Masui. The Japanese journal of anesthesiology
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A healthy 34 year old, male (70.2 kg, 168 cm) had lower leg fracture during rugby football and was scheduled for open reduction and fixation. Spinal anesthesia was planned by using Sprotte 24 gauge needle. In the operating theater, patient was positioned for spinal tap on his right side up. ⋯ To prevent these hazards, introducer for the Sprotte needle should be placed in epidural space before the Sprotte needle insertion. Also a Sprotte needle should be placed in subarachinoid space deep enough to prevent failed spinal anesthesia. The tip of the Sprotte needle is weak enough to bend and may present a new patient hazards.
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Excessively high concentration of halothane vapor was delivered to the inspiratory gas mixture due to the vaporizer malfunction (Fluotec 4). After disassembling the vaporizer, corrosion was observed on the internal components. ⋯ Anesthesia machines should receive regular check up at least once a year and anesthesia providers should routinely use an equipment checklist. It is also important to realize that anesthesiologist's senses of sight, hearing, touch, and smell are exceedingly reliable monitors for decreasing the incidence of anesthesia mishaps.
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In 108 spinal anesthetic cases, 2.36 ml of each of five 0.5% tetracaine solutions, either with distilled water (DW), normal saline (NS) or different concentrations of dextrose (2.5%-2.5 G, 5%-5 G, 10%-10 G) was injected intrathecally at the L2/3 or L3/4 interspace. The specific gravity and osmotic pressure of these solutions and cerebrospinal fluid were measured. The cephalad spread of analgesia was greater with higher concentration of dextrose (5 G-Th7.4, 10 G-Th6.0), compared with DW, NS and 2.5 G (Th9.5-9.8). ⋯ The hemodynamic changes after intrathecal injection were small with 2.5 G, DW and NS. Arterial hypotension requiring treatment occurred with 5 G and 10 G. The baricity of spinal anesthetic solution had an important effect on characteristics of the blockade.
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The effects of 1M sodium bicarbonate (NaHCO3) on cardiac function and myocardial metabolism during hypoxia were compared with those of 1M sodium chloride (NaCl) in anesthetized dogs. Metabolic acidosis was induced with inhalation of low fraction of oxygen (9%) for 2 hours. NaHCO3 (n = 9) or NaCl (n = 10) was infused intravenously in a half dose of 0.2 x body weight x base excess mEq in 30 seconds. ⋯ LV dP/dt max correlated significantly with LA in NaCl group (r = -0.614, P < 0.001). However, in NaHCO3 group, LV dP/dt max did not correlate with LA. Blood glucose level (r = 0.612, P < 0.001) and myocardial glucose uptake (r = 0.718, P < 0.001) correlated significantly with LV dP/dt max in NaHCO3 group.(ABSTRACT TRUNCATED AT 250 WORDS)