Masui. The Japanese journal of anesthesiology
-
Case Reports
[Prolonged respiratory depression following general anesthesia in a patient with dystrophia myotonica].
A case of general anesthesia for a 52 year old female with previously undiagnosed dystrophia myotonica was reported. The patient was diagnosed as flaccid paralysis of the bilateral lower extremities but myotonic symptoms were not found preoperatively. The patient underwent duodenal resection to have a benign tumor removed. ⋯ The patient was examined again by a neurologist and a final diagnosis of dystrophia myotonica was made. Prolonged recovery from anesthesia and postoperative respiratory depression observed in this patient was due to preoperatively undiagnosed dystrophia myotonica. A careful preoperative examination should be made to minimize possible complication related to anesthesia in the disease.
-
Comparative Study
[Systolic time intervals by intratracheal pneumocardiogram and the effects of inhalation anesthetics on cardiac function using this technic].
Intratracheal pressure change due to cardiogenic oscillation was obtained by a high gain pressure transducer attached to the endotracheal tube while the patient was apneic during the operation. Such pressure change has been called as intratracheal pneumocardiogram (ITCG), which consists of wide waves and some spikes. Systolic time interval (STI) was obtained by measuring the intervals between certain spikes. ⋯ The pre-ejection period (PEP) and the PEP/LVET ratio increased in all three types of anesthesia. Especially the PEPs during halothane and enflurane at 1.8 MAC (minimum alveolar concentration) were greater than that of isoflurane. The results suggest that isoflurane has less cardiac depressive action than halothane and enflurane.
-
One hundred healthy parturients scheduled for elective cesarean section were studied prospectively. Fifty patients received spinal anesthesia with 12mg of hyperbaric tetracaine and were defined as the spinal group. Other fifty patients received epidural anesthesia with 300mg of lidocaine and were defined as the epidural group. ⋯ Prehydration did not improve significantly neither acid-base balances of umbilical arterial and venous blood nor Apgar scores of the neonates in either group. We conclude that massive fluid load is not indispensable immediately before the regional anesthesia for the parturient. Furthermore, because this method is not reliable, its advantages and disadvantages including the possibility of enhancing pulmonary edema should be evaluated.
-
A series of 305 infants and children between 1 day to 14 years of age were operated upon using caudal anesthesia. We used 1% mepivacaine 1.2 ml.kg-1 to obtain a level of anesthesia above T10, 1.0 ml.kg-1 above L1, and 0.8 ml.kg-1 above S. Complete failure occurred in 4.3% of patients. ⋯ The coefficients of correlation between D and height is 0.97, and high correlation existed also between D and body weight (r = 0.93). This confirms that body weight can be used as a parameter to determine the dose of local anesthetic agent. We conclude that this technique is a safe, reliable and simple way to produce surgical analgesia in infants and children.