Masui. The Japanese journal of anesthesiology
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Randomized Controlled Trial Clinical Trial
[Usefulness and radiopacity of the two radiopaque epidural catheters].
We evaluated the radiopacity and usefulness of the two radiopaque epidural catheters, one by Portex CO. Ltd., and the other Flex Tip Plus with a stainless coil by Arrow Japan Co. Ltd. ⋯ The course of the catheter was identified easily in 1 case of Group A and 4 cases of Group B but was not identified at all in 10 cases of Group A and 8 cases of Group B. There were no differences between the two groups in the number of patients in whom the catheter was easily inserted, identified, or placed straight. Therefore, the usefulness of the two catheters in terms of insertion and identification of its course was not different.
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To make the most of the blood products, we have introduced maximum surgical blood order schedule (MSBOS) as well as Type and Screen (T&S) into Nagahama City Hospital. As the hospital dose not have blood transfusion service unit, we, anesthesiologists set up MSBOS and the procedure of blood preparations for elective surgery. The results of two year's experience demonstrate that there was no trouble by reducing the blood preparation. The cross-match to transfusion ratio (C/T ratio) in surgical procedures and that of red cell products in our hospital have decreased, the effective use of red cell products has been promoted, and the outdating of the blood product has been reduced.
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We report the anesthetic management of a patient with cardiac sarcoidosis. Cardiac sarcoidosis is characterized by a high incidence of complete atrioventricular block, right bundle branch block, and ventricular arrhythmias. Cases of sudden death during stable cardiac function have been reported. ⋯ Anesthesia was induced with midazolam and vecuronium, and the trachea was intubated. Anesthesia was maintained with nitrous oxide, sevoflurane in oxygen. Anesthetic method adapted to prevent severe complications including sudden death resulted in good condition of the patient during the perioperative period.
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We evaluated the alterations of the brain stem and mid-latency evoked potentials (BAEP and MLAEP) in 10-patients who were scheduled for elective abdominal surgery under oxygen-nitrous oxide-sevoflurane anesthesia. With oxygen 2 l.min-1 and nitrous oxide 4 l.min-1, we measured the latency of BAEP and MLAEP at the end-expired sevoflurane concentrations of 0%, 0.3%, 0.6%, 1.0%, 1.5% and 2.0%, respectively. The latency of BAEP was slightly prolonged with oxygen-nitrous oxide-sevoflurane anesthesia. The latency of MLAEP was markedly prolonged with the increase of sevoflurane concentration, and all waves but Na wave disappeared at the 2.0% sevoflurane concentration.
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To evaluate the potentiating effect of nitrous oxide on the succinylcholine (SCh)-induced neuromuscular blockade, 0.16, 0.20, 0.25 or 0.31 mg.kg-1 of Sch was given during thiamylal-fentanyl anesthesia with or without nitrous oxide, and the evoked electromyograph of hypothenar muscles was measured. ED50 and ED95 in the group receiving nitrous oxide were 0.187 and 0.301 mg.kg-1, and 0.218 and 0.389 mg.kg-1 in the group not receiving nitrous oxide respectively. ⋯ It was demonstrated that nitrous oxide decreased electromyographically measured SCh requirements by 16.1%. In addition, the dose-effect relationship for SCh-induced neuromuscular blockade varied widely, and gender did not affect the degree of block.