Abstract:
:Tissue damage during surgery induces coagulation factors and activates platelets. Surgical pain may provoke release of catecholamines, leading to hypercoagulability. We have investigated the effect of surgical pain on blood coagulability and fibrinolysis in orthopaedic operations using tourniquets in 22 patients undergoing total knee replacement. Patients were allocated to one of two groups to receive extradural anaesthesia (EA; n = 11) or general anaesthesia (GA; n = 11). The EA group received lumbar extradural block with lidocaine. The GA group received only general anaesthesia, maintained with 1.5-2.5% sevoflurane and 66% nitrous oxide in oxygen. Using a thrombelastogram technique, blood coagulability and fibrinolysis were measured. Mean maximum amplitude (MA), which reflects coagulability, increased after tourniquet inflation (11%) in group GA whereas MA in group EA did not change. After tourniquet deflation, MA values in both GA and EA groups increased significantly (10% and 20%, respectively) (P < 0.05), and there was also a significant difference in MA between groups (P < 0.05). The fibrinolytic rate did not change in either group during tourniquet inflation, but increased significantly (160%) after tourniquet deflation. There was no significant difference in fibrinolytic rate between the groups. We conclude that the hypercoagulability seen in group GA could have been caused by surgical or tourniquet pain, or both, and that extradural anaesthesia is a useful technique to prevent hypercoagulability.
journal_name
Br J Anaesthjournal_title
British journal of anaesthesiaauthors
Kohro S,Yamakage M,Arakawa J,Kotaki M,Omote T,Namiki Adoi
10.1093/bja/80.4.460subject
Has Abstractpub_date
1998-04-01 00:00:00pages
460-3issue
4eissn
0007-0912issn
1471-6771pii
S0007-0912(17)40464-8journal_volume
80pub_type
临床试验,杂志文章,随机对照试验abstract::Moderate to severe arterial oxygen desaturation (SaO2 75-88%) occurred in three of four patients who were given sedation during regional conduction block without the administration of oxygen. No desaturation occurred in six patients given oxygen 2 litre min-1 via a nasal catheter during similar procedures. It is concl...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/62.2.206
更新日期:1989-02-01 00:00:00
abstract:BACKGROUND:The optimal dose of oxytocin at Caesarean section is unclear. Oxytocin may cause adverse cardiovascular effects, including tachycardia and hypotension, whereas an inadequate dose can result in increased uterine bleeding. We compared the effects of two doses of oxytocin in a randomized double-blind trial. ME...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aen273
更新日期:2008-12-01 00:00:00
abstract:BACKGROUND:The role of repeated prone positioning in intubated subjects with acute respiratory distress syndrome caused by COVID-19 remains unclear. METHODS:We conducted a retrospective observational cohort study of critically ill intubated patients with COVID-19 who were placed in the prone position between March 18,...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1016/j.bja.2020.09.042
更新日期:2021-01-01 00:00:00
abstract::We describe the anaesthetic management of a patient undergoing lobectomy for cavitating lung abscess complicated by haemoptysis. Surgery for lung abscess is one of the absolute indications for the use of a double-lumen tube (DLT). Because pus or blood could impede fibreoptic-assisted DLT placement, a traditional, blin...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/85.5.791
更新日期:2000-11-01 00:00:00
abstract::A randomized, double-blind study of 40 women was performed to compare patient controlled anaesthesia (PCA) morphine requirements after spinal anaesthesia for elective Caesarean section. The women received 0.2 mg of either morphine or diamorphine mixed with 0.5% bupivacaine in 8% dextrose. There were no significant dif...
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/81.2.135
更新日期:1998-08-01 00:00:00
abstract::Intravenous doses of 0.3 mg/kg dimethyl tubocurarine were required for consistent and adequate surgical relaxation in patients during nitrous oxide anaesthesia and produced virtually complete neuromuscular paralysis (96-100%) of the tetanic and twitch responses of the adductor pollicis muscle. The duration of action o...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/48.10.969
更新日期:1976-10-01 00:00:00
abstract:BACKGROUND:There are regional differences in the effects of anaesthetics agents and perioperative stimuli on the EEG. We studied the topography of the EEG during induction of anaesthesia and intubation in patients receiving thiopental and fentanyl to document regional electrical brain activity. METHODS:EEG was recorde...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aeh020
更新日期:2004-01-01 00:00:00
abstract::We have studied the effect of P6 acupuncture on postoperative vomiting in 45 children undergoing tonsillectomy. After induction of anaesthesia and before the start of surgery, 50% of the patients received P6 acupuncture (in the middle of the ventral surface of the wrist) for 5 min. There was no difference in the incid...
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/67.6.779
更新日期:1991-12-01 00:00:00
abstract::Diaphragm strength can be assessed from twitch gastric (TwPgas), twitch oesophageal (TwPoes), and twitch transdiaphragmatic pressure (TwPdi) in response to phrenic nerve stimulation. This requires the passage of balloon catheters, which may be difficult. Changes in pressure measured at the mouth during phrenic nerve s...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/87.6.876
更新日期:2001-12-01 00:00:00
abstract::We report the successful preoperative control and anaesthetic management of severe hypertension in a 7-month-old baby with nephroblastoma and increased renin activity. The strategy for selection of appropriate antihypertensive pharmacological agents and the anaesthetic implications and management of the condition are ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/69.2.206
更新日期:1992-08-01 00:00:00
abstract::Mean venous pressures were measured in 20 patients in whom a catheter, inserted via the external jugular vein, failed to pass centrally. The catheter used had a rounded end and two side holes. Pressures were measured with the patient's head in three different positions. The pressures were compared with the central ven...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/58.12.1384
更新日期:1986-12-01 00:00:00
abstract::The majority of patients with acute respiratory distress syndrome (ARDS) require mechanical ventilation. This support provides time for the lungs to heal, but the adverse effects of mechanical ventilation significantly influence patient outcome. Traditionally, these were ascribed to mechanical effects, such as haemody...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/aeh031
更新日期:2004-02-01 00:00:00
abstract::We present a new pattern of nerve stimulation--double burst stimulation (DBS)--to detect residual neuromuscular block manually. The DBS consists of two short lasting, 50-Hz tetanic stimuli or bursts separated by a 750-ms interval. The response to this pattern of stimulation is two single separated muscle contractions ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/62.3.274
更新日期:1989-03-01 00:00:00
abstract::We have studied the effects of stepwise increasing infusion rates of propofol 200-500 micrograms kg-1 min-1 on blood concentrations of propofol and the disposition and clearance of a bolus dose of indocyanine green (ICG) 0.5 mg kg-1 in 10 acutely instrumented dogs. Drug concentrations and ICG clearance were measured 3...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/72.4.451
更新日期:1994-04-01 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::Plasma concentrations of amethocaine were measured after topical application of amethocaine cream 2 g (5% w/w) to the dorsum of the right hand of 10 adult volunteers. The cream was applied for 240 min and plasma was assayed for amethocaine and its metabolite p-n-butylaminobenzoic acid at 0, 30, 60, 90, 120 and 240 min...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/67.4.432
更新日期:1991-10-01 00:00:00
abstract::A variant of a rebreathing/indicator-dilution technique was used to measure lung volume. Two or three indicators, which should have essentially the same pulmonary volume of distribution, were used. Gas compositions were measured by respiratory mass spectrometry and an extrapolation was used to allow for oxygen consump...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/56.3.289
更新日期:1984-03-01 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:BACKGROUND:Endothelial dysfunction might be involved in the development of cerebral vasospasm after aneurysmal subarachnoid haemorrhage (SAH). METHODS:This prospective observational study of 48 SAH subjects and 23 control subjects examined associations between reactive hyperaemia index (RHI) measured by peripheral art...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aet331
更新日期:2014-02-01 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::We have studied haemodynamic responses to 0, 0.25, 0.5, 0.75 and 1 MAC isoflurane administration in 10 patients during a zero-order propofol infusion and normocapnia. Isoflurane reduced mean arterial pressure (MAP), systemic vascular resistance and left ventricular stroke work in a dose-dependent manner (29%, 38% 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/69.1.36
更新日期:1992-07-01 00:00:00
abstract::We describe a scavenging device, primarily for use during inhalation induction of anaesthesia in children; it was designed to optimize the often conflicting requirements of clinical acceptability and adequate gas collection. The performance was assessed in three ways. The device reduced the nitrous oxide concentration...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/64.1.117
更新日期:1990-01-01 00:00:00
abstract::We have studied in eight rabbits the cardiovascular effects of midazolam, propofol and alfentanil with graded hypoxia. Central blood volume was reduced progressively by gradual inflation of a thoracic vena cava cuff so that cardiac index (CI) decreased at a constant rate. Under control conditions the haemodynamic resp...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/75.5.610
更新日期:1995-11-01 00:00:00
abstract::Cholinesterase phenotyping studies have been carried out in two laboratories on blood specimens from 28 patients shown to be susceptible to malignant hyperpyrexia. In contrast to previously published reports, no evidence could be found for an increase in the frequency of the E1u E1f genotype above that known to occur ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/53.3.245
更新日期:1981-03-01 00:00:00
abstract::The Swedish Society of Anaesthetists conducted a nationwide retrospective survey of clinical experience with extradural and intrathecal opiates. Special interest was focused on the frequency and type of ventilatory depression. The questionnaire was answered by 84 of 93 departments (90%). Up to May 1981 extradural morp...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/54.5.479
更新日期:1982-05-01 00:00:00
abstract::We evaluated the use of an inexpensive trans-illuminating light wand for tracheal intubation. Expertise in its use was acquired quickly, thereby providing successful per-oral intubation in all patients who were able to open the mouth, irrespective of the view obtained of the epiglottis and larynx. ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/62.5.494
更新日期:1989-05-01 00:00:00
abstract::We studied a cat model simulating laudanosine accumulation in the "anephric" patient. Cardiovascular effects were seen only with the bolus doses of laudanosine 2 mg kg-1, and at plasma laudanosine concentrations unlikely to be achieved clinically. Similarly, EEG and power spectra analysis showed no evidence of epilept...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/58.suppl_1.14s
更新日期:1986-01-01 00:00:00
abstract:BACKGROUND:We investigated the effects of total i.v. anaesthesia (TIVA) and balanced anaesthesia (BAL) with sevoflurane on postoperative lung function in patients undergoing surgery in the prone position. METHODS:Sixty patients, aged 21-60 yr, undergoing elective lumbar disc surgery in the prone position were randomly...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aeq321
更新日期:2011-02-01 00:00:00
abstract::The anaesthetic risks of acromegaly include difficulties in airway management, hypertension, and cardiac, gastrointestinal and renal problems. To estimate the incidence of major complications in this rare group of patients, we reviewed 28 patients with acromegaly who had pituitary tumour excision over a 10-yr period. ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/oxfordjournals.bja.a013400
更新日期:2000-02-01 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