Masui. The Japanese journal of anesthesiology
-
Randomized Controlled Trial Comparative Study
[Effect of landiolol and combined use of landiolol and olprinone on hemodynamics in patients undergoing off-pump coronary artery bypass grafting].
Beta blockers are frequently used to reduce cardiac oxygen demand in off-pump coronary artery bypass grafting (OPCAB). However, significant bradycardia or negative inotropic effects are seen on occasion. We hypothesized that combined use of landiolol (L), an ultra short-acting beta blocker, and olprinone (O), a phosphodiesterase 3 inhibitor, is useful because it can increase cardiac index and prevent tachyarrhythmia even during dislocation of the heart in OPCAB. ⋯ Combined use of landiolol and olprinone increases cardiac index and decreases systemic vascular resistance index during OPCAB.
-
The effect of adding vasoconstrictors to local anesthetics for spinal anesthesia is controversial. The aim of this study was to investigate the effect of phenylephrine on neural blockade and hemodynamic changes in spinal anesthesia in elderly patients. ⋯ The addition of phenylephrine to hyperbaric tetracaine in spinal anesthesia did not affect the extent of sensory blocks and hemodynamic changes in elderly patients.
-
A 26-year-old woman with Ehlers-Danlos syndrome (EDS) underwent posterior spinal fusion with instrumentation for scoliosis. General anesthesia was maintained using propofol and remifentanil. The procedure was performed examining the motor evoked potential (MEP) and somatosensory evoked potential (SSEP) of the lower extremities with the patient placed in the prone position. ⋯ Brachial plexus injury is the most common among the nerve injuries resulting from intraoperative malpositioning. Patients with EDS are thought to be at high risk for the complications and it has also been reported that patients with joint hypermobility, such as that in EDS or Marfan syndrome, are highly susceptible to nerve injury. Intraoperative monitoring of the MEP and SSEP in the upper extremities should be considered for early detection and prevention of brachial plexus injury in patients with EDS who are thought to be at high risk.
-
The aim of this study was to evaluate the suitability of the C-MAC videolaryngoscope for the tracheal intubation especially by novice personnel. ⋯ The C-MAC videolaryngoscope is a useful device in education of endotracheal intubation by novice personnel.
-
Randomized Controlled Trial
[Evaluation of motor block of the lower legs in continuous lumbar epidural infusion of ropivacaine].
Continuous epidural infusion of ropivacaine is commonly used for postoperative analgesia because of its motor-sparing properties. But there are a few patients whose motor block of the lower legs is prolonged. The aim of this study is to investigate the effect of low density ropivacaine regarding motor block of the lower legs when administered continuously into the lumbar epidural space. ⋯ For avoiding prolongation of motor block of the lower legs in continuous lumbar epidural infusion for postoperative analgesia, 0.1% ropivacaine would be better than 0.2%. We should pay attention to the fact that the use of ropivacaine after spinal anesthesia prolongs and increases motor block of the lower legs.