Journal of anesthesia
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Journal of anesthesia · Oct 1992
Blood pressure, heart rate and catecholamine response during fiberoptic nasotracheal intubation under general anesthesia.
Arterial blood pressure (ABP) and heart rate were recorded at one-minute intervals during several stages of intubation in the fiberscope group and the laryngoscope group, to determine if fiberoptic nasotracheal intubation would result in fewer hemodynamic and catecholamine responses than when intubation was performed with a Macintosh laryngoscope. Blood samples were also taken to measure plasma catecholamine concentration immediately after intubation with the fiberscope. The mean ABP in the laryngoscope group was slightly greater than that of the fiberscope group for 4 min after intubation. ⋯ Other cardiovascular complications were more common in the laryngoscope group than in the fiberscope group. These results suggest that fiberoptic intubation results in less severe stress than does laryngoscopic intubation. Fiberoptic intubation should therefore be used not only in patients with difficult airway, hypertension, ischemic heart disease, or cerebrovascular atherosclerosis, but also it is recommended for all patients for whom nasotracheal intubation is indicated.
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Journal of anesthesia · Oct 1992
Effects of tilting in the sagittal plane on the cephalad spread of anesthesia.
The effect of tilting in the sagittal plane on the spread of anesthesia was studied in 30 healthy male patients. Two ml of 0.3% hyperbaric dibucaine was used for intrathecal injection in the lateral position. After 3 min of resting on their side, 15 patients were placed in the horizontal supine position. ⋯ There was no significant difference in the mean cephalad spread of the analgesic level in the dependent side between the two groups. Unilateral motor anesthesia of the dependent side seemed to be canceled by the sagittal tilting maneuver. A 7 to 8 degree tilt in the sagittal plane is recommended to facilitate the cephalad spread of analgesia and to avoid unilateral anesthesia.
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Journal of anesthesia · Jul 1992
Cardiovascular responses to fiberoptic intubation: a comparison of orotracheal and nasotracheal intubation.
We compared the cardiovascular responses between nasal and oral intubation with a fiberoptic bronchoscope under the combination of neuroleptic analgesia (NLA) and topical anesthesia. The 16 patients studied were divided into 2 groups: the nasal intubation group (N group: 8 patients) and the oral intubation group (O group: 8 patients). There were significant changes in systolic, diastolic and mean arterial pressures in the N group and in the pressure rate quotient in the O group. ⋯ The individual RPP in both groups was relatively stable except for one patient in the N group, who had a marked increase in RPP during the procedure. We conclude that, under the combination of NLA and topical anesthesia, the cardiovascular responses to oral fiberoptic intubation are less severe than those to the nasal approach. The oral approach is recommended, especially in patients with coronary artery disease, taking into consideration of the cardiovascular responses to fiberoptic intubation.
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Journal of anesthesia · Oct 1991
Report on the computer software contest at 38th Congress of the Japan Society of Anesthesiology.
We held a computer software contest at 38th Congress of the JSA, held in March, 1991. The aim is to encourage the members of the Society to write softwares and to help distribute them, especially as Freewares. ⋯ We received donations 3 million yen worth of instruments and goods for prizes plus some cash, which as prizes were distributed to those who made entries for the contest. Most of these programs have been registered as freewares at various computer networks, including our Ether-Net, one of the common computer network SIGBBS's among Japanese anesthesiologists.