Masui. The Japanese journal of anesthesiology
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Comparative Study
[Reactivity of sevoflurane with carbon dioxide absorbents--comparison of soda lime and Baralyme].
The reactivity of sevoflurane with carbon dioxide absorbents, soda lime and Baralyme which are commercially available carbon dioxide absorbents, was studied. A closed circuit system which was made only for this investigation was set up without rubber. Sevoflurane 5% was circulated for 17 hours. ⋯ There are two possible explanations for these results. One is the Baralyme contains more potassium hydroxide than soda lime. The other is that soda lime absorbs sevoflurane more because it contains more silica.
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We compared two methods of respiratory managements during bronchoplasty surgery. In one lung ventilation group (OLV-G), 10 patients were ventilated with Broncho-cath tube or Univent tube. On another 10 patients, ventilation was performed with Univent tube following insertion of bronchial blocker into main bronchus of dependent lung. ⋯ Oxygenation index (O. I.) of S-HFJV-G was significantly higher than that of OLV-G when bronchus was open. These phenomena might have occurred through prevention of pulmonary blood flow shift to the non-dependent lung when S-HFJV was used.
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A 58-year-old man suffering from esophageal cancer was scheduled for radical resection and reconstruction of the esophagus. Immediately after the start of the operation, with the patient under general anesthesia, cardiac arrest occurred. The operation was immediately discontinued and closed chest heart massage was started. ⋯ But resuscitation was successful without any resulting neurological damage. This was attributed to appropriate open chest massage. If a case of cardiac arrest due to any coronary artery disease does not respond to the usual cardiopulmonary resuscitation, we should consider open chest massage.
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Case Reports
[A case report of long-term post-thoracotomy pain management with intrapleural bupivacaine].
A 50-year old woman with right post-thoracotomy pain was referred to us for assistance with pain control. She required pentazocine 60-150 mg per day before our treatment. First, we treated her with intercostal nerve block or oral morphine sulfate. ⋯ She felt so good from the intrapleural analgesia and could be discharged. There was no hypotension, respiratory depression, urinary retention except burning thoracic sensation. We think it is possible to use this intrapleural bupivacaine to treat a certain kind of unilateral chronic pain.
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A 6-year-old girl with severe epilepsy received an orthopedic surgery of the right hand under new total intravenous anesthesia with droperidol, fentanyl and ketamine. For the induction of anesthesia, droperidol 0.25 mg.kg-1, fentanyl 5.0 micrograms.kg-1 and ketamine 2.0 mg.kg-1 was administered intravenously. She was intubated and ventilated manually throughout the operative procedure to maintain the end tidal CO2 between 4.5 and 5.5%. ⋯ The total doses of droperidol, fentanyl, ketamine and vecuronium were 8.75 mg, 1.0 mg, 210 mg and 7.5 mg, respectively. Neither epileptic seizure, nor any other adverse effects with anesthetics was observed during and after anesthesia and surgery. We conclude that this method of anesthesia for epileptic patients may deserve further detailed study.