Masui. The Japanese journal of anesthesiology
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Comparative Study Clinical Trial
[Convulsive seizure after craniotomy--comparison of isoflurane anesthesia and sevoflurane anesthesia].
The incidence of postoperative convulsive seizure was compared retrospectively during either isoflurane or sevoflurane anesthesia in patients after craniotomy. Overall, 5 of a total of 125 patients suffered convulsive seizures after craniotomy: 2 (4%) of 45 patients with isoflurane anesthesia and 3 (4%) of 80 patients with sevoflurane anesthesia. ⋯ The occurrence of postoperative convulsive seizure was not related with the inhalational anesthetic agents, the underlying disorders and patient characteristics. It is suggested that either isoflurane or sevoflurane anesthesia in neurosurgical patients may have no specific relationship with the postoperative convulsive seizures.
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Comparative Study Clinical Trial
[The utility of thermistor attached tracheal tube for pediatric patients in cardiac surgery].
During cardiac surgery, esophageal, rectal, or bladder temperature is usually monitored as an index of core temperature; however, these methods are invasive, and often inconsistently reflect the central body temperature, especially in pediatric patients. The purpose of this study was to evaluate the utility of tracheal temperature monitoring during cardiac surgery in pediatric patients. Fifteen children (ages; 8 m.-7 yr.) undergoing cardiac surgery with cardio-pulmonary bypass (CPB) were studied. ⋯ There were also good correlations of the esophageal as well as bladder temperatures with blood temperature. There were no patients who suffered tracheal inflammation or laryngeal edema from the thermistor. Monitoring tracheal temperature is not only valuable for monitoring the core temperature, but also is convenient for pediatric patients in cardiac surgery.
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The analgesic effect of iontophoresis with magnesium sulfate was studied in fourteen healthy adult volunteers. Magnesium sulfate 0.5 mg.5 ml-1 was locally administered by the iontophoresis with 1.0 mA electric current for 10 min. ⋯ The pain recognition time was significantly extended and lasted for 60 min. These results support the view that the iontophoresis with magnesium sulfate has analgesic effect and produces a good pain relief clinically.
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The changes of cognitive function after open heart surgery was examined using the Hasegawa's Dementia Scale (max. 30 points) in 47 patients with average age of 61.7 years. The patient's score was obtained preoperatively, and 1st and 7th postoperative days. Patients with postoperative scores above 24 points were classified as Non-Decline group, and those below 23 points as Decline group; comparative analyses were done on the relationship between various perioperative factors on both groups. ⋯ Moreover there were high incidences of postoperative complications, especially LOS, in the Decline group. It was concluded that one of the largest contributing factors of abnormality of the cognitive function postoperatively was age, and other factors such as pre- and postoperative general conditions of the patients, especially cardiac function, might also be related. The length of hospitalization in the cases of decreased cognitive function was longer.
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Clinical Trial Controlled Clinical Trial
[Augmentation by succinylcholine of the neuromuscular blocking effect of vecuronium in children].
To evaluate the influence of succinylcholine (Scc) on the neuromuscular blocking effect of subsequently administered vecuronium in children, 30 patients aged 2-14 years scheduled for elective surgery were studied after obtaining the informed consent from the parents. Anesthesia was induced with inhalation of sevoflurane, nitrous oxide and oxygen. T1 of the adductor pollicis muscle to ulnar nerve stimulation elicited by train of four stimulation at 2 Hz was monitored continuously by an acceleration transducer. ⋯ Short onset of action and potentiation of maximal block were demonstrated in group SV. After vecuronium administration, a complete suppression of T1 was observed in 8 patients of group SV and only 1 patient of group V. The present study demonstrates that the neuromuscular blockade of vecuronium can be potentiated with the prior administration of Scc in pediatric patients.