Masui. The Japanese journal of anesthesiology
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The effects of intrathecal clonidine on spinal fentanyl analgesia were studied by the hot-plate test (52.0 degrees C) in rats. Clonidine (5 micrograms) and/or fentanyl (5 micrograms) were administered alone or combined in volume of 10 microliters through a chronically-implanted polyethylene catheter (PE-10) whose tip was near the lumbar enlargement of the spinal cord. Injections were done repeatedly every two or three days to determine the time course of thermal analgesia. ⋯ In this group, the tolerance developed in only three animals by the 9th injection. In conclusion, combined intrathecal administration of clonidine with fentanyl potentiated the analgesic effect of fentanyl and then definitely suppressed the tolerance formation even if a small dose of clonidine which produces no analgesic effect was used. These results suggest that intrathecal or epidural administration of clonidine with narcotics might be useful in managing intractable pain.
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The optimum doses according to age of butorphanol tartrate as a supplemental drug during epidural and spinal anesthesia were investigated in 60 patients without complications. We classified patients into 4 groups by age as A, B, C and D-group. A-group consisting of patients between 20 to 40 years received 1.5mg of butorphanol. ⋯ Butorphanol injections decreased HRs, mean BPs and RRs significantly. But there was no one whose PaCO2 increased more than 50 mmHg and no difference was found in degree of side effects between the groups. In conclusion, this study suggests that the decision to administer doses depending on the age is useful to decrease frequency of the grave side effects, especially respiratory depression which the elderly people frequently fall into.
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Case Reports
[Prolonged respiratory depression following general anesthesia in a patient with dystrophia myotonica].
A case of general anesthesia for a 52 year old female with previously undiagnosed dystrophia myotonica was reported. The patient was diagnosed as flaccid paralysis of the bilateral lower extremities but myotonic symptoms were not found preoperatively. The patient underwent duodenal resection to have a benign tumor removed. ⋯ The patient was examined again by a neurologist and a final diagnosis of dystrophia myotonica was made. Prolonged recovery from anesthesia and postoperative respiratory depression observed in this patient was due to preoperatively undiagnosed dystrophia myotonica. A careful preoperative examination should be made to minimize possible complication related to anesthesia in the disease.
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Comparative Study
[Systolic time intervals by intratracheal pneumocardiogram and the effects of inhalation anesthetics on cardiac function using this technic].
Intratracheal pressure change due to cardiogenic oscillation was obtained by a high gain pressure transducer attached to the endotracheal tube while the patient was apneic during the operation. Such pressure change has been called as intratracheal pneumocardiogram (ITCG), which consists of wide waves and some spikes. Systolic time interval (STI) was obtained by measuring the intervals between certain spikes. ⋯ The pre-ejection period (PEP) and the PEP/LVET ratio increased in all three types of anesthesia. Especially the PEPs during halothane and enflurane at 1.8 MAC (minimum alveolar concentration) were greater than that of isoflurane. The results suggest that isoflurane has less cardiac depressive action than halothane and enflurane.