Acta anaesthesiologica Sinica
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Acta Anaesthesiol. Sin. · Mar 1996
Randomized Controlled Trial Clinical TrialInterpleural bupivacaine for pain relief after transthoracic endoscopic sympathectomy for primary hyperhidrosis.
Interpleural local anesthetic has been reported to provide good postoperative pain relief in patients receiving thoracotomy or upper abdominal surgery. However, there were few reports regarding interpleural local anesthetic for postoperative pain relief in patients receiving transthoracic endoscopic sympathectomy for palmar hyperhidrosis. The aim of the present study was to evaluate the effect of interpleural bupivacaine for postoperative pain relief in patients receiving transthoracic endoscopic sympathectomy for palmar hyperhidrosis. ⋯ Interpleural bupivacaine significantly decreased the intensity of postoperative pain and morphine consumption in patients undergoing transthoracic endoscopic sympathectomy for palmar hyperhidrosis. We are looking forward to seeing that with the addition of epinephrine to the anesthetic solution and a considerable increase of dosage and/or volume of bupivacaine may provide a better and longer pain relief, about which further studies are needed.
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Acta Anaesthesiol. Sin. · Mar 1996
Randomized Controlled Trial Comparative Study Clinical TrialEffectiveness of a manually controlled infusion scheme of propofol and alfentanil mixture for endotracheal intubation in hypertensive patients: in comparison with thiamylal and nifedipine plus thiamylal.
Bolus administration of propofol for induction causes hypotension, especially in elderly hypertensive patient. Carefully titrated infusion of propofol minimizes adverse effects, such as hypotension, and permits a rapid recovery of its central effects. The objective of this study was to investigate the effect of a manually controlled infusion scheme of propofol and alfentanil mixture on hemodynamic stability during induction and endotracheal intubation for hypertensive patient. At the same time, the effectiveness of this scheme was compared with two other induction regimens (thiamylal or nifedipine plus thiamylal). ⋯ The proposed manual infusion scheme of propofol and alfentanil mixture performed during induction and intubation attenuated the subsequent peak pressor response to incubation and reduced the hypotensive effect, in comparison to thiamylal or thiamylal plus nifedipine treatment, during post-intubation period. The same infusion scheme also attenuated the tachycardiac response to intubation.
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Acta Anaesthesiol. Sin. · Mar 1996
Case ReportsComplete resolution of diastolic mitral regurgitation in chronic, but not acute aortic regurgitation after aortic valve replacement--a transesophageal echocardiography study.
A 65-year-old male was admitted with progressive dyspnea on exertion. Severe aortic regurgitation (AR) had been disclosed by transthoracic echocardiography 10 mon previously. Aortic valve replacement was proposed and intraoperative transesophageal echocardiography on color Doppler imaging revealed severe aortic regurgitation, moderate global hypokinesis of the left ventricle and mild-to-moderate diastolic mitral regurgitation. ⋯ Surgery proceeded uneventfully and diastolic mitral regurgitation was resolved completely after the aortic valve was successfully replaced. Diastolic mitral regurgitation has been reported to be closely related to acute AR, but the picture differs somewhat from the present example. The possible cause for this disease presentation is to be further investigated.
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Acta Anaesthesiol. Sin. · Mar 1996
Changes of propofol levels in isolated cardiopulmonary bypass circuit.
High dose fentanyl anesthesia in cardiac surgery has been supplemented with propofol to prevent patient's awareness and recall. It has been known that during cardiopulmonary bypass (CPB), fentanyl or midazolam concentration decreases, except for propofol where it remains unknown. This study evaluated the interaction between propofol and the CPB circuit in vitro. ⋯ The results demonstrate the presence of propofol sequestration by the CPB circuit. Evaporation in the bubble oxygenator, absorption by and/or adherence to the circuit are suspected as the possible causative factors.