Masui. The Japanese journal of anesthesiology
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In 108 spinal anesthetic cases, 2.36 ml of each of five 0.5% tetracaine solutions, either with distilled water (DW), normal saline (NS) or different concentrations of dextrose (2.5%-2.5 G, 5%-5 G, 10%-10 G) was injected intrathecally at the L2/3 or L3/4 interspace. The specific gravity and osmotic pressure of these solutions and cerebrospinal fluid were measured. The cephalad spread of analgesia was greater with higher concentration of dextrose (5 G-Th7.4, 10 G-Th6.0), compared with DW, NS and 2.5 G (Th9.5-9.8). ⋯ The hemodynamic changes after intrathecal injection were small with 2.5 G, DW and NS. Arterial hypotension requiring treatment occurred with 5 G and 10 G. The baricity of spinal anesthetic solution had an important effect on characteristics of the blockade.
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Comparative Study
[Effects of inverse ratio ventilation and positive end-expiratory pressure on gas exchanges in dogs with oleic acid induced pulmonary edema].
The purpose of this study was to determine the effect of inverse ratio ventilation (IRV) on gas exchanges and circulatory systems in 56 mongrel dogs with oleic acid induced pulmonary edema. The dogs were divided into 9 groups and were ventilated with 9 kinds of ventilatory modes such as I:E ratio of 1:2 (control), 2:1 (2:1 IRV), 3:1 (3:1 IRV), 1:2 with 5 cmH2O PEEP (1:2 PEEP 5), 2:1 with 5 cmH2O PEEP (2:1 PEEP 5), 3:1 with 5 cmH2O PEEP (3:1 PEEP 5), 1:2 with 10 cmH2O PEEP (1:2 PEEP 10), 2:1 with 10 cmH2O PEEP (2:1 PEEP 10) and 3:1 with 10 cmH2O PEEP (3:1 PEEP 10), using a Servo ventilator 900C. IRV could not improve arterial oxygenation in dogs with oleic acid induced pulmonary edema, but PEEP could significantly improve arterial oxygenation depending on PEEP level. ⋯ There was no significant alteration in hemodynamics after ventilatory modes were changed to IRV. Although oxygen delivery was the best in the 3:1 IRV group, there was no statistical significance between the 3:1 IRV group and others. It was concluded that IRV did not improve arterial oxygenation but showed a favorable effect for CO2 elimination, in dogs with oleic acid induced pulmonary edema.
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The effects of 1M sodium bicarbonate (NaHCO3) on cardiac function and myocardial metabolism during hypoxia were compared with those of 1M sodium chloride (NaCl) in anesthetized dogs. Metabolic acidosis was induced with inhalation of low fraction of oxygen (9%) for 2 hours. NaHCO3 (n = 9) or NaCl (n = 10) was infused intravenously in a half dose of 0.2 x body weight x base excess mEq in 30 seconds. ⋯ LV dP/dt max correlated significantly with LA in NaCl group (r = -0.614, P < 0.001). However, in NaHCO3 group, LV dP/dt max did not correlate with LA. Blood glucose level (r = 0.612, P < 0.001) and myocardial glucose uptake (r = 0.718, P < 0.001) correlated significantly with LV dP/dt max in NaHCO3 group.(ABSTRACT TRUNCATED AT 250 WORDS)
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Comparative Study
[Effects of different positions for epidural block on skin-epidural space distance].
Epidural block was performed in the same intervertebral space by both approaches with either flank position or prone position under fluoroscopy. The distances from with both positions the skin to the epidural space (SED) were compared. The prone position approach under fluoroscopy resulted in a significantly greater SED in both T2/3 puncture and L4/5 puncture groups. ⋯ It was also thought to be due to the fact that in this position, compared with the flank position, a pillow is inserted under the thoracic (or abdominal) region, and the skin in the dorsal region is looser and the subcutaneous tissue is thicker. The lumbar vertebrae form the lordosis, and it does not disappear when the pillow is placed under the abdominal region. This causes the SED to be greater.
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A 51 year-old female with spinocerebrellar degeneration was anesthetized with O2-N2O-isoflurane for abdominal total hysterectomy. After monitoring of both orbicularis oculi and adductor pollicis twitches in the response to train-of-four stimulation of the facial and ulnar nerves had been prepared, vecuronium was administered as a bolus. ⋯ The onset with the adductor pollicis did not indicate good intubating conditions. In patients with spinocerebrellar degeneration, the twitch response of the orbicularis oculi should be monitored to determine accurately the degree of neuromuscular blockade when neuromuscular blocking drugs are administered.