Abstract:
BACKGROUND:Control of blood pressure remains a key goal of peri-operative care, because hypotension is associated with adverse outcomes after surgery. OBJECTIVES:We explored whether increased vigilance afforded by intra-arterial blood pressure monitoring may be associated with less morbidity after surgery. DESIGN:A prospective observational cohort study. SETTING:Four UK secondary care hospitals. PATIENTS:A total of 4342 patients ≥45 years who underwent noncardiac surgery. METHODS:We compared outcome of patients who received peri-operative intra-arterial blood pressure monitoring with those whose blood pressure was measured noninvasively. OUTCOMES:The primary outcome was peri-operative myocardial injury (high-sensitivity troponin-T ≥ 15 ng l-1 within 72 h after surgery), compared between patients who received intra-arterial versus noninvasive blood pressure monitoring. Secondary outcomes were morbidity within 72 h of surgery (postoperative morbidity survey),and vasopressor and fluid therapy. Multivariable logistic regression analysis explored associations between morbidity and age, sex, location of postoperative care, mode of blood pressure/haemodynamic monitoring and Revised Cardiac Risk Index. RESULTS:Intra-arterial monitoring was used in 1137/4342 (26.2%) patients. Myocardial injury occurred in 440/1137 (38.7%) patients with intra-arterial monitoring compared with 824/3205 (25.7%) with noninvasive monitoring [OR 1.82 (95% CI 1.58 to 2.11), P < 0.001]. Intra-arterial monitoring remained associated with myocardial injury when adjusted for potentially confounding variables [adjusted OR 1.56 (1.29 to 1.89), P < 0.001). The results were similar for planned ICU versus ward postoperative care. CONCLUSIONS:Intra-arterial monitoring is associated with greater risk of morbidity after noncardiac surgery, after controlling for surgical and patient factors. These data provide useful insights into the design of a definitive monitoring trial. STUDY REGISTRATION:The study was not registered with a registry.
journal_name
Eur J Anaesthesioljournal_title
European journal of anaesthesiologyauthors
Abbott TEF,Howell S,Pearse RM,Ackland GL,VISION-UK Investigators.doi
10.1097/EJA.0000000000001443subject
Has Abstractpub_date
2021-01-12 00:00:00eissn
0265-0215issn
1365-2346pii
00003643-900000000-98252pub_type
杂志文章abstract:BACKGROUND AND OBJECTIVE:It has been demonstrated that volatile anaesthetics have cardioprotective properties during open-heart procedures, especially when administered continuously. European Council Directive 93/42/EEC concerning medical devices bans the supplementary incorporation of anaesthetic vaporizers in the byp...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1017/S0265021507001330
更新日期:2008-02-01 00:00:00
abstract::Etomidate is an imidazole-derived hypnotic agent preferentially used for rapid sequence induction of anaesthesia because of its favourable haemodynamic profile. However, 11β-hydroxylase inhibition causes adrenal insufficiency with potentially fatal consequences in specific populations. We review the arguments against ...
journal_title:European journal of anaesthesiology
pub_type: 评论,杂志文章
doi:10.1097/EJA.0b013e32835819ca
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abstract:BACKGROUND AND OBJECTIVE:ProSeal Laryngeal Mask Airway (PLMA) and Laryngeal Tube Suction (LTS), supraglottic airway devices allowing gastric drainage, were compared in this prospective, randomized study for airway management under conditions with elevated intra-abdominal pressure induced by capnoperitoneum. METHODS:Fi...
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/s0265021505000220
更新日期:2005-02-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:The effects of altering the concentration of a local anaesthetic on the development of epidural anaesthesia in pregnant females are unclear. We compared the anaesthetic effects of a constant dose of two different concentrations of epidural lidocaine for Caesarean section. METHODS:After Institu...
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/s0265021502001308
更新日期:2002-11-01 00:00:00
abstract::Morbidly obese patients present with excess fatty tissue externally on the breast, neck, thoracic wall and abdomen and internally in the mouth, pharynx and abdomen. This excess tissue tends to make access (intubation, tracheostomy) to and patency (during sedation or mask ventilation) of the upper airway and the functi...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,评审
doi:10.1097/EJA.0b013e32833d91aa
更新日期:2010-11-01 00:00:00
abstract::The initial disposition of propofol was reported to change when the administration was preceded by fentanyl. The pharmacokinetic profile of the induction dose of propofol (2 mg kg-1 body weight) was studied in 20 ASA I patients randomly allocated to receive fentanyl 1.5 microgram kg-1 (n = 12) or not (n = 8). Anaesthe...
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:1994-03-01 00:00:00
abstract::Simulation is often used for training personnel in activities where the consequences of inappropriate actions are serious. We report a realistic training simulator, which can reproduce practically all potential malfunctions in the anaesthetic machine. Using actual standard equipment (Dameca 10750), the interior of the...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:
更新日期:1993-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Intravenous administration of compound sodium lactate (CSL) 30 ml kg to women undergoing gynaecological laparoscopy reduced the incidence of vomiting, nausea and antiemetic use when compared with 10 ml kg. The aim of this study was to evaluate the effect of intravenous fluid administration on n...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/EJA.0b013e32831c8793
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abstract:BACKGROUND AND OBJECTIVE:It has been hypothesized that combinations of analgesics with different mechanisms of action may reduce or even prevent postoperative pain. We, therefore, investigated the analgesic effect of gabapentin, dexamethasone and low-dose ketamine in combination with paracetamol and ketorolac as compar...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
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更新日期:2010-04-01 00:00:00
abstract::Anaesthetic agents for day-case surgery ideally should have a short duration of action. This study was designed to compare the efficacy and safety of mivacurium and vecuronium for healthy adults undergoing dental day-case surgery. Thirty fit healthy adult patients (ASA I or II) randomly received either mivacurium 0.15...
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.1365-2346.1994.00207.x
更新日期:1997-11-01 00:00:00
abstract::It is assumed that diabetic patients with uraemia have more complications at renal transplantation than those who are not diabetic. We compared the preoperative ECGs, and invasive perioperative haemodynamic and oxygenation parameters in 15 diabetic and 15 non-diabetic uraemic patients undergoing renal transplantation....
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1046/j.1365-2346.2000.00760.x
更新日期:2000-12-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:To determine if there is any significant difference between the effects of desflurane, isoflurane and sevoflurane on the QT interval, QT dispersion, heart rate corrected QT interval and QTc dispersion of the electrocardiogram. METHODS:The study was conducted in a prospective, double blind and ...
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:2004-07-01 00:00:00
abstract:BACKGROUND:Movement-evoked pain is more severe than pain at rest and is likely to interfere more with functional recovery after surgery. OBJECTIVE:To compare triple vs. double nonopioid perioperative analgesic regimens in women undergoing abdominal hysterectomy. DESIGN:A randomised, parallel design, double-blind cont...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
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更新日期:2015-04-01 00:00:00
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journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1097/EJA.0000000000001202
更新日期:2020-10-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:The laryngeal mask has become a widely accepted alternative to endotracheal intubation and mask ventilation. The laryngeal tube is a relatively new supraglottic airway device for airway management. We compared the new version of the laryngeal tube with the laryngeal mask. METHODS:In a randomiz...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1017/S0265021507000129
更新日期:2007-07-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:The aim of study was to investigate the electron microscopic changes in the medulla of the spinal cord that occur with intrathecal midazolam administration. METHODS:Twenty-eight albino rabbits of New Zealand type were randomized into two groups. Following anaesthesia, 16 rabbits were given 300...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1017/S0265021505001547
更新日期:2005-12-01 00:00:00
abstract:BACKGROUND:Hypoventilation is a major cause of morbidity and mortality in patients having procedures under sedation. Few clinical strategies have been evaluated to reduce intraoperative hypoventilation during surgical procedures under deep sedation. OBJECTIVE:The primary objective of this investigation was to examine ...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/EJA.0000000000000025
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abstract:BACKGROUND AND OBJECTIVES:Early recovery after anaesthesia is gaining importance in fast track management. The aim of this study was to quantify psychomotor recovery within the first 24 h after propofol/remifentanil anaesthesia using the Short Performance Test (Syndrom Kurztest (SKT)), consisting of nine subtests. The ...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1017/S0265021506001530
更新日期:2007-04-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Robot-assisted prostatectomy requires pneumoperitoneum in a steep Trendelenburg position, which may induce endobronchial intubation or accidental extubation. The aim of the study was to evaluate the effect of pneumoperitoneum in 30 degrees Trendelenburg position on the displacement of the trach...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1097/EJA.0b013e328333d587
更新日期:2010-05-01 00:00:00
abstract::Sixty patients were randomly assigned to two equal groups. Group I received epidural morphine 1 mg after surgery and used a patient-controlled analgesia device programmed to deliver morphine 0. 2 mg h-1, 0.2 mg per bolus. Group II received an epidural loading dose of morphine 1 mg plus ketamine 5 mg and used a patient...
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.1365-2346.1999.00592.x
更新日期:1999-12-01 00:00:00
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journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章
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更新日期:2003-08-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:To investigate whether the administration of ketamine before induction with propofol produces a smaller decrease in arterial pressure. METHODS:Twenty-two patients were assigned to one of two groups to receive either propofol with ketamine (n = 11) or propofol alone (n = 11, control). Anaesthes...
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.0265-0215.2000.00784.x
更新日期:2001-02-01 00:00:00
abstract::Competency frameworks are based on what are considered to be the general essential qualities of a doctor. Competencies, being behavioural descriptors, need a strong link to clinical practice to allow trainers to observe and then use them in assessing trainees' performance. The emerging concept of entrustable professio...
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:BACKGROUND AND OBJECTIVE:Intraoperative Doppler ultrasound can be used to measure cardiac output by transoesophageal echocardiography. Recently, its reliability, when compared to the thermodilution technique, has been questioned. The purpose of this study was to compare intraoperative changes in cardiac output measured...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1017/S0265021507001354
更新日期:2008-02-01 00:00:00
abstract::The effect of the duration of stabilization of control responses on the onset and duration of clinical relaxation of suxamethonium 1 mg kg-1 and rocuronium 0.6 mg kg-1 were investigated in 90 patients. The control responses were allowed to stabilize for 1, 5, 10, 15 or 20 min prior to administration of rocuronium and ...
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.1365-2346.1996.d01-379.x
更新日期:1996-07-01 00:00:00
abstract:CONTEXT:Strabismus surgery is one of the most common ophthalmic surgical procedures in children and is associated with significant postoperative nausea and vomiting (PONV). OBJECTIVE:We evaluated the effect of intravenous paracetamol on PONV in children after strabismus surgery. DESIGN:Prospective, placebo-controlled...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
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更新日期:2011-12-01 00:00:00
abstract::In this review paper, the authors critically analyse the use of a number of depth of anaesthesia monitors in light of the most recent literature and their own clinical experience. There appears to be increasing evidence that anaesthesia depth monitors reduce the incidence of unexpected intraoperative awareness and als...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,评审
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更新日期:2004-06-01 00:00:00
abstract:BACKGROUND:Although rotational thromboelastometry (ROTEM) is increasingly used to guide haemostatic therapy in a bleeding patient, there is a paucity of data guiding its use in the paediatric population. OBJECTIVE:The objective of this study is to develop an algorithm on the basis of ROTEM values obtained in our paedi...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
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更新日期:2015-05-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Because gastric mucosal PCO2 must be referenced to arterial values via a gastric-to-arterial PCO2 gap (Pg-aCO2), the gastric-to-end-tidal PCO2 difference (Pg-ETCO2) may be proposed as a surrogate method to monitor Pg-aCO2. However, the influence of arterial-to-end-tidal PCO2 (Pa-ETCO2) on its v...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
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更新日期:2003-02-01 00:00:00
abstract:BACKGROUND:Neuromuscular blockade (NMB) monitoring is essential to avoid residual NMB. While the adductor pollicis is the recommended site for monitoring recovery, it is not always accessible. The flexor hallucis brevis could be an interesting alternative. OBJECTIVE:The aim of our study was to compare NMB onset and re...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1097/EJA.0000000000001090
更新日期:2020-01-01 00:00:00