Journal of anesthesia
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We evaluated the incidence and severity of serum magnesium (Mg) abnormality along with other electrolyte and acid-base disturbances before and during the course of orthotopic liver transplantation (OLT) in pediatric patients. Serum Mg, Na, K, ionized Ca, pH, and blood gas measurements were performed before and hourly during the course of OLT. Hypomagnesemia was frequently observed in children undergoing OLT. ⋯ However, hypernatremia, hypokalemia, a decrease in ionized Ca, and metabolic acidosis were commonly observed during the course of OLT. We conclude that electrolyte abnormalities, including hypomagnesemia and metabolic acidosis, commonly develop in children during the course of OLT. The frequent assessment of electrolytes, pH and blood gases is essential for the correction of these abnormalities during the course of OLT.
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Journal of anesthesia · Mar 1994
The effects of low-dose midazolam for induction of high-dose fentanyl anesthesia for coronary artery bypass graft.
A small dose of midazolam 0.06 mg/kg or diazepam 0.15 mg/kg was used for induction of high-dose fentanyl (50 μg/kg) anesthesia in patients undergoing coronary artery bypass grafting operation. Hemodynamic variables were measured 5 min after the injection of midazolam or diazepam, after the end of the fentanyl infusion, and following endotracheal intubation. ⋯ Heart rate was decreased in the diazepam group but not in the midazolam group. Therefore, a small dose of midazolam may be a suitable induction agent for high-dose fentanyl anesthesia in patients with coronary artery disease.
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Journal of anesthesia · Mar 1994
Electrophysiologic effects of volatile anesthetics, sevoflurane and halothane, in a canine myocardial infarction model.
The effects of sevoflurane and halothane on the effective refractory period (ERP) and ventricular activation were examined in a canine myocardial infarction model. Sevoflurane (1 MAC) reduced the heart rate and prolonged ERP in both normal and infarcted zones. A prolongation of ERP with sevoflurane was observed also during atrial pacing at a fixed rate, but the effect was less than during sinus rhythm. ⋯ Halothane (1 MAC) prolonged ERP during sinus rhythm and atrial pacing, but to a lesser extent during the latter. Halothane also depressed ventricular activation in the infarcted zone during atrial pacing. In conclusion, sevoflurane as well as halothane selectively depresed the delayed activation and the prolongation of ERP in myocardial infarction, which may inhibit ventricular arrhythmias in myocardial infarction.
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Journal of anesthesia · Mar 1994
Evaluation of twitch responses obtained from abductor hallucis muscle as a monitor of neuromuscular blockade: Comparison with the results from adductor pollicis muscle.
The twitch responses evoked from the abductor hallucis muscle (AHM) and the adductor pollicis muscle (APM) were examined simultaneously in 20 anesthetized patients following a single bolus intravenous administration of 0.04 mg·kg-1 of vecuronium bromide. The mean onset time of vecuronium-induced depression of AHM twitch responses was significantly slower than that of APM twitch responses (4.9±1.5 minvs 3.7±1.2 min, mean±SD,P<0.001), and when the clinical duration times of vecuronium were compared, AHM twitch responses recovered more quickly than APM twitch responses (15.3±4.1 minvs 19.6±6.7 min,P<0.01), although there was no statistically significant difference in the spontaneous recovery time between AHM and APM (9.8±2.9 minvs 10.0±3.6 min). It is concluded that the twitch responses of AHM may be a useful monitor of neuromuscular blockade in anesthetized patients in whom setting the blockade monitor on the patient's arms is difficult, although monitoring of twitch response of AHM is less sensitive than that of APM in case of vecuronium administration.