Journal of anesthesia
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Journal of anesthesia · Sep 1995
Comparison of the placental transfer of halothane, enflurane, sevoflurane, and isoflurane during cesarean section.
The concentrations of placental transfer of halothane (H), enflurane (E), sevoflurane (S), and isoflurane (I) were measured in 46 patients during cesarean section. The mean inhalation times of H (0.5%), E (1%), S (0.8%), and I (0.6%) were 13 min 27 s, 13 min 49s, 13 min 20s, and 8 min 8s, respectively. The mean concentrations in the maternal artery (MA) were 5.2mg·dl-1 in H, 12.3 mg·dl-1 in E, 5.2mg·dl-1 in S, and 2.4mg·dl-1 in I. ⋯ The Apgar scores in these four groups were not different from that in the group given only 66% nitrous oxide in oxygen as anesthetic (N2O group). The cardiovascular changes induced by skin incision were bigger in the N2O group than in the other groups. The use of a low concentration of H, E, S, or I is, therefore, suggested to be a useful and acceptable anesthetic method for cesarean section.
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Journal of anesthesia · Sep 1995
Effect of glucose concentration on the subarachnoid spread of tetracaine in the parturient.
We have studied the effect of glucose concentration on the spread of tetracaine spinal anesthesia in 40 parturient patients. Forty women undergoing cesarean section received a subarachnoid injection of tetracaine 8 mg dissolved in either 5% or 10% glucose solution. ⋯ The cumulative dose of ephedrine was higher with 10% glucose (19 ± 10 mg) than with the 5% glucose (13± 8 mg). In tetracaine spinal anesthesia, the rate of onset of analgesia was faster and the maximum level of analgesia was higher in the 10% glucose solution than in the 5% glucose solution.
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Journal of anesthesia · Sep 1995
Effects of total intravenous anesthesia with propofol on immuno-endocrine changes during surgical stress.
Endocrine factors and cytokines are crucial to host responses to stress and infection. Because surgery is a major stressful condition, it is necessary to understand the influence of specific anesthetic procedures on immune-endocrine responses. The purpose of this study was to compare total intravenous anesthesia with propofol with conventional inhalational anesthesia on circulating cortisol, adrenocorticotropic hormone (ACTH), prolactin, alpha-melanocyte-stimulating hormone (αMSH), and the cytokine, interleukin-6 (IL-6) in healthy patients undergoing tubal ligation. ⋯ Because ACTH responses to surgery were similar in the two groups, the inhibition likely occurred directly on the adrenal glands. This study is the first to report the effects of anesthesia on circulating αMSH, which was decreased significantly after induction with both anesthetic techniques and was still depressed at 90 min in the propofol patients. Other aspects of immune-endocrine responses to surgery were similar irrespective of anesthetic type, which further suggests a specific suppression of adrenal function by propofol.
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Journal of anesthesia · Sep 1995
Endocrine responses to total intravenous anesthesia with droperidol, fentanyl, and ketamine in cardiac patients.
Ketamine-induced sympathetic stimulation can be inhibited by administration of sedatives such as benzodiazepines, droperidol, or opioids. We have developed total intravenous anesthesia with ketamine in combination with droperidol and fentanyl (DFK) and have used this anesthetic method in more than 4000 surgical cases. In this study, we compared DFK in cardiac surgery with isoflurane-fentanyl anesthesia (AOI-F). ⋯ All hormones were significantly elevated after the end of cardiopulmonary bypass. There were no significant differences in any of the hormones, blood pressure, and heart rate measured at different points in both groups. These results showed that DFK anesthesia as a total intravenous anesthesia deserves to be studied in more depth.
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Journal of anesthesia · Sep 1995
Dose-dependent effects of repeated ketamine administration on muscarinic acetylcholine receptors in the mouse forebrain.
To study the effects of repeated ketamine administration (0: saline, 12.5, 25, and 50 mg·kg-1 every 3 days for a total of five times, subcutaneously) on the central muscarinic acetylcholine receptors (mAchRs), receptor binding assays of mAchR were carried out in the forebrain of mice, using [3H]quinuclidinyl benzilate ([3H]QNB) as a ligand. We also examined whether repeated ketamine administration could modify the sensitivity to scopolamine (0.5 mg·kg-1) (a muscarinic antagonist). ⋯ Repeated ketamine reduced scopolamine-induced hyperlocomotion at 50 mg·kg-1 (P<0.05). We conclude that repeated ketamine administration produces up-regulation of mAchRs, which is probably associated with the altered Ach transmission of the central nervous system.