Masui. The Japanese journal of anesthesiology
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The present study aims to examine if children's anxiety could be reduced by the presence of the parent at induction of anesthesia. The subjects were children aged from 6 months to 6 years who underwent general anesthesia. Forty children (Group A) received premedication and without the parent at induction of anesthesia. ⋯ We examined whether children were crying or not during anesthetic induction. Number of crying children accompanied by the parent during induction were fewer than those who were not accompanied. We conclude that allowing the parent to be present during anesthetic induction reduces the number of crying children and we consider that the presence of the parent decreased the children's anxiety.
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The interaction between magnesium sulphate (MgSO4) and vecuronium was investigated during isoflurane-nitrous oxide-oxygen anesthesia. Neuromuscular function was evaluated by recording the single twitch of the abductor policis muscle. Anesthesia was induced with thiamylal followed by injection of vecuronium. ⋯ On the contrary, the onset time of vecuronium was decreased and the duration of action until 25% recovery was increased by pretreatment with MgSO4 40 mg. The serum concentration of magnesium ions after administration of MgSO4 40 mg was significantly higher than that after 20 mg. We conclude that pretreatment with MgSO4 40 mg but not 20 mg enhances vecuronium-induced neuromuscular block.
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A 28 year-old male patient developed anaphylactic shock on separate occasions, possibly due to the contact with a central venous catheter impregnated with chlorhexidine and silver sulfadiazine. He was successfully resuscitated. On the second operation, blood basophils disappeared and plasma histamine level increased extremely up to 80 ng.ml-1 soon after anaphylactic shock. ⋯ Latex-specific anti-IgE antibody was not detected. Therefore, chlorhexidine was confirmed as the causative agent of anaphylactic shock. Because chlorhexidine is extensively used as an antiseptic drug in emergency rooms and intensive care units, we should be aware of the possibility of chlorhexidine induced anaphylactic reactions.
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Randomized Controlled Trial Clinical Trial
[Preventive effect of fluid warmer system on hypothermia induced by rapid intravenous infusion].
The changes in body temperature induced by rapid intravenous infusion of lactated Ringer solution and the effect of a fluid warmer system (HOT LINE, Level 1 Technologies, Inc., Rockland, MD) were investigated in 35 patients undergoing cardiovascular surgery. The patients were divided into 5 groups by categories of the fluid temperature (-19 or -38 degrees C), infusion route (radial or right subclavian vein), and infusion rate of lactated Ringer solution (1000 or 250 ml for 30 min). Pulmonary arterial, esophageal, bladder, and forehead deep temperatures, which reflect core temperature, were significantly decreased by the rapid infusion of unwarmed solution (0.8-1.0 degree C, P < 0.05). ⋯ With regard to the infusion route, there was no significant difference in the temperature between the radial vein and subclavian vein groups. Plantar deep temperature showed no significant change during this study. In conclusion, infusion of warmed solution using HOT LINE could prevent hypothermia induced by rapid intravenous infusion, and this effect is not greatly influenced by route of venous infusion.
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Case Reports
[A patient with drug abuse who developed multiple psychotic symptoms during sedation with propofol].
We report a patient with drug abuse who developed multiple psychotic symptoms including euphoria, excitement, hallucination and delirium during sedation with propofol under spinal anesthesia. A 37-year-old man who had abused methamphetamines, thinner, phychomimetics and alcohol for 20 years was scheduled for skin transplant as day-case surgery. He was treated with cholorpromazine, haloperidol and flunitrazepam just before the surgery. ⋯ He also demonstrated excitement, hallucination and delirium under propofol 6-8 mg.kg-1.h-1. His symptoms were suppressed by intravenous injection of haloperidol 5 mg. We speculate that propofol may produce psychotic symptoms when it is used in patients with a history of drug abuse.