Masui. The Japanese journal of anesthesiology
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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)
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Case Reports
[The catecholamine concentrations of collected autologous blood during adrenalectomy for pheochromocytoma].
We studied the catecholamine concentrations in collected autologous blood of a patient undergoing adrenalectomy for pheochromocytoma. In the preoperative laboratory data, plasma concentrations (normal ranges) of epinephrine, norepinephrine and dopamine were 60180 pg.ml-1 (< 100), 11090 pg.ml-1 (100-450) and 104 pg.ml-1 (< 20), respectively. The catecholamine levels of collected blood were epinephrine 2490000 pg.ml-1, norepinephrine 352300 pg.ml-1 and dopamine 6100 pg.ml-1 before wash. ⋯ The dilution effect for epinephrine and norepinephrine probably reflects the washout of greater amount of plasma catecholamines. However, saline wash was unable to reduce catecholamines contained in the collected blood to a safe level, and hypertension following autotransfusion was predictable. We conclude that hemodynamic change should be monitored carefully during intraoperative autotransfusion in a case of pheochromocytoma.
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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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Comparative Study
[Measurements of ventilatory parameters during closed circuit anesthesia--comparisons with semiclosed circuit, high-flow anesthesia].
Since induction of anesthesia using a closed-circuit technique is difficult with most modern anesthesia machines, it is a common clinical practice to convert semiclosed, high-flow anesthesia (SCA) to closed circuit anesthesia (CCA) during the maintenance phase by decreasing the fresh gas flow. The purpose of the current studies was to determine if such changes in the fresh gas flow influence parameters of ventilatory dynamics. The tidal volume, airway pressure, and a ratio of expiratory volume in one second to a tidal volume (EV1.0/VT) were measured in six patients and in a lung simulator during CCA with a fresh gas flow of 200 ml.min-1 and SCA with a flow of 6 l.min-1. ⋯ It was also suggested that these differences were secondary to differences in the fresh gas flow and not to the circuit situation (closed vs. semiclosed) per se. The results emphasize that the fresh gas flow should be taken into consideration in interpreting the data of ventilatory dynamics during anesthesia. This is especially so during CCA because CCA employs a minimum fresh gas flow.
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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.