Journal of anesthesia
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Journal of anesthesia · Sep 1989
Effects of various catecholamines on high-energy phosphates of rat liver and brain during hemorrhagic shock measured by 31P-NMR spectroscopy.
The effects of dopamine, epinephrine and norepinephrine on energy metabolism as well as intracellular pH in rat liver and brain during hemorrhagic shock were examined by in vivo 31P-NMR spectroscopy. The hemorrhagic shock was induced by arterial bleeding to a mean arterial pressure (MAP) of 30-40 mmHg. Upon the induction of hemorrhagic shock, there was a dramatic fall in adenosine triphosphate (ATP) and a rise in inorganic phosphate (Pi) in the liver. ⋯ After infusion of the above catechollamines following 10 min of hemorrhagic shock, MAP increased to 90-100% of its control value. Only dopamine improved hepatic energy metabolism, whereas brain energy metabolism was not affected by any of them. This suggests that dopamine protects liver function during hemorrhagic shock without affecting brain energy metabolism.
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Journal of anesthesia · Sep 1989
Anesthesia for a patient with recessive dystrophic epidermolysis bullosa.
Two different anesthetic methods were employed for a patient with recessive dystrophic epidermolysis bullosa (R-DEB). One was plexus brachial block in combination with ketamine infusion. ⋯ In the later, however, some blisters were newly formed on the region where the anesthesist's fingers were attached to hold a face mask. Although mask anesthesia was considered to be not always suitable for patients with DEB, we chose it because tracheal intubation may cause more serious damage to the upper airway leading to airway obstruction.
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Journal of anesthesia · Mar 1989
A new technique of identifying the epidural space "dripping infusion method".
We developed a new visual technique o identifying the epidural space, using the hydrostatic pressure produced by a suspended micro-drip intravenous apparatus. When the needle pierces the ligamentum flavum, the resistance to positive pressure disappears and the saline in the apparatus flows freely into the epidural space. Thus, the entry of the needle point into the epidural space is visually confirmed by the appearance of dripping flow in the drip bulb (dripping infusion sign). ⋯ In the remaining 11 patients (2.2%), a false dripping infusion sign appeared at the more superficial site than expected. If the pressure waveform in the epidural space is analyzed, the correct positioning of the needle can be easily confirmed. We believe that this method is one of the most accurate visual methods of identifying the epidural space and useful for teaching the epidural blockade to students and residents.
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Journal of anesthesia · Mar 1989
Effects of tracheal insufflation of oxygen (TRIO) on blood gases during external cardiac compressions in dogs under ventricular fibrillation.
Tracheal insufflation of oxygen (TRIO) is a form of constant-flow ventilation. We studied the effect of TRIO at a flow rate of 2 L/kg/min on arterial blood gases during external cardiac compressions in dogs with ventricular fibrillation. ⋯ No pulmonary barotrauma was observed. The findings suggest that TRIO might be used as a temporary measure for emergency ventilation when CPR is performed in certain situations such as upper airway abnormalities or cardiac arrest outside the hospital setting, where intermittent positive pressure ventilation is not feasible.