Masui. The Japanese journal of anesthesiology
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To evaluate effects of stellate ganglion block (SGB) on coronary circulation under coronary occlusion, the changes in cardiac function and tissue blood flow in the myocardial ischemic area after right and left SGB were observed in the dogs. Tissue blood flow in the myocardial ischemic area measured with laser doppler flowmeter showed no significant change after right or left SGB. ⋯ On the other hand, in the left SGB group, heart rate, circumflex branch blood flow and rate pressure product showed no significant changes, while end-diastolic pressure and myocardial oxygen extraction rate increased significantly (P < 0.05). These data suggest that although right SGB might be useful to improve the oxygen demand-supply relation, left SGB does not improve the oxygen demand-supply relation and might increase the risk of myocardial ischemia.
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The present study was designed to examine whether palpation of the endotracheal tube cuff indicates appropriate positioning in the children. In 59 children, we used a cuffed endotracheal tube (3.5-5 mm ID) to measure the distance from the carina to the distal tip of the endotracheal tube, when we can palpate the endotracheal tube cuff between the cricoid cartilage and the suprasternal notch. Following slow induction of anesthesia and muscle relaxation, each patient was intubated with a cuffed endotracheal tube of size suitable for age. ⋯ The cuff was deflated after measurement. There were no complications attributable to use of cuffed endotracheal tubes. We concluded that the cuff palpation method was a rapid, reliable and simple technique to ensure the proper tube position in children.
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Clinical Trial Controlled Clinical Trial
[Tele-ECG transmission for patients with out-of-hospital cardiac arrest in Osaka City].
The efficacy of a tele-ECG transmission system for transmission of electrocardiograms from ambulance to Osaka City University Hospital for 59 patients with out-of-hospital cardiac arrest was evaluated from December 1992 to November 1993. Authorized emergency life saving technicians (ELSTs) transmitted electrocardiograms by automobilephone connected with electrocardiogram from the location of out-of-hospital cardiac arrest recognized by them to the ICU. Successful tele-ECG transfer was achieved in 34 cases (57.6%). ⋯ The group with tele-ECG transmission required longer time for transfer to the hospital. The time required for insertion of the laryngeal mask airway and tele-ECG transmission appeared to be the main reason for the delay in transport. Although use of tele-ECG transmission can be useful for patients with out-of-hospital cardiac arrest, further improvement on the transmission system will be needed.
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We examined the efficacy of systemic local anesthetics on various types of neuropathic pain in 89 patients. Lidocaine 1.5 mg.kg-1 was infused intravenously for one minute. ⋯ PS decreased to less than 50 percent of pre-infusion value in more than 75 percent of cases of cancer pain, postherpetic neuralgia, trigeminal neuralgia, low back pain with signs of root pain or spinal canal stenosis, peripheral nerve injury and thalamic pain, in 50-75 percent of cases of herpetic neuralgia, and in less than 50 percent of cases of cervical spondylosis, spinal cord injury, reflex sympathetic dystrophy, causalgia and psychogenic pain. This study suggests that systemic local anesthetics is effective in neuropathy due to cancer pain, postherpetic neuralgia, trigeminal neuralgia, low back pain with signs of root pain or spinal canal stenosis, peripheral nerve injury and thalamic pain.
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We analyzed preoperative blood preparation and intraoperative blood transfusion in Kagawa Prefectural Central Hospital and evaluated the effectiveness of maximum surgical blood order schedule (MSBOS) and Type and Screen (T&S). Forty seven kinds of surgery were performed on 1,283 cases from May, 1991 to April, 1992. Transfusion was performed in 179 cases of them. ⋯ The Crossmatched to Transfused ratio (C/T ratio) was 1.71. If we adopted MSBOS and T&S in 13 elective surgery, 766 units of blood and labour work for preoperative blood preparation could have been saved. MSBOS and T&S are beneficial for efficient usage of blood transfusion in surgery.