Masui. The Japanese journal of anesthesiology
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Randomized Controlled Trial Clinical Trial
[Bispectral index based comparison of propofol dose requirement combined with various types of analgesic methods for total intravenous anesthesia].
We hypothesized that propofol dose requirement for total intravenous anesthesia is varied with the analgesic methods during anesthesia if the depth of anesthesia is maintained at the same level with bispectral index. Adult gynecological patients without any complications were randomly allocated to four groups; propofol with 1) continuous epidural block-oxygen-nitrous oxide (n = 18), 2) continuous epidural block-oxygen-air (n = 21), 3) fentanyl (total 5 micrograms.kg-1)-oxygen-nitrous oxide (n = 18) and 4) fentanyl (total 5 micrograms.kg-1)-oxygen-air (n = 21) group. Propofol 1.5 mg.kg-1 and vecuronium 0.15 mg.kg-1 were administered intravenously for endotracheal intubation. ⋯ The age, body weight, height and hemodynamic changes during anesthesia among the groups were not significantly different. Total required dose of propofol for continuous epidural block-oxygen-nitrous oxide, continuous epidural block-oxygen-air, fantanyl-oxygen-nitrous oxide and fentanyl-oxygen-air group were 4.78 +/- 0.87 mg.kg-1.h-1, 6.10 +/- 0.93 mg.kg-1.h-1, 5.79 +/- 0.75 mg.kg-1.h-1 and 6.58 +/- 1.19 mg.kg-1.h-1, respectively. Nitrous oxide was able to reduce the dose of propofol significantly either with epidural anesthesia or fentanyl used for analgesia.
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Randomized Controlled Trial Clinical Trial
[Transdermal nitroglycerin before induction of anesthesia prevents redistribution hypothermia in patients under general anesthesia].
Initial anesthesic-induced hypothermia results largely from core-to-peripheral redistribution of heat. Administration of transdermal nitroglycerin induces vasodilation. Such vasodilation, induced well before induction of anesthesia, might redistribute heat to peripheral tissues. ⋯ Core temperature during the first hour of anesthesia decreased significantly more in the control patients than in those given either dose of nitroglycerin. Vasodilation induced by transdermal nitroglycerin before induction of anesthesia significantly decreased subsequent redistribution hypothermia. Drug-induced modulation of vascular tone thus produces clinically important alterations in intraoperative core temperature.
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Case Reports
[A case of endotracheal tube obstruction caused by pneumoperitoneum during laparoscopic cholecystectomy].
A 56-year-old man with cholecystolithiasis was scheduled for laparoscopic cholecystectomy. Anesthesia was induced with pentazocine and propofol i.v., and the trachea was intubated using vecuronium i.v. Anesthesia was maintained with 70% nitrous oxide and 1-3% sevoflurane in oxygen, and vecuronium was used for muscle relaxation. ⋯ One hour after the end of surgery, PaCO2 was 48.9 mmHg under spontaneous respiration. We speculate that the pneumoperitoneum shifted the tracheal carina cephalad, causing obstruction of the endotracheal tube. Our findings show that displacement of the endotracheal tube must be carefully monitored during laparoscopic cholecystectomy.