Masui. The Japanese journal of anesthesiology
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We studied the relationship between postoperative brain dysfunction and the state of atherosclerosis in the patients of open heart surgery, by analyzing the intraoperative cerebral oxygen saturation (rSO2) and the CO2 reaction. The subjects were 143 patients with average age of 64 years. ⋯ There were significantly high values of AI and beta as well as low rSO2, in elder age with low cardiac index and no correlation was observed between rSO2 and PaCO2 in the brain dysfunction group. The results suggested that a higher level of atherosclerosis is associated with the postoperative brain dysfunction with resultant decreased cerebral blood flow and disturbed reaction to CO2 of cerebral blood vessels.
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We have evaluated the effectiveness of central venous catheter placement using right atrial electrocardiography (RAECG). Consecutive patients under general anesthesia (n = 42) who required a central venous catheter underwent RAECG-guided catheter insertion procedure via right internal jugular vein. Catheter tip position was verified by post procedure portable chest radiography. ⋯ The average insertion depth of catheters was 16.4 cm. We also attempted to predict the optimal catheter insertion depth for each patient from the previous measurements of external landmarks, but it was found to be difficult to predict reliably. In this point of view, we should use RAECG technique to make sure the proper positioning of the catheter tip.
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Randomized Controlled Trial Clinical Trial
[Does the difference in anesthetic methods influence postoperative nitrogen balance?].
To evaluate the influence of anesthesia on postoperative nitrogen balance after upper abdominal surgery, twenty-seven patients undergoing the surgery were investigated. They were allocated randomly to three groups receiving different anesthetic methods, i.e., epidural anesthesia, general anesthesia or balanced anesthesia. In the epidural anesthesia group, anesthesia was maintained with 0.5% isoflurane, nitrous oxide and oxygen supplemented with epidural analgesia extending from Th 1 to L 3. ⋯ Postoperative values of IL-6 and CRP also did not differ significantly among the three groups. Postoperative WBC was significantly higher in the balanced anesthesia group than in other two groups. The results suggest that the difference in anesthetic methods does not influence postoperative nitrogen balance.
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Randomized Controlled Trial Clinical Trial
[Evaluation of postoperative hypoxemia with a pulse oximeter].
We investigated postoperative hypoxemia by monitoring of SPO2 with a pulse oximeter for the first 5 hours in the ward. Forty-eight adults were divided into the general anesthesia along (G) group and the combination of epidural and general anesthesia (E) group. The patients were randomly administered either 3 l. min(-1) oxygen with face mask for the initial 3 hours or room air. ⋯ Significant correlations were found between Spo2 levels and both age (R = 0.75) and preanesthetic Spo2 (R = 0.66) in G group. Spo2 was significantly lower in the patients whose anesthesia was stopped after 5 p.m. than in those who were weaned before 5 p.m. In conclusion, there is a high incidence of postoperative hypoxemia for several hours in the ward, which can be relieved by 3 l. min(-1) oxygen inhalation with face mask.