Masui. The Japanese journal of anesthesiology
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A newly developed oral airway, laryngeal mask (LM), was used in 40 patients by anesthesiologists of varied clinical experiences. Clear airway was obtained in 37 patients (92.5%). ⋯ Controlled or assisted ventilation was performed adequately in most of the patients, but there was recognizable gas leak in 13 patients when the airway pressure was above 15 cmH2O. The LM has many attractive features compared with a traditional face mask, and some of the promising clinical applications of LM are discussed.
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A 65-year-old woman with height of 156 cm and weight of 54 kg, who had previously been healthy, was scheduled for resection of axillary abscess. She was not premedicated. After local infiltration of 1%-lidocaine 25 ml, operation was started under electrocardiographic monitoring. ⋯ After the recovery of heart beat, the patient became responsive, alert, and oriented, and neither arrhythmia nor ST-T change was observed. Laboratory data showed no abnormality which might have predisposed her to the development of cardiac arrest. Because the cardiac arrest occurred soon after lidocaine injection and no drug other than lidocaine had been used, lidocaine was thought to be the cause of the cardiac arrest.
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This study was undertaken to examine the thermal pain thresholds over a wide area of the lower body surface following the intrathecal administration of capsaicin in rats. Thermal nociceptive thresholds measured under light halothane anesthesia were determined as skin twitch or escape response latencies to the heat stimulation (52.0 degrees C) by a thermal probe. Capsaicin (50 micrograms in 10 microliters) was injected through a chronically implanted catheter whose tip was near the lumbar enlargement of the spinal cord. ⋯ Intensities of thermal analgesia at the sole of hind paws measured by hot-plate test correlated well with those by thermal probe test. In conclusion, intrathecal capsaicin definitely produced thermal analgesia, but its intensity was considerably variable in the hind paws. These results are in keeping with our previous finding that there was much variability in the effect of capsaicin assessed by the hot-plate test, indicating a possibility that capsaicin does not spread uniformly in the CSF because of its water insolubility or difficulty in penetrating to the large nerve roots innervating the hind paws.
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In order to determine the optimal level of epidural anesthesia, the author examined respiratory function of 138 full-term pregnant women in sitting and supine positions without anesthesia, and in supine position under epidural anesthesia prior to the cesarean section. Vital capacity (VC) increased in the sitting position in comparison with supine position because expiratory reserve volume (ERV) and tidal volume (TV) increased. In contrast, %FFV1.0, peak expiratory flow (PEF) and V75 decreased as uterus shifted anteriorly in the sitting position. ⋯ This change depended on the paralysis of respiratory muscles and the dyspneic feeling of patient. Generally %FFV1.0 and the data related to flow volume curve decreased under epidural anesthesia. In conclusion, epidural anesthesia with T4-T6 levels accompanied a sufficient analgesic efficacy and respiratory function comparable with that in the sitting position without anesthesia, therefore this was considered to be a method of choice for cesarean section.
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To investigate the effects of carbon dioxide on the local blood flow during hemorrhagic shock, the tissue surface PO2 of liver, kidney and femoral muscle was measured during normocapnia, hypocapnia and hypercapnia. Eight adult mongrel dogs were anesthetized with pentobarbital, intubated and ventilated mechanically with 100% oxygen to maintain normocapnia. After laparotomy, miniature clark-type polarographic oxygen electrodes were placed on the surface of the liver, kidney and femoral muscle. ⋯ Hypocapnia decreased the liver and kidney surface PO2, and increased the muscle surface PO2. On the contrary, hypercapnia increased the liver and kidney surface PO2 and decreased the muscle surface PO2. So, it is possible that hypocapnia may compromise the oxygenation of the liver and kidney in the hemorrhagic shock.