Masui. The Japanese journal of anesthesiology
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We compared our new sedation technique with propofol during spinal anesthesia (Group B, n = 50) with a previously described method by Mackenzie et al. (Group A, n = 20). In Group A, propofol was started at a rate of 6 mg.kg-1.h-1 for 10 minutes, followed by continuous infusion at a rate of 4 mg.kg-1.h-1 till the end of surgery. In Group B, propofol 0.4 mg.kg-1 was administered by a bolus injection at the beginning. ⋯ The blood concentrations of propofol in Group B was 0.946 +/- 0.076 microgram.ml-1 and 0.693 +/- 0.136 microgram.ml-1 at 5 minutes and 10 minutes after the beginning of propofol, respectively. These values were significantly lower than those reported by Kugimiya. Our newly developed method for sedation with propofol during spinal anesthesia would be safer and more effective than that previously described by Mackenzie et al.
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Cornelia de Lange syndrome involves anomalies in cardio-vascular and musculo-skeletal systems, and mental retardation. In addition, a patient with this syndrome shows a peculiar look. A 22-year-old woman with Cornelia de Lange syndrome underwent general anesthesia twice. ⋯ After the administration of 4% lidocaine 3.5 ml into the pharynx, orotracheal intubation was attempted, but was not successful. Then blind naso-tracheal intubation was performed successfully under spontaneous respiration under sevoflurane-oxygen inhalation. The induction of anesthesia with sevoflurane under spontaneous respiration was useful for blind naso-tracheal intubation in a case with difficult intubation such as in Cornelia de Lange syndrome.
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We found fine cracks in a three-way stopcock after continuous infusion of propofol (Diprivan, Astra-Zeneca, UK). In this paper the possible mechanism was investigated. At first we checked various three-way stopcocks of various manufactures, such as JMS, Terumo, Nipro and Top. ⋯ But there was no significant difference in cracks between fat and propofol groups. The size of crack increased in a time and strength dependent manner. We conclude that the cause of cracks in three-way stopcock is fat emulsion as a vehicle of propofol not propofol itself.
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Comparative Study
[Intra- and postoperative heart rate changes following propofol anesthesia; a comparison with isoflurane anesthesia].
Bradycardia during propofol anesthesia is well known, but bradycardia after propofol anesthesia has not been studied well. We compared perioperative heart rates in patients who had undergone gynecological surgery under lumbar epidural anesthesia supplemented with light general anesthesia using isoflurane and nitrous oxide in oxygen (Group Iso, n = 25) with those who had received lumbar epidural anesthesia supplemented with propofol (Group Prop, n = 25). ⋯ In one of them intravenous atropine was necessary to treat bradycardia. We conclude that more attention should be paid to postoperative as well as intraoperative bradycardia in patients who receive propofol.
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Randomized Controlled Trial Clinical Trial
[Total intravenous anesthesia with Diprivan (1% propofol emulsion) using a manual drip-infusion technique].
Continuous intravenous administration of Diprivan (1% propofol emulsion, P) is usually carried out using a syringe-pump or an infusion-pump to adjust the infusion rate. We assessed the accuracy of the infusion dose of P and the serum concentration of propofol by manual controls during anesthesia. Twenty eight patients, anesthetized with oxygen, P and vecuronium in combination with fentanyl and epidural block were randomly assigned to either of the following groups; P was administered using the drip-infusion (the group D, n = 14) or a syringe-pump (the group S; n = 14). ⋯ The Vc was well correlated with the Vm in the group D (r = 0.976) and in the group S (r = 0.974). Mean serum propofol concentrations of the group D and S were 2.50 +/- 0.57 and 2.35 +/- 0.62 micrograms.ml-1, respectively. The results suggest that the drip-infusion technique of P may be substituted safely by the syringe-pump for continuous total intravenous anesthesia.