Masui. The Japanese journal of anesthesiology
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Randomized Controlled Trial
[Treatment of epidural morphine induced pruritus with butorphanol].
Epidural morphine has been used to provide postoperative analgesia. However, one of the most common side effects of epidural morphine is pruritus. The incidence may or may not be related to the dose of morphine administered. First, we examined whether epidural morphine induced a dose-related increase in pruritus or not. Secondly, the purpose of this study was to evaluate the relief of pruritus when a combination of epidural morphine (a mu-receptor agonist) and butorphanol (a mu-receptor antagonist and kappa-receptor agonist) was administered. ⋯ Butorphanol 2 mg x day(-1) was effective in preventing pruritus associated with continuous epidural infusion of morphine 3.3 mg x day(-1).
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Herpes zoster causes acute pain and sometimes leads to postherpetic neuralgia (PHN). The previously reported risk factors of PHN such as old age, allodynia, paresthesia and so on are not based on evidence. Although nerve block is useful to relieve acute pain and recommended for prevention of PHN, evidence is scanty. ⋯ Old age, hypesthesia and delayed nerve blocks were the risk factors of PHN. Nerve blocks in the early phase of herpes zoster may be useful to prevent PHN, particularly in the younger patients.
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Induced hypotensive anesthesia is a well established technique in adult patients. We examined retrospectively the effect of sodium nitroprusside pediatric patients undergoing pelvic osteotomy with simultaneous femoral osteotomy. ⋯ These results suggest that sodium nitroprusside is a safe and effective drug for induced hypotension in pediatric patients.
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Comparative Study
[Comparison of the changes in blood glucose levels during anesthetic management using sevoflurane and propofol].
Recent studies have shown that sevoflurane impairs glucose tolerance, but the effect of propofol on glucose metabolism is not still clear. ⋯ Results in this study imply that the effect on glucose metabolism of propofol is much less than that of sevoflurane.
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Case Reports
[Case of pulmonary edema and transient heart failure during difficult airway management].
Many kinds of side effects are likely to occur while managing difficult airway. This article describes a case of a man who fell into pulmonary edema and heart failure during the difficult airway management. He was to undergo arthroscopic surgery on his knee. ⋯ Ventilation with 100% O2 could not maintain the oxygenation well. Chest X-ray revealed the pulmonary edema. We presumed that hypertension associated with airway stimulation had caused acute pulmonary edema and heart failure resulting from diastolic dysfunction induced by increased catecholamine.