Journal of anesthesia
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Journal of anesthesia · Jun 1997
Effect of external high-frequency oscillation on severe cardiogenic pulmonary edema.
Effective gas exchange can be maintained in animals without endotracheal intubation using external high-frequency oscillation (EHFO). The aim of this study was to evaluate the effect of EHFO in patients with respiratory failure due to severe cardiogenic pulmonary edema. Seven patients were ventilated with EHFO for 2h at 60 oscillations·min(-1), with a cuiras pressure of 36 cmH2O (-26 to +10) and an inspiratory to expiratory ratio of 1:1, with EHFO. ⋯ Arterial CO2 pressure (Paco2) did not, however, decrease. Increased stroke volume without a change in pulmonary artery wedge pressure (preload) suggests either improved inotropic function of the left ventricle or reduced left ventricular afterload with EHFO. The use of EHFO may be effective not only for gas exchange but also for left ventricular function in patients with severe cardiogenic pulmonary edema.
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Journal of anesthesia · Jun 1997
Simple pain relief score by observers (PRSO) for assessing chronic pain.
In 56 patients with severe chronic pain, pain relief was evaluated by observation of changes in activities of daily life (ADL), drug intake, and patients' mood. The degree of pain relief was scored on the basis of these evaluations by a pain clinic physician, a nurse, and a member of the patient's family. The resulting score was termed "pain relief score by observers" (PRSO). ⋯ Although a significant correlation (rS=0.755,P<0.001) was demonstrated between the mean PRSO and VAS values, there was some dissociation between the two values in patients with underlying personal problems such as compensation lawsuits or job loss. The results suggest that an objective evaluation of pain relief is possible by PRSO alone without subjective assessment, and that PRSO can be used for patients with various types of pain. Combined assessment of pain relief by the VAS and PRSO methods may be useful to detect the influence of personal background factors in patients with chronic pain.
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Journal of anesthesia · Jun 1997
Right ventricular performance during hypotension induced by prostaglandin E1, nicardipine HCl, glycerine trinitrate, and isosorbide dinitrate.
This study investigated right ventricular (RV) performance during hypotensive anesthesia and compared the effect of the vasodilators prostaglandin E1 (PGE1), nicardipine HCl (Nic), glycerin trinitrate (GTN), and isosorbide dinitrate (ISDN) on RV function. Fifty patients were allocated into four groups [PGE1 (n=20), Nic (n=10), GTN (n=10), and ISDN (n=10)] in random order. Pulmonary and RV hemodynamics were measured using a rapid-response thermodilution catheter before and during induced hypotension, when systolic arterial pressure was maintained at 80 mmHg. ⋯ Nic was a useful alternative agent for hypotensive anesthesia. GTN and ISDN reduced RV preload and RVSV; however, cardiac output was maintained by increasing heart rate (HR). Therefore, such nitrates should be used under an adequate RV preload.