K. Holte, N. B. Foss, J. Andersen, L. Valentiner, C. Lund, P. Bie, ...
Background. Evidence-based guidelines on optimal perioperative fluid management have not been established, and recent randomized trials in major abdominal surgery suggest that large amounts of fluid...
Orthostatic intolerance and the cardiovascular response to early postoperative mobilization (2009)
Bundgaard-Nielsen, M., Jørgensen, C. C., Jørgensen, T. B., Ruhnau, B., Secher, N. H., Kehlet, H.
Background A key element in enhanced postoperative recovery is early mobilization which, however, may be hindered by orthostatic intolerance, that is, an inability to sit or stand because of symptoms...
Postoperative pain after hip fracture is procedure specific (2009)
Foss, N. B., Kristensen, M. T., Palm, H., Kehlet, H.
Background Hip fracture patients experience high pain levels during postoperative rehabilitation. The role of surgical technique on postoperative pain has not been evaluated previously. Methods One...
Introduction. Patients with hip fractures are usually frail and elderly with a 30-day mortality in excess of 10 % in European series. Perioperative morbidity is often multifactorial in nature, and...
Aasvang, E., Hansen, J., Malmstrom, J., Asmussen, T., Gennevois, D., Struys, Michel, ...
BACKGROUND: Acute postoperative pain is common after most surgical procedures. Despite the availability of many analgesic options, postoperative pain management is often unsatisfactory. Purified...
Holte, K., Foss, N. B., Andersen, J., Valentiner, L., Lund, C., Bie, P., ...
Background Evidence-based guidelines on optimal perioperative fluid management have not been established, and recent randomized trials in major abdominal surgery suggest that large amounts of fluid...
Flow-related techniques for preoperative goal-directed fluid optimization (2007)
Bundgaard-Nielsen, M., Ruhnau, B., Secher, N. H., Kehlet, H.
Background. Improved postoperative outcome has been demonstrated by perioperative maximization of cardiac stroke volume (SV) with fluid challenges, so-called goal-directed therapy. Oesophageal...
Short-term mortality in hip fracture patients admitted during weekends and holidays (2006)
Background. Acute surgical admission during weekends, with reduced staffing levels, has been associated with increased risk of mortality, but the effect of longer vacation/holiday periods has not...
Andersen, F. H., Nielsen, K., Kehlet, H.
Background. Local infiltration anaesthesia for inguinal hernia repair is cost-effective, but fear of intra-operative pain may hinder its widespread use. It is unknown whether a combined ilioinguinal...
Mortality analysis in hip fracture patients: implications for design of future outcome trials (2005)
Introduction. Patients with hip fractures are usually frail and elderly with a 30-day mortality in excess of 10% in European series. Perioperative morbidity is often multifactorial in nature, and...
Andersen, F. H., Nielsen, K., Kehlet, H.
Background. Local infiltration anaesthesia for inguinal hernia repair is cost-effective, but fear of intra-operative pain may hinder its widespread use. It is unknown whether a combined ilioinguinal...
Gray, A., Kehlet, H., Bonnet, F., Rawal, N.
Number needed to treat (NNT) values have been recommended and used to assess efficacy of analgesics for acute pain management. However, the data analysed come from a variety of procedures, which may...
Mortality analysis in hip fracture patients: implications for design of future outcome trials (2004)
Introduction. Patients with hip fractures are usually frail and elderly with a 30-day mortality in excess of 10% in European series. Perioperative morbidity is often multifactorial in nature, and...
Mortality analysis in hip fracture patients: implications for design of future outcome trials (2004)
Introduction. Patients with hip fractures are usually frail and elderly with a 30-day mortality in excess of 10% in European series. Perioperative morbidity is often multifactorial in nature, and...
Pathophysiology and clinical implications of perioperative fluid excess (2003)
Mitchell, G., Hucker, T., Venn, R., Wakeling, H., Forni, L., Sartain, J., ...
Hyllested, M., Jones, S., Pedersen, J. L., Kehlet, H.
Background. Quantitative reviews of postoperative pain management have demonstrated that the number of patients needed to treat for one patient to achieve at least 50% pain relief (NNT) is 2.7...
Forrest, J. B., Camu, F., Greer, I. A., Kehlet, H., Abdalla, M., Bonnet, F., ...
Background. Ketorolac is approved for the relief of postoperative pain but concerns have been raised over a possible risk of serious adverse effects and death. Two regulatory reviews in Europe on the...
Pathophysiology and clinical implications of perioperative fluid excess (2002)
Holte, K., Sharrock, N. E., Kehlet, H.
Br J Anaesth 2002; 89: 622–32
Effect of postoperative analgesia on surgical outcome (2001)
Br J Anaesth 2001; 87: 47–61
Effect of peripheral morphine in a human model of acute inflammatory pain (2000)
Lillesø, J., Hammer, N. A., Pedersen, J. L., Kehlet, H.
Several studies have demonstrated the presence of opioid inducible receptors on peripheral nerves and peripheral antinociceptive effects of opioids. However, the effects of peripheral opioid...
Levobupivacaine vs bupivacaine as infiltration anaesthesia in inguinal herniorrhaphy (1999)
Bay-Nielsen, M., Klarskov, B., Bech, K., Andersen, J., Kehlet, H.
Combined epidural--spinal opioid-free anaesthesia and analgesia for hysterectomy (1999)
Callesen, T., Schouenborg, L., Nielsen, D., Guldager, H., Kehlet, H.
Body position and late postoperative nocturnal hypoxaemia (1997)
Rosenberg, J., Kehlet, H., Edvardsen, L., Zwarts, M.J., Rosenberg-Adamsen, S.
Sleep after laparoscopic cholecystectomy (1996)
Rosenberg-Adamsen, S., Skarbye, M., Wildschiodtz, G., Kehlet, H., Rosenberg, J.
Comparison of three devices for oxygen administration in the late postoperative period (1995)
STAUSHOLM, K., ROSENBERG-ADAMSEN, S., SKRIVER, M., KEHLET, H., ROSENBERG, J.
We have evaluated three different devices for oxygen administration in the surgical ward, the Hudson face mask (oxygen 3 litre min−1 air 12 litre min−1) the nasal prong (oxygen 3 litre min−1)...
Late postoperative nocturnal episodic hypoxaemia and associated sleep pattern (1994)
ROSENBERG, J., WILDSCHIØDTZ, G., PEDERSEN, M. H., VON JESSEN, F., KEHLET, H.
Ten patients undergoing major abdominal surgery under general anaesthesia were monitored with a pulse oximeter, electroencephalogram, electromyogram, electrocardiogram and eye and hand movement...
Topical glucocorticoid has no antinociceptive or anti-inflammatory effect in thermal injury (1994)
PEDERSEN, J. L., MØINICHE, S., KEHLET, H.
We have studied the antinociceptive and antiinflammatory effects of topical glucocorticoids in human thermal injury. The right and left legs of 12 healthy volunteers were allocated randomly to be...
TIME COURSE OF PRIMARY AND SECONDARY HYPERALGESIA AFTER HEAT INJURY TO THE SKIN (1993)
MØINICHE, S., DAHL, J. B., KEHLET, H.
We have examined the time course of, and relationship between, primary and secondary hyperalgesia after thermal injury to the skin in humans. Burn injuries (15×25mm rectangular thermode, 49°C, 5...
PAIN SENSATION AND NOCICEPTIVE REFLEX EXCITABILITY IN SURGICAL PATIENTS AND HUMAN VOLUNTEERS (1992)
DAHL, J. B., ERICHSEN, C. J., FUGLSANG-FREDERIKSEN, A., KEHLET, H.
Pain threshold, nociceptive flexion reflex (NFR) threshold and responses to suprathreshold stimulation were investigated in 15 female patients (mean age 32 yr (range 22–48 yr)) before and 68 (range...
PRE-EMPTIVE EXTRADURAL ANALGESIA (1992)
DAHL, J. B., HANSEN, B. L., ERICHSEN, C. J., MøINICHE, S., KEHLET, H.
EFFECT OF OXYGEN THERAPY ON LATE POSTOPERATIVE EPISODIC AND CONSTANT HYPOXAEMIA (1992)
ROSENBERG, J., PEDERSEN, M. H., GEBUHR, P., KEHLET, H.
As constant hypoxaemia itself may trigger development of apnoea and periodic breathing, we have studied the effect of oxygen therapy on the occurrence of late postoperative episodic hypoxaemia....
DIERKING, G. W., DAHL, J. B., KANSTRUP, J., DAHL, A., KEHLET, H.
The analgesic effects of an identical inguinal field block, performed before or immediately after inguinal herniorrhaphy, were evaluated in 32 healthy patients in a double-blind, randomized study....
DAHL, J. B., HANSEN, B. L., HJORTSØ, N. C., ERICHSEN, C. J., MØINICHE, S., KEHLET, H.
We have studied the effect of continuous extradural analgesia with bupivacaine and morphine, initiated before or after colonic surgery, in a double-blind, randomized study. Thirty-two patients were...
LUND, C., HANSEN, O. B., KEHLET, H.
We have studied the effect of surgical injury on cutaneous sensitivity and somatosensory evoked potentials (SSEP) to dermatomal electrical stimulation in 10 patients undergoing hysterectomy....
PREVENTION OF POSTOPERATIVE PAIN BY BALANCED ANALGESIA (1990)
DAHL, J. B., ROSENBERG, J., DIRKES, W. E., MOGENSEN, T., KEHLET, H.
Fourteen patients undergoing colorectal surgery received an intraoperative afferent neural block with combined intrathecal and extradural local anaesthetics plus a balanced postoperative lowdose...
LATE POSTOPERATIVE EPISODIC AND CONSTANT HYPOXAEMIA AND ASSOCIATED ECG ABNORMALITIES (1990)
ROSENBERG, J., RASMUSSEN, V., VON JESSEN, F., ULLSTAD, T., KEHLET, H.
Twenty-two patients without cardiopulmonary disease and undergoing elective major abdominal surgery were monitored continuously with a Holter tape recorder and a pulse oximeter on one night before...
ROSENBERG, J., DIRKES, W. E., KEHLET, H.
In 20 patients undergoing elective major abdominal surgery, heart rate and arterial oxygen saturation were monitored continuously during the night 2 days before operation and during the first and...
LUND, C., QVITZAU, S., GREULICH, A., KEHLET, H.
We have examined the effects of extradural clonidine 150 μg or morphine 4 mg on postoperative pain, stress responses, cardiopulmonary function and motor and sensory block in a double-blind,...
MØLLER, I. W., DINESEN, K., SØNDERGÅRD, S., KNIGGE, U., KEHLET, H.
To quantify the effects of postoperative pain relief on surgical stress response, 16 patients undergoing cholecystectomy were allocated randomly to double-blind treatment with either fentanyl by...
SCOTT, N. B., MOGENSEN, T., GREULICH, A., HJORTSØ, N. C., KEHLET, H.
In a double-blind prospective study, 20 patients undergoing major abdominal surgery were allocated randomly to receive a continuous 8-h i.p. infusion of either physiological saline or 0.25%...
MOGENSEN, T., BIGLER, D., LUND, C., KEHLET, H.
Twenty-four otherwise healthy patients scheduled for elective major abdominal surgery received general anaesthesia plus lumbar extradural analgesia. A loading dose of 0.5% plain bupivacaine...
Prediction of cardiac risk in non-cardiac surgery (1987)
LARSEN, S.FREY, OLESEN, K. H., JACOBSEN, E., NIELSEN, H., NIELSEN, A.LYNGE, PIETERSEN, A., ...
This prospective study was carried out to develop a model for the prediction of cardiac risk in non-cardiac surgery. Detailed data were collected concerning the preoperative status of 2609...
EFFECT OF EXTRADURAL MORPHINE ON SOMATOSENSORY EVOKED POTENTIALS TO DERMATOMAL STIMULATION (1987)
LUND, C., SELMAR, P., HANSEN, O. B., JENSEN, C. M., KEHLET, H.
The effect of the extradural (L2-3) administration of morphine 6 mg on early (< 0.5 s) somatosensory evoked cortical potentials (SEP) to electrical stimulation of the L1- and S1-dermatomes was...
MØLLER, I. W., KRANTZ, T., WANDALL, E., KEHLET, H.
Plasma concentrations of cortisol and glucose were measured from before to 9 h after skin incision in 24 patients undergoing abdominal hysterectomy. The patients were randomly allocated to receive...
POSTOPERATIVE GLUCOSE TOLERANCE DURING EXTRADURAL ANALGESIA (1982)
BUCKLEY, F. P., KEHLET, H., BROWN, N. S., SCOTT, D. B.
Thirteen patients undergoing lower abdominal gynaecological surgery were allocated to general anaesthesia (halothane and nitrous oxide) or general anaesthesia plus extradural analgesia (T8-S5) I v....
INFLUENCE OF EXTRADURAL MORPHINE ON THE ADRENOCORTICAL AND HYPERGLYCAEMIC RESPONSE TO SURGERY (1982)
CHRISTENSEN, P., BRANDT, M. R., REM, J., KEHLET, H.
Plasma cortisol and glucose concentrations were measured repeatedly from before the induction of anaesthesia until 9 h after skin incision in 36 patients undergoing abdominal hysterectomy. Twelve...
KEHLET, H., NIKKI, P., JÄÄTTELA, A., TAKKI, S.
Plasma catecholamine (CA) concentrations, mean arterial pressure (MAP) and plasma corticosteroids were measured in fifteen unsupplemented glucocorticoid-treated patients undergoing major surgery....
PLASMA VOLUME DURING SURGERY IN UNSUPPLEMENTED GLUCOCORTICOID-TREATED PATIENTS (1974)
KEHLET, H., ENGQUIST, A., GREIBE, J.
Changes in plasma volume and plasma cortisol concentrations were investigated in seven unsupplemented and three supplemented glucocorticoid-treated patients and in eight control patients subjected to...
Adrcnocortical function, as expressed by repeated plasma corticosteroid measurements and the clinical course, were studied in 104 glucocorticoid-treated patients undergoing surgery without...
Influence of age on the endocrine-metabolic response to surgery.
Blichert-Toft, M, Christensen, V, Engquist, A, Fog-Moller, F, Kehlet, H, Madsen, S N, ...
The pathogenesis of the increased operative risk in elderly patients is unknown. From a theoretical point of view, a change in endocrine-metabolic response might be involved. In the present study, a...
Epidural analgesia improves postoperative nitrogen balance.
Brandt, M R, Fernades, A, Mordhorst, R, Kehlet, H
Postoperative nitrogen balance was monitored in twelve patients undergoing hysterectomy under either epidural analgesia or general anaesthesia. The mean cumulative five-day nitrogen losses were...
Short ACTH test in assessing hypothalamic-pituitary-adrenocortical function.
Kehlet, H, Blichert-Toft, M, Lindholm, J, Rasmussen, P
The adrenocortical response to the simple 30-minute ACTH stimulation test was compared with the hypothalamic-pituitary-adrenocortical (HPA) response to insulin-induced hypoglycaemia in 25 patients...
Kehlet, H, Blichert-Toft, M, Hancke, S, Pedersen, J F, Kristensen, J K, Efsen, F, ...
Twenty-seven consecutive patients with endocrinological disease necessitating adrenal surgery underwent blind preoperative investigation with ultrasound, renal aortography, and adrenocortical...
Influence of age on the endocrine-metabolic response to surgery.
Blichert-Toft, M, Christensen, V, Engquist, A, Fog-Moller, F, Kehlet, H, Madsen, S N, ...
The pathogenesis of the increased operative risk in elderly patients is unknown. From a theoretical point of view, a change in endocrine-metabolic response might be involved. In the present study, a...
Epidural analgesia improves postoperative nitrogen balance.
Brandt, M R, Fernades, A, Mordhorst, R, Kehlet, H
Postoperative nitrogen balance was monitored in twelve patients undergoing hysterectomy under either epidural analgesia or general anaesthesia. The mean cumulative five-day nitrogen losses were...
Short ACTH test in assessing hypothalamic-pituitary-adrenocortical function.
Kehlet, H, Blichert-Toft, M, Lindholm, J, Rasmussen, P
The adrenocortical response to the simple 30-minute ACTH stimulation test was compared with the hypothalamic-pituitary-adrenocortical (HPA) response to insulin-induced hypoglycaemia in 25 patients...
Kehlet, H, Blichert-Toft, M, Hancke, S, Pedersen, J F, Kristensen, J K, Efsen, F, ...
Twenty-seven consecutive patients with endocrinological disease necessitating adrenal surgery underwent blind preoperative investigation with ultrasound, renal aortography, and adrenocortical...
Impaired conversion of prednisone to prednisolone in patients with liver cirrhosis.
Madsbad, S, Bjerregaard, B, Henriksen, J H, Juhl, E, Kehlet, H
Fourteen patients with liver cirrhosis received oral prednisone or prednisolone (0.3 mg per kg) randomised on two consecutive days. Serum prednisone and prednisolone were measured over the following...