Masui. The Japanese journal of anesthesiology
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Randomized Controlled Trial Clinical Trial
[Changes in circulation and end-tidal sevoflurane concentration during infusion of sevoflurane into vaporizer].
We observed the changes in circulation and endtidal sevoflurane concentration during the infusion of the anesthetic into a vaporizer, and investigated some techniques to prevent these changes during general anesthesia. The patients were randomly divided into three groups: conventional, high concentration (conc.) and low flow groups. Inspiratory concentration of sevoflurane was kept at 1.0% and the duration of the pause in sevoflurane supply was 90 sec. ⋯ An increase in blood pressure and a tendency towards tachycardia were observed in the conventional group, and the circulation was kept constant best in the low flow group. The lowest concentrations of sevoflurane during the pause were 0.46, 0.46 and 0.93% in the conventional, high conc., and low flow groups, respectively, and exposure to high concentration of the anesthetic could not prevent the decrease. These results indicate that low flow anesthesia is a useful technique to prevent undesirable changes in circulation and anesthetic concentration.
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Biography Historical Article
[Sir Humphry Davy, the discoverer of anesthetic action of nitrous oxide--Davy and poets of British Romanticism and inhalation of laughing gas by his friends].
In "Dove Cottage", the old house of the poet laureate William Wordsworth (1770-1850) in Grasmere, England, there is a portrait of Sir Humphry Davy (1778-1829). In 1804, Wordsworth invited his young friend to his home. Davy's works in the field of chemistry are well known. ⋯ But he has chosen the way of chemist. The author found some facts from literatures and received some information by courtesy of the Wordsworth Trust, Centre for British Romanticism. Davy's life and his works were introduced chronologically.
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To evaluate the present status of blood transfusion during operation in our hospital, we retrospectively analyzed the amount of preoperative preparation & intraoperative use of homologous blood and the circumstances of autologous blood transfusions. The amount of prepared blood was 4,505 units of which 1,187 units were transfused; the mean cross matched-to-transfused (C/T) ratio was 3.8. ⋯ Preoperative blood donation (PBD) and intraoperative autologous blood transfusion (IAT) were performed in 74 cases (47.4%) and 55 cases (35.3%), respectively, of all 156 blood-transfused cases, and the operations were performed without homologous blood transfusion in 88.0% of PBD cases and 67.3% of IAT cases respectively. We are sure that the introduction of MSBOS will lead to a more efficient use of autologous blood, and that we should use homologous blood transfusion techniques so far as is possible to avoid autologous blood transfusion.
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Clinical Trial
[Cervival spine movement during light-guided orotracheal intubation with lightwand stylet (Trachlight)].
We assessed the degree of movement of the cervical spine (C-spine) during light-guided orotracheal intubation using a lightwand stylet (Trachlight). Twenty ASA 1-2 patients were studied. Following induction of anesthesia and obtaining muscle relaxation, the cross-table lateral radiograph of C-spine was taken before and during the intubation with Trachlight. ⋯ The results showed that delta C1-occiput was larger and delta C1 + C5 was smaller with Trachlight than with conventional or McCoy laryngoscopy we had previously reported. We concluded that light-guided intubation technique using Trachlight needed less movement of the C-spine in contrast to direct laryngoscopy. We believe that Trachlight is an easy, alternative and beneficial device for patients in whom cervical spine movement is limited or undesirable.
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Comparative Study Clinical Trial Controlled Clinical Trial
[Effect of epidural pressure gradient on buprenorphine flux through the dural hole after combined spinal-epidural anesthesia--comparison between bolus injection and continuous infusion].
Combined spinal-epidural anesthesia is a useful technique. However, there has been no attempt to investigate the risk of epidural opioid, especially buprenorphine, flux through the dural hole. The purpose of this study was to compare the effect of epidural buprenorphine administered across the dura into subarachnoid space, between two different methods of administration; bolus injection (Group I) and continuous infusion (Group II). ⋯ It indicates that the increase of nausea and vomiting is predominantly determined by a high rate of flux into subarachnoid space and only partly determined by blood concentrations. In contrast to continuous infusion, the drug movement through the dural hole may increase by bolus injection due to its higher pressure. We recommend careful injection of epidural buprenorphine such as by continuous infusion with low pressure after combined spinal-epidural anesthesia.