Masui. The Japanese journal of anesthesiology
-
Improvement of perinatal mortality rate in Japan is remarkable for the last two decades, but maternal mortality rate is still relatively high in comparison with the improvement of the perinatal mortality rate. Maternal mortality rate 1991 in Japan was 8.5. Maternal deaths occurred mostly in perinatal period. ⋯ Antacid medications were rare in our study group. After induction of general anesthesia, airway was maintained by masks (36.0%) or endotracheal tube (64.0%). Obstetric analgesia by local anesthetics was not used widely.
-
In our hospital, a patient must be transported to one of several types of wards according to the degree of severity of illness (PPC-system). Severely ill patients are surveyed in ICU and HCU with various kinds of monitors. On the contrary, for the patients outside the ICU and HCU wards, the number of monitors is not enough even during postoperative periods. ⋯ The number of hypoxemic patients was greater not only after longer operations and anesthesia, but also in obese patients (P < 0.05) as reported previously. Interestingly, we also found more hypoxemic patients in common wards than in ICU and HCU wards. In conclusion, a portable pulse oximeter is a useful equipment in ordinary wards during postanesthesia round.
-
Brachial plexus block using a nerve stimulator is an accurate procedure. But prolonged analgesic effect can not be obtained. Therefore we used "around the needle" catheter technique to have a long analgesic effect. ⋯ The success rate is about 90%. If we stimulate other nerves in the same sheath, it is not necessary to seek aimed one. But the musculocutaneous nerve is the only exception, because it may be stimulated outside the neurovascular sheath.
-
We studied the postoperative anti-emetic effects of low dose droperidol which was compared with that of metoclopramide in 60 gynecological patients. The effects at the third and 24th hours after surgery were evaluated by means of the nausea and vomiting score; 0 = none, 1 = discomfort, 2 = nausea, 3 = vomiting. ⋯ However, there was a significant difference between the two groups after 24 hours (D: 0.2 +/- 0.5, M: 0.8 +/- 1.0). We conclude that droperidol has a potent antiemetic effect that lasts after 24 hours.
-
We have studied the effects of prostaglandin E1 (PGE1) on the release of lysosomal enzymes such as beta-glucuronidase in leukocyte (beta-GL) and granulocyte elastase (GEL) in 52 patients for major abdominal surgery. All patients were divided into two groups; the PG group (24 patients) and the control group (28 patients). The patients of the PG group received PGE1 continuously at the rate of 0.03 to 0.1 micrograms.kg-1.min-1 during surgery. ⋯ The GEL/granulocyte ratio in the PG group was significantly smaller than that of the control group during surgery. The rate of change of beta-GL was significantly depressed in the PG group compared to that of the control group. These findings suggest that the administration of PGE1 during major abdominal surgery inhibits the release of lysosomal enzymes, and this prevents tissue injury during and after surgery.