Masui. The Japanese journal of anesthesiology
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Randomized Controlled Trial Clinical Trial
[The effects of low dose clonidine on perioperative hemodynamics and anesthetic requirements in elderly patients].
The effects of clonidine, alpha 2-adrenergic receptor agonist, on perioperative hemodynamics and anesthetic requirements were studied in randomized 20 elderly patients without hypertension (ASA I-II) scheduled for elective abdominal surgery under general anesthesia. The control group (n = 10) was premedicated with oral diazepam 0.1 mg.kg-1 90 min prior to arrival in the operating room. The clonidine group (n = 10), in addition, received clonidine approximately 2.5 micrograms.kg-1 orally at the same time. ⋯ Intraoperative variability of heart rate was significantly lower in patients receiving clonidine compared with controls. No significant differences in the requirements of either isoflurane or narcotic supplementation were observed between the two groups. We conclude that a low dose clonidine is a useful adjunct in the management of elderly patients without producing side effects.
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Clinical Trial Controlled Clinical Trial
[Rectal diclofenac coupled with continuous epidural infusion with buprenorphine and bupivacaine for pain relief after upper and lower abdominal surgery].
This investigation was conducted to determine the analgesic efficacy of rectal diclofenac coupled with continuous epidural infusion with buprenorphine and bupivacaine for pain relief after upper and lower abdominal surgery. Forty patients in control group received epidural buprenorphine 0.1 mg in 8 ml of 0.25% bupivacaine immediately after surgery and subsequently infusion was started with the solution of epidural buprenorphine 15 micrograms in 1 ml of 0.23% bupivacaine at a rate of 1 ml.h-1 for 48 h. ⋯ Adding rectal diclofenac to continuous epidural infusion of buprenorphine and bupivacaine produced enhanced analgesia and reduced pain scores measured by VAS after upper abdominal surgery. However, after lower abdominal surgery, such effects of rectal diclofenac obtained after upper abdominal surgery were not demonstrable.
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Clinical Trial
[Fatigue and stress of anesthesiologists at work--third report: investigation with a flicker photometer and a stabilo-meter].
We previously studied the fatigue and stress of anesthesiologists at work using a flicker photometer, visual reaction time test, questionnaires, and Holter EKG. In the present study, we investigated the fatigue and stress in seven junior anesthesiologists at work using a flicker photometer and a stabilo-meter. The stabilo-meter measures postural stabilization. ⋯ Increase of fatigue in both the flicker and stabilo-tests was observed in 13 tests (61%) of 6 subjects. There was a good relationship between the flicker test and the stabilo-test. Therefore, the stabilo-test appears to be a useful method for investigating the fatigue of anesthesiologists.
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Case Reports
[A case of spasticity following spinal cord injury improved by epidural spinal cord stimulation].
Epidural spinal cord stimulation was performed in a patient complaining of spasticity with intractable pain after operation of metastatic spinal tumor. The end of the electrode was positioned along a line extending down the 11th vertebral body. ⋯ Although the treatment of this case resulted in clinical success, the problem concerning the payment of the transmitter remained. We hope that the health insurance system will extend its indications to cover medical fees for the transmitter.
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The effects of ulinastatin on postoperative renal function after the open cardiac surgery under cardiopulmonary bypass (CPB) were studied. N-acetyl-beta-D-glucosaminidase in urine as a marker of tubular function and serum creatinine rose significantly after CPB in the control group but not in the ulinastatin group. Ulinastatin was considered to be effective in protection of tubular function after CPB. In patient with poor preoperative renal function, ulinastatin prevented the deterioration of postoperative renal function by protecting tubular function.