Abstract:
BACKGROUND:The observation that patients presenting for bariatric surgery had a high incidence of neuromuscular blocking agent (NMBA) anaphylaxis prompted this restricted case-control study to test the hypothesis that obesity is a risk factor for NMBA anaphylaxis, independent of differences in pholcodine consumption. METHODS:We compared 145 patients diagnosed with intraoperative NMBA anaphylaxis in Western Australia between 2012 and 2020 with 61 patients with cefazolin anaphylaxis with respect to BMI grade, history of pholcodine consumption, sex, age, comorbid disease, and NMBA type and dose. Confounding was assessed by stratification and binomial logistic regression. RESULTS:Obesity (odds ratio [OR]=2.96, χ2=11.7, P=0.001), 'definite' pholcodine consumption (OR=14.0, χ2=2.6, P<0.001), and female sex (OR=2.70, χ2=9.61, P=0.002) were statistically significant risk factors for NMBA anaphylaxis on univariate analysis. The risk of NMBA anaphylaxis increased with BMI grade. Confounding analysis indicated that both obesity and pholcodine consumption remained important risk factors after correction for confounding, but that sex did not. The relative rate of rocuronium anaphylaxis was estimated to be 3.0 times that of vecuronium using controls as an estimate of market share, and the risk of NMBA anaphylaxis in patients presenting for bariatric surgery was 8.8 times the expected rate (74.9 vs 8.5 per 100 000 anaesthetic procedures). CONCLUSIONS:Obesity is a risk factor for NMBA anaphylaxis, the risk increasing with BMI grade. Pholcodine consumption is also a risk factor, and this is consistent with the pholcodine hypothesis. Rocuronium use is associated with an increased risk of anaphylaxis compared with vecuronium in this population.
journal_name
Br J Anaesthjournal_title
British journal of anaesthesiaauthors
Sadleir PHM,Clarke RC,Goddard CE,Day C,Weightman W,Middleditch A,Platt PRdoi
10.1016/j.bja.2020.12.018subject
Has Abstractpub_date
2021-01-13 00:00:00eissn
0007-0912issn
1471-6771pii
S0007-0912(20)31007-2pub_type
杂志文章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::Amethocaine 1% solution was mixed with equal volumes of water, 0.9% saline or 10% dextrose to prepare respectively, hypobaric, isobaric and hyperbaric solutions which were compared for intradural spinal anaesthesia in 60 patients. Thirty patients received 10 mg and 30 patients received 15 mg of amethocaine. Injections...
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/52.6.589
更新日期:1980-06-01 00:00:00
abstract::When using endobronchial anaesthesia for the management of transthoracic endoscopic sympathectomy (TES), excessive insufflation of carbon dioxide into the pleural space may cause haemodynamic instability, hypoxaemia and tension pneumothorax. We prospectively studied an alternative technique using a tracheal tube, i.v....
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/74.2.141
更新日期:1995-02-01 00:00:00
abstract::The effect of gas leakage around an uncuffed tracheal tube on the performance of Heat and Moisture Exchangers (HME) was examined experimentally. Such leaks were shown to cause measurable decreases in the humidity output and efficiency of HME. The magnitude of the decrease in humidity output was shown to be dependent u...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/59.9.1181
更新日期:1987-09-01 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::This study tests the hypothesis that naloxone, but not its quarternary salt, naloxone methiodide (which does not enter the central nervous system), improves recovery from myocardial stunning in conscious dogs. Twenty dogs were chronically instrumented for measurement of heart rate, left atrial, aortic and left ventric...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/86.4.545
更新日期:2001-04-01 00:00:00
abstract::Thiopental is a racemate of equimolar R- and S-thiopental enantiomers that have different potencies in laboratory experiments. We measured concentrations of R- and S-thiopental in plasma, tissues and brain microdialysate of rats after computer-controlled infusion of thiopental i.v. to a plasma concentration of 40 micr...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/oxfordjournals.bja.a013385
更新日期:2000-01-01 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::Plasma concentrations of pancuronium were measured using a fluorimetric method in six patients with normal renal function and seven patients in chronic renal failure. A tow-compartment open model was used in the pharmacokinetic analysis of the data. With this model, the clearance of pancuronium was found to be reduce...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/48.4.341
更新日期:1976-04-01 00:00:00
abstract::The speeds of onset of pancuronium, atracurium and vecuronium are increased by prior administration of magnesium sulphate. A prospective, randomized, double-blind, controlled, clinical study was performed to examine the effects of prior i.v. administration of magnesium sulphate 60 mg kg-1 on the neuromuscular blocking...
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/79.1.122
更新日期:1997-07-01 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::In a randomized study of patients undergoing Caesarean section, either enflurane (mean 0.24 MAC-h) or halothane (mean 0.23 MAC-h) and 50% nitrous oxide in oxygen were administered to women (n = 12) with severe pre-eclampsia-eclampsia and to 16 healthy pregnant patients with normal renal and hepatic function. No eviden...
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/56.6.587
更新日期:1984-06-01 00:00:00
abstract::We investigated whether low-dose erythromycin (200 mg) given as an oral premedicant altered the residual gastric volume and its acidity in fasted patients at induction of anaesthesia in a single-blinded study. Sixty patients were allocated randomly to receive either an erythromycin tablet (200 mg) or nothing with 10 m...
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/85.6.861
更新日期:2000-12-01 00:00:00
abstract::The effects of the i.v. infusion of insulin, 70 mu. kg-1h-1 for the first 60 min and 35 mu. kg-1h-1 subsequently, on the metabolic and endocrine responses to gynaecological surgery were investigated. In comparison with a control group of patients, the insulin infusion caused a marked decrease in circulating glucose, n...
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/55.10.939
更新日期:1983-10-01 00:00:00
abstract:BACKGROUND:Fresh-frozen plasma (FFP) is widely used in critically ill patients, despite a weak evidence base. Factors that influence the decision to transfuse FFP before intravascular catheter insertion are poorly described. METHODS:We undertook a case-controlled study based on a prospective cohort study of 1923 admis...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aes337
更新日期:2012-12-01 00:00:00
abstract::Lung function and clinical evidence of muscle weakness were assessed in 12 ASA I patients who received vecuronium 0.01 mg kg-1 pretreatment as a part of their anaesthetic management, before and 3 min after pretreatment. Most patients demonstrated ptosis and diplopia, while five of the 12 were unable to raise the head ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/69.3.318
更新日期:1992-09-01 00:00:00
abstract::An oxygen consuming lung model was used for evaluation and validation of a technique for metabolic gas exchange measurements during controlled ventilation. The technique comprised a Servo 900 C ventilator (Siemens) and separate oxygen and carbon dioxide analysers (Beckman). Measurements of oxygen consumption and carbo...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/64.3.311
更新日期:1990-03-01 00:00:00
abstract:BACKGROUND:Patients undergoing non-cardiac, non-vascular surgery are at risk of major cardiovascular complications. In non-cardiac surgery, troponin elevation has previously been shown to be an independent predictor of major adverse cardiac events and postoperative mortality; however, a majority of studies have focused...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,meta分析,评审
doi:10.1093/bja/aew321
更新日期:2016-11-01 00:00:00
abstract::Clevidipine is a new vascular-selective, calcium channel antagonist of the dihydropyridine type with an ester side chain susceptible to esterase metabolism. In healthy volunteers, it has high clearance (0.069 litres min-1 kg-1) with a small volume of distribution at steady state (0.19 litres kg-1). The half-lives of t...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/85.5.683
更新日期:2000-11-01 00:00:00
abstract::As the physiology of deliberate hypotension has been unravelled, and as each new pharmacological agent has become available which either depresses or blocks peripheral vascular tone, depresses myocardial performance, or interferes with the conducting tissues within the myocardium, its possible incorporation into the a...
journal_title:British journal of anaesthesia
pub_type: 历史文章,杂志文章
doi:10.1093/bja/47.7.745
更新日期:1975-07-01 00:00:00
abstract::Riluzole modulates several transmitter systems which may be involved in nociception. Antinociceptive effects have been shown in animal studies, but there are no human data. Therefore, we have examined the acute analgesic effect of riluzole in a human model of inflammatory pain induced by a thermal injury on the distal...
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/82.5.718
更新日期:1999-05-01 00:00:00
abstract::We have investigated, in six healthy male volunteers, the effect of high thoracic extradural anaesthesia on the ventilatory pattern and hypercapnic ventilatory response. Ventilatory variables were determined using a respiratory inductive plethysmograph. Duration of inspiration, rib cage excursion and its contribution ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/62.4.362
更新日期:1989-04-01 00:00:00
abstract::The Gapmeter Lab Kit series of flowmeters has been calibrated using air. Two of the flowmeters were also calibrated using argon and oxygen as the priming gases. Linear calibration graphs have been obtained for all the Gapmeters. The two low flow Gapmeters are extremely susceptible to back-pressure. ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/49.3.277
更新日期:1977-03-01 00:00:00
abstract::We have determined the effect of pretreatment with mivacurium on the potency of suxamethonium and the effect of prior administration of suxamethonium on the potency of mivacurium. We studied 100 ASA I or II patients during thiopentone-fentanyl-nitrous oxide-isoflurane anaesthesia. Neuromuscular block was recorded as t...
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/74.1.26
更新日期:1995-01-01 00:00:00
abstract::Atropine and glycopyrronium are frequently used for premedication to reduce oral and respiratory secretions and prevent bradycardia. Glycopyrronium is said to have similar antisialagogue effects, but is less likely to cause significant tachycardia than atropine. Different antimuscarinic receptor selectivity patterns c...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/74.5.549
更新日期:1995-05-01 00:00:00
abstract:OBJECTIVES:To evaluate the effects of phosphodiesterase type III and V (PDEIII and PDEV) inhibition on pulmonary and systemic haemodynamics in a porcine model of acute pulmonary hypertension. METHODS:Twenty-four adult swine were anaesthetized with 1 MAC isoflurane and mechanically ventilated with an FI(O(2)) of 100%. ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/ael009
更新日期:2006-03-01 00:00:00
abstract:BACKGROUND:We measured the effect of two weight adjusted i.v. doses (0.2 mg per 70 kg and 0.4 mg per 70 kg) of the potent opioid buprenorphine on analgesia and respiratory depression in healthy volunteers. The aim of the study was to compare buprenorphine's behaviour with respect to the occurrence of ceiling (or appare...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/ael051
更新日期:2006-05-01 00:00:00
abstract::One hundred and forty male rats received a cryoinjury to a segment of the exposed sciatic nerve. A variety of temperatures and freeze patterns was used and the recovery of function was monitored. Where obvious nerve freezing occurred, the cryoinjury caused complete loss of function in the limb. The return of motor act...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/53.11.1121
更新日期:1981-11-01 00:00:00
abstract::Forty-five patients undergoing circumcision were allocated randomly to one of three study groups to compare topical analgesia with dorsal nerve block using the midline or lateral approach. Pain scores, side effects and analgesic requirements were recorded after surgery. Patients who received topical analgesia required...
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/73.4.437
更新日期:1994-10-01 00:00:00
abstract::To assess the usefulness of the Gram stain in the early diagnosis of ventilator-associated pneumonia (VAP), we performed 146 protected specimen brushings (PSB) and bronchoalveolar lavages (BAL) in 118 patients suspected of having nosocomial pneumonia. Gram stain and counts of infected cells were performed in all sampl...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/83.6.845
更新日期:1999-12-01 00:00:00