Abstract:
:Conventional extradural analgesia during labour with 0.25-0.375% bupivacaine may induce motor weakness and subjective sensory deficit, reducing maternal satisfaction. Even in a regimen for ambulatory extradural analgesia (0.1% bupivacaine-fentanyl 2 micrograms ml-1), a potential for proprioreception impairment exists, which may impair safe ambulation. We have combined fentanyl with clonidine for extradural analgesia in labour, and compared its effects with 0.25% bupivacaine, in a randomized, double-blind study. We studied 28 women requesting extradural analgesia for labour; they were allocated randomly to either group 1, who received clonidine 120 micrograms with fentanyl 50 micrograms, or group 2, who received bupivacaine 25 mg. Detailed clinical neurological examination was undertaken 30 min later. Pain was assessed subjectively using a 10-cm visual analogue scale (VAS). There were no significant differences in VAS between the groups at any time. Median onset of analgesia was longer in group 1 (24.3 (interquartile range 20-35) compared with 17.5 (15-25) min) (P < 0.05) and 79% of group 1 vs 86% of group 2 patients reported a high degree of satisfaction with extradural analgesia. Patients in group 2 had a much higher incidence of motor weakness (P < 0.01), impaired perception of pinprick (P < 0.01) and impaired distal joint proprioception (P < 0.05) than group 1. We conclude that clonidine 120 micrograms-fentanyl 50 micrograms provided comparable extradural analgesic efficacy as 0.25% bupivacaine for the first stage of labour. Furthermore, unwanted neurological effects were significantly less.
journal_name
Br J Anaesthjournal_title
British journal of anaesthesiaauthors
Buggy DJ,MacDowell Cdoi
10.1093/bja/76.2.319subject
Has Abstractpub_date
1996-02-01 00:00:00pages
319-21issue
2eissn
0007-0912issn
1471-6771pii
S0007-0912(17)43913-4journal_volume
76pub_type
临床试验,杂志文章,随机对照试验abstract::In 1849 John Snow, already the leading anaesthetic practitioner and innovator of his day, made a historic contribution to the epidemiology of infectious disease by his famous study of the distribution of cholera around the area of Broad Street in London. We report on our experience as anaesthetists in a field hospital...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/75.6.810
更新日期:1995-12-01 00:00:00
abstract:BACKGROUND:Forty-eight ASA I-II patients undergoing total abdominal hysterectomy (TAH) were studied in a double blind, randomized placebo controlled trial of parecoxib for postoperative analgesia. METHODS:All patients were given propofol 2-4 mg kg(-1) i.v., a non-depolarizing muscle relaxant, morphine 10 mg i.v. and p...
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/aeg139
更新日期:2003-06-01 00:00:00
abstract::A 72-yr-old patient was to undergo a left lumbar plexus block by the posterior approach to achieve postoperative analgesia after hip replacement. The block failed after three unsuccessful attempts to identify nerve structures and a fascia iliaca compartment block was performed. Postoperatively the patient received eno...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aeh242
更新日期:2004-10-01 00:00:00
abstract:BACKGROUND:Handover of anaesthesia patient care during surgery is common; however, its association with patient outcome is unclear. This systematic review aimed to assess the impact of anaesthesia handover during surgery on patient outcome. METHODS:All prospective and retrospective clinical studies specifically invest...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,meta分析
doi:10.1016/j.bja.2020.05.062
更新日期:2020-10-01 00:00:00
abstract::We present a case of pulmonary thromboendarterectomy performed successfully in a patient with stomatocytosis. Stomatocytosis is a rare condition of abnormal erythrocyte morphology in which haemolysis and hyperkalaemia occur at cooler temperatures. A 35-yr-old male with stomatocytosis was referred for pulmonary thrombo...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aeg237
更新日期:2003-11-01 00:00:00
abstract::The induction dose requirements of propofol were compared in three age groups in 300 unpremedicated healthy Chinese children: group A, younger than 2 yr (n = 48); group B, 2-5 yr (n = 117); group C, 6-12 yr (n = 135). Patients in each group were allocated randomly to receive one of eight doses of propofol (1.2, 1.4, 1...
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/68.1.64
更新日期:1992-01-01 00:00:00
abstract:BACKGROUND:Tetrodotoxin (TTX) is a powerful sodium channel blocker extracted from the puffer fish. The analgesic effects of TTX were investigated in different animal pain models. METHODS:Wistar rats were submitted to the formalin test and to partial ligation of the sciatic nerve (Seltzer's model). Swiss Webster mice w...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/ael096
更新日期:2006-06-01 00:00:00
abstract:BACKGROUND:None of the currently available hypnosis monitoring systems have evaluated balanced xenon anaesthesia. We investigated the performance of the bispectral index (BIS) and the composite A-line autoregressive index (cAAI) while comparing balanced xenon with sevoflurane anaesthesia. METHODS:Sixty patients underg...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aeq163
更新日期:2010-09-01 00:00:00
abstract:BACKGROUND:This study evaluated the A-Line Autoregressive Index (AAI) response to surgical stimulation during lumbar arthrodesis, as an estimate of the anti-nociceptive component of a Bispectral Index (BIS) guided anaesthesia combined with epidural analgesia. METHODS:An epidural catheter was inserted in 23 patients al...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/ael004
更新日期:2006-03-01 00:00:00
abstract:BACKGROUND:Previous national survey research has shown significant deficits in routine postoperative pain management in the UK. This study used an organizational change perspective to explore in detail the organizational challenges faced by three acute pain services in improving postoperative pain management. METHODS:...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,多中心研究
doi:10.1093/bja/aep066
更新日期:2009-06-01 00:00:00
abstract::The interaction of three new non-depolarizing neuromuscular blocking agents--atracurium, vecuronium and Duador--on human red cell acetylcholinesterase (AChE; EC 3.1.1.7) and human plasma butyrylcholinesterase (BuChE; EC 3.1.1.8) was investigated. The binding of these neuromuscular blockers to human plasma proteins (pr...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:
更新日期:1983-01-01 00:00:00
abstract::We investigated in 60 patients scheduled for elective aorto-coronary bypass grafting if loud sounds by themselves can induce cardiovascular responses and if these could be related to mid-latency auditory evoked potentials (MLAEP). Anaesthesia was induced in group I (n = 20) with flunitrazepam-fentanyl 0.01 mg kg-1 and...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/72.3.307
更新日期:1994-03-01 00:00:00
abstract:BACKGROUND:The use of lipid emulsions to reduce cardiac toxicity of local anaesthetics (LAs) has shown success in experimental studies and some clinical cases, and thus has been implemented in clinical practice. However, lipid treatment is usually given after the occurrence of neurological or cardiovascular symptoms of...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aet353
更新日期:2014-04-01 00:00:00
abstract::By analysing the EEG, reticular multi-unit activity and behavioural changes, we have classified general anaesthetics into three groups: central nervous system (CNS) depressant, CNS excitant and epileptogenic agents. Changes in CNS neural activity are associated with alteration in transmitter release. We have attempted...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/80.3.365
更新日期:1998-03-01 00:00:00
abstract::Dose-duration relationships for vecuronium were determined and the duration of action produced by vecuronium 0.3 mg kg-1 shown to equal that of pancuronium 0.1 mg kg-1. Using these doses, the neuromuscular blocking properties and cardiovascular effects of the two drugs were compared. With large dose administration of ...
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/61.2.180
更新日期:1988-08-01 00:00:00
abstract::Studies with an emulsion formulation of ICI 35 868 (2,6- diisopropylphenol ) indicate that this new formulation has anaesthetic properties in rats and mice, and haemodynamic effects in the mini-pig which are similar to those of the previously available Cremophor formulation. Administration of the emulsion formulation ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/56.6.617
更新日期:1984-06-01 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::We have examined the influence of electrical stimulation on caffeine-induced tension generation during contracture testing used to diagnose malignant hyperthermia. The cumulative contracture response to caffeine was compared in pairs of morphologically comparable muscle bundles obtained from the same patient. Only one...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/69.1.87
更新日期:1992-07-01 00:00:00
abstract::We have investigated the effect of dopamine and dopexamine on the isolated perfused rat kidney. After an equilibration period of 20 min and two control periods of 10 min, dopexamine 1.0, 2.5 or 4.0 micrograms kg-1 min-1 or dopamine 2.0 micrograms kg-1 min-1 were perfused for a further 40 min in random order. Renal blo...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/83.6.898
更新日期:1999-12-01 00:00:00
abstract:BACKGROUND:Ketamine is widely used as an i.v. anaesthetic agent and as a drug of abuse. Hepatocytes contribute to the metabolism of endogenous and exogenous substances. This study evaluated the toxic effects of S-(+)-ketamine and possible mechanisms using human hepatoma HepG2 cells as the experimental model. METHODS:H...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aen322
更新日期:2009-01-01 00:00:00
abstract::Intravenous dose-response relationships for dimethyl tubocurarine showed that vagal blockade only became appreciable (50-83%) at doses 8-16 times those sufficient for full neuromuscular paralysis in anaesthetized cats (0.0625 mg/kg) and rhesus monkeys (0.125 mg/kg); heart rate was unchanged. Sympathetic function was u...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/48.9.847
更新日期:1976-09-01 00:00:00
abstract::Summary While complex physiological mechanisms exist to regulate and optimize tissue oxygenation under various conditions, clinical and experimental evidence indicates that anaemia, unchecked, is associated with organ injury and unfavourable outcomes. More data (especially from human studies) are needed to answer ques...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/aer350
更新日期:2011-12-01 00:00:00
abstract::Successful tracheal intubation with the flexible fibreoptic bronchoscope requires a certain amount of skill which is acquired by practice. It has been suggested that the new Bullard laryngoscope may be mastered more easily. To determine if learning was superior with a flexible fibreoptic or the Bullard device, the eas...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/65.2.268
更新日期:1990-08-01 00:00:00
abstract:BACKGROUND:Cerebral state index (CSI) has recently been introduced as an intra-operative monitor of anaesthetic depth. We compared the performance of the CSI to the bispectral index (BIS) in measuring depth of anaesthesia during target-controlled infusion (TCI) of propofol. METHODS:Twenty Chinese patients undergoing g...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aei253
更新日期:2005-12-01 00:00:00
abstract:BACKGROUND:Chronic pain is no longer an effective warning system, but a syndrome with co-morbidities and many causes, needing a careful evaluation. Questions remain about the pain behaviour of chronic pain patients compared with patients with acute pain, or healthy subjects that we investigated. METHODS:We compared th...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1016/j.bja.2018.04.042
更新日期:2018-09-01 00:00:00
abstract::The role of endothelin-1, a potent vasoconstrictor released by vascular endothelium, in the vasoconstriction that develops after prolonged operations is not clear. This study was performed in order to determine if there was any relationship between endothelin-1 and the degree of vasoconstriction during prolonged plast...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/74.6.661
更新日期:1995-06-01 00:00:00
abstract::Intraoperative awareness, with or without recall, continues to be a topic of clinical significance and neurobiological interest. In this article, we review evidence pertaining to the incidence, sequelae, and prevention of intraoperative awareness. We also assess which aspects of the complication are well understood (i...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/aev034
更新日期:2015-07-01 00:00:00
abstract::Critical narrowing of the dependent airways was examined in anaesthetized dogs with closed chests. Two techniques were used, (a) "closing" volume (CV), measured from the expired nitrogen plateau and (b) tantalum bronchography, to measure the calibre of airways of 3-8 mm diameter in the upper (UZ), middle (MZ) and lowe...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/50.8.735
更新日期:1978-08-01 00:00:00
abstract:BACKGROUND:Early clot amplitudes measured on thromboelastometry (ROTEM®) predict maximum clot firmness (MCF) in adults. In this multicentre, retrospective study, we aimed to confirm the suspected relationship between early ROTEM® variables and MCF, in children undergoing cardiac or non-cardiac surgery. METHODS:4762 RO...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,多中心研究
doi:10.1093/bja/aev369
更新日期:2015-12-01 00:00:00
abstract::Using human nasal cytological brushings, we have investigated the effects of morphine on ciliary function by measurement of cilia beat frequency in vitro, and we have also determined opioid receptor binding in these specimens. We obtained ciliated samples from seven volunteers, and measured cilia beat frequency using ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/76.2.274
更新日期:1996-02-01 00:00:00