Masui. The Japanese journal of anesthesiology
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Optimal dose of epidural midazolam with saline for postoperative pain relief was investigated. Forty three patients for upper abdominal surgery were divided into 5 groups. Each group had either 10 ml saline only (saline group), 10 ml saline + midazolam 0.025 mg.kg-1 (0.025 group), 10 ml saline + midazolam 0.05 mg.kg-1 (0.05 group), 10 ml saline + midazolam 0.075 mg.kg-1 (0.075 group), or 10 ml saline + midazolam 0.1 mg.kg-1 (0.1 group) administered epidurally for complaint of postoperative pain. ⋯ TNA was about 2 hours in 0.025 and 0.05 groups, over 6 hours in 0.075 and 0.1 groups. Complete sleep was the cause of long TNA in 0.075 and 0.1 groups. It was concluded that optimal dose of epidural midazolam with saline 10 ml was 0.05 mg.kg-1 for postoperative pain relief after upper abdominal surgery.
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The changes in EMG evoked by train-of-four (TOF) stimulation of ulnar nerve were recorded to determine proper single bolus dose of vecuronium for endotracheal intubation in surgical patients. Onset and duration of neuromuscular block were judged by percent depression of EMG. Mean time intervals for 90% depression in TOF seen in 0.10 mg.kg-1 vecuronium group (n = 10), 0.15 mg.kg-1 vecuronium group (n = 10) and 0.20 mg.kg-1 vecuronium group (n = 10), were 181.1 sec, 135.0 sec and 120.0 sec, respectively. ⋯ No statistically significant difference was observed in recovery time between 0.10 mg.kg-1 and 0.15 mg.kg-1 group. These results indicate that the appropriate dose of vecuronium for rapid intubation is considered to be 0.15 mg.kg-1. This dose is allowable for surgical procedures of short duration.
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In spite of many investigations done for many years, the mechanism of general anesthesia remains still unclear. To elucidate the mechanism of general anesthesia, effects of sevoflurane anesthesia on norepinephrine metabolism in rat brain was studied. Sevoflurane 3% was administered for 20 minutes to Wistar male rats weighing 230-270g under spontaneous respiration. ⋯ Significant increases in NE levels were observed in the pons, thalamus and hippocampus by sevoflurane anesthesia for 20 minutes compared with the control group and also in the pons and midbrain at recovery from anesthesia. MHPG levels were significantly decreased in the pons and cortex by sevoflurane anesthesia, while an appreciable increase in MHPG levels was observed in the thalamus by sevoflurane anesthesia. It is concluded that NE metabolism is significantly suppressed in the pons, thalamus and hippocampus during sevoflurane anesthesia and this change in NE metabolism may be associated with a mechanism of sevoflurane anesthesia.
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Comparative Study
[Comparison between T-connecter and three-way stopcock as a portal for obtaining samples from indwelling catheter].
The accuracy of measurements on a sample obtained via either T-connecter or three-way stopcock connected directly with an indwelling catheter was comparatively evaluated. The sample was obtained through them after drawing glucose standard fluid (100 mg.dl-1) into a catheter which was primed with saline. ⋯ The results showed that both sample volume and discarded volume required smaller amount with a T-connecter than with a three-way stopcock to obtain more accurate measurements. The results also suggested that remaining discard aliquot in the connecting port of the three-way stopcock might influence the accuracy of the obtained sample when the sample volume was small.
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Randomized Controlled Trial Comparative Study Clinical Trial
[Continuous intravenous pethidine infusion for analgesia after upper abdominal surgery: a randomized, prospective double-blind comparison with continuous epidural infusion of pethidine].
We conducted a randomized double-blind controlled study comparing patients receiving continuous intravenous pethidine infusion with those receiving continuous epidural infusion for postoperative analgesia after upper abdominal surgery. Twenty patients scheduled for upper abdominal surgery were randomized into 2 groups: IV Group (n = 10) received 100 mg.24 h-1 of pethidine intravenously and saline epidurally, Epi Group (n = 10) received 100 mg.24 h-1 of pethidine epidurally and saline intravenously. During 24-hour postoperatively, verbal descriptor pain scale, sedative scale, respiratory rate, pulse rate and blood pressure were evaluated at each 2 hours. ⋯ However in the first 12 hours postoperatively, VAS in Epi Group tended to be lower than that in IV Group. There was no respiratory depression in either group. We conclude that continuous intravenous infusion of 100 mg.24h-1 of pethidine was effective for postoperative analgesia after upper abdominal surgery without major side effects, and almost the same analgesic effect was obtained as compared with continuous epidural analgesia.