Abstract:
BACKGROUND:Near-infrared spectroscopy non-invasively measures regional cerebral oxygen saturation. Intraoperative cerebral desaturations have been associated with worse neurological outcomes. We investigated whether perioperative cerebral desaturations are associated with postoperative delirium in older patients after cardiac surgery. METHODS:Patients aged 70 yr and older scheduled for on-pump cardiac surgery were included between 2015 and 2017 in a single-centre, prospective, observational study. Baseline cerebral oxygen saturation was measured 1 day before surgery. Throughout surgery and after ICU admission, cerebral oxygen saturation was monitored continuously up to 72 h after operation. The presence of delirium was assessed using the confusion assessment method for the ICU. Association with delirium was evaluated with unadjusted analyses and multivariable logistic regression. RESULTS:Ninety-six of 103 patients were included, and 29 (30%) became delirious. Intraoperative cerebral oxygen saturation was not significantly associated with postoperative delirium. The lowest postoperative cerebral oxygen saturation was lower in patients who became delirious (P=0.001). The absolute and relative postoperative cerebral oxygen saturation decreases were more marked in patients with delirium (13 [6]% and 19 [9]%, respectively) compared with patients without delirium (9 [4]% and 14 [5]%; P=0.002 and P=0.001, respectively). These differences in cerebral oxygen saturation were no longer present after excluding cerebral oxygen saturation values after patients became delirious. Older age, previous stroke, higher EuroSCORE II, lower preoperative Mini-Mental Status Examination, and more substantial absolute postoperative cerebral oxygen saturation decreases were independently associated with postoperative delirium incidence. CONCLUSIONS:Postoperative delirium in older patients undergoing cardiac surgery is associated with absolute decreases in postoperative cerebral oxygen saturation. These differences appear most detectable after the onset of delirium. CLINICAL TRIAL REGISTRATION:NCT02532530.
journal_name
Br J Anaesthjournal_title
British journal of anaesthesiaauthors
Eertmans W,De Deyne C,Genbrugge C,Marcus B,Bouneb S,Beran M,Fret T,Gutermann H,Boer W,Vander Laenen M,Heylen R,Mesotten D,Vanelderen P,Jans Fdoi
10.1016/j.bja.2019.09.042subject
Has Abstractpub_date
2020-02-01 00:00:00pages
146-153issue
2eissn
0007-0912issn
1471-6771pii
S0007-0912(19)30802-5journal_volume
124pub_type
杂志文章abstract::We have compared the viability criteria of muscle bundles used in the in vitro contracture test for susceptibility to malignant hyperthermia (MH) in a group of 28 patients with various neuromuscular diseases (NMD) and 93 MH-related family patients. In the patients with NMD, this standard test gave one positive, six eq...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/72.1.93
更新日期:1994-01-01 00:00:00
abstract::Advances in cannabis research have paralleled developments in opioid pharmacology whereby a psychoactive plant extract has elucidated novel endogenous signalling systems with therapeutic significance. Cannabinoids (CBs) are chemical compounds derived from cannabis. The major psychotropic CB delta-9-tetrahydrocannabino...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/aen119
更新日期:2008-07-01 00:00:00
abstract::A total of 1442 patients who had major gynaecological surgery were recruited into three multicentre studies using a standard general anaesthetic technique in order to assess the efficacy of various doses of orally administered ondansetron in the prevention of postoperative nausea and vomiting. A total of 1257 patients...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,meta分析,多中心研究,随机对照试验
doi:10.1093/bja/71.4.517
更新日期:1993-10-01 00:00:00
abstract::We have investigated the effects of 9.5% and 14.1% MAC concentrations of isoflurane on some psychometric measurements. Both concentrations depressed peak saccadic velocity (P < 0.01), choice reaction time (P < 0.05) and visual analogue scores for sedation (P < 0.05), but not the critical flicker fusion threshold. The ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/71.6.839
更新日期:1993-12-01 00:00:00
abstract::We have studied post-tetanic count (PTC) and single twitch height at the onset of reflex movement to carinal stimulation after administration of vecuronium with five different types of anaesthesia. Seventy-five adult patients were allocated randomly to five groups of 15 patients each, to receive one of the following a...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验,收录出版
doi:10.1093/bja/72.6.688
更新日期:1994-06-01 00:00:00
abstract::We have examined dimethylthiourea, a potent scavenger of free radicals, for its anaesthetic properties in mice and rats. In mice, dimethylthiourea abolished the righting reflex at intraperitoneal doses greater than 1.5 mg g-1 bodyweight; in rats, it decreased the MAC value for isoflurane in a dose-dependent fashion. D...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/70.4.456
更新日期:1993-04-01 00:00:00
abstract::A retrospective study was carried out to determine analgesic requirements in a group of orthopaedic outpatients (n = 145) and oral surgery inpatients (n = 172). The orthopaedic patients received a codeine-paracetamol premedication, an opioid during operation, or no analgesic. Less than 50% of the orthopaedic patients ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/64.5.617
更新日期:1990-05-01 00:00:00
abstract:BACKGROUND:Propofol use during sedation for colonoscopy can result in cardiopulmonary complications. Intravenous lidocaine can alleviate visceral pain and decrease propofol requirements during surgery. We tested the hypothesis that i.v. lidocaine reduces propofol requirements during colonoscopy and improves post-colono...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.bja.2018.06.019
更新日期:2018-11-01 00:00:00
abstract::We have compared the effects of inhalation of aerosolized surfactant on experimental acute respiratory distress syndrome. Escherichia coli endotoxin (55 (SD 20) mg kg(-1)) was injected into the tracheas of 36 adult rats anaesthetized and mechanically ventilated with pure oxygen. When the Pa(O(2)) decreased to 11.3 (3....
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/87.2.266
更新日期:2001-08-01 00:00:00
abstract::The effects of bolus doses of phenoperidine 1-2 mg i.v. either alone, or combined with pancuronium 2-4 mg, were investigated in seven patients in traumatic coma. Phenoperidine alone significantly reduced mean arterial pressure (MAP) by a mean (+/- SEM) of 13.2 (+/- 2.8) mm Hg. Overall there was no significant change i...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/59.5.592
更新日期:1987-05-01 00:00:00
abstract::We have compared bispectral index (BIS), 95% spectral edge frequency (SEF) and approximate entropy (ApEn) in 37 patients during induction and recovery from a short general anaesthetic. Heart rate variability (HRV) was also compared during induction only. These indices were noted at the start of induction, when a syrin...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/82.5.666
更新日期:1999-05-01 00:00:00
abstract::We studied 40 elderly patients undergoing cataract surgery. Ten non-insulin-dependent diabetes mellitus (NIDDM) patients received standardized general anaesthesia, 10 NIDDM patients received local anaesthesia using retrobulbar block, 10 non-diabetic control patients received general anaesthesia and 10 non-diabetic con...
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/74.5.500
更新日期:1995-05-01 00:00:00
abstract:BACKGROUND:A multidisciplinary approach to improve postoperative outcomes in frail elderly patients is gaining interest. Multidisciplinary team care should be targeted at complex patients at high risk for adverse postoperative outcome to limit the strain on available resources and to prevent an unnecessary increase in ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1016/j.bja.2019.12.042
更新日期:2020-02-14 00:00:00
abstract::It is known that propofol can have effects on atrioventricular node conduction. We report a case where administration of propofol was associated with termination of supraventricular tachycardia. Although a similar phenomenon has been reported in children, this is the first such case in an adult. ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:
更新日期:2002-06-01 00:00:00
abstract:BACKGROUND:The incidence of pain on injection of propofol remains unacceptably high in children, despite various strategies to reduce it. A new drug formulation of propofol has, in adult studies, been reported to cause less injection pain compared with other propofol solutions. The aim of the present prospective random...
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/aei156
更新日期:2005-08-01 00:00:00
abstract:BACKGROUND:Tracheal tube tip and cuff positions of different cuffed paediatric tracheal tube brands in the trachea can vary with design. METHODS:Data from three clinical studies with measured tracheal lengths were pooled in a database including 422 children aged from birth to 16 yr. Dimensional data of seven cuffed pa...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1016/j.bja.2018.05.002
更新日期:2018-08-01 00:00:00
abstract::We have studied 16 healthy volunteers whose lungs were preoxygenated six times each in order to assess the amount of room air entrained during tidal volume preoxygenation if a good seal is not maintained between the face mask and the face. With a fresh gas flow of 10 litre min-1, we found that using gravity alone to h...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/75.6.777
更新日期:1995-12-01 00:00:00
abstract::We have examined the role of gamma-aminobutyric acid (GABA) neurones in propofol anaesthesia in mice using the righting reflex. Propofol i.p. increased the percentage of loss of the righting reflex in a dose-dependent manner with an ED50 value of 140 (95% confidence limits 123-160) mg kg-1 (n = 40; eight animals per d...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/83.4.665
更新日期:1999-10-01 00:00:00
abstract:BACKGROUND:This study was undertaken to compare the effects of general anaesthesia (GA) and spinal anaesthesia (SA) on the need for postoperative hospitalization and early postoperative comfort in patients undergoing fast-track total knee arthroplasty (TKA). METHODS:One hundred and twenty subjects were randomly alloca...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aet104
更新日期:2013-09-01 00:00:00
abstract::We have evaluated the effect of delivering nitric oxide using a continuous flow system (CFS) or two commercially available proportional gas injection systems (PGIS), Nodomo (Dräger, Lübeck, Germany) and Pulmonox-Mini (Messer Griesheim Austria, Gumpoldskirchen, Austria) on measured and simulated concentrations of nitri...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/81.4.544
更新日期:1998-10-01 00:00:00
abstract:BACKGROUND:In a series of ex vivo and in vivo studies we investigated the ability of repetitive ketamine administration to alter the metabolism and anaesthetic effect of propofol and the role of ketamine-mediated P-450 2B induction in rats. METHODS:Male Wistar rats were pretreated with 80 mg kg(-1) ketamine i.p. twice...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/ael173
更新日期:2006-09-01 00:00:00
abstract::Atropine and glycopyrrolate were compared in a mixture with neostigmine for reversal of neuromuscular blockade in patients undergoing open heart surgery. In patients not receiving beta-blocking drugs, glycopyrrolate was shown to possess advantages over atropine in terms of a lower initial increase in heart rate, bette...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/57.2.184
更新日期:1985-02-01 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
doi:10.1093/bja/67.4.402
更新日期:1991-10-01 00:00:00
abstract::The in vitro halothane and caffeine contracture tests have been performed on muscle tissue from six survivors of the neuroleptic malignant syndrome. The results, which are expressed in accordance with the criteria of the European MH Group, defined five of the subjects as MHN and one patient as MHE. It is concluded tha...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/59.12.1554
更新日期:1987-12-01 00:00:00
abstract::We studied cardiovascular and catecholamine responses for 3 days in three groups of patients undergoing abdominal hysterectomy. The night before surgery and again 2 h before induction of anaesthesia, patients received the ACE inhibitor, ramipril, the beta 1 blocker, metoprolol, or placebo. In the actively treated grou...
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/72.6.633
更新日期:1994-06-01 00:00:00
abstract:BACKGROUND:We investigated the effects of total i.v. anaesthesia (TIVA) and balanced anaesthesia (BAL) with sevoflurane on postoperative lung function in patients undergoing surgery in the prone position. METHODS:Sixty patients, aged 21-60 yr, undergoing elective lumbar disc surgery in the prone position were randomly...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aeq321
更新日期:2011-02-01 00:00:00
abstract::The analgesic effects and bioavailability of a slow-release preparation of morphine (Duromorph) were studied in 12 patients with acute postoperative pain. Duromorph produced significant analgesia within 1-2 h of administration i.m., and there was a progressive decrease in the mean pain score for at least 8 h. None of ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/57.10.949
更新日期:1985-10-01 00:00:00
abstract:BACKGROUND:The aim of this study is to test the hypothesis that a standard 30-min break in a routine 7.5 h period of work makes a difference in cognitive function. METHODS:In a double-blinded, cross-over trial 30 residents in anaesthesia were randomized to receive or not to receive a 30-min break between the assessmen...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/ael151
更新日期:2006-09-01 00:00:00
abstract::Gastric pH and volume were measured in 87 patients who had received i.v. omeprazole (a new gastric antisecretory agent) 40 mg or placebo 1 or 3 h before surgery. Omeprazole increased the pH of gastric contents in the majority of patients. Administration 1 h before surgery produced greater gastric pH and smaller volume...
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/63.5.536
更新日期:1989-11-01 00:00:00
abstract:BACKGROUND:The effect of anaesthesia on postoperative outcome is unclear. Cardioprotective properties of volatile anaesthetics have been demonstrated experimentally and in haemodynamically stable patients undergoing coronary artery bypass grafting. Their effects in patients undergoing high-risk cardiac surgery have not...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1093/bja/aeu290
更新日期:2014-12-01 00:00:00