Masui. The Japanese journal of anesthesiology
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Comparative Study
[Comparison of the severity of postoperative pain in patients after thoracic, upper abdominal or lower abdominal surgery].
Different factors influence the severity of postoperative pain. Personality and cultural factors as well as anxiety and fear modify the degree of postoperative pain. The site of surgery is also a major determinant. ⋯ Demands of analgesics were not different among three groups at any evaluated point. Pain after thoracic surgery was consistent during 72 postoperative hs, but in the upper and lower abdominal surgery groups pain at 72 hs was significantly weaker than that at 24 hs. We conclude that postoperative pain was not different among the three surgery groups, but pain after upper and lower abdominal surgery decreased more rapidly compared with that after thoracic surgery.
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Case Reports
[Postoperative disturbance of consciousness due to tumor emboli of the orifice of pulmonary artery].
We reported a case of an abrupt hypotension and hypoxemia which lasted more than 60 min due to emboli of tumor at the orifice of the pulmonary artery during operation. Although the emboli were removed under the cardiopulmonary bypass (CPB) and later the patient regained good respiratory and hemodynamic conditions, he had a disturbance of consciousness after the operation. ⋯ His consciousness improved quickly after the beginning of OHP. We conclude that OHP and CPB might be useful to treat the postoperative disturbance of consciousness due to hypotension and hypoxemia during operation.
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Randomized Controlled Trial Clinical Trial
[Patient-controlled analgesia with epidural pethidine or buprenorphine plus bupivacaine for postoperative analgesia].
We evaluated the efficacy of epidural patient-controlled analgesia (PCA) with pethidine or buprenorphine plus 0.25% bupivacaine for postoperative analgesia after laparotomy with a midline incision under general anesthesia. Twenty patients were randomly allocated to two groups. In one group (PCEA-P group; n = 10), epidural pethidine plus 0.25% bupivacaine by PCA with 5 mg of pethidine and 2.5 ml of 0.25% bupivacaine bolus with a lockout interval of 20 min was added to a continuous epidural infusion of 0.25% bupivacaine (2 ml.h-1) plus pethidine (100 mg.24h-1) for 72 h. ⋯ There were no significantly different analgesic effects between PCEA-P and PCEA-B for 48 h. The average doses of epidural PCA were 1.9 mg.kg-1.24 h-1 of pethidine, and 0.012 mg.kg-1.24 h-1 of buprenorphine, respectively. We conclude that PCEA-P and PCEA-B were effective for postoperative pain to the same degree for the first 48 h, but PCEA-P was superior to PCEA-B for the last 24 h.
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Comparative Study
[Effects of laryngeal mask airway on circulation and on incidence of postoperative sore throat and hoarseness].
We studied the effects of laryngeal mask airway (LM) insertion on circulation and on the incidence of postoperative sore throat or hoarseness as compared with tracheal intubation in 50 pediatric patients. LM insertion caused less change of heart rate and systolic blood pressure than tracheal intubation. The incidence of postoperative sore throat and hoarseness was less in the patient of LM group. We conclude that LM is useful in pediatric anesthesia when less circulatory changes are desirable or when the postoperative sore throat or hoarseness is to be avoided.
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We evaluated fatigue, stress and workload of anesthesiologists during anesthetic works using Holter ECG. Recorded heart rates of anesthesiologists enable us to draw the task graph and to calculate the workload scores according to their task behavior. We conclude that the application of Holter ECG is useful in measuring the fatigue, stress, and especially workload of anesthesiologists.