Abstract:
BACKGROUND:Ivabradine lowers heart rate (HR) without affecting contractility or vascular tone. It is licensed for HR control in chronic heart diseases. We performed a systematic review and meta-analyses to examine whether ivabradine could decrease major adverse cardiovascular events (MACE) and mortality in critically ill patients. METHODS:We searched Medline, Embase, Cochrane Library, and Web of Science for RCTs. Trial quality was assessed using the Cochrane risk of bias tool. Random-effects meta-analyses were performed if at least three trials or 100 patients were available. Results are reported as weighted mean difference (WMD), odds ratio (OR), and 95% confidence intervals (CIs). Trial sequential analyses were performed to estimate the sample size needed to reach definitive conclusions of efficacy or futility. RESULTS:We included 13 RCTs (n=1497 patients). We found no evidence of an impact of ivabradine on MACE (three RCTs, 819 patients; OR=0.77; 95% CI, 0.53-1.11) or mortality (10 RCTs, 1356 patients; OR=1.07; 95% CI, 0.63-1.82), but sample sizes were not reached to allow definitive conclusions. Compared with placebo or standard care, ivabradine reduced HR (eight RCTs, 464 patients; WMD, -9.5 beats min-1; 95% CI, -13.3 to -5.8). Risk of bradycardia was not different between ivabradine and control (five RCTs, 434 patients; OR=1.2; 95% CI, 0.60-2.38). Risk of bias was overall high or unclear. CONCLUSIONS:Ivabradine reduces HR compared with placebo or standard care. The effect on MACE or mortality in acute care remains unclear. Further RCTs powered to detect changes in clinically relevant outcomes are warranted. CLINICAL TRIAL REGISTRATION:Prospero CRD42018086109.
journal_name
Br J Anaesthjournal_title
British journal of anaesthesiaauthors
Chen A,Elia N,Dunaiceva J,Rudiger A,Walder B,Bollen Pinto Bdoi
10.1016/j.bja.2020.01.027subject
Has Abstractpub_date
2020-06-01 00:00:00pages
726-738issue
6eissn
0007-0912issn
1471-6771pii
S0007-0912(20)30096-9journal_volume
124pub_type
杂志文章,meta分析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::Intracuff pressure (c.p.) was measured continuously in 12 patients during prolonged periods of tracheal intubation. High residual volume--low pressure (floppy) and low residual volume--high pressure (conventional) cuffs were studied. The mean baseline c.p. at minimal occluding pressure was significantly smaller in flo...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/53.1.97
更新日期:1981-01-01 00:00:00
abstract:BACKGROUND:The properties of methadone suggest a potential advantage for epidural over i.v. administration for pain relief, but little supportive evidence exists. METHODS:To investigate the pharmacokinetic and the pharmacodynamic properties of epidural and i.v. methadone, four doses of methadone (0.1, 0.25, 0.5, and 0...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aet234
更新日期:2014-01-01 00:00:00
abstract::In obstetric patients undergoing postpartum tubal ligation, we found that metoclopramide produced dose-dependent prolongation of suxamethonium-induced neuromuscular block. Mean block times after suxamethonium 1 mg kg-1 were 8.0 min, 9.83 min and 12.45 min for control and metoclopramide 10 mg and metoclopramide 20 mg g...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/65.2.220
更新日期:1990-08-01 00:00:00
abstract:BACKGROUND:We investigated the effects of spinal and general anaesthesia and surgical tourniquet on acute pain and early recovery after total knee arthroplasty (TKA). METHODS:Patients (n=413) were randomised to four parallel groups: spinal anaesthesia with or without tourniquet, and general anaesthesia with or without...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.bja.2020.03.036
更新日期:2020-11-01 00:00:00
abstract::We describe the anaesthetic management of a patient undergoing lobectomy for cavitating lung abscess complicated by haemoptysis. Surgery for lung abscess is one of the absolute indications for the use of a double-lumen tube (DLT). Because pus or blood could impede fibreoptic-assisted DLT placement, a traditional, blin...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/85.5.791
更新日期:2000-11-01 00:00:00
abstract::The clinical understanding of the dynamics of myocardial contraction is hampered by an over-simplified interpretation of the intramural pattern of force generation. This limits the anaesthetist's knowledge of the direct effects of commonly used anaesthetics. A discrimination between a negative inotropic effect and cha...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/60.suppl_1.2s
更新日期:1988-01-01 00:00:00
abstract::Using respiratory inductive plethysmography, we have measured rib cage and abdominal motion during isoflurane anaesthesia in 16 healthy day-surgery patients. Anaesthesia was induced with propofol and maintained with 1 MAC isoflurane in air-oxygen via a laryngeal mask. Measurements were taken during both resting ventil...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/67.6.712
更新日期:1991-12-01 00:00:00
abstract:BACKGROUND:Recent studies have concluded that i.v. dexamethasone can prolong the duration of peripheral nerve blockade. We hypothesized that a 4 mg dose would equally prolong the duration of psoas compartment blocks (PCBs) when compared with 8 mg, and that both doses would prolong the duration when compared with placeb...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.bja.2017.11.073
更新日期:2018-02-01 00:00:00
abstract::Eighty-one consenting women undergoing elective Caesarean section under spinal anaesthesia were randomly divided into two groups. In Group O patients, ondansetron 4 mg was given intravenously at the end of the surgery and 8 mg added to the morphine solution in the PCA syringe. Patients in Group P received only morphin...
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/87.3.502
更新日期:2001-09-01 00:00:00
abstract:BACKGROUND:Short-axis ultrasound-guided placement of central venous catheters (CVCs) is widely accepted as safe practice. However, utilizing the long-axis approach could further improve safety, as it allows for better visualization of the needle as it is advanced to the target vessel. However, the long-axis approach ha...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aer329
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND:Fibrinolysis contributes to coagulopathy after major trauma and surgery. We hypothesized that progressive haemodilution is responsible, at least in part, for increased fibrinolytic tendency of blood clot. METHODS:The study was performed in two parts. First, whole blood (WB) samples collected from six health...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aeq001
更新日期:2010-03-01 00:00:00
abstract:BACKGROUND:Opioids can increase sensitivity to noxious stimuli and cause opioid-induced hyperalgesia. We performed a systematic review to evaluate the clinical consequences of intra-operative doses of opioid. METHODS:We identified randomized controlled trials which compared intra-operative opioid to lower doses or pla...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,meta分析,评审
doi:10.1093/bja/aeu137
更新日期:2014-06-01 00:00:00
abstract::We have examined the correlation between the evoked electromyographic response in the first dorsal interosseous muscle of the hand, temperature and forearm position in 40 female patients after enflurane anaesthesia with spontaneous breathing. In 20 patients the supinated forearm with the wrist extended was immobilized...
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/72.4.407
更新日期:1994-04-01 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::We have studied the effect of analgesia on maternal temperature (oral and tympanic membrane) progression in 53 women during normal spontaneous labour. Three groups were studied: two received extradural analgesia with a continuous infusion of 0.25% bupivacaine with or without the addition of fentanyl; the third group r...
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/67.5.565
更新日期:1991-11-01 00:00:00
abstract::This study has examined the effect of hydration on immediate recovery from anaesthesia in two groups of 15 patients undergoing therapeutic abortion. A standard anaesthetic technique was administered. Patients in group I received no preoperative fluid; those in group II received, before anaesthesia, 20 ml kg-1 of 4% gl...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/68.6.576
更新日期:1992-06-01 00:00:00
abstract::Thoracic imaging is regularly performed on the majority of critical care patients. Conventionally, this uses a combination of plain radiography and computed tomography. There is growing enthusiasm for the use of ultrasound to replace much of this radiology and provide more immediate, point-of-care imaging with reducti...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/aet076
更新日期:2013-08-01 00:00:00
abstract::A double-blind randomized trial was conducted to compare etidocaine, the new local anaesthetic agent, with bupivacaine. One hundred patients were each given a single dose of one of the drugs during the surgical induction of labour. The results showed that etidocaine had a quicker onset of action than bupivacaine, but ...
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/47.12.1305
更新日期:1975-12-01 00:00:00
abstract::The anaesthetic and surgical problems associated with Caesarean section in eight grossly obese patients (weight 150-204 kg) are described. In addition to an increase in the frequency and severity of the complications of obesity, those weighing more than 150 kg present a panniculus which may weigh 70 kg. Extradural ana...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/52.9.919
更新日期:1980-09-01 00:00:00
abstract::We conducted a randomized, double-blind comparison of 8% sevoflurane and propofol as induction agents for day-case cystoscopy in 102 patients. All patients received an i.v. cannula and breathed oxygen 5 litre min-1. Anaesthesia was induced with propofol i.v. or inhalation of 8% sevoflurane and 10% Intralipid (as a pla...
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/78.4.356
更新日期:1997-04-01 00:00:00
abstract::We studied psychomotor performance in 10 healthy volunteers during recovery after a target-controlled infusion of propofol. Choice reaction time, dual task tracking with secondary reaction time and a within-list recognition task were assessed at target blood propofol concentrations of 0.8, 0.4 and 0.2 microgram ml-1. ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/85.3.396
更新日期:2000-09-01 00:00:00
abstract::The physical and pharmacological properties of the structural isomers isoflurane and enflurane differ from each other and from those of other potent inhaled anaesthetics. The minimum alveolar concentration (MAC) for isoflurane (1.15%) is one-and-one-half times that for halothane (0.75%) and two-thirds that for enflura...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:
更新日期:1984-01-01 00:00:00
abstract::Plasma concentrations of amethocaine were measured after topical application of amethocaine cream 2 g (5% w/w) to the dorsum of the right hand of 10 adult volunteers. The cream was applied for 240 min and plasma was assayed for amethocaine and its metabolite p-n-butylaminobenzoic acid at 0, 30, 60, 90, 120 and 240 min...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/67.4.432
更新日期:1991-10-01 00:00:00
abstract::Using an airway management training model, we have assessed anaesthesia personnel in their use of correct cricoid force and ability to retain this skill after a short training programme. A perspex device, working on a hydraulic principle, was used to measure cricoid pressure when applied to the model. After initial as...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/77.4.468
更新日期:1996-10-01 00:00:00
abstract::In inflammation, leucocytes containing opioid peptides migrate into the tissue. Opioid peptides can be released and bind to opioid receptors on peripheral nerve terminals, which counteracts inflammatory pain. Migration of opioid peptide-containing leucocytes is controlled by chemokines and adhesion molecules. Neurokin...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/aen078
更新日期:2008-07-01 00:00:00
abstract::We have studied patterns of oxygen saturation (SpO2) before and after thoracotomy in 20 patients monitored nightly from the preoperative night to the fourth postoperative night. After operation, 10 patients received paravertebral bupivacaine (PVB) infusion and 10 received paravertebral saline (PVS) infusion. Papaveret...
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/67.6.704
更新日期:1991-12-01 00:00:00
abstract::The analgesic effect of subanaesthetic concentrations of ether, trichloroethylene, methoxyflurane and halothane has been investigated previously using either clinical assessment or pain threshold measurements, but with conflicting results. The purpose of the present study was to evaluate the analgesic effect of isoflu...
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/75.1.55
更新日期:1995-07-01 00:00:00
abstract::Haemodynamic changes (supraventricular tachycardia, decreases in arterial pressure) were observed during laryngoscopy and intubation of the trachea in a patient receiving nifedipine and verapamil. Before the induced stresses of laryngoscopy and tracheal intubation, these drugs had controlled the patient's arterial pre...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/58.3.357
更新日期:1986-03-01 00:00:00
abstract::Simple methods are described for computing the variables derived from the Siggaard-Andersen nomogram, where the in vitro buffer line is either established by direct measurement or calculated from measurements of pH, Pco2 and haemoglobin. Calculations are performed using the equation of the pH-log Pco2 buffer line, the...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/47.4.500
更新日期:1975-04-01 00:00:00