Masui. The Japanese journal of anesthesiology
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A 74-yr-old man was scheduled for the biopsy of prostatic tumor under spinal anesthesia. Preoperative serologic test for syphilis was highly positive. Spinal anesthesia was performed in the sitting position, and 2 ml of hyperbaric Neo-percamine S (a mixture of 0.24% dibucaine and 0.12% T-caine) was administered uneventfully with the onset of warm sensation on the perineal region. ⋯ Because the pain was not relieved by analgesics, he was then anesthetized with enflurane and N2O in oxygen, and there were no neurological complications after anesthesia. Several cases of severe pain during spinal anesthesia have been reported in patients with tabes dorsalis. Although the patient lacks clear symptoms of neurosyphilis, positive serologic examination for syphilis without any other possible causes suggests altered sensitivity of the spinal cord to anesthetic solutions.
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A comparative investigation into the functioning time of three brands of CO2 absorbents was performed. The three investigated brands were: Viosorb, Wakolime, and Wakolime-A. In this study PICO2 was measured to know the drug's functioning time and CO2 elimination from the model lung fixed at 200 or 300 ml.min-1. ⋯ There were statistically significant relation between PICO2 and time. The CO2 absorbent whose shape is tablet has the longest functioning time because it could be placed smoothly in the canister. It is concluded that the shape of CO2 absorbent plays a role in determining its functioning time.
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Tracheal temperature was evaluated to monitor core temperature during cardiac, upper abdominal and lower abdominal operations. The tracheal temperature was measured by a thermistor attached to the intra-cuff of the tracheal tube. In cardiac surgery, there was a good correlation between tracheal temperature and forehead deep temperature (r = 0.93) before and after cardiopulmonary bypass, and also between tracheal temperature and the temperature of blood from the cardiopulmonary bypass (r = 1.00) during cardiopulmonary bypass. ⋯ In upper abdominal operations, the tracheal temperature showed good correlations with forehead core, esophageal, bladder and rectal temperatures (r = 0.81-0.90). On the other hand, bladder and rectal temperatures were different from forehead deep (r = 0.43, 0.55) and tracheal temperatures in lower abdominal operations. These results suggest that the tracheal temperature is valuable to monitor core temperature.
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The effect of ketamine on the arrhythmogenic dose of epinephrine (ADE) was studied in dogs anesthetized with halothane-nitrous oxide. Groups K (ketamine 2, 4, 6, 10, 20 mg.kg-1.hr-1) were compared with group C (only halothane-nitrous oxide), and the ADE in group K2, 10 was significantly lower than that in group C. The arrhythmogenicity of ketamine was not found in group K20. ⋯ The ketamine inhibited adrenal catecholamine secretion, but plasma epinephrine level in group K4 was higher than that in group C when the same dose of epinephrine was infused. Therefore the inhibition of neuronal and extraneuronal catecholamine uptake by ketamine would offer an explanation for the augmentation of response to epinephrine. Then, this augmentation would cause the arrhythmogenic action of ketamine.