Masui. The Japanese journal of anesthesiology
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Lactated Ringer's solution was prepared, in which concentration of potassium was either 10 or 20 mEq.l-1, and that of glucose was 1.4%. Each preparation was infused into 10 patients who underwent surgical operations under general anesthesia. Effects of this fluid therapy on changes in serum potassium and blood sugar were studied comparing with infusion of lactated Ringer's solution in which concentration of potassium was 10 mEq.l-1, and glucose was 0.7%. ⋯ On the other hand, the former tended to decrease and the latter tended to increase with the lactated Ringer's solution containing potassium 10 mEq.l-1 and glucose 1.4%. We consider that the homeostatic effect with the lactated Ringer's solution containing 20 mEq.l-1 of potassium and 1.4% of glucose would be to lower blood glucose level by concomitant intracellular influx of potassium and glucose. Therefore these high potassium lactated Ringer's solutions balanced adequately with glucose are useful for fluid therapy during surgical procedure under general anesthesia.
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We studied the cardiovascular responses to laryngoscopy and intubation in 30 patients who received continuous infusion of either diltiazem 10 micrograms.kg-1.min-1, 40 micrograms.kg-1.min-1 or saline as control group during 20 min before induction. Heart rate, arterial pressure, rate pressure product (RPP), pressure rate quotient (PRQ) were measured starting 20 min before induction to 3 min after tracheal intubation. The increases in arterial pressure and RPP following tracheal intubation were reduced significantly in patients receiving diltiazem 40 micrograms.kg-1.min-1, but they were not reduced in patients receiving diltiazem 10 micrograms.kg-1.min-1 compared with control. We conclude that continuous infusion of diltiazem during 20 min before induction is effective for preventing the increases in arterial pressure and RPP following tracheal intubation, and the optimal infusion rate is from 10 to 40 micrograms.kg-1.min-1.
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Case Reports
[Utility of Bullard intubating laryngoscope with a special stylet in two cases of difficult tracheal intubation].
The Bullard intubating laryngoscope is useful for cases of difficult tracheal intubation, but a skilled hand is needed to manipulate it. In two cases of difficult tracheal intubation, we used a recently improved Bullard intubating laryngoscope to which a special stylet is attached to introduce an endotracheal tube easily into the larynx. ⋯ Using the Bullard intubating laryngoscope with the special stylet, intubation was done smoothly in both cases. This improved Bullard intubating laryngoscope is recommended for cases of difficult tracheal intubation.
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Forty-four patients were studied to evaluate their postoperative hepatic and renal functions on 2nd to 4th and 7th to 10th postoperative days as judged by serum GOT, GPT, BUN and creatinine levels. The patients were divided into two groups. Twenty two patients received total intravenous anesthesia with droperidol, fentanyl and ketamine (FK group). ⋯ S-GPT on 2nd to 4th postoperative days of the enflurane group were significantly higher than those of the FK group. As to serum BUN and creatinine, no significant differences were observed between the two groups. These data suggest that FK is much more beneficial than enflurane anesthesia to protect hepatic functions, particularly when it is applied for prolonged surgical procedures.