Masui. The Japanese journal of anesthesiology
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Randomized Controlled Trial Clinical Trial
[Changes in dementia rating scale scores of elderly patients with femoral neck fracture during perioperative period].
We evaluated changes in dementia rating scale scores in the revised version of Hasegawa's dementia scale (HDS-R), and rated dementia, 2 days before and 7 days after surgery in the elderly patients with femoral neck fracture. The 50 patients examined ranged in age from 70 years to 101 years. A perfect score in the HDS-R is 30 points, and a score below 20 points strongly suggests dementia. ⋯ In octogenarian patients, there was a negative correlation between "postoperative score minus preoperative score" and "the number of the days from suffering fracture to surgery". These results showed that general anesthesia is more advantageous than epidural anesthesia from the viewpoint of the intellectual faculty in septuagenarian and octogenarian patients with femoral neck fracture, and it is within the bounds of possibility that the intellectual faculty may decline if an octogenarian patient is operated after a long delay from the occurrence of fracture. To prevent this decline, patients must be operated on as soon as possible.
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Randomized Controlled Trial Clinical Trial
[Effects of nitrous oxide on electroencephalographic activity during sevoflurane anesthesia: a zero-crossing analysis].
We have investigated the influence of nitrous oxide (N2O) on central nervous system (CNS) during sevoflurane anesthesia by using zero-crossing method of EEG in 31 patients. The study was divided into three parts: Study 1 (n = 18), Study 2 (n = 6) and Study 3 (n = 7). (Study 1) After induction of anesthesia, sevoflurane 1.0 % in oxygen (O2), and sevoflurane 1.0 % with 67 % N2O in O2 were given to the patients sequentially in a random fashion, and EEG was recorded. (Study 2) Sevoflurane 1.7 % in O2, and sevoflurane 0.7 % with 67 % N2O in O2, which were considered to be the same anesthetic depth (= sevoflurane 1 MAC), were inhaled, and EEG was recorded in the same manner as in the study 1. (Study 3) We compared the effects of N2O on EEG during intravenous administration of fentanyl and midazolam with 67 % N2O, and without N2O, and EEG was recorded in the same manner. ⋯ But there were no significant changes in EEG activity of the patient with and those without N2O during intravenous anesthesia. We concluded that the influences of N2O on CNS can be evaluated by quantitative analysis of EEG.
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We have assessed the deleterious effects of methyl methacrylate (MMA) on cardiac function and metabolism in the isolated heart-lung preparation and their protection by ulinastatin. Twenty-four male Wistar rats were prepared for the heart-lung model. They were randomly divided into 3 groups. ⋯ MMA 1000 micrograms.ml-1 is much higher than the blood level (0.05-31.89 micrograms.ml-1) reported clinically in patients who had femoral prosthesis. Ulinastatin increased myocardial glycogen content which had been reduced by MMA. This may suggest that ulinastatin has a protective effect on heart damaged by MMA.