Journal of anesthesia
-
We compared the effects of normothermic cardiopulmonary bypass (CPB) with those of hypothermic CPB in patients who underwent coronary artery bypass grafting (CABG) with respect to hemodynamics and oxygen balance. The patients in our study were divided into two groups according to temperature during CPB: systemic normothermia combined with warm blood cardioplegia (group W,n=36) and systemic hypothermia combined with cold crystalloid cardioplegia (group C,n=26). In group W, the use of directcurrent (DC) defibrillators was less frequent after release of the cross clamp, and the duration of CPB and of reperfusion was shorter. ⋯ Mixed venous oxygen saturation ([Formula: see text]) was maintained above 65% during and after CPB in group W and group C. Our results showed that normothermia may be superior to hypothermia during CPB with respect to recovery of cardiac function and avoidance of hyperglycemia. The whole-body oxygen demand-supply balance may be preserved during normothermic as well as hypothermic CPB.
-
Journal of anesthesia · Mar 1996
Prophylactic epidural administration of fentanyl for the suppression of tourniquet pain.
Severe dull pain on the side of tourniquet application and marked rises in blood pressure and heart rate associated with that pain are often observed even under adequate regional analgesia. The purpose of this study was to evaluate the effect of epidural fentanyl on the suppression of tourniquet pain during orthopedic surgical procedures. Forty-five patients undergoing orthopedic surgery of the lower extremities with a tourniquet were maintained by continuous epidural anesthesia with 2% lidocaine through an epidural indwelling polyethylene catheter (L3-4). ⋯ Blood pressure during tourniquet application in the epidural group was more stable than in the other two groups. No severe side-effects were observed in any patient. Prophylactic epidural administration of fentanyl might be useful in the suppression of tourniquet pain.
-
Journal of anesthesia · Mar 1996
RETRACTED ARTICLE: Dobutamine increases contractility of fatigued diaphragm in dogs: The relationship between dose and diaphragmatic contractility.
The dose-related effects of dobutamine (DOB) on the contractility of fatigued diaphragm were studied in 16 anesthetized, mechanically ventilated dogs. The animals were divided into two groups of eight: the control (group C) and the DOB (group D). Diaphragmatic fatigue was induced by intermittent supramaximal electrophrenic stimulation at a frequency of 20 Hz applied for 30 min. ⋯ In group C, the speed of Pdi recovery at 20-Hz stimulation was relatively slower. The integrated diaphragmatic electric activity (Edi) in each group did not change at any frequency of stimulation throughout the study. It is concluded that DOB increases the contractility of fatigued diaphragm in a dose-dependent manner.
-
Journal of anesthesia · Mar 1996
A comparison of sympathetic adrenal nerve responses to intravenous high-dose morphine and fentanyl administration in rats.
We compared the effects of intravenous morphine (5 mg·kg(-1)) and fentanyl, (50μg·kg(-1)) on systolic blood pressure (SBP), heart rate (HR), and efferent sympathetic adrenal nerve action potentials (SANA) in rats. We also determined the extent of the reflex responses of these parameters of 9% carbon dioxide (CO2) challenge during the above narcotic anesthesia. In the morphine group, SBP was elevated and the elevated levels were maintained, while changes in SBP in the fentanyl group were not significant. ⋯ CO2 challenge induced only very small changes in SBP and HR, suggesting that during high-dose narcotic anesthesia the hypercapnic stimulus may not be reflected in circulatory parameters. In both groups, hypercapnia increased SANA to 30% of the baseline values from the pre-challenge level. However, these values were only 91% and 56% of the baseline value in the morphine and the fentanyl, groups, respectively.
-
Journal of anesthesia · Mar 1996
Effects of phenol on vascular smooth muscle in rabbit mesenteric resistance arteries.
Although phenol has long been used clinically as a neurolytic agent or as a preservative for injections, little information is available regarding its direct vascular action. We therefore studied the effects of phenol (0.1 μM-2mM) on isolated rabbit small mesenteric arteries, using isometric tension recording methods. All experiments were performed on endothelium-denuded strips. ⋯ The results suggest that phenol stimulates Ca(2+) release from intracellular Ca(2+) stores, which are sensitive to both caffine and NA in this resistance artery. The effect does not appear to reflect a toxic effect on vascular smooth muscle. It seems unlikely that phenol causes adverse hemodynamic changes because of the observed direct vascular action.