Osaka city medical journal
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Phosphodiesterase type III inhibitors are often delivered by continuous intravenous infusion without initial loading to prevent hypotension, i.e., by "slow induction". We evaluated the pharmacokinetics (PK) and pharmacodynamics (PD) of olprinone slow induction after open-heart surgery. ⋯ Olprinone slow induction is useful and safe for critically ill patients.
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The purpose of this study was to assess the usefulness of three-dimensional (3D) gadolinium-enhanced magnetic resonance (MR) angiography for evaluation of the intracranial venous system. ⋯ Three-dimensional gadolinium-enhanced MR angiography is noninvasive and very useful for imaging of the intracranial venous system. It can replace 2D TOF MR venography not only because of its short examination time but because it better demonstrates intracranial venous structures. For evaluation of the SSS, lateral sinus, sigmoid sinus and straight sinus in particular, conventional catheter angiography seems to be unnecessary.
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Randomized Controlled Trial Clinical Trial
Preoperative epidural morphine using double-catheter technique for esophagectomy.
This study was undertaken to determine whether preoperative epidural morphine using double-catheter technique would improve postoperative analgesia in patients undergoing esophagectomy with or without continuous intraoperative epidural lidocaine in a randomized double-blind and controlled manner. Thirty patients undergoing esophagectomy for esophageal cancer received preoperative epidural morphine 2 mg at T 6-7 and 2 mg at L 3-4 through the catheters, respectively. Thereafter, continuous thoracic epidural infusion of either 1% lidocaine (lidocaine group, n = 15) or normal saline solution (control group, n = 15) at 6 ml/h was initiated. ⋯ There was no significant difference in these values between the groups. In conclusion, preoperative epidural morphine using double-catheter technique provided adequate analgesia following esophagectomy. The addition of intraoperative continuous epidural lidocaine did not improve analgesia.
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Randomized Controlled Trial Clinical Trial
Intraoperative continuous epidural lidocaine for early postoperative analgesia.
We determined the early postoperative analgesia using intraoperative continuous epidural infusion of lidocaine during general anesthesia in patients undergoing upper abdominal surgery in a prospective double-blind manner. After insertion of an epidural catheter at the T10-T11 interspace, general anesthesia was induced. Thirty patients were randomly allocated to receive continuous epidural infusion of either 0.5% (n = 15) or 1% (n = 15) plain lidocaine at 10 ml/hr. ⋯ Visual analog pain scale (0-10) within 30 minutes after the end of surgery was significantly lower in the 1% lidocaine group (5.6 +/- 0.9, mean +/-SE) than in the 0.5% lidocaine group (8.2 +/- 0.8), however, it was unsatisfactory in both groups. Plasma concentrations of lidocaine and its principal metabolite, monoethylglycinexylidide, gradually increased through epidural infusion, but remained below the toxic range in both groups. We conclude that continuous epidural lidocaine during general anesthesia offered limited analgesia in the early postoperative period.