Abstract:
BACKGROUND:Data on the best norepinephrine bolus dose for management of hypotension are limited. The aim of this study was to compare the efficacy and safety of two norepinephrine bolus doses in the rescue management of maternal hypotension during cesarean delivery. METHODS:This randomized, controlled trial included mothers scheduled for cesarean delivery with spinal anesthesia with a prophylactic norepinephrine infusion. Following spinal anaesthesia administration, a participant was considered hypotensive if systolic blood pressure was ≤80% compared to the baseline reading. Participants were allocated to receive either 6 mcg or 10 mcg norepinephrine bolus for the management of hypotensive episodes. The hemodynamic response after administration of norepinephrine bolus was recorded. The episode was considered successfully managed if systolic blood pressure returned to within 80% from the baseline reading within 2 min after norepinephrine bolus administration, and did not drop again within 6 min after the norepinephrine bolus. The primary outcome was the incidence of successful management of the first hypotensive episode. Other outcomes included systolic blood pressure, heart rate, incidence of maternal bradycardia, and reactive hypertension. RESULTS:One hundred and ten mothers developed hypotensive episodes and received norepinephrine boluses for management. The number of successfully managed first hypotensive episodes was 50/57 (88%) in the 6 mcg-treated episodes and 45/53 (85%) in the 10 mcg-treated episodes (p = 0.78). Systolic blood pressure was comparable after administration of either bolus dose. Heart rate was lower after administration of 10 mcg bolus compared to 6 mcg bolus, without significant bradycardia requiring atropine administration. The incidence of reactive hypertension was comparable between both groups. CONCLUSION:In mothers undergoing elective cesarean delivery under prophylactic norepinephrine infusion at 0.05 mcg/kg/min, there was no advantage to the use of 10 mcg norepinephrine bolus over 6 mcg norepinephrine bolus for the rescue management of first hypotensive episode. Neither of the 2 bolus doses reached a 100% success rate. The incidences of bradycardia and reactive hypertension were comparable between both norepinephrine doses. TRIAL REGISTRATION:At clinicaltrial.gov registry system on January 4, 2019 Clinical trial identifier: NCT03792906.
journal_name
BMC Anesthesioljournal_title
BMC anesthesiologyauthors
Hassabelnaby YS,Hasanin AM,Adly N,Mostafa MMA,Refaat S,Fouad E,Elsonbaty M,Hussein HA,Mahmoud M,Abdelwahab YM,Elsakka A,Amin SMdoi
10.1186/s12871-020-01004-ysubject
Has Abstractpub_date
2020-04-17 00:00:00pages
84issue
1issn
1471-2253pii
10.1186/s12871-020-01004-yjournal_volume
20pub_type
杂志文章abstract:BACKGROUND:Sevoflurane is suitable for low-flow anesthesia (LFA). LFA needs a wash-in phase. The reported sevoflurane wash-in schemes lack simplicity, target coverage, and applicability. We proposed a one-step 1-1-8 wash-in scheme for sevoflurane LFA to be used with both N2O and Air. The objective of our study was to i...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-020-0940-2
更新日期:2020-01-24 00:00:00
abstract:BACKGROUND:There are doubts among anesthesiologists on the use of the Laryngeal Mask Airway (LMA) in nasal surgeries because of concerns about the occurrence of blood leakages to the airway. We hypothesized that the use of LMA-Supreme (LMA-S) in nasal surgery is comparable with endotracheal tube (ETT) according to airw...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-020-01222-4
更新日期:2021-01-07 00:00:00
abstract:BACKGROUND:In what way volume, concentration and dose affect block duration is controversial. The purpose of the present study is to investigate the effect of dose, volume and concentration of mepivacaine on the duration of sensory and motor blockade in ultrasound-guided single shot axillary brachial plexus blockade. ...
journal_title:BMC anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12871-015-0110-0
更新日期:2015-09-30 00:00:00
abstract:BACKGROUND:Post-operative delirium (POD) is a common post-operative complication in elderly individuals and imposes a significant health and financial burden. Identifying predictive biomarkers may help understand the pathophysiology of POD. Our objective is to summarize the evidence of pre-operative biomarkers and imag...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-019-0693-y
更新日期:2019-02-23 00:00:00
abstract:BACKGROUND:Hyperthermic isolated limb perfusion (HILP) is used for patients with intractable or extensive in-transit metastatic melanoma of the limb to deliver high concentrations of cytotoxic agents to the affected limb and offers a treatment option in a disease stage with a poor prognosis when no treatment is given. ...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/1471-2253-13-15
更新日期:2013-07-17 00:00:00
abstract:BACKGROUND:Ultrasound gels may contain propylene glycol and glycerol, which are neurotoxic in high concentrations. If the needle passes through gel during regional anesthesia, gel may be injected near the nerve. It is unknown if this practice poses a risk for neurotoxicity. Using an animal model, we assessed the histol...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/1471-2253-13-18
更新日期:2013-09-03 00:00:00
abstract:BACKGROUND:The quality of patients' recovery following surgery and anesthesia has been a matter of focus and concern over the past decade. The Quality of Recovery-40 (QoR-40) questionnaire was developed and validated for post-anesthesia patient evaluation. The QoR-40, however, is English-based and was tested and valida...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-016-0229-7
更新日期:2016-08-18 00:00:00
abstract:BACKGROUND:Sugammadex reverses neuromuscular block (NMB) through binding aminosteroid neuromuscular blocking agents. Although sugammadex appears to be highly selective, it can interact with other drugs, like corticosteroids. A prospective single-blinded randomized clinical trial was designed to explore the significance...
journal_title:BMC anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12871-016-0254-6
更新日期:2016-10-21 00:00:00
abstract:BACKGROUND:As defined by evidence-based medicine randomized controlled trials rank higher than observational studies in the hierarchy of clinical research. Accordingly, when assessing the effects of treatments on patient outcomes, there is a tendency to focus on the study method rather than also appraising the key elem...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-016-0264-4
更新日期:2016-10-14 00:00:00
abstract:BACKGROUND:Delayed gastric emptying and the resultant "full stomach" is the most important risk factor for perioperative pulmonary aspiration. Using point-of-care gastric sonography, we aimed to investigate the prevalence of full stomach and its risk factors in elective surgical patients with type 2 diabetes. METHODS:...
journal_title:BMC anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12871-019-0848-x
更新日期:2019-10-10 00:00:00
abstract:BACKGROUND:Patients in intensive care units (ICUs) are often physically unable to communicate with their physicians. Thus, the sharing of information about the on-going treatment of the patients in ICUs is directly related to the communication attitudes governing a patient's relatives and the physician. This study aims...
journal_title:BMC anesthesiology
pub_type: 杂志文章,多中心研究
doi:10.1186/s12871-017-0388-1
更新日期:2017-07-17 00:00:00
abstract:BACKGROUND:Carbon monoxide (CO) poisoning can be a life threatening condition. Systemic hyperbaric oxygen (HBO) therapy is used to induce CO detoxification. However, little is known about the hemodynamic response to HBO in severely intoxicated patients. METHODS:We retrospectively analyzed the medical records of 6 CO-p...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/1471-2253-13-26
更新日期:2013-09-27 00:00:00
abstract:BACKGROUND:Acute kidney injury (AKI) occurs frequently after liver transplant surgery and is associated with significant morbidity and mortality. While the impact of intraoperative hypotension (IOH) on postoperative AKI has been well demonstrated in patients undergoing a wide variety of non-cardiac surgeries, it remain...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-020-01228-y
更新日期:2021-01-11 00:00:00
abstract:BACKGROUND:Quadratus lumborum block (QLB) is an effective analgesia that lowers opioid consumption after lower abdominal and hip surgeries. The subcostal approach to transmuscular QLB is a novel technique that can provide postoperative analgesia by blocking more dermatomes. The aim of this study is to evaluate the effi...
journal_title:BMC anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12871-019-0825-4
更新日期:2019-08-14 00:00:00
abstract::BACKGROUND: We report a case of a patient with apparent resistance to local anesthetics. While similar cases of failure of regional anesthetics are often attributed to technical failure, the overall clinical presentation and history of this patient suggests a true resistance to local anesthetics. CASE PRESENTATION: Th...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/1471-2253-4-1
更新日期:2004-01-16 00:00:00
abstract:BACKGROUND:Compared to conventional tidal volume ventilation, low tidal-volume ventilation reduces mortality in cased of acute respiratory distress syndrome. The aim of the present study is to determine whether low tidal-volume ventilation reduces the production of inflammatory mediators in the lungs and improves physi...
journal_title:BMC anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12871-016-0209-y
更新日期:2016-07-30 00:00:00
abstract:BACKGROUND:Ketamine and hyperoxia are widely used in obstetric and pediatric settings. Either ketamine or hyperoxia has been reported to cause neuroapoptosis in the developing brain, and ketamine-induced neuronal apoptosis may involve a compensatory upregulation of the N-methyl-D-aspartate (NMDA) receptor NR1 subunit. ...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-018-0511-y
更新日期:2018-05-10 00:00:00
abstract:BACKGROUND:Total knee arthroplasty (TKA) is the most common treatment for end-stage knee osteoarthritis and continuous femoral nerve block (CFNB) has become the gold standard for analgesia. But the lack of knowledge about CFNB and patient-controlled analgesia (PCA) often leads to inappropriate dose of medications and i...
journal_title:BMC anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12871-019-0826-3
更新日期:2019-08-14 00:00:00
abstract:BACKGROUND:Renal dysfunction following intraoperative arterial hypotension is mainly caused by an insufficient renal blood flow. It is associated with higher mortality and morbidity rates. We hypothesised that the intraoperative haemodynamics are more stable during xenon anaesthesia than during isoflurane anaesthesia i...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-019-0799-2
更新日期:2019-07-09 00:00:00
abstract:BACKGROUND:The primary goal of this study was to determine whether administration of intrathecal morphine reduces postoperative pain. The secondary goal was to determine the effect of intrathecal morphine upon circulating levels of the weakly analgesic endocannabinoids, anandamide (AEA) and 2-arachidonoylglycerol (2-AG...
journal_title:BMC anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12871-018-0489-5
更新日期:2018-02-27 00:00:00
abstract:BACKGROUND:Pierre Robin Sequence (PRS) patients are known for their triad of micrognathia, glossoptosis, and airway obstruction. Their airway can be a challenge even for the most experienced pediatric anesthesiologist. CASE PRESENTATION:We report the case of a 9 day old 3.5 kg boy diagnosed with PRS, cleft palate, and...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-019-0754-2
更新日期:2019-05-22 00:00:00
abstract:BACKGROUND:Mismanagement of remifentanil leads to severe side effects such as opioid-induced tolerance and hyperalgesia. Recently studies revealed an alternative withdrawal method to limit these side effects. A gradual withdrawal of remifentanil seems to be associated with less pain. The hypothesis of this double-blind...
journal_title:BMC anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12871-019-0731-9
更新日期:2019-04-25 00:00:00
abstract:BACKGROUND:Perioperative hemodynamic fluctuations are seen more often in hypertensive patients than in normotensive patients. The purpose of our study was to investigate the perioperative hemodynamic effects of dexmedetomidine and midazolam used for premedication in hypertensive patients relative to each other and in c...
journal_title:BMC anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1186/1471-2253-14-113
更新日期:2014-12-10 00:00:00
abstract:BACKGROUND:Enhanced recovery after surgery programs (ERAS) using thoracic epidural anesthesia and perioperative patient conditioning with omega-3 fatty acids (n3FA), glucose control (GC) and on-demand fluid therapy, respectively, showed beneficial effects. In the MOFA- study these components were used together in patie...
journal_title:BMC anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12871-019-0823-6
更新日期:2019-08-17 00:00:00
abstract:BACKGROUND:Preoperative intravenous rehydration for patients with pheochromocytomas and paragangliomas (PPGLs) is widely used in many medical centers, but its usefulness has not been well evaluated. The objective of this study was to compare the perioperative hemodynamics and early outcome between patients who received...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-020-01212-6
更新日期:2020-11-30 00:00:00
abstract:BACKGROUND:The present anonymous multicenter online survey was conducted to evaluate the application of regional anaesthesia techniques as well as the used local anaesthetics and adjuncts at German and Austrian university hospitals. METHODS:39 university hospitals were requested to fill in an online questionnaire, to ...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/1471-2253-10-4
更新日期:2010-04-17 00:00:00
abstract:BACKGROUND:Blood biomarkers are increasingly used to diagnose, guide therapy in, and risk-stratify community-acquired pneumonia (CAP) patients in emergency departments (EDs). How pre-analytic factors affect these markers' initial levels in this population is unknown. METHODS:In this secondary analysis of consecutive E...
journal_title:BMC anesthesiology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1186/1471-2253-14-102
更新日期:2014-11-15 00:00:00
abstract:BACKGROUND:Carbohydrate-rich liquid drinks (CRLDs) have been recommended to attenuate insulin resistance by shortening the preoperative fasting interval. The aim of our study the effect of preoperative oral administration of CRLDs on the well-being and clinical status of patients. METHODS:A randomized, double blind, p...
journal_title:BMC anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1186/1471-2253-14-93
更新日期:2014-10-17 00:00:00
abstract:BACKGROUND:Transpulmonary thermodilution (TPTD) derived parameters are used to direct fluid management in ICU-patients. Extravascular lung water EVLW and its ratio to pulmonary blood volume (pulmonary vascular permeability index PVPI) have been associated with mortality. In single indicator TPTD pulmonary blood volume ...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/1471-2253-14-81
更新日期:2014-09-24 00:00:00
abstract:BACKGROUND:Surgical stress index (SSI) is an established indicator for intraoperative nociception. Opioids are used to block stimulus of cranial pinning in neurosurgery. We investigated the effect of different infusion rates of sufentanil on SSI during cranial pinning in children under general anaesthesia. METHODS:For...
journal_title:BMC anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12871-017-0448-6
更新日期:2017-12-08 00:00:00