Masui. The Japanese journal of anesthesiology
-
Randomized Controlled Trial Comparative Study Clinical Trial
[Lack of effect of i.v. lidocaine on cardiovascular responses to laryngoscopy and intubation].
A randomized open study was carried out on 36, ASA I-II adult surgical patients to assess the effect of intravenous lidocaine and fentanyl on circulatory responses to laryngoscopy and intubation. The three treatment groups include: group L, intravenous lidocaine 1.5 mg.kg-1 2 minutes before laryngoscopy, group F, intravenous fentanyl 4 micrograms.kg-1, and group C, no treatment. Induction, preceded by preoxygenation was performed by intravenous vecuronium for precurarisation, followed by thiopental 4-5 micrograms.kg-1 and succinylcholine 1.5 mg.kg-1. ⋯ The maximum values attained after intubation did not differ significantly between the two groups for any of the variables. In group F, these hemodynamic variables showed no significant changes after laryngoscopy and intubation and were significantly less than those in group F and group C. Intubating conditions were better in the fentanyl group than in the lidocaine group.
-
Comparative Study Clinical Trial Controlled Clinical Trial
[The comparison of hypnotic potency of nitrous oxide with that of sevoflurane: evaluation by the middle latency auditory evoked response].
In 10 consented patients (ASA I-II) we quantitated the hypnotic potencies of 0.7 MAC nitrous oxide and 0.7 MAC sevoflurane by measuring auditory evoked response (AER), and compared the hypnotic potency of nitrous oxide with that of sevoflurane at the same MAC. In each patient, measurements of AER waves were performed in the following three stages, 0.7 MAC nitrous oxide, 0.7 MAC sevoflurane and 0.7 MAC nitrous oxide after induction of anesthesia. ⋯ However, we found that there were no statistical significances in our results. In conclusion, nitrous oxide exerts as much hypnotic effect as sevoflurane.
-
Clinical Trial Controlled Clinical Trial
[Diltiazem potentiates the neuromuscular blockade by vecuronium in humans].
We investigated interaction of diltiazem with vecuronium using constant infusion technique in 24 ASA class I or II elective surgical patients with no preoperative administration of Ca antagonists. Neuromuscular blockade was evaluated with accelerometry, which measured single twitch height of adductor pollicis muscle. After tracheal intubation under isoflurane anesthesia, patients received either no diltiazem (control group, n = 8)m, 5 mg (bolus) + 2 mcg.kg-1.min-1 constant infusion (2 mcg group, n = 8) or 5 mg (bolus) + 4 mcg.kg-1.min-1 constant infusion (4 mcg group, n = 8). ⋯ Diltiazem infusion of 4 mcg.kg-1.min-1 decreased the vecuronium infusion rate by 45% compared with 2 other groups. Plasma diltiazem concentrations in patients receiving 4 mcg.kg-1.min-1 were significantly higher than those receiving 2 mcg.kg-1.min-1. In conclusion diltiazem 4 mcg.kg-1.min-1 potentiates the neuromuscular blockade of vecuronium and it relates with the plasma diltiazem concentration.
-
Clinical Trial Controlled Clinical Trial
[Pediatric anesthesia and stress response].
The hyperglycemic and adrenocortical responses to upper and lower abdominal surgery were studied in four groups of children. In F group, lower abdominal surgery was performed under light general anesthesia (halothane 0.3-0.5% plus nitrous oxide and oxygen) combined with intravenous injections of fentanyl 10-13 micrograms.kg-1. In L-E group, lower abdominal surgery was performed under light general anesthesia combined with lumbar epidural anesthesia (intermittent injections of 1.0% lidocaine). ⋯ On the other hand, in other three groups, those responses were not inhibited. Therefore we must consider the concentration and the volume of lidocaine in epidural groups. But general anesthesia combined with epidural anesthesia had a excellent effect on the postoperative pain management.
-
Clinical Trial Controlled Clinical Trial
[Use of ketamine combined with local anesthetics in epidural anesthesia].
Postoperative pain relief and sedation with epidural ketamine were studied. Twenty-four patients for elective upper abdominal surgery were divided into 4 groups. Epidural catheter was inserted into thoracic epidural space before induction of general anesthesia. ⋯ In ketamine injected groups, blood pressure and heart were unchanged, but respiration rate increased significantly. Patients in ketamine 0.3 or 0.5 mg.kg-1 injected groups, pain relief and sedation score were significantly intensified, but patients in ketamine 0.5 mg.kg-1 injected group, incidence of pain in the back during injection and headache was high. We conclude that epidural ketamine is useful for postoperative pain relief, and the superior dose of epidural ketamine is 0.3 mg.kg-1.