Masui. The Japanese journal of anesthesiology
-
Comparative Study
[A comparison of hemodynamic changes with sufentanil-O2 and fentanyl-O2 anesthesia for coronary bypass grafting].
Hemodynamic changes were investigated in twenty patients undergoing coronary artery bypass grafting. Thirteen patients received sufentanil-O2 anesthesia and seven patients had fentanyl-O2 anesthesia. Systolic, diastolic, as well as mean arterial blood pressures, heart rate and rate pressure product (RPP) were measured before and after intubation, one minute after skin incision, and one minute after sternotomy. ⋯ Diastolic pressure was not significantly changed in each group. Stable hemodynamic parameters with no ST-T change were noticed during surgical procedure in each group. We conclude that sufentanil is a superior narcotic agent than fentanyl for the patients undergoing CABG, and it effectively blocks sympathetic reflex activity.
-
Renal transplantation has come into use as a treatment for renal insufficiency, but infusion management before and after anesthesia for this operation is important. In order to prevent acute necrosis of the uriniferous tubules and to obtain urine outflow in early postoperative stage, a recent practice has been to give rapid infusions of large amounts of fluid, starting during the anastomosis of the renal vessels. ⋯ The cardiac output increased as a result, and no pulmonary edema was seen. We believe that our method of infusion management using a Swan-Ganz catheter is a useful technique in such cases.
-
To investigate the effects of carbon dioxide on the local blood flow during hemorrhagic shock, the tissue surface PO2 of liver, kidney and femoral muscle was measured during normocapnia, hypocapnia and hypercapnia. Eight adult mongrel dogs were anesthetized with pentobarbital, intubated and ventilated mechanically with 100% oxygen to maintain normocapnia. After laparotomy, miniature clark-type polarographic oxygen electrodes were placed on the surface of the liver, kidney and femoral muscle. ⋯ Hypocapnia decreased the liver and kidney surface PO2, and increased the muscle surface PO2. On the contrary, hypercapnia increased the liver and kidney surface PO2 and decreased the muscle surface PO2. So, it is possible that hypocapnia may compromise the oxygenation of the liver and kidney in the hemorrhagic shock.
-
A 65-year-old woman with height of 156 cm and weight of 54 kg, who had previously been healthy, was scheduled for resection of axillary abscess. She was not premedicated. After local infiltration of 1%-lidocaine 25 ml, operation was started under electrocardiographic monitoring. ⋯ After the recovery of heart beat, the patient became responsive, alert, and oriented, and neither arrhythmia nor ST-T change was observed. Laboratory data showed no abnormality which might have predisposed her to the development of cardiac arrest. Because the cardiac arrest occurred soon after lidocaine injection and no drug other than lidocaine had been used, lidocaine was thought to be the cause of the cardiac arrest.
-
A newly developed oral airway, laryngeal mask (LM), was used in 40 patients by anesthesiologists of varied clinical experiences. Clear airway was obtained in 37 patients (92.5%). ⋯ Controlled or assisted ventilation was performed adequately in most of the patients, but there was recognizable gas leak in 13 patients when the airway pressure was above 15 cmH2O. The LM has many attractive features compared with a traditional face mask, and some of the promising clinical applications of LM are discussed.