Acta anaesthesiologica Sinica
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Acta Anaesthesiol. Sin. · Dec 1996
Detection of cerebral desaturation during cardiopulmonary bypass by cerebral oximetry.
As oxygen consumption increases acutely during rewarming period in extracorporeal cardiopulmonary bypass (CPB), it is crucial to maintain cerebral oxygen delivery at this critical moment. The aim of this study was to evaluate the effectiveness of a cerebral oximeter (INVOS 3100, Somanetics Corporation, Troy, MI, USA) in monitoring cerebral oxygen balance during rewarming in CPB by correlating optical spectroscopic determinations with jugular bulb oxyhemoglobin saturation measurements. ⋯ Jugular bulb desaturation which correlated inversely with rewarming speed as disclosed in this study indicated that the temperature change during rewarming was crucial for cerebral oxygen balance. Being less sensitive and still more unspecific, the INVOS 3100 cerebral oximeter is incapable and not recommended for monitoring cerebral oxygen saturation in CPB.
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Acta Anaesthesiol. Sin. · Dec 1996
[Clinical experience of laryngeal mask airway combined with continuous intravenous propofol infusion during general anesthesia].
Propofol's greatest attributes are its pharmacokinetic properties which result in a rapid, clear emergency and lack of cumulative effects even after prolonged administration. It is a drug of popular choice for the maintenance of general anesthesia. The laryngeal mask airway (LMA), originally described by Dr. Brain is now a good alternative as the airway management technique. Because of its high success rate in securing a clinically acceptable airway in anesthetized patients, LMA has been proposed as a practical airway and conveyer for general anesthesia. This study was designed to observe and evaluate the feasibility of propofol infusion combined with N2O for maintenance of anesthesia, with a LMA as airway and conveyer during general anesthesia. ⋯ The combination of propofol infusion and N2O with laryngeal mask as airway and recovery was a good alternative in administration of general anesthesia.
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Acta Anaesthesiol. Sin. · Sep 1996
Randomized Controlled Trial Clinical TrialConscious sedation by low dose propofol infusion during spinal anesthesia for cesarean section.
A simple sedative technique without inducing oversedation or amnesia for birth experience would be necessary for patients undergoing Cesarean section receiving regional anesthesia. Clinical effects and dose requirement of intravenous propofol infusion were evaluated for this purpose. ⋯ Intravenous infusion of propofol with a rate of 3-4 mg/kg/h after 0.3-0.4 mg/kg bolus injection is a sale, simple and satisfactory intraoperative postdelivery sedation technique in elective patients undergoing Cesarean section under spinal anesthesia.
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Acta Anaesthesiol. Sin. · Sep 1996
Case ReportsEpidural coadministration of ketamine, morphine and bupivacaine attenuates post-herpetic neuralgia--a case report.
The N-methyl-D-aspartate (NMDA) receptor system plays an important role in nociceptive signal modulation in the central nerve system. There is considerable evidence that NMDA receptor antagonists can abolish hypersensitivity of nociceptors in animal models. In this case report, we described a patient who suffered post-herpetic neuralgia with severe pain, allodynia, and hyperesthesia over right side T2 to T8 dermatomes. ⋯ The combination of relatively low doses of morphine, ketamine and bupivacaine epidurally provides effective pain relief in this case. The result strongly suggests a synergy from this combination that warrants a formal study of the dose-response relationship involved in this treatment and the mechanism by which this effect is achieved. This regimen provides a promising treatment for the neuropathic pain with limited side effects.
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Acta Anaesthesiol. Sin. · Sep 1996
Perioperative alterations of the thromboelastography in patients receiving one-stage bilateral total knee arthroplasty.
Total knee arthroplasty is associated with activation of coagulation and fibrinolytic system in the perioperative period. The coagulation and fibrinolytic activation in one-stage bilateral total knee arthroplasty has not been described before. Thromboelastography is a real-time aid in the monitoring of coagulation and is clinically valuable in the evaluation of whole blood hemostasis. We evaluated the coagulation and fibrinolysis system activation during and after one-stage bilateral total knee arthroplasty by thromboelastography. ⋯ The activation of coagulation, as monitored by thromboelastography, is predominant in one-stage bilateral total knee arthroplasty after releasing tourniquet of the second leg and returns to baseline 24 h postoperatively.