Masui. The Japanese journal of anesthesiology
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Randomized Controlled Trial Clinical Trial
[Premixing of 5% dextrose in Ringer's acetate solution with propofol reduces incidence and severity of pain on propofol injection].
The purpose of this study was to compare the effect of premixed 5% dextrose in Ringer's acetate solution and premixed lidocaine with propofpl on the reduction of pain during injection of propofol in adult patients. We conducted a prospective, randomized, double-blinded trial. Ninety-six patients were randomly allocated to one of three groups according to the agents added to 1% propofol 20 ml; Group C, normal saline 2 ml, Group L, 2% lidocaine 2 ml, and Group A, 5% dextrose in Ringer's acetate solution 2 ml. ⋯ Seventy percent of patients in the C group experienced pain, while 33% and 25% of patients experienced pain in the A group and the L group, respectively. Forty-two percent of patients in the C group complained moderate to severe pain but only one patient in both A group and L group. In conclusion, 5% dextrose in Ringer's acetate solution premixed with 200 mg propofol significantly reduces incidence and severity of pain associated with propofol injection and is easier to use than premixed lidocaine.
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Randomized Controlled Trial Clinical Trial
[Effects of speed of injection on anesthesia induction with propofol and fentanyl].
We examined the effects of injection rate of propofol on injection pain and postinduction hypotension and bradycardia when fentanyl was administrated before propofol. Fifty-five patients premedicated with midazolam and atropine were randomly allocated to two groups. Three minutes after administration of fentanyl 100 micrograms, propofol 1.5 mg.kg-1 was injected to a forearm vein at a rate of 800 ml.hr-1 in Group FS or 1 ml.s-1 in Group FR. ⋯ The rapid rate of injection significantly shortened the induction time. The decrease in systolic and diastolic blood pressures and heart rate after induction were not affected by injection speed. In conclusion, rapid injection of propofol after fentanyl was effective to shorten the induction time without increasing the postinduction hypotension and bradycardia.
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Case Reports
[A case of pulmonary edema following upper airway obstruction after general anesthesia].
A 30-year-old man underwent tonsillectomy and laryngomicrosurgery under nitrous oxide oxygen-isoflurane anesthesia. Preoperative physical examinations and interview revealed no cardiopulmonary abnormalities. Two minutes after extubation, he showed dyspnea with marked inspiratory efforts and cyanosis due to laryngeal spasm. ⋯ He was discharged from the hospital on the 8th post-operative day. We reported a case of pulmonary edema after laryngeal spasm. It was suggested that a patient after acute upper airway obstruction should be carefully treated considering secondary pulmonary edema.
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Clinical Trial
[Cardiovascular responses during laryngeal mask airway insertion in normotensive, hypertensive and chronic renal failure patients].
The hemodynamic response to the insertion of the laryngeal mask airway (LM) following induction with propofol 2 mg.kg-1 was assessed and compared in normotensive (Normal), hypertensive (HT) and chronic renal failure (CRF) patients (n = 23 in each group). Before induction, in HT and CRF groups blood pressure and rate pressure products (RPP) were higher than in Normal group (P < 0.05). ⋯ There were no differences between groups in heart rate and rate of successful LM insertion. We concluded that LM insertion with propofol 2 mg.kg-1 was an effective induction method preventing the adverse circulatory responses in normotensive, hypertensive and chronic renal failure patients.
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We report a case of emergency caesarean section due to bleeding from placenta praevia under general anesthesia in a patient with asthma. General anesthesia was induced by propofol 150 mg and suxamethonium 80 mg, and operation was started immediately after tracheal intubation under cricoid cartilage pressure. ⋯ Although anesthetic maintenance was carried out by oxygen-nitrous oxide-isoflurane after delivery, no asthmatic attack was seen throughout the operation. Anesthetic induction by propofol for emergency caesarean section might be safe and useful in a patient with asthma with little effects to neonates.