Journal of anesthesia
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Journal of anesthesia · Sep 1994
Tolerance to the mydriatic effect of buprenorphine, butorphanol, nalbuphine, and cyclorphan, and cross-tolerance to morphine in mice.
An increase in the use of opioid derivatives in the treatment of pain syndrome in clinical practice, and especially in the treatment of cancer, has added impetus to the search for an agent which does not induce tolerance and cross-tolerance to other opiodis. The mydriatic effect of opioids in mice, the correlation between analgesia and mydriasis, and tolerance to the analgesic effect of morphine in mice were evaluated previously. ⋯ Tolerance and cross-tolerance to morphine were developed following a chronic use of buprenorphine, nalbuphine, and cyclorphan. After chronic injection of butorphanol, no tolerance or cross-tolerance to morphine was observed.
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Journal of anesthesia · Sep 1994
Comparative study on the effects of acetated Ringer's solution, lactated Ringer's solution, Ringer's solution, and 5% glucose-acetated Ringer's solution on canine hemorrhagic shock.
The abilities of acetated Ringer's solution (AR), lactated Ringer's solution (LR), Ringer's solution (R), and 5% glucose-acetated Ringer's solution (AR-D) to improve canine hemorrhagic shock were investigated. All solutions studied were infused at 1 ml·kg(-1)·min(-1) for 90 min after base excess (BE) reached about -13 mEq·l(-1) by maintaining the mean blood pressure (MBP) at 40 mmHg. MBP, renal blood flow (RBF), vertebral blood flow (VBF), and urinary output significantly increased after the start of infusion of AR, LR, R, and AR-D. ⋯ These results indicate that the effectiveness of various infusion solutions such as AR, LR, R, and AR-D during canine hemorrhagic shock varies. AR-D may be useful for increasing both peripheral blood flow and urine output. AR may also be useful for improvement in metabolic acidosis and surgical diabetes induced by hemorrhagic shock.
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Journal of anesthesia · Sep 1994
Assessment of postoperative pain: Contributing factors to the differences between patients and doctors.
This study was undertaken to compare the assessment of pain intensity by 50 patients and by their doctors according to a visual analog scale 5 h and 20 h after major abdominal surgery, and to examine the relationships between the differences in rating of patients and doctors and the factors inherent in the patients which include preoperative expectation of pain, level of anxiety, and the surgical history of the patient. The ratings given by the patients were significantly higher than those given by the doctors at both time periods. ⋯ The results of analysis using Hayashi's quantification theory Type II indicated a moderate association between the rating difference and the patient's age, surgical history, preoperative state of anxiety, and expectation of pain. It is concluded that postoperative pain management, whether in clinical practice or in research, necessitates more consideration of the several above-mentioned individual factors and a preoperative interview in which the patient's level of anxiety and the amount of information the patient has concerning the surgery and post-operative pain is clearly assessed.
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Journal of anesthesia · Sep 1994
Effects of halothane and enflurane on the peripheral vasoconstriction and shivering induced by internal body cooling in rabbits.
General anesthetic agents have central and peripheral effects on body temperature regulation, and its alterations are related to the depth of anesthesia. To evaluate the effect of halothane and enflurane on thermoregulation, we investigated the threshold of body core temperatures to induce peripheral vasoconstriction and shivering in spontaneously breathing rabbits. Rabbits were anesthetized with halothane or enflurane at 0.0 (control), 0.2, and 0.4 MAC (minimum alveolar concentration). ⋯ The incidence of peripheral vasoconstriction was not significantly affected by halothane or enflurane. However, the incidence of shivering decreased in a dose-dependent fashion with both anesthetic agents. At 0.2 MAC, the incidence of shivering in the enflurane group was significantly higher than that in the halothane group, suggesting that suppression of shivering by halothane is stronger than enflurane.
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The purpose of this study was to determine the mortality rate in 527 critically ill patients with multiple organ failure (MOF), treated in our ICU between August, 1986 and January, 1992, and to compare it with the results obtained in a group of patients studied who had been treated between October, 1978 and July, 1986. The relationship between the mortality rate and each type of organ failure and the extent of organ system involvement was also investigated. ⋯ The mortality rate of patients with the failure of two organs in the present study was significantly lower than that found in those in the previous study. Although artificial organ mechanical life support technology other than that for patients with renal failure is still unsatisfactory, these results suggest that the prognosis of patients with MOF is improving.