Masui. The Japanese journal of anesthesiology
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Clinical Trial
[Postoperative pain relief by patient controlled analgesia using intravenous pentazocine].
Patient controlled analgesia (PCA) by intravenous pentazocine was performed to determine its efficacy and the dose required for the pain relief after gynecological or obstetric operations. After obtaining informed consent, studies were performed on 28 female patients (ASA I, II: Mean age 38.1 years: Mean weight, 53.8 kg) who had received gynecological or obstetric operations with lower abdominal incision. Anesthesia given was nitrous oxide and isoflurane combined with epidural anesthesia with 1% mepivacaine used only during the operation. ⋯ Evaluation of PCA by the patients after the procedure showed excellent (13 patients) good (12) and passable (3) analgesia. No significant complication was observed except temporary nausea in two patients. Satisfactory postoperative pain relief could be obtained by relatively small doses of pentazocine and adverse reactions related especially to sigma receptor could be avoided.
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We investigated hemodynamic and blood gas changes in eight patients undergoing femoral neck prosthetic replacement. We measured blood pressure, heart rate, pulmonary artery pressure, cardiac output and blood gas before packing bone cement with a cement gun and 5, 10, and 15 min after the insertion of the prosthesis. ⋯ These pulmonary circulatory and blood gas alterations suggested that pulmonary embolism or pulmonary vasospasm had been brought about by the insertion of the prosthesis, but this did not result in systemic changes in the patients in this study. In conclusion, it is recommended to monitor circulatory and respiratory changes closely to detect pulmonary embolism during femoral neck prosthetic replacement using a cement gun.
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Randomized Controlled Trial Comparative Study Clinical Trial
[Comparison of intubating condition under sevoflurane and halothane anesthesia in pediatric patients].
We compared intubating conditions under sevoflurane (group S) and halothane (group H) anesthesia in pediatric patients for otorhinolaryngological surgery. One hundred and six patients were divided randomly into group S (n = 60) and group H (n = 46). Anesthesia was induced with nitrous oxide-oxygen-sevoflurane (GOS, end-tidal sevoflurane concentration; 4.5%) or nitrous oxide-oxygen-halothane (GOF, end-tidal halothane concentration; 1.6%). ⋯ There were significantly more cases in group S than in group H in which vocal cord visibility was insufficient. Body movement during intubation was observed in 27% and 26% of patients in group S and H, respectively. In conclusion, halothane anesthesia provides better intubating conditions than sevoflurane anesthesia in slow induction for pediatric patients.
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Comparative Study Clinical Trial
[MAC-awake and wake-up time of isoflurane and sevoflurane with reference to the concentration of gas, duration of inhalation and patient's age and obesity].
We evaluated the influence of the concentration of volatile anesthetics, the duration of inhalation time, the patient's age and degree of obesity on MAC-awake (the end-tidal concentration of volatile anesthetics on awakening) and Wake-up time (the period from stopping inhalation to eye-opening in response to verbal command) following isoflurane (Iso) or sevoflurane (Sev) anesthesia in 240 patients (ASA I or II, age 17-84 yr). The patients were anesthetized with 50% oxygen, 50% nitrous oxide and various concentrations of Iso or Sev. ⋯ MAC-awake value of Iso was 0.14 +/- 0.05% (SD)% in all groups and that of Sev was 0.17 +/- 0.05% in Sev 0.9% group, 0.16 +/- 0.05% in Sev 1.3%, 0.17 +/- 0.06% in Sev 1.8%, respectively. All of them became smaller in aged groups than in younger groups but they were not influenced by the concentration of gas, the duration of inhalation nor the degree of obesity.(ABSTRACT TRUNCATED AT 250 WORDS)