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British Journal of Anaesthesia

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https://www.readbyqxmd.com/read/29045567/individualized-positive-end-expiratory-pressure-in-obese-patients-during-general-anaesthesia-a-randomized-controlled-clinical-trial-using-electrical-impedance-tomography
#1
C Nestler, P Simon, D Petroff, S Hammermüller, D Kamrath, S Wolf, A Dietrich, L M Camilo, A Beda, A R Carvalho, A Giannella-Neto, A W Reske, H Wrigge
Background: General anaesthesia leads to atelectasis, reduced end-expiratory lung volume (EELV), and diminished arterial oxygenation in obese patients. We hypothesized that a combination of a recruitment manoeuvre (RM) and individualized positive end-expiratory pressure (PEEP) can avoid these effects. Methods: Patients with a BMI ≥35 kg m-2 undergoing elective laparoscopic surgery were randomly allocated to mechanical ventilation with a tidal volume of 8 ml kg-1 predicted body weight and (i) an RM followed by individualized PEEP titrated using electrical impedance tomography (PEEPIND) or (ii) no RM and PEEP of 5 cm H2O (PEEP5)...
October 16, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29045562/attenuation-of-high-frequency-30-200%C3%A2-hz-thalamocortical-eeg-rhythms-as-correlate-of-anaesthetic-action-evidence-from-dexmedetomidine
#2
G Plourde, F Arseneau
Background: Gamma (30-80 Hz) and high-gamma (80-200 Hz) thalamocortical EEG rhythms are involved in conscious processes and are attenuated by isoflurane and propofol. To explore the hypothesis that this attenuation is a correlate of anaesthetic action, we characterized the effect dexmedetomidine, a selective adrenergic α-2 agonist with lesser hypnotic potency, on these rhythms. Methods: We recorded local field potentials from barrel cortex and ventroposteromedial thalamic nucleus in ten previously instrumented rats to measure spectral power (30-50 Hz, 51-75 Hz, 76-125 Hz, 126-200 Hz bands) during baseline, at four dexmedetomidine plasma concentrations obtained by i...
October 16, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29045580/early-pitfalls-in-establishing-the-british-journal-of-anaesthesia
#3
A G McKenzie
No abstract text is available yet for this article.
October 13, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29045578/effectiveness-of-enhanced-pulse-oximetry-sonifications-for-conveying-oxygen-saturation-ranges-a-laboratory-comparison-of-five-auditory-displays
#4
E Paterson, P M Sanderson, N A B Paterson, R G Loeb
Background: Anaesthetists monitor auditory information about a patient's vital signs in an environment that can be noisy and while performing other cognitively demanding tasks. It can be difficult to identify oxygen saturation (SpO2) values using existing pulse oximeter auditory displays (sonifications). Methods: In a laboratory setting, we compared the ability of non-clinician participants to detect transitions into and out of an SpO2 target range using five different sonifications while they performed a secondary distractor arithmetic task in the presence of background noise...
October 13, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29045577/drug-safety-in-paediatric-anaesthesia
#5
J Kaufmann, A R Wolf, K Becke, M Laschat, F Wappler, T Engelhardt
No abstract text is available yet for this article.
October 13, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29045576/activation-of-cannabinoid-receptor-1-is-involved-in-protection-against-mitochondrial-dysfunction-and-cerebral-ischaemic-tolerance-induced-by-isoflurane-preconditioning
#6
M Cai, Q Yang, G Li, S Sun, Y Chen, L Tian, H Dong
Background: Isoflurane preconditioning (IPC) induces cerebral ischaemic tolerance, but the mechanism remains poorly understood. The aim of this study was to determine changes in mitochondrial function in the brain after IPC, and whether the cannabinoid receptor 1 (CB1R) could be involved in the mechanism of mitochondrial protection mediated by IPC. Methods: Adult male Sprague-Dawley rats were pretreated with isoflurane 2% for 1 h day-1, for 5 days consecutively, and then subjected to 120 min right middle cerebral artery occlusion...
October 13, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29040496/changes-in-platelet-bax-levels-contribute-to-impaired-platelet-response-to-thrombin-after-cardiopulmonary-bypass-prospective-observational-clinical-and-laboratory-investigations
#7
M Murase, Y Nakayama, D I Sessler, N Mukai, S Ogawa, Y Nakajima
Background: Anucleate platelets can undergo apoptosis in response to various stimuli, as do nucleated cells. Cardiopulmonary bypass (CPB) causes platelet dysfunction and can also activate platelet apoptotic pathways. We therefore evaluated time-dependent changes in blood platelet Bax (a pro-apoptotic molecule) levels and platelet dysfunction after cardiac surgery. Methods: We assessed blood samples obtained from subjects having on-pump or off-pump coronary artery bypass graft surgery (n=20 each)...
October 10, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29040455/influence-of-deep-neuromuscular-block-on-the-surgeon%C3%A5-assessment-of-surgical-conditions-during-laparotomy-a-randomized-controlled-double-blinded-trial-with-rocuronium-and-sugammadex
#8
M V Madsen, S Scheppan, E Mørk, P Kissmeyer, J Rosenberg, M R Gätke
No abstract text is available yet for this article.
October 10, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29040433/low-end-tidal-co2-as-a-real-time-severity-marker-of-intra-anaesthetic-acute-hypersensitivity-reactions
#9
A Gouel-Chéron, L de Chaisemartin, F Jönsson, P Nicaise-Roland, V Granger, A Sabahov, M-T Guinnepain, S Chollet-Martin, P Bruhns, C Neukirch, D Longrois
Background: Prompt diagnosis of intra-anaesthetic acute hypersensitivity reactions (AHR) is challenging because of the possible absence and/or difficulty in detecting the usual clinical signs and because of the higher prevalence of alternative diagnoses. Delayed epinephrine administration during AHR, because of incorrect/delayed diagnosis, can be associated with poor prognosis. Low end-tidal CO2 (etCO2) is known to be linked to low cardiac output. Yet, its clinical utility during suspected intra-anaesthetic AHR is not well documented...
October 10, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29040402/is-postspinal-hypotension-a-sign-of-impaired-cardiac-performance-in-the-elderly-an-observational-mechanistic-study
#10
J Jakobsson, S H Kalman, M Lindeberg-Lindvet, E Bartha
Background: We have previously reported that stroke volume is reduced in a majority of elderly patients undergoing surgical repair of hip fracture before and after intrathecal injection of anaesthetic. We aimed to investigate these observations further in a prospective study of elderly patients undergoing elective hip or knee arthroplasty under spinal anaesthesia. Methods: Patients ≥65 yr undergoing elective arthroplasty were monitored with LiDCOplus™ preoperatively (baseline), before and continuously for 45 min after spinal anaesthesia...
October 10, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29028933/novel-method-for-intraoperative-assessment-of-cerebral-autoregulation-by-paced-breathing
#11
N H Sperna Weiland, J Hermanides, M W Hollmann, B Preckel, W J Stok, J J van Lieshout, R V Immink
Background: Cerebral autoregulation (CA) is the mechanism that maintains constancy of cerebral blood flow (CBF) despite variations in blood pressure (BP). Patients with attenuated CA have been shown to have an increased incidence of peri-operative stroke. Studies of CA in anaesthetized subjects are rare, because a simple and non-invasive method to quantify the integrity of CA is not available. In this study, we set out to improve non-invasive quantification of CA during surgery. For this purpose, we introduce a novel method to amplify spontaneous BP fluctuations during surgery by imposing mechanical positive pressure ventilation at three different frequencies and quantify CA from the resulting BP oscillations...
October 6, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29029042/does-pharmacokinetic-pharmacodynamic-model-guided-anaesthesia-improve-outcome-after-hip-fracture-surgery
#12
M Coburn, R D Sanders
No abstract text is available yet for this article.
October 4, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29029015/an-experimental-study-comparing-the-respiratory-effects-of-tapentadol-and-oxycodone-in-healthy-volunteers
#13
R van der Schrier, K Jonkman, M van Velzen, E Olofsen, A M Drewes, A Dahan, M Niesters
Background: There is a clinical need for potent opioids that produce little or no respiratory depression. In the current study we compared the respiratory effects of tapentadol, a mu-opioid receptor agonist and noradrenaline reuptake inhibitor, and oxycodone, a selective mu-opioid receptor agonist. We hypothesize that tapentadol 100 mg has a lesser effect on the control of breathing than oxycodone 20 mg. Methods: Fifteen healthy volunteers were randomized to receive oral tapentadol (100 and 150 mg), oxycodone 20 mg or placebo immediate release tablets in a crossover double-blind randomized design...
October 4, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29028983/guidelines-on-informed-consent-in-anaesthesia-unrealistic-unethical-untenable%C3%A2
#14
A M Cyna, S W Simmons
No abstract text is available yet for this article.
October 4, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29028951/big-data-small-airways-big-problems
#15
M Aziz
No abstract text is available yet for this article.
October 4, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29028932/surgical-pleth-index-prediction-of-postoperative-pain-in-children
#16
T Ledowski, D Sommerfield, L Slevin, J Conrad, B S von Ungern-Sternberg
Background: Surgical Pleth Index (SPI) is a non-invasive, dimensionless score (0-100) aimed to allow an estimate of intraoperative nociception. Thus, it may be a useful tool to guide intraoperative analgesia. However, no optimum SPI target range for the use in children has yet been defined. It was the aim of this study to define a clinically appropriate SPI target to predict moderate-severe postoperative pain in children. Methods: After ethics approval 105 children (2-16 yr) undergoing elective sevoflurane/opioid-based anaesthesia were included...
October 4, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29028928/effectiveness-of-tip-rotation-in-fibreoptic-bronchoscopy-under-different-experimental-conditions-an-in-vitro-crossover-study
#17
T Piegeler, N G Clausen, M Weiss
Background: Proper manipulation of fibreoptic bronchoscopes is essential for successful tracheal intubation or diagnostic bronchoscopy. Failure of proper navigation and rotation of the fibrescope may lead to difficulties in advancing the fibrescope and might also be responsible for (unnecessary) difficulties and delays in fibreoptic tracheal intubation, with subsequent hypoxaemia. The present study, therefore, aimed to assess the effectiveness of tip rotation in flexible bronchoscopes in different experimental conditions...
October 4, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29028918/is-science-the-answer
#18
M J Keane, C Berg
No abstract text is available yet for this article.
October 4, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29028912/evidence-based-medicine-the-clue-is-in-the-name
#19
I K Moppett, R M Pearse
No abstract text is available yet for this article.
October 4, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29029049/intraoperative-naloxone-reduces-remifentanil-induced-postoperative-hyperalgesia-but-not-pain-a-randomized-controlled-trial
#20
C-H Koo, S Yoon, B-R Kim, Y J Cho, T K Kim, Y Jeon, J-H Seo
Background: Intraoperative use of a high-dose remifentanil may induce postoperative hyperalgesia. Low-dose naloxone can selectively reverse some adverse effects of opioids without compromising analgesia. We thus hypothesized that the intraoperative use of a high-dose remifentanil combined with a low-dose naloxone infusion reduces postoperative hyperalgesia compared with the use of remifentanil alone. Methods: Patients undergoing elective thyroid surgery were randomly assigned into one of three groups, depending on the intraoperative effect-site concentration of remifentanil, with or without a continuous infusion of naloxone: 4 ng ml-1 remifentanil with 0...
October 3, 2017: British Journal of Anaesthesia
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