Abstract:
:We have measured the partial pressure of isoflurane simultaneously in inspired gas (PIiso), end-expired gas (PE'iso), mixed-expired gas (PEiso), arterial (Paiso) and mixed venous blood (Pviso) in six patients (aged 57-79 yr) anaesthetized with nitrous oxide, oxygen and isoflurane before surgery and after PE'iso had been stable for at least 15 min. We related these changes to the various indices of pulmonary maldistribution to determine if they were sufficient to explain reported differences between PE'iso and Paiso. Alveolar deadspace dilution of end-expired gas was calculated for carbon dioxide and this dilution factor used to calculate the "ideal" alveolar Piso (PAiso) from the observed inspired and end-expired concentrations. Shunt fraction was measured for oxygen and then used to calculate the partial pressure of isoflurane in the pulmonary end-capillary blood (Pc'iso) from the partial pressure in arterial and mixed venous blood. Mean (SE) values were: PIiso 0.69 (0.05) kPa; PE'iso 0.52 (0.04) kPa; PAiso 0.50 (0.04) kPa; Pc'iso 0.38 (0.04) kPa; Paiso 0.35 (0.03) kPa and Pviso 0.22 (0.02) kPa; Paiso: PE'iso 0.66 (0.02) kPa. The mean "ideal" alveolar to pulmonary end-capillary Piso difference was 0.12 (0.01) kPa and highly significant (P < 0.001). Paiso was substantially less than PE'iso but, for isoflurane, the difference was reasonably constant (range 0.14-0.22 kPa). The difference was attributable in part to the effects of shunt and deadspace, but also a failure of equilibration of isoflurane between the alveolar gas and pulmonary end-capillary blood. It is likely to be different for other anaesthetics. We conclude that, while PE'iso may adequately reflect Paiso for isoflurane, it cannot be assumed that the relation between end-expiratory gas and arterial partial pressures is the same for all anaesthetics.
journal_name
Br J Anaesthjournal_title
British journal of anaesthesiaauthors
Landon MJ,Matson AM,Royston BD,Hewlett AM,White DC,Nunn JFdoi
10.1093/bja/70.6.605subject
Has Abstractpub_date
1993-06-01 00:00:00pages
605-11issue
6eissn
0007-0912issn
1471-6771pii
S0007-0912(17)45810-7journal_volume
70pub_type
杂志文章abstract:BACKGROUND:Intraoperative fluid therapy regimens using oesophageal Doppler monitoring (ODM) to optimize stroke volume (SV) (goal-directed fluid therapy, GDT) have been associated with a reduction in length of stay (LOS) and complication rates after major surgery. We hypothesized that intraoperative GDT would reduce the...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aer273
更新日期:2012-01-01 00:00:00
abstract::We have studied the efficacy of preoxygenation using the Triservice Anaesthetic Apparatus (TSA) in healthy patients and found it to be unsatisfactory. An alternative technique suitable for field use was explored. The Mapleson D system (Bain) was found to be suitable for preoxygenation with a fresh gas flow of only 4 l...
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/66.2.196
更新日期:1991-02-01 00:00:00
abstract::We carried out a randomized prospective study in 60 patients who had undergone major abdominal surgery for cancer. For postoperative pain control, 30 patients received continuous extradural infusion of 0.125% bupivacaine 12.5 mg h-1 and morphine 0.25 mg h-1 (EXI group) and 30 received patient-controlled analgesia (PCA...
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/80.6.742
更新日期:1998-06-01 00:00:00
abstract::Forty patients (age range 60-79 yr) undergoing transurethral surgery were allocated randomly to receive 0.5% plain bupivacaine 4 ml at the L2-3 (n = 20) or L4-5 (n = 20) space. The solution was injected over 30 s with the patient in the sitting position. The patient was kept sitting for 2 min, then placed supine and, ...
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/64.2.170
更新日期:1990-02-01 00:00:00
abstract::We gave either midazolam or propofol for induction of anaesthesia to 140 ASA I or II female patients (18-60 yr). ED50 values were obtained by probit analysis for three clinical end-points: loss of response to command; loss of eyelash reflex; failure to respond to application of an anaesthetic face mask delivering 1% i...
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/69.3.240
更新日期:1992-09-01 00:00:00
abstract::A 4-year-old girl developed severe hepatitis following the fourth administration of halothane in a period of 5 months. She was shown to have a circulating antibody which acted specifically against rabbit hepatocyte previously sensitized to halothane. The patient made a full recovery from the hepatitis, but 5 months la...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/54.3.349
更新日期:1982-03-01 00:00:00
abstract::The study was performed to determine the ED50 and ED95 of a continuous infusion of the emulsion formulation of propofol during 67% nitrous oxide anaesthesia in 57 patients premedicated with morphine sulphate 0.15 mg kg-1. Anaesthesia was induced with propofol 2 mg kg-1, and maintained before incision with a fixed-rate...
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/58.10.1080
更新日期:1986-10-01 00:00:00
abstract:BACKGROUND:The aim of this study was to test if intraoperative administration of N(2)O during propofol-remifentanil anaesthesia prevented the onset of postoperative opioid-induced hyperalgesia (OIH). METHODS:Fifty adult ASA I-II patients undergoing elective open septorhinoplasty under general anaesthesia were studied....
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aer323
更新日期:2011-12-01 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:BACKGROUND:Pain management in craniotomy patients is challenging, with mild-to-moderate pain intensity, moderate-to-high risk of postoperative nausea and vomiting (PONV), and potentially catastrophic consequences of analgesic-related side-effects. The aim of this study was to determine whether i.v. parecoxib administer...
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/aer223
更新日期:2011-09-01 00:00:00
abstract::Placental transfer of 14C-dimethyltubocurarine (14C-dmtc) was studied during Caesarean section. Liquid scintillation counting was used for determination of 14C activity from the maternal and foetal blood samples. Paper chromatography was used to confirm the stability of 14C-dmtc. In all cases 14C-dmtc was able to cros...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/48.3.239
更新日期:1976-03-01 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::Blood transfusion saves many lives but carries significant risk of injury. Currently, red blood cell (RBC) concentrates can be stored up to 42 days. Concerns have recently been raised about the safety and efficacy of transfusing stored RBCs. Refrigerated storage results in a 'storage lesion' that is reflected by metab...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/aet405
更新日期:2013-12-01 00:00:00
abstract:Background:Retrospective clinical studies suggest there is a risk for neurodevelopmental impairment following early childhood exposure to anaesthesia. In the developing animal brain, including those of non-human primates (NHPs), anaesthetics induce apoptotic cell death. We previously reported that a 5 h isoflurane (ISO...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aex123
更新日期:2017-09-01 00:00:00
abstract::The efficacy of nitroglycerine, verapamil and nifedipine in controlling post-sternotomy hypertension was compared in four groups of 20 patients anaesthetized with fentanyl 100 micrograms kg-1 undergoing elective coronary artery surgery. Vasodilators were started before surgery and adjusted to maintain systolic arteria...
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/58.3.267
更新日期:1986-03-01 00:00:00
abstract::We have studied the effects of alfentanil administered intrathecally on somatosympathetic reflexes evoked by stimulation of radial and tibial nerves in 10 anaesthetized and paralysed dogs. In five animals, alfentanil was administered in doses of 100, 100, 200 and 400 micrograms in 0.8 ml and 800 micrograms in 1.6 ml p...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/68.5.503
更新日期:1992-05-01 00:00:00
abstract::In nine patients, undergoing repeat operations because of severe intra-abdominal infection developing after major abdominal surgery, serum potassium concentrations were monitored during induction of anaesthesia. Four patients showed an increase of serum potassium ranging from 2.5 to 3.1 mmol/litre above baseline value...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/48.6.557
更新日期:1976-06-01 00:00:00
abstract::The influence of halothane was studied on train-of-four fade during spontaneous recovery from neuromuscular block produced by atracurium in 42 children undergoing routine surgical procedures under general anaesthesia. The ulnar nerve was stimulated at the wrist, and compound electromyographic responses were recorded f...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/65.4.540
更新日期:1990-10-01 00:00:00
abstract:BACKGROUND:Reported outcome benefits after surgical pleth index (SPI, GE Healthcare, Helsinki, Finland) guided anaesthesia are conflicting. One potential explanation may be the lack of evidence for the selection of meaningful SPI target values. A recently published trial found an SPI cut-off of 30 as a 'best-fit' to pr...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1016/j.bja.2018.10.066
更新日期:2019-08-01 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::A patient with a tracheostomy and an iatrogenic tracheo-oesophageal fistula presented for diagnostic bronchoscopy and right upper lobectomy. The anaesthetic management is discussed with reference to the options available and, in particular, the use of a Brompton Pallister single lumen endobronchial tube. ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/74.4.461
更新日期:1995-04-01 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::Recent research has shown that high-frequency, gamma-band electroencephalographic (EEG) oscillations (40-60 Hz) may be an important marker of the conscious state. We compared the ability of the bispectral index (BIS) to distinguish the awake and anaesthetized states during the induction of general anaesthesia with: (i...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/86.1.50
更新日期:2001-01-01 00:00:00
abstract::Bispectral index (BIS) was assessed as a monitor of depth of anaesthesia during fentanyl and midazolam anaesthesia for coronary bypass surgery. In 10 patients given morphine premedication, anaesthesia was induced with a combination of midazolam and fentanyl and thereafter maintained with a continuous infusion of a mix...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/oxfordjournals.bja.a013587
更新日期:2000-06-01 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::The concentrations of volatile hydrocarbons were studied in breath samples from patients before and after anaesthesia. In patients to whom halothane was administered, there was a significant increase in the concentration of isobutene (from 0.43 +/- 0.09 to 4.66 +/- 2.22 nmol litre-1). There was no change in the concen...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/52.10.989
更新日期:1980-10-01 00:00:00
abstract::Regional haemodynamic control by the cardiovascular baroreceptors was examined in dogs anaesthetized with 1 + MAC halothane in oxygen (1%). The open-loop relationships between carotid sinus pressure (CSP) and regional haemodynamics in the iliac, renal, mesenteric, aortic and coeliac beds were examined before vagotomy,...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/49.6.535
更新日期:1977-06-01 00:00:00
abstract::We report a case of lumbar radiculopathy after zygapophyseal joint injections for chronic low back pain. The management of the patient and potential causes for the radiculopathy are discussed. The case acts as a reminder that the spinal nerve roots should be considered when performing intra-articular facet joint injec...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aem178
更新日期:2007-09-01 00:00:00
abstract::The use of atracurium during major abdominal surgery was assessed in 20 infants with hepatic dysfunction caused by biliary atresia. An initial dose of 0.6 mg kg-1 provided excellent intubating conditions in all patients. Subsequent neuromuscular blockade was monitored with a peripheral nerve stimulator and incremental...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/58.11.1214
更新日期:1986-11-01 00:00:00
abstract:BACKGROUND:Lidocaine is frequently used as an agent to treat ventricular arrhythmias associated with acute myocardial ischaemia. Lidocaine is a potent blocker not only of sodium channels, but also of ATP-sensitive potassium channels. The opening of these channels is a key mechanism of ischaemic preconditioning. We inve...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aeh262
更新日期:2004-11-01 00:00:00