Masui. The Japanese journal of anesthesiology
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Randomized Controlled Trial Comparative Study Clinical Trial
[Effects of thiopental and sevoflurane on hemodynamics during anesthetic management of electroconvulsive therapy].
The effect of thiopental and sevoflurane (1 MAC, 2 MAC) on hemodynamics was assessed in a randomized study involving 38 adult patients undergoing electroconvulsive therapy (ECT). Blood pressure, heart rate and electrocardiogram (ECG) were monitored during the ECT procedure. After oxygenation, hypnosis was induced with a bolus injection of thiopenal (TPS) 4 mg.kg-1. ⋯ The rate pressure product increased in every group right after ECT, but the use of sevoflurane (2 MAC) significantly diminished the response compared with sevoflurane (1 MAC) and thiopental. In the sevoflurane (2 MAC) group, no ventricular arrhythmias were observed. In general, it seems that sevoflurane (2 MAC) is as effective as thiopental and sevoflurane (1 MAC) as an induction agent for ECT.
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A 71-year-old male patient with rheumatoid arthritis was scheduled for posterior fusion of the cervical spine. He showed limited cervical movement and atrophic mandible. Tracheal intubation was difficult in his last anesthetic management for the same surgery. ⋯ The laryngeal mask airway and the endotracheal tube were withdrawn simultaneously leaving the tube changer. Finally, a 7.5-mm-ID armored endotracheal tube was inserted through the tube changer. The procedure applied in this case is a safe and reliable intubating method in patients with difficult tracheal intubation.
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Anesthetized surgical patients frequently become hypothermic, because of decreased metabolic heat production, increased heat loss, surgical exposure, and dry respiration gases. Intraoperative hypothermia may trigger postoperative protein breakdown, shivering, myocardial ischemia, and many other problems. For that reason, heat conservation is a major anesthetic management. ⋯ Rectal temperature increased 0.62 degrees C after 60 minutes in the Warm Touch group, but significant changes were absent in warming blanket group. Temperature gradient between the rectum and finger-tip skin decreased markedly in the Warm Touch group. This study suggests that Warm Touch is useful to restore body temperature and to prevent postoperative problems arising from intraoperative hypothermia.