Masui. The Japanese journal of anesthesiology
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Facioscapulohumeral muscle dystrophy (FSHMD) is characterized by slowly progressive wasting of facial, pectoral and shoulder-girdle muscles that begins in adolescence. A 31 year-old man with FSHMD had dystrophic changes in the deltoid, anterior serratus and pectoralis major muscles but not in the distal muscle of his arms and legs. He underwent an operation for thoraco-scapula fixation under enflurane-nitrous oxide anesthesia with vecuronium 6 mg. ⋯ It was clear that there was a difference in the degree of neuromuscular block between the arm and the leg in a FSHMD patient. Use of the peripheral nerve stimulator only in the arm may be an unreliable guide to assess neuromuscular block in FSHMD patients. Therefore, two sites should be chosen for monitoring neuromuscular blockade in a FSHMD patient.
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The efficacy of three kinds of fluid such as isotonic sodium chloride (0.9% NaCl), hypertonic sodium chloride (7.5% NaCl) and iso-oncotic (3% in saline) albumin solutions to maintain the hemodynamics was investigated in rats with superior mesenteric artery occlusion (SMAO) shock. Three kinds of fluid were infused so as to maintain the mean arterial pressure within 70% of the control values. Animals in the control group without fluid therapy died within three hours because of shock. ⋯ The hypertonic crystalloid solution was effective in the early period of SMAO shock to regain the blood pressure by infusing a small volume. An excessively large amount of volume was required in the group infused with an isotonic crystalloid, providing inadequate tissue perfusion. The iso-oncotic colloid produced a stable circulatory status with minimum changes in tissue perfusion.
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A 74-yr-old man was scheduled for the biopsy of prostatic tumor under spinal anesthesia. Preoperative serologic test for syphilis was highly positive. Spinal anesthesia was performed in the sitting position, and 2 ml of hyperbaric Neo-percamine S (a mixture of 0.24% dibucaine and 0.12% T-caine) was administered uneventfully with the onset of warm sensation on the perineal region. ⋯ Because the pain was not relieved by analgesics, he was then anesthetized with enflurane and N2O in oxygen, and there were no neurological complications after anesthesia. Several cases of severe pain during spinal anesthesia have been reported in patients with tabes dorsalis. Although the patient lacks clear symptoms of neurosyphilis, positive serologic examination for syphilis without any other possible causes suggests altered sensitivity of the spinal cord to anesthetic solutions.
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A comparative investigation into the functioning time of three brands of CO2 absorbents was performed. The three investigated brands were: Viosorb, Wakolime, and Wakolime-A. In this study PICO2 was measured to know the drug's functioning time and CO2 elimination from the model lung fixed at 200 or 300 ml.min-1. ⋯ There were statistically significant relation between PICO2 and time. The CO2 absorbent whose shape is tablet has the longest functioning time because it could be placed smoothly in the canister. It is concluded that the shape of CO2 absorbent plays a role in determining its functioning time.
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Tracheal temperature was evaluated to monitor core temperature during cardiac, upper abdominal and lower abdominal operations. The tracheal temperature was measured by a thermistor attached to the intra-cuff of the tracheal tube. In cardiac surgery, there was a good correlation between tracheal temperature and forehead deep temperature (r = 0.93) before and after cardiopulmonary bypass, and also between tracheal temperature and the temperature of blood from the cardiopulmonary bypass (r = 1.00) during cardiopulmonary bypass. ⋯ In upper abdominal operations, the tracheal temperature showed good correlations with forehead core, esophageal, bladder and rectal temperatures (r = 0.81-0.90). On the other hand, bladder and rectal temperatures were different from forehead deep (r = 0.43, 0.55) and tracheal temperatures in lower abdominal operations. These results suggest that the tracheal temperature is valuable to monitor core temperature.