Journal of anesthesia
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Journal of anesthesia · Mar 1998
Thoracic epidural blockade preserves left ventricular early diastolic filling assessed by transesophageal echocardiography.
The objective of this study was to examine the effect of thoracic epidural anesthesia (TEA) on left ventricular systolic and diastolic function assessed by transesophageal echocardiography under general anesthesia. ⋯ High TEA reduces fractional shortening without any changes in preload and afterload, indicating impairment of systolic function, but early peak velocity, deceleration rate, and deceleration time, which are the indices of diastolic function, are not changed during high TEA combined with general anesthesia.
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Journal of anesthesia · Mar 1998
Differential vascular reactivity of canine mesenteric arteries and veins to sevoflurane.
The aim of this study was to compare the vascular reactivities of canine mesenteric arteries and veins to sevoflurane and to elucidate the underlying mechanism that is responsible for sevoflurane-induced hypotension. ⋯ Sevoflurane attenuated the contractile responses to transmural ES in veins but not in arteries. The concentration responses to NE were not affected by sevoflurane in arteries or in veins. At stable precontraction induced by NE, when sevoflurane was placed in the bathing medium, arteries with intact endothelium had significant contraction at 1.7% and 3.4% sevoflurane, followed by relaxation at 5.1%. On the contrary, sevoflurane produced dose-dependent relaxation in endothelium-denuded arteries and endothelium-intact veins CONCLUSION: It is suggested that the relaxation of the veins by sevoflurane may be due to the inhibition of NE release from sympathetic nerve endings and to the direct inhibition of the contractile mechanisms of vascular smooth muscle. In arteries, sevoflurane causes endothelium-dependent vasocontraction, probably by inhibiting the release of basal endothelium-derived relaxing factor (EDRF).
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Journal of anesthesia · Mar 1998
Combined spinal-epidural anesthesia for cesarean section; needle-through-needle approach.
The Portex "Spinal/Epidural Set" is designed for combined spinal-epidural (CSE) anesthesia by the needle-through-needle approach. We evaluated the technical and clinical usefulness of CSE with this needle set, and also isobaric tetracaine, for cesarean section. ⋯ CSE technique by the needle-through-needle approach is easy to handle, and provides a speedy, reliable, and flexible analgesia as well as postoperative pain relief for patients undergoing cesarean section.