Nitrous oxide does not produce a clinically important sparing effect during closed-loop delivered propofol-remifentanil anaesthesia guided by the bispectral index: a randomized multicentre study†‡

Background Nitrous oxide (N2O) offers both hypnotic and analgesic characteristics. We therefore tested the hypothesis that N2O administration decreases the amount of propofol and remifentanil given by a closed-loop automated controller to maintain a similar bispectral index (BIS). Methods In a randomized multicentre double-blind study, patients undergoing elective surgery were randomly assigned to breathe 60% inspired N2O (N2O group) or 40% oxygen (AIR group). Anaesthesia depth was evaluated by the proportion of time where BIS was within the range of 40-60 (BIS40-60). The primary outcomes were propofol and remifentanil consumption, with reductions of 20% in either being considered clinically important. Results A total of 302 patients were randomized to the N2O group and 299 to the AIR group. At similar BIS40-60 [79 (67-86)% vs 76 (65-85)%], N2O slightly decreased propofol consumption [4.5 (3.7-5.5) vs 4.8 (4.0-5.9) mg kg−1 h−1, P=0.032], but not remifentanil consumption [0.17 (0.12-0.23) vs 0.18 (0.14-0.24) µg kg−1 min−1]. For the subgroups of men, at similar BIS40-60 [80 (72-88)% vs 80 (70-87)%], propofol [4.2 (3.4-5.3) vs 4.4 (3.6-5.4) mg kg−1 h−1] and remifentanil [0.19 (0.13-0.25) vs 0.18 (0.15-0.23) µg kg−1 min−1] consumptions were similar in the N2O vs AIR group, respectively. For the subgroups of women, at similar BIS40-60 [76 (64-84)% vs 72 (62-82)%], propofol [4.7 (4.0-5.8) vs 5.3 (4.5-6.6) mg kg−1 h−1, P=0.004] and remifentanil [0.18 (0.13-0.25) vs 0.20 (0.15-0.27) µg kg−1 min−1, P=0.029] consumptions decreased with the co-administration of N2O. Conclusions With automated drug administration titrated to comparable BIS, N2O only slightly reduced propofol consumption and did not reduce remifentanil consumption. There was a minor gender dependence, but not by a clinically important amount. Clinical trial registration This study was registered at ClinicalTrials.gov, number NCT0054720

Quaternary glacial history of the Mediterranean mountains

Glacial and periglacial landforms are widespread in the mountains of the Mediterranean region. The evidence for glacial and periglacial activity has been studied for over 120 years and it is possible to identify three phases of development in this area of research. First, a pioneer phase characterized by initial descriptive observations of glacial landforms; second, a mapping phase whereby the detailed distribution of glacial landforms and sediments have been depicted on geomorphological maps; and, third, an advanced phase characterized by detailed understanding of the geochronology of glacial sequences using radiometric dating alongside detailed sedimentological and stratigraphical analyses. It is only relatively recently that studies of glaciated mountain terrains in the Mediterranean region have reached an advanced phase and it is now clear from radiometric dating programmes that the Mediterranean mountains have been glaciated during multiple glacial cycles. The most extensive phases of glaciation appear to have occurred during the Middle Pleistocene. This represents a major shift from earlier work whereby many glacial sequences were assumed to have formed during the last cold stage. Glacial and periglacial deposits from multiple Quaternary cold stages constitute a valuable palaeoclimatic record. This is especially so in the Mediterranean mountains, since mountain glaciers in this latitudinal zone would have been particularly sensitive to changes in the global climate system. © 2006 Edward Arnold (Publishers) Ltd

Sedimentation and preservation of the Miocene Atacama Gravels in the Pedernales-Chañaral Area, Northern Chile: Climatic or Tectonic Control?

In recent years, longitudinal changes on the thin/thick-skinned tectonic styles of the Central Andes has been intensively discussedwhile other studies have considered the role ofmass transfers on the unloading of the orogen, and on the stress regime along the plate interface arising from changes on the volume of sediment arriving into the Peru–Chile trench. The search for paleo-climate records is therefore crucial for our understanding of the history of the Central Andes. In this paper, we focus on the Atacama Gravels, an extensive blanket ofMiocene continental deposits filling a Neogene paleo-valley systemalong the southern Atacama Desert in northern Chile. An east–west transect, between Pedernales and Chañaral (26°30′S), enabled us to carry out a sedimentological and tectonic study of the Atacama Gravels, based on logging and field observations along the Rio Salado canyon. New 39Ar–40Ar ages obtained on intercalated and overlying ignimbrites date the beginning of the Atacama Gravels sedimentation at around the Oligocene–Miocene boundary and cessation of sedimentation in the Late Miocene. Thirteen lithofacies, included within five facies associations (A1 to A5) were identified. Depositional environments vary from proximal alluvial fan (A1, A2) in the Precordillera through ephemeral fluvial (A3, A4) to distal playa lake (A5) in the Coastal Cordillera. No evidences of synsedimentary deformation have been found, showing that the change from sediment removal to sediment preservation cannot be explained by tectonic causes, and climate change appears to be the dominant controlling factor of sediment preservation. A progressive change from semiarid towards hyper-arid climatic conditions during theMiocene, led to a reduction on the transport capacity of the fluvial system and sediment preservation along the paleo-valley system formed during the Oligocene

Exhumation history and timing of supergene copper mineralisation in an arid climate : new thermochronological data from the Centinela District, Atacama, Chile

Supergene copper mineralisation (SCM) processes occur during the unroofing of porphyry copper deposits. However, the geomorphological stage during which the main mineralisation occurs is still under debate. Here, we present 24 new thermochronological data from Cenozoic intrusives and compare them with the evolution of supergene mineralisation from the Centinela Mining District in the Atacama Desert. Our results indicate a two-step cooling path: a rapid Late Eocene exhumation followed by a slow denudation. Previously published supergene mineralisation ages cluster after the main Upper Oligocene exhumation period. Ours is the first study that establishes the relationship between exhumation and supergene processes on the scale of a single mining district. It confirms that SCM took place during pediplanation, likely a required condition for efficient SCM under arid climatic conditions, in contrast to wet tropical environments where SCM occurs during rapid relief growth but has limited preservation potential