Journal of anesthesia
-
Journal of anesthesia · Dec 1995
Inhibitory effect of prostaglandin E1 on gastric secretion during general anesthesia in humans.
The present study was undertaken to clarify the effects of prostaglandin E1 (PGE1) on gastric secretion during general anesthesia. Thirty-three patients, 16 with (PGE1 group) and 17 without (control group) PGE1 administration, scheduled for selective surgery were studied during general anesthesia with nitrous oxide (67%) and enflurane (1%-2% inspired). PGE1 was administered at a rate of 50-200 ng·kg(-1)·min(-1) when hypotensive medication was required. ⋯ The pH of gastric juice increased significantly, and the acidity and pepsin activity decreased after the beginning of the administration of PGE1, and these changes were observed even 1h after discontinuation. There was significant differences in the pH, acidity, and pepsin activity between the two groups after administration of PGE1. The results indicate that PGE1 inhibits gastric secretion at doses that produce a sufficient hypotensive effect under general anesthesia.
-
Journal of anesthesia · Dec 1995
Relationship between plasma neutrophil elastase and respiratory index of patients who had undergone cardiac surgery with cardiopulmonary bypass.
To evaluate the effects of cardiopulmonary bypass (CPB) on the release of polymorphonuclear leukocyte elastase (PMN-E) and postoperative pulmonary function, the perioperative plasma levels of PMN-E in α1-antitrypsin complex (EAC) and hydrogen peroxide concentration in the expired breath were measured in eight patients who underwent cardiac surgery with CPB, and the relationship between EAC levels and the respiratory index (RI) was studied. Although PMN, EAC, and the ratio of EAC to neutrophil (E/N) were elevated significantly after surgery, alveolar-arterial oxygen difference (A-aDO2) and respiratory index (A-aDO2/PaO2) did not change when compared with those of the preoperative period. ⋯ However, there was a significant positive correlation between E/N ratio and respiratory index (r=0.67,P<0.01). Thus excessive release of PMN-E during CPB may be implicated in the etiology of postoperative respiratory dysfunction.
-
Journal of anesthesia · Dec 1995
Liver and renal functions following total intravenous anesthesia using midazolam and fentanyl-comparison with enflurane-nitrous oxide anesthesia.
Thirty patients undergoing lower abdominal surgery were studied to compare liver and renal functions in total intravenous anesthesia (TIVA) using midazolam and fentanyl with those in enflurane-nitrous oxide anesthesia (GOE). Patients were randomly divided into two groups of 15. In the TIVA group, anesthesia was induced with 0.3 mg·kg(-1) midazolam and maintained with 0.68 mg·kg(-1)·h(-1) midazolam for 15 min followed by 0.125 mg·kg(-1)·h(-1) midazolam and fentanyl. ⋯ BUN and Cr were within the normal range. There were no differences between the two groups regarding these parameters and the numbers with abnormally high levels of each parameter. In conclusion, liver and renal functions following TIVA using midazolam and fentanyl were the same as those following enflurane-nitrous oxide anesthesia.
-
To reduce the doses of intravenous anesthetics (ketamine, diazepam, droperidol, and vecuronium) used in total intravenous anesthesia (TIVA), epidural administration of a ϰ-stimulating opioid, eptazocine, was combined with TIVA in 115 patients. Surgical procedures were uneventful under TIVA plus epidural eptazocine; significant depression of EEG and somatosensory-evoked potentials during anesthesia were observed without delay in recovery. ⋯ Therefore, epidural eptazocine may make it possible to use lower doses of anesthesia in TIVA, thus reducing the adverse effects associated with TIVA such as hypertension during surgery, intraoperative awareness, postanesthetic respiratory depression, delayed recovery from anesthesia, and neurological signs after anesthesia. This may be due to the ϰ-stimulating action of epidural eptazocine on the spinal cord and its σ-blocking action, as well as its lack of μ-action on the brain.