Masui. The Japanese journal of anesthesiology
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Randomized Controlled Trial Comparative Study Clinical Trial
[Comparison of zopiclone and midazolam premedication for preoperative anxiolysis].
To compare the anxiolysis property of zopiclone (ZPC) and midazolam (MDZ), 117 patients were given zopiclone 7.5 mg p.o. or midazolam 0.05 mg.kg-1 i.m. as premedication. In the study 1, patients were randomly allocated to 4 groups: ZZ group (n = 16) received ZPC in the night before operation and 2 h before operation, ZM group (n = 18) received ZPC in the night before operation and MDZ 1 h before operation, Z group (n = 18) received ZPC 2 h before operation, and M group (n = 24) received MDZ 1 h before operation. The degree of anxiety was evaluated using the state-trait anxiety inventory (STAI) on the day before operation and after receiving premedication. ⋯ The degree of anxiety was evaluated using the visual analog scale (VAS) on the day before operation and after receiving premedication. ZPC showed a significant reduction in the VAS score, but MDZ showed no changes in the VAS. It is concluded that ZPC (7.5 mg p.o.) is suitable to reduce the preoperative anxiety in patients who are to undergo surgery as compared to MDZ (0.05 mg.kg-1 i.m.).
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The segmental spread of thoracic epidural analgesia was measured in 14 patients scheduled for elective surgery with ages ranging from 35 to 80 years. Epidural puncture was performed in the seventh or eighth thoracic intervertebral space using 17 gauge Tuohy needle with the patient in the left lateral position. ⋯ Fifteen minutes after injection of anesthetic, the spinal segments anesthetized were determined by absence of cold sensation. A statistically significant correlation was found between age and a segmental dose (ml.seg-1) (r = -0.72), and between age and a segmental dose corrected by height (ml.seg-1.m-1) (r = -0.65).
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A 64-year-old man was scheduled for transure thral resection of the prostate. The patient's medical history showed borderline diabetic state and two uncomplicated surgeries under spinal anesthesia. Spinal anesthesia was performed at the L 3/4 interspace using hyperbaric 0.24% dibucaine 2.2 ml, which was followed by general anesthesia because the anesthesia level had spread only to the lower left side of the body. ⋯ None of these are contraindication for spinal anesthesia. Many elderly patients particularly undergoing urological surgeries are likely to have such risk factors. Therefore at least dibucaine should be avoided for spinal anesthesia because of its high neurotoxicity compared with other local anesthetics.