the human literature. We integrate these new data with prior studies to provide further insights into how these clinical findings can be applied to children.
journal_name
Br J Anaesthjournal_title
British journal of anaesthesiaauthors
O'Leary JD,Warner DOdoi
10.1093/bja/aex141subject
Has Abstractpub_date
2017-09-01 00:00:00pages
458-464issue
3eissn
0007-0912issn
1471-6771pii
S0007-0912(17)53762-9journal_volume
119pub_type
杂志文章,评审abstract::The haemodynamic effects of diltiazem were studied in six dogs during fentanyl-nitrous oxide (in oxygen) anaesthesia. A bolus of diltiazem 300 micrograms kg-1 was given, followed by infusions at 30, 60 and 90 micrograms kg-1 min-1 which produced plasma diltiazem concentrations of 392 +/- 30, 908 +/- 54 and 1483 +/- 13...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/60.6.655
更新日期:1988-05-01 00:00:00
abstract::The activity of a new i.v. anesthetic agent ICI 35 868, a compound unrelated to currently used barbiturate, eugenol or steroid agents, has been examined in a range of animal species. Some of the properties of ICI 35 868 resemble those of thiopentone in that it is a rapidly acting agent which produces anaesthesia of sh...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/52.8.731
更新日期:1980-08-01 00:00:00
abstract::A study of core temperature monitoring during general anesthesia indicates that this can be introduced as a routine procedure in order to reduce mortality from malignant hyperpyrexia. The temperature profiles of 2410 patients are presented. Both mean rectal and mean oesophageal temperatures decreased during general an...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/52.12.1223
更新日期:1980-12-01 00:00:00
abstract::The concentrations of volatile hydrocarbons were studied in breath samples from patients before and after anaesthesia. In patients to whom halothane was administered, there was a significant increase in the concentration of isobutene (from 0.43 +/- 0.09 to 4.66 +/- 2.22 nmol litre-1). There was no change in the concen...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/52.10.989
更新日期:1980-10-01 00:00:00
abstract::We have studied the effect of doxapram on the rates of spontaneous and neostigmine-induced recovery from neuromuscular block with atracurium and vecuronium, by measurement of the time to recovery of T1 (first twitch in the train-of-four) from 25 to 75% of control (recovery index, RI). After each neuromuscular blocking...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/68.5.527
更新日期:1992-05-01 00:00:00
abstract:BACKGROUND:Anaesthetics blunt neuronal responses to noxious stimulation, including effects on electroencephalographic (EEG) responses. It is unclear how anaesthetics differ in their ability to modulate noxious stimulation-evoked EEG activation. We investigated the actions of propofol and halothane on EEG responses to n...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aei208
更新日期:2005-10-01 00:00:00
abstract::This was a prospective, non-randomized, multicentre study of rocuronium (Org 9426) in 40 elective Caesarean section patients at full term without fetal distress. Anaesthesia was induced with thiopentone 4-6 mg kg-1 i.v. and rocuronium 0.6 mg kg-1 and maintained with isoflurane and nitrous oxide in oxygen. Monitors inc...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1093/bja/73.3.336
更新日期:1994-09-01 00:00:00
abstract::Two techniques for endotracheal anaesthesia in dental outpatients have been compared: a spontaneous ventilation technique using nitrous oxide, oxygen and halothane, and a controlled ventilation technique using nitrous oxide and oxygen, with tubocurarine and fentanyl. The latter technique has several advantages: abolit...
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/48.9.919
更新日期:1976-09-01 00:00:00
abstract::We present an unusual case of hypercapnia and surgical emphysema during transanal endoscopic microsurgery, which led to delayed post-operative ventilatory failure. The hypercapnia and surgical emphysema were secondary to rectal insufflation with carbon dioxide used to facilitate visualization and resection of a rectal...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/86.4.586
更新日期:2001-04-01 00:00:00
abstract::We have recently reported that continuous administration of butorphanol into the brachial plexus neurovascular sheath provided superior analgesia compared with that obtained with continuous i.v. administration. Furthermore, we found that analgesia was most pronounced when a mixture of mepivacaine and butorphanol was g...
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/78.1.83
更新日期:1997-01-01 00:00:00
abstract:BACKGROUND:Even mild perioperative hypothermia is associated with several severe adverse effects. Resistive heating has possible advantages compared with other active warming systems because it can heat several fields independently. To assess this new warming system, we measured core temperature in patients during surg...
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/aeg106
更新日期:2003-05-01 00:00:00
abstract:BACKGROUND:The debate on lung-protective ventilation strategies for surgical patients is ongoing. Evidence suggests that the use of low tidal volume VT improves clinical outcomes. However, the optimal levels of PEEP and recruitment manoeuvre (RM) strategies incorporated into low VT ventilation remain unclear. METHODS:...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,meta分析
doi:10.1016/j.bja.2019.10.024
更新日期:2020-03-01 00:00:00
abstract::All 484 candidates for the 1988 Fellowship in Anaesthesia (Part Three) were surveyed to investigate any differences between successful and unsuccessful candidates in study techniques, work and domestic factors, and examination history that might lead to better guidance to those preparing for the examination and an imp...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/64.6.752
更新日期:1990-06-01 00:00:00
abstract::We have measured in 38 patients the plasma concentration profile of atracurium and its effect on the electromyographic first response of the train-of-four. One of three techniques was used to supplement anaesthesia with 66% nitrous oxide in oxygen, 0.9% isoflurane (end-tidal), 0.5% halothane (end-tidal) or midazolam 3...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/70.1.38
更新日期:1993-01-01 00:00:00
abstract::MHS and normal pigs were anaesthetized with nitrous oxide and diazepam. Halothane 1% was then administered for 1 hr. Immediately before and immediately after the halothane inhalation, 10 g of vastus lateralis muscle was excised. SR was isolated from this muscle. Calcium accumulation by the MHS sarcoplasmic reticulum i...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/47.6.650
更新日期:1975-06-01 00:00:00
abstract::We investigated in 60 patients scheduled for elective aorto-coronary bypass grafting if loud sounds by themselves can induce cardiovascular responses and if these could be related to mid-latency auditory evoked potentials (MLAEP). Anaesthesia was induced in group I (n = 20) with flunitrazepam-fentanyl 0.01 mg kg-1 and...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/72.3.307
更新日期:1994-03-01 00:00:00
abstract::The evidence for an association between hypertensive disease, elevated admission arterial pressure, and perioperative cardiac outcome is reviewed. A systematic review and meta-analysis of 30 observational studies demonstrated an odds ratio for the association between hypertensive disease and perioperative cardiac outc...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,meta分析,评审
doi:10.1093/bja/aeh091
更新日期:2004-04-01 00:00:00
abstract:BACKGROUND:Propofol can scavenge free radicals because it has a chemical structure similar to antioxidants. METHODS:We examined if free radical scavenging occurs with propofol during CABG operations. We studied 24 patients undergoing CABG surgery for triple vessel disease, randomized into two groups. After induction o...
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/aef173
更新日期:2002-08-01 00:00:00
abstract::Cholinesterase phenotyping studies have been carried out in two laboratories on blood specimens from 28 patients shown to be susceptible to malignant hyperpyrexia. In contrast to previously published reports, no evidence could be found for an increase in the frequency of the E1u E1f genotype above that known to occur ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/53.3.245
更新日期:1981-03-01 00:00:00
abstract::We have studied the effects of bilateral ilioinguinal nerve block and wound infiltration with 0.5% bupivacaine on postoperative pain and analgesic requirements in 62 patients undergoing Caesarean section under general anaesthesia. A control group received no local anaesthetic supplementation. Both ilioinguinal block 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/72.2.229
更新日期:1994-02-01 00:00:00
abstract::Regional haemodynamic control by the cardiovascular baroreceptors was examined in dogs anaesthetized with 1 + MAC halothane in oxygen (1%). The open-loop relationships between carotid sinus pressure (CSP) and regional haemodynamics in the iliac, renal, mesenteric, aortic and coeliac beds were examined before vagotomy,...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/49.6.535
更新日期:1977-06-01 00:00:00
abstract::The effect of the i.v. administration of methylene blue dye on haemoglobin oxygen saturation, measured by a pulse oximeter was investigated. The absorption spectra of various concentrations of haemoglobin, oxyhaemoglobin and methylene blue were compared. The amount of 660-nm light absorbed by methylene blue was suffic...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/60.4.439
更新日期:1988-03-01 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::I.V. fluid therapy plays a fundamental role in the management of hospitalized patients. While the correct use of i.v. fluids can be lifesaving, recent literature demonstrates that fluid therapy is not without risks. Indeed, the use of certain types and volumes of fluid can increase the risk of harm, and even death, in...
journal_title:British journal of anaesthesia
pub_type: 共识发展会议,杂志文章,评审
doi:10.1093/bja/aeu300
更新日期:2014-11-01 00:00:00
abstract::All currently available aminoacylaniline local anaesthetics, except lignocaine, contain a chiral centre but are used as racemates, a fact usually ignored in pharmacokinetic studies. This study reports the cardiovascular effects, and the regional and total body clearances of the enantiomers of bupivacaine determined at...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/67.3.247
更新日期:1991-09-01 00:00:00
abstract:BACKGROUND:Investigators planning dose-response studies of neuromuscular blockers have rarely used a priori power analysis to determine the minimal sample size their protocols require. Institutional Review Boards and peer-reviewed journals now generally ask for this information. This study outlines a proposed method fo...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aeq310
更新日期:2011-02-01 00:00:00
abstract::Gastric (GP) and lower oesophageal sphincter pressures (LOSP) were measured in non-pregnant female volunteers (group I) and pregnant women with (group III) or without (group II) heartburn. Patients in early pregnancy had greater gastric pressures than group I. Mean barrier pressure (LOSP-GP) was significantly decrease...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/53.4.381
更新日期:1981-04-01 00:00:00
abstract:BACKGROUND:Cerebral state index (CSI) has recently been introduced as an intra-operative monitor of anaesthetic depth. We compared the performance of the CSI to the bispectral index (BIS) in measuring depth of anaesthesia during target-controlled infusion (TCI) of propofol. METHODS:Twenty Chinese patients undergoing g...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aei253
更新日期:2005-12-01 00:00:00
abstract::Thiopentone 4 mg/kg, Althesin 0.055 ml/kg and ketamine 2 mg/kg were compared in 157 children undergoing minor otolaryngological surgery, mostly adenotonsillectomy. Premedication was with pethidine and atropine and anaesthesia was maintained with nitrous oxide in oxygen and halothane. Tracheal intubation was facilitate...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/49.4.363
更新日期:1977-04-01 00:00:00
abstract::Volume loading with crystalloid solution results in more pronounced haemodilution in patients who develop arterial hypotension during induction of extradural anaesthesia than in those who remain normotensive. The aim of this study was to describe the time course of this increase in haemodilution. Heart rate, systolic ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/77.2.223
更新日期:1996-08-01 00:00:00