Masui. The Japanese journal of anesthesiology
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We studied the protective effect of prostaglandin E1 (PGE1)-induced hypotensive anesthesia on gastric mucosa in 30 elective surgical patients. Three groups, each composed of 10 patients, received PGE1, nitroglycerin or none during general anesthesia. ⋯ In the PGE1 group the viscosity and pH increased significantly and rapidly (P less than 0.05) as compared with the other groups. This suggests that PGE1 offers prophylactic effect against postoperative acute gastric mucosal lesion (AGML).
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Although internal jugular vein cannulation is performed commonly, most physicians are not aware of existence of the internal jugular venous valve. This is the only valve between the right atrium of the heart and the brain, and it has an important role of preventing retrograde blood flow and increased back pressure to the brain. In this study, anatomic appearance of human internal jugular valves is described, and the competence of these valves is assessed. ⋯ The opening and closing of the valve were easily visualized with both superfine fiberscope and real-time ultrasound technique. Patients with competent valves showed transvalvular pressure gradients of 50-100 mmHg during cough-induced high intrathoracic pressure. Internal jugular venous valve is located 0.5-2.0 cm above the union of the subclavian and internal jugular veins, and the central approach performed at the summit of the cervical triangle has been shown to have a risk of injuring the internal jugular venous valve.(ABSTRACT TRUNCATED AT 250 WORDS)
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The effects of intravenous nicardipine on the neuromuscular blockade produced by single bolus injection of vecuronium were studied in surgical patients undergoing tracheal intubation. We measured the mechanical response of the abductor pollicis muscle to stimulation of the ulnar nerve in a train-of-four sequence at 2 Hz and recorded the amplitudes of the first response (T1). Anesthesia was induced with thiopental 5 mg.kg-1 with or without nicardipine 10 micrograms.kg-1 followed by injection of vecuronium in a dose of either 0.1 or 0.15 mg.kg-1. ⋯ These values were significantly shorter than those observed in patients without nicardipine administration (n = 10, P less than 0.05), and were not significantly different from the values in patients who had received vecuronium 0.15 mg.kg-1 (n = 10). On the other hand, the time for 25% recovery in T1 was uninfluenced by nicardipine. Present study indicates that nicardipine pretreatment possibly shortens the onset time after minor or moderate dose of vecuronium.
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The author designed a cart which can safely carry and accommodate Selectatec vaporizers (Ohmeda). The cart consists of ten parking brackets on which Selectatec vaporizers can be mounted and their support arms with castors. An anesthetic machine which has a Selectatec manifold allows easy removal and replacement of vaporizers, but there are several troublesome regulations regarding conveyance and accommodation of vaporizers. By the use of the cart, all these problems were completely solved and the advantage of the centralization of many vaporizers was accomplished.
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In order to find out the effectiveness of continuous epidural infusion with a portable disposable pump (Baxter Infusor) in management of post-operative pain, a comparative study was made on a continuous epidural infusion method with a syringe pump versus a twice-a-day intermittent epidural infusion method. Study 1: With 41 patients who underwent thoracic/abdominal surgery between June, 1991 and September, 1991, researches were conducted on the effects of pain relief, methods for postoperative pain relief and weaning course from confinement to bed. The degree of pain examined at five points--at 4 hours, 12 hours, 16 hours, 24 hours and 28 hours postoperatively--indicated a significantly lower level in the Infusor group, compared with the intermittent infusion group (P less than 0.05). ⋯ When the syringe pump method and the intermittent method were compared, the evaluation of the syringe pump method was significantly higher (P less than 0.05). The evaluation by nurses, on the other hand, was remarkably higher on the infusion method than on the other two methods (P = 0.0001). Based on the results of the two studies summarized above, the Infusor method is considered to be most effective for pain control among the three methods.