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
Ketamine and its isomers have equipotent relaxant effects on tracheal smooth muscle contracted by tachykinins.
Recent studies indicate that not only inflammatory cells but also neural mechanisms by which tachykinins such as substance P (SP) and neurokinin A (NKA) are released from vagal afferent C-fiber contribute to asthma. Although ketamine (K) has been used in the anesthetic management of asthmatic patients, the mechanism by which K relaxes the airway smooth muscle is still uncertain, and no information exists on any differential effect of K and its isomers. We determined the spasmolytic effect of racemic [R(±)]K and its isomers S(+) K and R(-) K on SP and NKA-induced contraction of tracheal smooth muscle in guinea pigs. ⋯ R(±), R(-), or S(+) K (4.5-18.0×10(-4)M) was cumulatively administered into the bath. The calculated ED50 values (the concentration that relaxed the contraction by 50%) of R(±), R(-) and S(+) K were 7.6±0.5, 7.8±0.6, and 7.6±0.5 (10(-4)M), respectively, when the contraction was elicited with SP, and 8.0±1.0, 8.2±1.2, and 7.9±1.3 (10(-4)M), respectively, when NKA was used. We concluded that K and its isomers have equipotent spasmolytic effects on airway smooth muscle precontracted with tachykinins.
-
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.