Abstract:
BACKGROUND:Continuous positive airway pressure (CPAP) prevents peri-operative atelectasis in adults, but its effect in children has not been quantified. OBJECTIVE:The aim of this study was to evaluate the role of CPAP in preventing postinduction and postoperative atelectasis in children under general anaesthesia. DESIGN:A randomised controlled study. SETTING:Single-institution study, community hospital, Mar del Plata. Argentina. PATIENTS:We studied 42 children, aged 6 months to 7 years, American Society of Anesthesiologists physical status class I, under standardised general anaesthesia. INTERVENTIONS:Patients were randomised into two groups: Control group (n = 21): induction and emergence of anaesthesia without CPAP; and CPAP group (n = 21): 5 cmH2O of CPAP during induction and emergence of anaesthesia. Lung ultrasound (LUS) imaging was performed before and 5 min after anaesthesia induction. Children without atelectasis were ventilated in the same manner as the Control group with standard ventilatory settings including 5 cmH2O of PEEP. Children with atelectasis received a recruitment manoeuvre followed by standard ventilation with 8 cmH2O of PEEP. Then, at the end of surgery, LUS images were repeated before tracheal extubation and 60 min after awakening. MAIN OUTCOME MEASURES:Lung aeration score and atelectasis assessed by LUS. RESULTS:Before anaesthesia, all children were free of atelectasis. After induction, 95% in the Control group developed atelectasis compared with 52% of patients in the CPAP group (P < 0.0001). LUS aeration scores were higher (impaired aeration) in the Control group than the CPAP group (8.8 ± 3.8 vs. 3.5 ± 3.3 points; P < 0.0001). At the end of surgery, before tracheal extubation, atelectasis was observed in 100% of children in the Control and 29% of the CPAP group (P < 0.0001) with a corresponding aeration score of 9.6 ± 3.2 and 1.8 ± 2.3, respectively (P < 0.0001). After surgery, 30% of children in the Control group and 10% in the CPAP group presented with residual atelectasis (P < 0.0001) also corresponding to a higher aeration score in the Control group (2.5 ± 3.1) when compared with the CPAP group (0.5 ± 1.5; P < 0.01). CONCLUSION:The use of 5 cmH2O of CPAP in healthy children of the studied age span during induction and emergence of anaesthesia effectively prevents atelectasis, with benefits maintained during the first postoperative hour. TRIAL REGISTRY:Clinicaltrials.gov NCT03461770.
journal_name
Eur J Anaesthesioljournal_title
European journal of anaesthesiologyauthors
Acosta CM,Lopez Vargas MP,Oropel F,Valente L,Ricci L,Natal M,Suarez Sipmann F,Tusman Gdoi
10.1097/EJA.0000000000001351subject
Has Abstractpub_date
2021-01-01 00:00:00pages
41-48issue
1eissn
0265-0215issn
1365-2346journal_volume
38pub_type
杂志文章abstract:BACKGROUND AND OBJECTIVE:To compare the inotropic and lusitropic effect of lidocaine and mepivacaine on rat papillary muscle. METHODS:Effects of lidocaine and mepivacaine (10-8-10-3 M) were studied in rat left ventricular papillary muscles in vitro at a calcium concentration of 1 mmol, under low (isotony) and high (is...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1017/S0265021506001359
更新日期:2007-02-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Hypoxia-reperfusion injury is an important determinant of secondary brain injury. In the acute phase of cerebral reperfusion, pro-inflammatory events enhance expression of cerebral endothelial (intercellular adhesion molecule-1 and P-selectin) adhesion molecules, which play an important role in...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1017/S0265021507003018
更新日期:2008-03-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Postoperative nausea and vomiting causes discomfort in many patients despite both antiemetic prophylactics and improved anaesthetic techniques. Stimulation of acupoint P6 is described as an alternative method for prophylaxis of postoperative nausea and vomiting.In a randomised, double-blinded s...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/EJA.0b013e32833f6f42
更新日期:2011-06-01 00:00:00
abstract:BACKGROUND AND AIM:This study assessed the accuracy of using capnography with a modified, hollow gum elastic bougie in predicting tracheal intubation, and its effectiveness as a method of apnoeic oxygenation. METHODS:Patients were randomly allocated to having the gum elastic bougie inserted, under anaesthesia, in the ...
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.0265-0215.2000.00774.x
更新日期:2001-01-01 00:00:00
abstract::We studied whether long-term epidural catheter (nylon) placement for bupivacaine administration (morphine in 2 pigs) would cause any pathological changes in the epidural space and spinal cord of pigs. There were similar kinds of slight inflammatory changes in ligamentum flavum and dura mater in bupivacaine-treated (4 ...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:
更新日期:1986-11-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Administration of calcium safely and effectively reverses many of the electrophysiological actions of hyperkalaemia, but it has not been studied for pretreatment. Based on cellular studies, magnesium also has been suggested to prevent the effects of potassium on the heart. As their mechanisms o...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1017/s0265021503000978
更新日期:2003-08-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:It is known that esmolol, a short-acting beta1-blocker, reduces anaesthetic requirement. In this study, we evaluated whether a low dose of landiolol, a new ultra-short-acting beta1-blocker, can reduce the sevoflurane requirement. METHODS:Twenty-five patients undergoing hip surgery were randoml...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/EJA.0b013e328318c6a9
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND:The dorsalis pedis artery (DPA) is a good alternative to the radial artery (RA) for invasive blood pressure monitoring when the upper limb is burned or injured, or if the RA is not available. Understanding the pattern of pressure difference between DPA and the commonly used RA during inhalational anaesthesia...
journal_title:European journal of anaesthesiology
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doi:10.1097/EJA.0000000000000295
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journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
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abstract:BACKGROUND:Preoperative anaemia is associated with increased postoperative morbidity and mortality. Patient blood management (PBM) is advocated to improve patient outcomes. OBJECTIVES:NATA, the 'Network for the advancement of patient blood management, haemostasis and thrombosis', initiated a benchmark project with the...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,多中心研究
doi:10.1097/EJA.0000000000000519
更新日期:2016-12-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Previous studies have shown that L-type voltage-sensitive Ca2+ channel blocking agents increased and the L-type Ca2+ channel activator Bay K 8644 reduced the general anaesthetic potency in animals. As the bispectral index correlates with the depth of sedation, we examined whether L-type Ca2+ ch...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章
doi:10.1017/s0265021503001303
更新日期:2003-10-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Adding various opioids to the local anaesthetic solution administrated intrathecally improves the analgesic potency of spinal analgesia. The purpose of this study was to evaluate the efficacy and safety of intrathecal fentanyl 10 microg added to 15 mg hyperbaric ropivacaine in patients undergoi...
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/s0265021505000785
更新日期:2005-06-01 00:00:00
abstract::The relative potencies of the intravenous anaesthetics propofol and thiopentone have been investigated by finding the dose necessary to produce unconsciousness in approximately 30%, 50% and 80% of patients. The estimated potency of propofol to thiopentone was 1:1.604 as obtained by the probit method of analysis which ...
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:1986-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Intravenously administered paracetamol is an effective analgesic in postoperative pain management. However, there is a lack of data on the effect of intravenous (i.v.) paracetamol on pain following soft tissue surgery. METHODS:Eighty-seven patients undergoing elective breast surgery with total...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/EJA.0b013e328329b0fd
更新日期:2009-08-01 00:00:00
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journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1017/s0265021502000352
更新日期:2002-03-01 00:00:00
abstract::The thrombogenicity of polyethylene, silicone and polyurethane central venous catheters was compared in a prospective clinical, phlebographic and post-mortem study in 52 patients. The incidence of central venous thrombosis was high with polyethylene catheters (70%), but much lower with silicone (20%) and with polyuret...
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:1984-12-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Transurethral prostatectomy is routinely performed under spinal anaesthesia. This technique can cause hypotension, which is particularly undesirable in the elderly. The objective was to compare spinal anaesthesia for transurethral prostatectomy using hyperbaric bupivacaine 15 mg (control group)...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
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journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1046/j.1365-2346.1999.00530.x
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journal_title:European journal of anaesthesiology
pub_type: 杂志文章,多中心研究,随机对照试验
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pub_type: 杂志文章,多中心研究
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更新日期:2019-02-01 00:00:00
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journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1046/j.1365-2346.1997.00201.x
更新日期:1997-09-01 00:00:00
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pub_type: 杂志文章,多中心研究
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更新日期:2019-05-01 00:00:00
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journal_title:European journal of anaesthesiology
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更新日期:2017-08-01 00:00:00
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journal_title:European journal of anaesthesiology
pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2009-10-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:The study compared the analgesic efficacy and safety of two preoperatively administered cyclo-oxygenase-2 inhibitors, celecoxib and rofecoxib. METHODS:Ninety adult patients undergoing thyroid surgery were divided into three groups (each n = 30). They were given a single oral dose of placebo, c...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:2003-06-01 00:00:00
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journal_title:European journal of anaesthesiology
pub_type: 杂志文章
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更新日期:2011-04-01 00:00:00
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journal_title:European journal of anaesthesiology
pub_type: 杂志文章,评审
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更新日期:2015-02-01 00:00:00
abstract::Cardiovascular and hormonal responses to reconstructive abdominal aortic surgery were studied in 20 patients anaesthetized either with moderate-dose fentanyl (20 micrograms kg-1) combined with isoflurane, nitrous oxide and oxygen (n = 10), or with thoracolumbar epidural bupivacaine combined with isoflurane, nitrous ox...
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:1991-11-01 00:00:00