Masui. The Japanese journal of anesthesiology
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Randomized Controlled Trial Comparative Study Clinical Trial
[Comparison of analgesic effect of lidocaine tape versus eutectic mixture of lidocaine and tetracaine during infiltration of local anesthetics before epidural block].
We compared analgesic effects of a lidocaine tape (Penles) and the eutectic mixture of lidocaine and tetracaine (LT ointment) during local infiltration before epidural block. Ninety-six patients were randomly assigned to 3 groups. In groups 1 and 2, lidocaine tape was applied on the skin of the epidural puncture site 30-60 min before epidural block. ⋯ Although no significant difference in pain relief in 5 pin prick tests was observed among the three groups, there was a significantly greater decrease in the pain score during the infiltration of local anesthetics in groups 1 and 2, compared with group 3. There was no significant difference in the pain score between groups 1 and 2. We concluded that lidocaine tape is more useful than LT ointment in decreasing pain of local infiltration anesthesia, and midazolam did not exert any supplementary analgesic effect.
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Case Reports
[A case of severe hypertension caused by stellate ganglion block in a patient with facial palsy].
We report a case of severe hypertension following stellate ganglion block. A 61-year old woman received the left stellate ganglion block with 5 ml of 1% mepivacaine for her left facial palsy. ⋯ Systolic blood pressure remained above 190 mmHg for 60 minutes following the stellate ganglion block. We suggest that the extreme increase in blood pressure was due to the vagal nerve block associated with the left stellate ganglion block.
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Randomized Controlled Trial Clinical Trial
[Treatment of postoperative nausea and vomiting with ondansetron in patients administered anti-neoplastic agents].
The antiemetic effect of ondansetron (a 5-HT3 antagonist) was evaluated in patients treated with intraperitoneally administered anti-neoplastic agents (cisplatin and mitomycin-C) during surgery for ovarian cancer. Anesthesia was induced with intravenous thiopental 5 mg x kg-1 and maintained with nitrous oxide 66% in oxygen and isoflurane. After surgery, 6 patients received a single intravenous dose of ondansetron 4 mg (group O), 6 others did not receive ondansetron (group C). ⋯ Total dose of metoclopramide was 20 +/- 13 mg (mean +/- SD) in group C and 2 +/- 4 mg in group O. Administration of anti-neoplastic agents during surgery caused severe nausea and vomiting after surgery and ondansetron prevented the occurrence of nausea and vomiting almost completely. We conclude that ondansetron is an effective antiemetic for preventing postoperative nausea and vomiting in patients administered anti-neoplastic agents.
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Clinical Trial Controlled Clinical Trial
[Postoperative sore throat--a comparison of standard cuff, gas-barrier cuff and Brandt anesthesia tube cuff].
Excessive intracuff pressure due to nitrous oxide diffusion into the cuff can damage the tracheal mucosa. Several endotracheal tubes have been developed (Trachelon gas barrier type tube, Brandt Anaesthesia tube) to limit nitrous oxide-related intracuff pressure increase. We investigated whether the incidence of postoperative sore throat could be reduced by using these tubes. ⋯ The incidence of postoperative sore throat was not significantly different among the groups, 36% (5/14) in group S, 45% (5/11) in group G, and 33% (4/12) in Group B. This incidence did not correlate with intracuff pressure increase. In conclusion, specially manufactured endotracheal tubes to limit excessive intracuff pressure did not effectively attenuate the incidence of postoperative sore throat in this patient population.
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A 73-year-old female was scheduled for left upper lobectomy. She had no history of asthma or chronic obstructive pulmonary disease. During the operation, respiratory sound was clear. ⋯ Inspiratory sevoflurane concentration was 4% at first, and was decreased to 2%. About 20 minutes after starting sevoflurane inhalation, wheezing was reduced. Sevoflurane may be useful in the treatment of bronchospasm after extubation.