British journal of anaesthesia
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Little is known about cerebral autoregulation in children. The aim of this study was to examine cerebral autoregulation in children. ⋯ We found no age-related differences in autoregulatory capacity during low-dose sevoflurane anaesthesia. We report no differences in autoregulatory capacity between children and adults.
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The crucial role of L-type Ca(2+) channels in airway smooth muscle contraction suggests that these channels could be an important therapeutic target. There are three separate drug binding sites on this channel: those for dihydropyridines, benzothiazepines and phenyl alkylamines. In this study, we examined the effects of the dihydropyridines nifedipine and nicardipine, the benzothiazepine diltiazem, and the phenylalkylamine verapamil on airway constriction. ⋯ Although supraclinical doses of dihydropyridines and benzothiazepines can produce airway relaxant effects, these agents are unlikely to be used in the treatment of bronchoconstriction. In addition, verapamil may aggravate airway constriction.
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Case Reports
Detection of cerebral hypoperfusion with bispectral index during paediatric cardiac surgery.
The bispectral index (BIS) may indicate changes in cerebral activity when the cerebral circulation is affected by acute hypotension. ⋯ Our findings suggest that an acute decrease in BIS during acute hypotension indicates cerebral hypoperfusion, and that cerebral hypoperfusion caused by hypotension may occur frequently during paediatric cardiac surgery.
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The role of nitrous oxide in modern anaesthesia is questioned. The routine use of nitrous oxide was almost completely stopped in our department after November 1, 2000, and we now report some consequences. ⋯ The staff questionnaire showed a strong acceptance of the new policy, and the use of other anaesthetic agents did not increase as expected. Has the value of nitrous oxide been overestimated?