Masui. The Japanese journal of anesthesiology
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We investigated the intraocular pressure (IOP) during sevoflurane anesthesia in 20 children. We measured IOP, mean blood pressure and heart rate at 7 points in each subject. IOP was measured first after induction, then after vecuronium administration, immediately after intubation, and 5, 10, 15, 30 min after intubation. ⋯ We consider that the optimal time for IOP measurement is 5 or 10 min after intubation and the normal range of IOP is within the mean +/- 2 standard deviation. The peak values of IOP were 19.2 and 18.8 mmHg at 5 and 10 min after intubation. The results suggest that normal range of IOP is below 20 mmHg during sevoflurane anesthesia in children.
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Hemodynamic changes and left ventricular performance were investigated by simplified mechanocardiography using finger plethysmography instead of carotid artery pulse tracing in patients who received 4 volatile anesthetics with or without nitrous oxide. Systolic blood pressure (Ps), diastolic blood pressure (Pd), heart rate (HR), pre-ejection period (PEP), left ventricular ejection time (LVET), isovolemic contraction time (ICP), PEP/LVET, Pd/ICT, and 1/PEP2 were selected as indices which represent hemodynamics and systolic time intervals. Enflurane 0.6 and 1.2MAC prolonged PEP, and shortened 1/PEP2 and Pd/ICT significantly. ⋯ Addition of nitrous oxide prolonged PEP and PEP/LVET, and shortened Pd/ICT. Isoflurane 1.2MAC lowered Ps and increased HR. The results indicate that cardiac performance was depressed by volatile anesthetics in the order of enflurane, halothane, sevoflurane and isoflurane.
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We investigated appropriate puncture site, angle of needle entry, and the distance of the insertion for CT monitored celiac plexus block using CT photograms on prone position in sixteen patients with gastrointestinal diseases. In retrocrural approach during CT monitored celiac plexus block, the average distances of puncture sites to midline were 3.84 cm on the right and 4.06 cm on the left, and the average needle angles were 74.1 degrees on the right and 76.9 degrees on the left. ⋯ From these results, we found high possibilities of organ injuries using the conventional technique for celiac plexus block. We conclude that we could perform celiac plexus block more safely and surely using the retrocrural approach by CT monitoring, as serious complications are avoidable by viewing ideal puncture course on CT photographs.
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The effects of atropine or pirenzepine on bronchoconstriction and reduction in heart rate during vagus nerve stimulation were studied in 10 anesthetized dogs. The bronchoconstriction produced by electrical stimulation of the vagus nerves, 5 min after intravenous injection of atropine or pirenzepine, was recorded as an increase in pulmonary inflation pressure. ⋯ Pirenzepine inhibited the increase in pulmonary inflation pressure more than atropine. Our results suggest that pirenzepine which inhibits bronchoconstriction is useful in patients with bronchial asthma and/or COPD as an anticholinergic agent.
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The change in electroencephalographic (EEG) activity during sevoflurane anesthesia was quantitatively evaluated by using zero-crossing analysis in 10 adult patients. The deceleration of EEG activity was significant and dose-dependent. Such change was not significantly different among the regions. ⋯ The significant decrease in both alpha and beta activities and the significant increase in delta activity disappeared with 1% or less of sevoflurane. Toward the emergence from anesthesia, EEG activity accelerated and there was no significant difference in its activity between the emergence period and control period. The results demonstrated that the effect of sevoflurane on EEG activity is similar to that of other inhalation anesthetics, but the difference among anesthetics should be clarified in a further study.