Journal of anesthesia
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Journal of anesthesia · Mar 1995
Effects of rapid inhalation induction with sevoflurane-oxygen anesthesia on epidural pressure in humans.
In this study, we chose sevoflurane as the volatile anesthetic for rapid inhalation induction (RII) and investigated its usefulness. We also assessed how RII with sevoflurane affected epidural pressure, and compared RII with rapid intravenous induction by thiopental on epidural pressure. The results were as follows: RII with 5% sevoflurane had a shorter induction time compared with published results on RII with other volatile anesthetics like halothane and isoflurane, and was accompanied by fewer complications. ⋯ Epidural pressure measurements are reportedly useful in monitoring intracranial pressure. Consequently, in patients with increased intracranial pressure, exhaling to residual volume and increasing arterial blood pressure during laryngoscopy and endotracheal intubation should be avoided. The results of this study suggest that RII with 5% sevoflurane in itself is safe and useful, and that it is unlikely to increase intracranial pressure as compared with rapid intravenous induction by thiopental.
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Journal of anesthesia · Mar 1995
Transcutaneous electrical acupoint-stimulation potentiates the anesthetic effect of enflurane in humans.
The effect of transcutaneous electrical acupoint stimulation (TEAS) on enflurane anesthesia and hemodynamic changes during craniotomy was studied. Eighty neurosurgical patients were randomly divided into two groups. Anesthesia was induced with fentanyl, droperidol, thiopental, and suxamethonium by intubation. ⋯ The results showed that the ratio between expired concentration and minimum alveolar concentration of enflurane during operation in group B was 37.8%-47% lower than that in group A, and that the hemodynamics were more stable during operation. The results also demonstrated that the patients in Group B recovered faster after operation. It was concluded that TEAS with HANS significantly potentiated the anesthetic effect of enflurane.
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Journal of anesthesia · Mar 1995
Prophylactic hemostatic drugs do not reduce hemorrhage: Thromboelastographic study during upper abdominal surgery.
Although a number of hemostatic drugs are currently used during surgery to reduce hemorrhage, their effects on bleeding are still controversial. Furthermore, few studies have been made on their prophylactic effects. The purpose of this study was to clarify the effects of hemostatic drugs on bleeding. ⋯ No significant difference in blood loss was observed between the groups. Our findings, therefore, suggest that these two hemostatic drugs do not have prophylactic effects on intraoperative bleeding. Further studies are, however, necessary before applying these results to all surgical patients.
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Journal of anesthesia · Mar 1995
Fibrinolytic shutdown after cardiopulmonary bypass surgery is caused by circulating cytokines during operation, accompanied by endothelial injury.
It has been hypothesized that increased cytokines during cardiopulmonary bypass surgery cause postoperative fibrinolytic shutdown. To investigate the role of cytokines and to elucidate its mechanism, tumor necrosis factor alpha (TNF-α), interleukin-1 beta (IL-1β), plasminogen activator inhibitor-1 antigen (PAI-1 Ag), PAI-1 activity, and thrombomodulin in 16 patients undergoing elective cardiopulmonary bypass surgery were analyzed after induction of anesthesia, before and after cardiopulmonary bypass, and at the end of the operation. during surgery, TNF-α and LI-1β were detected in 44% and 63% of the cases, respectively. PAI-1 Ag (P<0.01), PAI-1 activity (P<0.001) and thrombomodulin (P<0.01) were significantly increased at the end of the operation. ⋯ In group 1, there was a significant positive correlation between thrombomodulin and PAI-1 Ag (r (2)=0.117,P<0.05) and PAI-1 activity (r (2)=0.124,P<0.05). In conclusion, TFN-α and IL-1β were released into the systemic circulation during cardiopulmonary bypass surgery, and this release may have been caused by vascular endothelial injury. These cytokines increased PAI-1 activity.