| 1. |
|
|
| 2. |
- Enlund, Mats, et al.
(författare)
-
Impact of general anaesthesia on breast cancer survival: a 5-year follow up of a pragmatic, randomised, controlled trial, the CAN-study, comparing propofol and sevoflurane
- 2023
-
Ingår i: EClinicalMedicine. - : Elsevier. - 2589-5370. ; 60
-
Tidskriftsartikel (refereegranskat)abstract
- Background Anaesthesia may impact long-term cancer survival. In the Cancer and Anaesthesia study, we hypothesised that the hypnotic drug propofol will have an advantage of at least five percentage points in five-year survival over the inhalational anaesthetic sevoflurane for breast cancer surgery. Methods From 2118 eligible breast cancer patients scheduled for primary curable, invasive breast cancer surgery, 1764 were recruited after ethical approval and individual informed consent to this open label, single-blind, randomised trial at four county- and three university hospitals in Sweden and one Chinese university hospital. Of surveyed patients, 354 were excluded, mainly due to refusal to participate. Patients were randomised by computer at the monitoring organisation to general anaesthesia maintenance with either intravenous propofol or inhaled sevoflurane in a 1:1 ratio in permuted blocks. Data related to anaesthesia, surgery, oncology, and demographics were registered. The primary endpoint was five-year overall survival. Data are presented as Kaplan-Meier survival curves and Hazard Ratios based on Cox univariable regression analyses by both intention-to-treat and perprotocol. EudraCT, 2013-002380-25 and ClinicalTrials.gov, NCT01975064. Findings Of 1764 patients, included from December 3, 2013, to September 29, 2017, 1670 remained for analysis. The numbers who survived at least five years were 773/841 (91.9% (95% CI 90.1-93.8)) in the propofol group and 764/829 (92.2% (90.3-94.0)) in the sevoflurane group, (HR 1.03 (0.73-1.44); P = 0.875); the corresponding results in the per-protocol-analysis were: 733/798 (91.9% (90.0-93.8)) and 653/710 (92.0% (90.0-94.0)) (HR = 1.01 (0.71-1.44); P = 0.955). Survival after a median follow-up of 76.7 months did not indicate any difference between the groups (HR 0.97, 0.72-1.29; P = 0.829, log rank test). Interpretation No difference in overall survival was found between general anaesthesia with propofol or sevoflurane for breast cancer surgery. Copyright (c) 2023 The Author(s). Published by Elsevier Ltd.
|
|
| 3. |
- Flisberg, A., et al.
(författare)
-
Prognostic capacity of automated quantification of suppression time in the EEG of post-asphyctic full-term neonates
- 2011
-
Ingår i: Acta Paediatrica. - : Wiley-Blackwell. - 0803-5253 .- 1651-2227. ; 100:10, s. 1338-1343
-
Tidskriftsartikel (refereegranskat)abstract
- Aim: To evaluate the prognostic capacity of a new method for automatic quantification of the length of suppression time in the electroencephalogram (EEG) of a group of asphyxiated newborn infants. Methods: Twenty-one full-term newborn infants who had been resuscitated for severe birth asphyxia were studied. Eight channel continuous EEG was recorded for prolonged time periods during the first days of life. Artefact detection or rejection was not applied to the signals. The signals were fed through a pretrained classifier and then segmented into burst and suppression periods. Total suppression length per hour was calculated. All surviving patients were followed with structured neurodevelopmental assessments to at least 18 months of age. Results: The patients who developed neurodevelopmental disability or died had significant suppression periods in their EEG during the first days of life while the patients who had a normal follow-up had no or negligible amount of suppression. Conclusions: This new method for automatic quantification of suppression periods in the raw, neonatal EEG discriminates infants with good from those with poor outcome.
|
|
| 4. |
- Flisberg, Per, et al.
(författare)
-
Induction dose of propofol in patients using cannabis.
- 2009
-
Ingår i: European Journal of Anaesthesiology. - 1365-2346. ; 26:3, s. 192-195
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND OBJECTIVE: An estimated 150 million people worldwide use cannabis. The effect of cannabis on anaesthetic requirements in humans does not appear to have been studied. METHODS: In this prospective, randomized, single-blinded study, 30 male patients using cannabis more than once per week (group C) and 30 nonusers (group NC), aged 18-50 years, were induced with propofol 1.5, 2, 2.5, 3 or 3.5 mg kg. Additional doses were given when required. The primary outcome was the 50% effective dose of propofol and successful induction was determined by loss of consciousness with a bispectral index value of less than 60 and satisfactory insertion of a laryngeal mask. Propofol requirements to achieve these outcomes were recorded. RESULTS: The dose required to achieve the target bispectral index value was not significantly higher in group C, but group C required a significantly higher propofol dose to achieve laryngeal mask insertion (314.0 +/- 109.3 vs. 263.2 +/- 69.5 mg, P < 0.04). The estimated effective propofol induction dose in 50-95% of patients did not significantly differ between groups. CONCLUSION: We conclude that cannabis use increases the propofol dose required for satisfactory clinical induction when inserting a laryngeal mask.
|
|
| 5. |
- Löfgren, N., et al.
(författare)
-
Remote sessions and frequency analysis for improved insight into cerebral function during pediatric and neonatal intensive care.
- 2003
-
Ingår i: IEEE transactions on information technology in biomedicine. - 1089-7771 .- 1558-0032. ; 7:4, s. 283-90
-
Tidskriftsartikel (refereegranskat)abstract
- A project involving recording and analysing EEG together with cardiovascular signals and temperature has been initiated. The aim of this project is to establish difficulties and possibilities involved with implementing a system for remote sessions and analysing EEG in correlation with other physiological signals. One objective is to find indicators of cerebral function during postasphyxia neonatal intensive care and pediatric cardiopulmonary bypass surgery with hypothermia. Remote sessions for joint interpretation have been carried out between pediatricians and clinical neurophysiologists, and EEG has been analyzed using frequency analyzing tools. One result is the discovery of reversible spectral changes coinciding with blood pressure falls, which may indicate loss of autoregulation function. This finding is one outcome from initial use of a system, developed during the project to facilitate communication about, and analysis of the recorded signals. Thus, already from a limited number of remote sessions and the use of basic signal processing techniques, important results have been achieved and better insight has been gained of how cerebral function is affected by cardiopulmonary bypass surgery. In this paper, we present our experiences from introducing a system for remote consultations, and evaluate the use for such a system in the current applications.
|
|
| 6. |
|
|
| 7. |
- Löfhede, J., et al.
(författare)
-
Classifying burst and suppression in the EEG of post asphyctic newborns using a support vector machine
- 2007
-
Ingår i: Proceedings of the 3rd International IEEE EMBS Conference on Neural Engineering. - : IEEE. - 9781424407910 ; , s. 630-633
-
Konferensbidrag (refereegranskat)abstract
- A Support Vector Machine (SVM) was trained to distinguish bursts from suppression in burst-suppression EEG, using Ave features inherent in the electro-encephalogram (EEG) as input. The study was based on data from six full term infants who had suffered from perinatal asphyxia, and the machine was trained with reference classifications made by an experienced electroencephalographer. The results show that the method may be useful, but that differences between patients in the data set makes optimization of the system difficult.
|
|
| 8. |
|
|
| 9. |
|
|
| 10. |
- Schug, S, et al.
(författare)
-
Local anesthetics
- 2007
-
Ingår i: Side Effects of Drugs Annual. - 9780444519863 - 0444519866 ; 29, s. 135-135
-
Bokkapitel (övrigt vetenskapligt/konstnärligt)
|
|
