Masui. The Japanese journal of anesthesiology
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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.
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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.
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We experienced an anesthetic management with rocuronium and neurostimulator for a surgical patient with amyotrophic lateral sclerosis. A 61-year-old man was scheduled for intrathecal baclofen pump implantation as treatment for his spasticity under general anesthesia. After oxygenation and totally intravenous induction with propofol and remifentanil, we administered 10 mg of rocuronium repeatedly monitoring with neurostimulator. ⋯ We could confirm his stable and adequate respiration and trachea was extubated without reversal of rocuronium. In the postanesthesia care unit, he showed no discomfort and was returned to the ward. His symptoms did not deteriorate postoperatively and he was discharged on the 36th postoperative day.