Journal of anesthesia
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Journal of anesthesia · Sep 1996
Clinical evaluation of a new continuous intraarterial blood gas monitoring system in the intensive care setting.
The present study was designed to evaluate a new continuous intraarterial blood gas monitoring system under routine clinical intensive care conditions. Nine mechanically ventilated adult patients were enrolled in this study. A multiparameter intravascular sensor was inserted into the radial or dorsalis pedis artery through a 20-gauge cannula in each patient. ⋯ In clinically important ranges of Po2, less than 200 mmHg in particular, the bias and precision values were -2.25±6.48 mmHg in the range of less than 100mmHg, and 0.98±14.38 mmHg in the range of 100-200 mmHg. Variations of sensor accuracy as a function of elapsed time were within the clinically acceptable range throughout the study period. These findings suggest that this new device is sufficiently useful for routine clinical settings.
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Journal of anesthesia · Sep 1996
Neuromuscular effects of sevoflurane in patients with myasthenia gravis.
The current study evaluated the neuromuscular responses following administration of sevoflurane in 14 patients with myasthenia gravis (MG) (I-IIb in Osserman's classification) scheduled for thymectomy and in 11 control patients (ASA I-II) who underwent elective surgery. The electromyographic (EMG) response of the abductor digiti minimi was measured following train-of-four (TOF) stimulation of the ulnar nerve every 20 s. After induction of anesthesia with a combination of 3-4 mg·kg(-1) thiopental and 1-2 μg·kg(-1) fentanyl with 66% N2O and oxygen, an inspired concentration of 4% sevoflurane was administered via a face mask for 7 min. ⋯ On the other hand, no notable changes were observed in patients with normal neuromuscular functions. The most significant factor that correlated with the depression of the TOFR values induced by 1 MAC sevoflurane was the anti-AchR antibody titers (P=0.029). Our results indicate that MG patients have an increased neuromuscular sensitivity to sevoflurane.
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Journal of anesthesia · Sep 1996
Comparative hemodynamic effects of hypotension induced by CGRP and PGE1 in dogs.
Calcitonin gene-related peptide (CGRP) produces vasodilation, hypotension, and tachycardia. We compared the hemodynamic effects of CGRP-induced hypotension with the effects of prostaglandin E1 (PGE1), which is currently used as a hypotensive agent during anesthesia. Eighteen mongrel dogs were anesthetized with pentobarbital (25 mg·kg(-1)), and 0.87% halothane in oxygen (1MAC). ⋯ The different results for changes in CI and cardiac contractility during the CGRP- and PGE1-induced hypotension were probably due to differences in ventricular filling pressure. Hypotension induced by PGE1 was associated with a significant decrease in heart rate (HR), whereas CGRP did not affect HR. This study shows that both CGRP and PGE1 are effective in decreasing afterload and in inducing hypotension; the results suggest that CGRP is a useful vasodilator for inducing hypotension during halothane anesthesia.
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Journal of anesthesia · Sep 1996
RETRACTED ARTICLE: Dibutyryl cyclic AMP increases the contractility of fatigued diaphragm in dogs.
The effects of dibutyryl cyclic AMP (DBcAMP) on the contractility of nonfatigued and fatigued diaphragms were studied in 36 anesthetized and mechanically ventilated dogs. The animals were divided into four groups. In group C1 (n=8), dogs without fatigue received only Ringer's lactate solution. ⋯ In group D2, Pdi at both stimuli increased significantly with an infusion of DBcAMP compared with the fatigue values (20 Hz; 13.3±3.3vs 9.3±2.1, 100 Hz; 23.4±3.6vs 21.3±3.2;P<0.05). In group C2, the speed of recovery from fatigue was relatively slower at 20-Hz stimulation than at 100-Hz stimulation. It is concluded that DBcAMP increases the contractility of fatigued diaphragm, but that this agent does not affect the contractility of nonfatigued diaphragm.