Masui. The Japanese journal of anesthesiology
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We studied the fatigue and stress of anesthesiologists at work using a flicker photometer, visual reaction time test and questionnaires to them. The two kinds of visual apparatus enabled us to measure two types of fatigue. On the other hand, the questionnaires relating to fatigue and stress indicated the stress tendencies and stressors by age, anesthetic experience, and sex. The results suggest that these methods are useful for measuring the fatigue and stress of anesthesiologists.
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Twelve chest trauma patients with severe pain were studied. All of them had multiple rib fractures, hemopneumothorax or pulmonary contusion, and needed the continuous chest drainage. 16 G epidural block catheter was introduced 20 cm into the apex of the pleural space. Furthermore, another catheter was placed into the base of the pleural space. ⋯ It was reported that it was difficult to obtain effective pain relief after thoracotomy. However, when the catheter is placed at the apex, it seems to be effective to relief pain on the chest site. In conclusion, IPA seems to be simple, effective and useful to remove pain from chest trauma when epidural block is difficult to induce.
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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.
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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.
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We examined the ventilation of patients whose faces were draped during facial surgery under local anesthesia. Ten patients who underwent eye surgery received hydroxyzine 25 mg and pentazocine 15 mg i.m. before local anesthesia. ⋯ Hypercapnea was completely eliminated by suctioning the expired gases. It is concluded that hypercapnea is inevitable during face or neck surgery under local anesthesia, and that the expired gases should be monitored and removed.