Masui. The Japanese journal of anesthesiology
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Comparative Study
[Intraoperative fluid therapy by lactated Ringer's solution with various concentrations of potassium].
Lactated Ringer's solutions, whose concentration of potassium was 10 or 20 mEq.l-1, were infused into 10 and 9 patients undergoing surgical operations under general anesthesia, respectively. Effects of these fluid therapies on serum potassium and blood sugar were studied comparing with the effect of infusion of regular lactated Ringer's solution. ⋯ Furthermore, base excess remained at a normal level in patients of high potassium groups, but it decreased in patients of the regular potassium group. Lactated Ringer's solutions of high potassium levels are useful to maintain serum potassium and glucose levels at more normal levels during surgical procedures under general anesthesia.
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Facioscapulohumeral muscle dystrophy (FSHMD) is characterized by slowly progressive wasting of facial, pectoral and shoulder-girdle muscles that begins in adolescence. A 31 year-old man with FSHMD had dystrophic changes in the deltoid, anterior serratus and pectoralis major muscles but not in the distal muscle of his arms and legs. He underwent an operation for thoraco-scapula fixation under enflurane-nitrous oxide anesthesia with vecuronium 6 mg. ⋯ It was clear that there was a difference in the degree of neuromuscular block between the arm and the leg in a FSHMD patient. Use of the peripheral nerve stimulator only in the arm may be an unreliable guide to assess neuromuscular block in FSHMD patients. Therefore, two sites should be chosen for monitoring neuromuscular blockade in a FSHMD patient.
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The efficacy of three kinds of fluid such as isotonic sodium chloride (0.9% NaCl), hypertonic sodium chloride (7.5% NaCl) and iso-oncotic (3% in saline) albumin solutions to maintain the hemodynamics was investigated in rats with superior mesenteric artery occlusion (SMAO) shock. Three kinds of fluid were infused so as to maintain the mean arterial pressure within 70% of the control values. Animals in the control group without fluid therapy died within three hours because of shock. ⋯ The hypertonic crystalloid solution was effective in the early period of SMAO shock to regain the blood pressure by infusing a small volume. An excessively large amount of volume was required in the group infused with an isotonic crystalloid, providing inadequate tissue perfusion. The iso-oncotic colloid produced a stable circulatory status with minimum changes in tissue perfusion.