Acta anaesthesiologica Sinica
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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.
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Acta Anaesthesiol. Sin. · Dec 1995
Randomized Controlled Trial Comparative Study Clinical TrialThe use of intranasal nitroglycerin to prevent pressor responses during intubation in general anesthesia--a comparison of various doses.
Intranasal nitroglycerin (NTG) was first reported to successfully prevent an increase in arterial blood pressure following laryngoscopy and tracheal intubation by Hill et al. Various different effective dosages of NTG have been reported. Grover et al. indicated 0.75 mg of intranasal NTG to be the most suitable dose. However, no definite conclusion has yet been made. This study was designed to compare the efficacy of four different dosages of intranasal NTG (0.3, 0.5, 0.75, and 1.0 mg) in preventing pressor responses to laryngoscopy and tracheal intubation during the induction of general anesthesia. ⋯ Intranasal NTG does not attenuate the pressor responses to laryngoscopy and tracheal intubation.
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Acta Anaesthesiol. Sin. · Dec 1995
ReviewClinical applications of excitatory amino acid antagonists in pain management.
Pain is an important indicator of stress particularly after surgical operation. It is not only a physical and mental suffering but also a main factor for postoperative complications. Relieving of postoperative pain is perquisite for improving outcome and shortening hospital stay. ⋯ Therefore, methods to avoid the narcotic-associated side effects are still being searched. Excitatory amino acid receptor antagonists, particularly the NMDA receptor, have been demonstrated to produce satisfactory analgesic effect under certain conditions. This article is an introductory overview of some possible applications of the excitatory amino acid receptor antagonists in future clinical pain management.