Masui. The Japanese journal of anesthesiology
-
Comparative Study Clinical Trial
[A comparison of the incidence of postoperative nausea and vomiting after propofol-fentanyl anesthesia and that after nitrous oxide-isoflurane anesthesia].
We compared the incidence of postoperative nausea and vomiting after total intravenous propofol-fentanyl anesthesia (TIVA group) and that after thiamylal-nitrous oxide-isoflurane anesthesia (GOI group) in 60 ASA physical I and II patients for elective abdominal simple total hysterectomy. When the patients returned to the ward, the incidence of nausea was lower in TIVA group than in GOI group (P < 0.05), but no difference was found in the incidence of vomiting between the two groups. ⋯ Postoperative pain scores were similar between the two groups, while total postoperative evaluation scores (nausea, vomiting, pain, fever, and sleep disturbance) were lower in TIVA group (P < 0.05). We conclude that TIVA with propofol-fentanyl reduced the incidence of nausea and improved total evaluation scores in the immediate postoperative period.
-
Epidural block is very useful in the treatment of herpetic pain and post herpetic neuralgia. However, in the elderly patients with cardiac disease or diabetes mellitus, severe cardiovascular changes may occur by epidural block. Epidural block caused severe hypotension in two elderly patients with herpetic pain and post herpetic neuralgia who had diabetes mellitus or hypertension. Continuous thoracic sympathetic ganglion block with local anesthetics through a placed catheter reduced their pain and caused almost no changes in cardiovascular system.
-
Microlaryngeal surgery was performed with total intravenous anesthesia using pentazocine and propofol in 20 patients. The patients were paralyzed by suxamethonium infusion and ventilated by high frequency jet ventilation via the laryngoscope. In place of the opioid analgesics commonly used in TIVA for microlaryngeal surgery, pentazocine was given. ⋯ Average time of surgeries was 33.6 minutes. Average doses of pentazocine and suxamethonium given during surgeries were 369 m.g. and 286 m.g., respectively. This technique allowed stable anesthesia to be achieved with rapid postoperative recovery, without serious complications like intraoperative return of awareness.
-
Pharmacokinetics of propofol and ketamine during propofol-fentanyl-ketamine (PFK) anesthesia for pediatric surgery was studied. Plasma levels of propofol (Pp) were maintained approximately at 2.5 micrograms.ml-1 during surgery. Fifteen minutes after the cessation of propofol infusion, Pp decreased to 1.5 micrograms.ml-1. ⋯ On the other hand, plasma norketamine (Pn) levels increased gradually during surgery and stayed at 100-150 ng.ml-1 after the end of ketamine infusion to play an important role in post-operative sedation and pain relief. In conclusion, pharmacokinetics of propofol and ketamine in pediatric patients was similar to that in adult patients. PFK anesthesia can be used safely for pediatric as well as for adult patients.
-
We monitored bilateral cerebral oxygen saturation and hemoglobin index while the brain received separate perfusion for major vascular surgery. Before surgery, left cerebral oxygen saturation and hemoglobin index were within normal limits but right cerebral oxygen saturation and right hemoglobin index were low. ⋯ No paralysis or any other neurological complications occurred postoperatively. We conclude that such monitoring is useful during and after anesthesia under separate brain perfusion.