Journal of anesthesia
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Journal of anesthesia · Jun 1994
Epidural anesthesia affects pulse oximeter readings and response time.
We investigated the effects of epidural anesthesia on pulse oximeter readings (Spo2) and response time because this type of anesthesia causes significant changes in microcirculation at measurement sites. Twenty patients were divided into lumbar epidural (L-EPI;n=10) and the cervical epidural (C-EPI;n=10) groups. Spo2 and skin blood flow (SBF) were measured at the finger and toe simultaneously by pulse oximeter and laser Doppler flowmeter, respectively. ⋯ The difference in the response time became larger in the C-EPI group and smaller or opposite in the L-EPI group after anesthesia. The difference in response time and SBF were significantly correlated (r=0.71;P<0.05). These results indicated that epidural anesthesia lowerd Spo2 and shortened the response time through vasodilation in the blocked area and caused the opposite reactions in the nonblocked area through compensatory vasoconstriction.
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Journal of anesthesia · Jun 1994
Effect of the lithotomy position on spinal anesthesia with hyperbaric tetracaine.
This study was performed to determine the effects of lithotomy position on the spread of analgesia and hemodynamics following spinal anesthesia with 0.5% hyperbaric tetracaine. Thirty patients who underwent hysterectomy due to myoma uteri were studied. ⋯ There were no significant differences between the groups in mean arterial pressure, heart rate, cardiac output, and in the cephalad spread of analgesia. The lithotomy position had no effect on the spread of analgesia or anesthetic course of spinal anesthesia with hyperbaric tetracaine.
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We observed the changes in partial pressure of arterial oxygen (PaO 2) and carbon dioxide (PaCO 2) before and during assumption of the lateral position prior to lumbar puncture in 81 patients to investigate whether lung volume decreased and ventilation was suppressed. PaO 2 significantly decreased while the patients were in the lateral position, while PaCO 2 remained unchanged. ⋯ The fact that closing volume increases with age implies that the decrease in functional residual capacity in the lateral position could have caused the decrease in PaO 2. It is therefore advisable to continuously monitor arterial oxygenation using a noninvasive monitor, such as a pulse oximeter, while performing spinal or epidural block, especially in elderly patients.
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Journal of anesthesia · Jun 1994
Relationship between cardiac output and mixed venous-arterialPCO 2 gradient in sodium bicarbonate-treated dogs.
We examined the relationship between cardiac output (CO) and mixed venous-arterialPCO 2 gradient ([Formula: see text]) along with the other variables derived from arterial and/or mixed venous blood gases in sodium bicarbonate-treated dogs. Six dogs with low cardiac output following cardiopulmonary resuscitation were used. CO, blood gases, and hemoglobin measurements were repeated every 20-30 min after administration of sodium bicarbonate or normal saline. ⋯ Arteriovenous oxygen content difference ([Formula: see text]), mixed venous oxygen saturation ([Formula: see text]), and[Formula: see text] were highly correlated with CO. The correlation coefficients between[Formula: see text],[Formula: see text], and[Formula: see text] werer=-0.81 (P<0.001),r=0.70 (P<0.001), andr=-0.77 (P<0.001), respectively. The results suggest that, if[Formula: see text] is measured during the steady state, except for the period during the transient increase in CO2 elimination just after the administration of sodium bicarbonate,[Formula: see text] can be used as an index of systemic perfusion even after the administration of sodium bicarbonate.
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Journal of anesthesia · Jun 1994
Textbook of anesthesia on electronic media: trial version as a free software.
The author has compiled a textbook of anesthesia on a floppy diskette and has made it available as free software. It is called "KSAP", which stands for "Knowledge Source for Anesthesia Practice". He aims to create a new form of textbook that is appropriate for current technology. ⋯ The entire book consists of approximately 500 text files, all of which were written by this author. All that is required to use this textbook is an MS-DOS computer and software which reads ASCII text files. Individual files are all simple text files.