Abstract:
:We have tested the hypothesis that intradermal testing is a more effective method for determining the drug responsible for anaesthetic anaphylactic reactions than prick testing in 212 consecutive patients, aged more than 10 yr, referred to an anaesthetic allergy clinic over a 4-yr period. The study was a prospective, non-randomized design. Intradermal testing was conducted using a previously described method and diluted drugs, and prick testing using undiluted drugs (with the exception of opioid analgesics which were diluted 1:10). The tests were performed on individual patients' forearms on the same occasion. Patients were followed-up to determine the results of subsequent anaesthesia and the difference between tests was analysed using kappa and tau statistics. There was 93% agreement overall between the paired tests. Which test detected the drug responsible was dependent on diagnostic criteria for positivity. The differences between the tests were not statistically significant. Using both tests improved predictability by 67% (tau = 0.67, P < 0.001). We conclude that in the absence of data to support one test being superior, other factors influence the choice of test. Prick testing was cheaper, and the reduction in pain and trauma with prick testing makes it more suitable for children. However, there are no data available on the safety of subsequent anaesthesia based on the results of prick testing alone, and reliability with time has not been assessed. Intradermal testing may be easier for the infrequent user. Skin testing is valuable in the investigation of anaesthetic anaphylaxis whichever test is chosen. When there is doubt both tests should be performed.
journal_name
Br J Anaesthjournal_title
British journal of anaesthesiaauthors
Fisher MM,Bowey CJdoi
10.1093/bja/79.1.59subject
Has Abstractpub_date
1997-07-01 00:00:00pages
59-63issue
1eissn
0007-0912issn
1471-6771pii
S0007-0912(17)39905-1journal_volume
79pub_type
临床试验,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 effect of clonidine, dexmedetomidine and morphine on gastric emptying and gastrointestinal transit in the rat. In one group, each agonist was injected i.p. in 6-12 male Wistar rats. In another group of rats, yohimbine, naloxone or saline was injected with an agonist. At 30 min, radiolabelled saline...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/78.3.301
更新日期:1997-03-01 00:00:00
abstract::"Priming" with alcuronium has been studied in 72 female patients. Blockade of single twitch responses of the adductor pollicis by alcuronium 0.15, 0.2 or 0.3 mg kg-1 could be accelerated by priming with a suitable priming portion of the total dose. Giving alcuronium 0.04 mg kg-1 30 s after the induction of anaesthesia...
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/58.8.827
更新日期:1986-08-01 00:00:00
abstract::The metabolic effect of infusing 1.0-1.5 litre of Hartmann's solution to normal subjects and those with maturity onset diabetes has been studied during surgery. It was found that the use of Hartmann's solution after operation was associated with a 7.5 mmol litre-u increase in plasm glucose concentration compared with ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/50.2.185
更新日期:1978-02-01 00:00:00
abstract::The haemodynamic responses to isovolumic anaemia (dextran-for-blood exchange) were studied in seven dogs pretreated with propranolol 20 mg/kg body weight for 3 weeks. Adrenergic beta-receptor blockade did not prevent significant increases in heart rate (up to 19%). Cardiac output increased by about 20% while systemic ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:
更新日期:1980-03-01 00:00:00
abstract::One hundred and one patients with osteoarthritis were randomly allocated to undergo total hip arthroplasty under either spinal (subarachnoid) or general anaesthesia. Venous blood was sampled before, during and after surgery and on the 5th day after operation to study the haemostatic mechanism. There were no preoperati...
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/59.5.561
更新日期:1987-05-01 00:00:00
abstract::The time course of the plasma lignocaine concentration, following caudal anaesthesia, was studied in 11 healthy children (3.5-9 yr). Plasma lignocaine concentrations were measured for up to 6 h after administration (5 mg kg-1). Peak plasma concentration was 2.05 +/- 0.08 micrograms ml-1 and occurred at 28.2 +/- 2.9 mi...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/56.12.1399
更新日期:1984-12-01 00:00:00
abstract::Two techniques for endotracheal anaesthesia in dental outpatients have been compared: a spontaneous ventilation technique using nitrous oxide, oxygen and halothane, and a controlled ventilation technique using nitrous oxide and oxygen, with tubocurarine and fentanyl. The latter technique has several advantages: abolit...
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/48.9.919
更新日期:1976-09-01 00:00:00
abstract::We randomized women having elective Caesarean section to receive either no preload (control group, n=33) or 4% gelatin solution (Gelofusine) 15 ml kg(-1) (colloid group, n=35) i.v. before spinal anaesthesia. Intravenous metaraminol was titrated at 0.25-0.75 mg min(-1) to maintain systolic arterial pressure (SAP) in th...
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/87.5.772
更新日期:2001-11-01 00:00:00
abstract:BACKGROUND:Short-axis ultrasound-guided placement of central venous catheters (CVCs) is widely accepted as safe practice. However, utilizing the long-axis approach could further improve safety, as it allows for better visualization of the needle as it is advanced to the target vessel. However, the long-axis approach ha...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aer329
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND:Movement responses are an important indicator of noxious perception in the unconscious state. To allow for a continual monitoring of the responsiveness to noxious stimuli during general anaesthesia, surrogate parameters are needed. Here we compare the performance of the bispectral index (BIS) and the RIII th...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aep357
更新日期:2010-02-01 00:00:00
abstract:BACKGROUND:Obstructive sleep apnoea (OSA) affects ~9-24% of the general population, and 90% remain undiagnosed. Those patients with undiagnosed moderate-to-severe OSA may be associated with an increased risk of perioperative complications. Our objective was to evaluate the proportion of surgical patients with undiagnos...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aes465
更新日期:2013-04-01 00:00:00
abstract:BACKGROUND:Microvascular dysfunction is considered to play an important pathophysiological role in sepsis. We addressed the hypothesis that macrovascular and microvascular flow are uncoupled in early sepsis, using a rodent model with well-characterized haemodynamic and biochemical markers of severity and subsequent mor...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aes093
更新日期:2012-06-01 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::Three anaesthetic techniques based on isoflurane were compared in outpatients undergoing laparoscopy. Sixty healthy patients were randomly allocated to receive isoflurane via mask (spontaneous respiration), via tracheal tube (spontaneous respiration) or via tracheal tube with controlled ventilation. Moderate hypercarb...
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/59.2.189
更新日期:1987-02-01 00:00:00
abstract:BACKGROUND:There is considerable evidence that the use of tidal volumes <6 ml kg(-1) predicted body weight (PBW) reduces mortality in mechanically ventilated patients. We evaluated the effectiveness of using a large screen displaying delivered tidal volume in ml kg(-1) (PBW) for reducing tidal volumes. METHODS:We asse...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aev110
更新日期:2015-08-01 00:00:00
abstract:BACKGROUND:Beta-adrenergic agonists enhance behavioural and electroencephalographic arousal reactions. We explored whether adding esmolol, a short-acting beta(1)-adrenoceptor antagonist, to propofol anaesthesia modified the bispectral index (BIS) during induction of anaesthesia and orotracheal intubation. METHODS:Fift...
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/aef275
更新日期:2002-12-01 00:00:00
abstract::We present a case where rocuronium 80 mg (3 x ED95) was used in a rapid sequence induction in a 80-kg pregnant patient with an open eye injury. The patient was also receiving magnesium 2 g h-1 i.v. for preterm labour. The expected duration for neuromuscular block of rocuronium in the absence of magnesium would be appr...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/77.5.669
更新日期:1996-11-01 00:00:00
abstract::The effect of the combination of opiates and hypnotics on bispectral index (BIS) is unclear. This double-blind placebo-controlled trial investigated the effect on BIS and sedation of different infusion doses of remifentanil combined with a steady infusion of propofol. Forty patients initially received a target-control...
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/oxfordjournals.bja.a013474
更新日期:2000-04-01 00:00:00
abstract:BACKGROUND:Guidelines recommend discontinuation of clopidogrel for 7 days before a neuraxial injection, while other directives suggest that 5 days might be adequate. We examined the time course of antiplatelet activity after clopidogrel discontinuation in patients undergoing epidural injections. METHODS:Thirteen patie...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aer298
更新日期:2011-12-01 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:BACKGROUND:The effects of thoracic epidural anaesthesia (TEA) on gastric mucosal microvascular haemoglobin oxygenation (microHbO(2)) are unclear. At the splanchnic level, reduction of sympathetic tone may promote vasodilation and increase microHbO(2). However, these splanchnic effects are counteracted by systemic effec...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aeh235
更新日期:2004-10-01 00:00:00
abstract::We describe three histaminoid reactions occurring on induction of anaesthesia. The patients were all resuscitated successfully and subsequent skin testing suggested sensitivity to rocuronium. In this hospital, the incidence of such reactions is of the order of 1 in 3000. This may be coincidental but suggests that ther...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/oxfordjournals.bja.a013365
更新日期:2000-01-01 00:00:00
abstract:BACKGROUND:Emotional information has the ability to alter the formation and strength of a memory ('memory modulation'). Memory modulation by negative emotion is mediated by the amygdala. It is not known how gamma aminobutyric acid (GABA)ergic drugs affect the processes involved in memory modulation. This study investig...
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/aeh211
更新日期:2004-09-01 00:00:00
abstract:BACKGROUND:The safety of performing spinal anaesthesia for both patients and anaesthetists alike in the presence of active infection with the novel coronavirus disease 2019 (COVID-19) is unclear. Here, we report the clinical characteristics and outcomes for both patients with COVID-19 and the anaesthetists who provided...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1016/j.bja.2020.03.007
更新日期:2020-06-01 00:00:00
abstract:BACKGROUND:Clinicians frequently warn patients of discomfort before potentially painful procedures, despite the lack of evidence that such communications are helpful. We aimed to compare two communications (one with, and the other without, a warning of a 'sting') immediately before i.v. cannulation in order to measure ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aem308
更新日期:2007-12-01 00:00:00
abstract::A modification of an i.v. regional anaesthesia (IVRA) technique is described in which the arm is re-exsanguinated before surgery (re-IVRA). IVRA and re-IVRA were compared for quality of operative field, sensory and motor block, quality of analgesia and blood concentrations of prilocaine, lignocaine and mepivacaine in ...
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/70.3.280
更新日期:1993-03-01 00:00:00
abstract:BACKGROUND:The efficacy of opioids typically decreases after long-term use owing to the development of tolerance. Glial activation and the upregulation of proinflammatory cytokines are related to the induction of tolerance. We investigated the effect of leukemia inhibitory factor (LIF) on morphine analgesia and toleran...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aew247
更新日期:2016-10-01 00:00:00
abstract::We describe an obstetric patient who presented for removal of a retained placenta. After insertion of the spinal anaesthetic, she developed a severe headache, and a subarachnoid haemorrhage was diagnosed. We discuss the differential diagnosis of the headache, the occurrence of intracranial haemorrhages after dural pun...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/86.3.442
更新日期:2001-03-01 00:00:00
abstract::Sleep disordered breathing is a common problem affecting all age groups, particularly in association with certain other medical conditions and syndromes. The pathological consequences of the disorder may be severe, with significant implications for the perioperative management of sufferers. Research into the effects o...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/86.2.254
更新日期:2001-02-01 00:00:00