Masui. The Japanese journal of anesthesiology
-
Clinical Trial
[The effect of vasodilator on the occurrence of postoperative shivering and the fall of core temperature].
We evaluated the effect of intraoperative vasodilator therapy on the occurrence of postoperative shivering and the fall of core temperature during 37 abdominal operations by the stepwise multiple regression analysis. As the vasodilator, we used PGE1 at the dose of 0.02-0.05 microgram.kg-1.min-1. ⋯ And intraoperative and postoperative core temperatures were not affected by that therapy. From these results, we conclude that intraoperative vasodilator therapy suppressed the occurrence of postoperative shivering without a fall of core temperature.
-
Case Reports
[A patient who recovered successfully from severe anemia which continued for one hour].
A 79-year-old woman had her cervical spinal cord injured and laminoplasty of the neck was performed. Uncontrollable venous bleeding was encountered during the operation and about 5000 ml of blood was lost in one hour. Massive infusion of 5% albumin and hydroxyethylstarch (HES) was done to maintain the intravascular volume. ⋯ Seven of twenty patients complained of the leg pain a few minutes after spinal block. The pain was localized in the parts of deafferentation or phantom limb, and was relatively mild and controllable. We consider that the inhibitory system is inactivated when the somatic impulse is blocked by spinal anesthesia, and as a result the abnormal burst activity of dorsal horn produced by peripheral nerve damage of leprosy causes phantom pain.
-
Clinical Trial
[Epidural fentanyl provide sufficient analgesia for extracorporeal shock wave lithotripsy (ESWL)].
Epidural fentanyl (0.2 mg in 10 ml normal saline) was administrated in 10 unpremedicated patients undergoing extracorporeal shock wave lithotripsy (ESWL). No test dose of local anesthetics was administrated and accessory drugs such as narcotics or analgesics were not used. Painful procedures except for shock wave such as insertion of urethral catheter were not applied. ⋯ Respiratory rate and Spo2 slightly decreased during ESWL. Postoperative side effects were mild especially in the patients treated with epidural fentanyl alone. Epidural fentanyl is considered to be useful analgesic technique for ESWL.
-
Randomized Controlled Trial Clinical Trial
[Preoperative flurbiprofen provides pain relief after laparoscopic cholecystectomy].
In a single-blind randomized prospective study, postoperative pain was assessed in 60 patients undergoing elective laparoscopic cholecystectomy with three types of anesthesia: standardized general anesthesia (control group), preoperative 50 mg flurbiprofen as an addition to the same method of general anesthesia (flurbiprofen group), and conventional combined epidural and general anesthesia with epidural administration of 0.25% bupivacaine 5-8 ml and 0.1-0.2 mg buprenorphine after surgery (epidural group). After the operation we found that the average time from the end of surgery to the first request for an analgesic was 3.9 h, 22.7 h and 43.7 h in the control, flurbiprofen and epidural group, respectively. ⋯ Patients in the control group requested analgesics for a longer period of time after the initial request compared with patients in the other groups. Our results indicate that postoperative pain can be reduced when flurbiprofen is added to general anesthesia before surgery, although use of flurbiprofen was not as effective as the conventional combined epidural and general anesthesia used for treating pain after laparoscopic cholecystectomy.
-
Randomized Controlled Trial Clinical Trial
[Postoperative epidural fentanyl administration in patients for hysterectomy with para-aortic lymph node resection].
In our experience, continuous epidural administration of fentanyl in doses of 12.5 micrograms.h-1, has not been sufficient to relieve postoperative pain in patients after hysterectomy with para-aortic lymph node resection. Thus, a prospective, randomized, single-blind study was performed to compare the analgesic efficacy of fentanyl 25 micrograms.h-1 with 12.5 micrograms.h-1 in these patients for 48 hours after surgery. Twenty-one women undergoing hysterectomy with para-aortic lymph node resection were allocated into three groups; Group C (control, n = 7): fentanyl 12.5 micrograms.h-1, infusion rate 2 ml.h-1, Group S2 (double speed, n = 7): fentanyl 25 micrograms.h-1, infusion rate 4 ml.h-1, and Group C2 (double concentration, n = 7): fentanyl 25 micrograms.h-1, infusion rate 2 ml.h-1. ⋯ At movement, the analgesic efficacy was not sufficient in any groups, but, at rest, groups S2 and C2 experienced significantly less pain than the group C. The degree of pain relief was not different between groups S2 and C2. In conclusion, epidural fentanyl 25 micrograms.h-1 provided significantly superior analgesia compared with epidural fentanyl 12.5 micrograms.h-1.