Articles: patients.
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Journal of anesthesia · Mar 1995
Attenuation of the vagolytic effect of atropine during high thoracic epidural anesthesia by heart rate fluctuation analysis.
Fifteen surgical patients received an epidural injection of 12 ml of 1.5% lidocaine through a catheter placed at C7-T1, followed by further injection as required. An intravenous bolus of 0.5 mg of atropine sulfate was administered simultaneously with the initial epidural injection. ⋯ At 90 min, the HFC showed gradual recovery to 69% whereas the LFC remained low (22%). These results indicate that 0.5 mg of intravenous atropine reduces the autonomic imbalance that occurs under high thoracic epidural anesthesia, but its duration is too short to be effective throughout the course of anesthesia.
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Journal of anesthesia · Mar 1995
Compound A concentration and the temperature of CO2 absorbents during low-flow sevoflurane anesthesia in surgical patients.
Sevoflurane, a new inhalational anesthetic, is metabolically broken down into several decomposition products in the presence of CO2 absorbents. One of the products, CF2=C (CF3) OCH2F (compound A), which appears to be the most toxic, was quantitated in 20 surgical patients subjected to more than 3 h of anesthesia using a low-flow anesthesia circuit. To minimize the variables in the reaction velocity between sevoflurane and the CO2 absorbents, we maintained the sevoflurane concentration at 2%. ⋯ We also measured the temperature in CO2 absorbents, which had been reported to influence compound A production. The elevation in the temperature was 27.9±1.3°C in Wakolime-A, 29.4±8.4°C in Baralyme, and 31.0±5.0°C in Sodasorb II. Further studies are needed to assess the safety and efficacy of sevoflurane.
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Journal of anesthesia · Mar 1995
Effects of rapid inhalation induction with sevoflurane-oxygen anesthesia on epidural pressure in humans.
In this study, we chose sevoflurane as the volatile anesthetic for rapid inhalation induction (RII) and investigated its usefulness. We also assessed how RII with sevoflurane affected epidural pressure, and compared RII with rapid intravenous induction by thiopental on epidural pressure. The results were as follows: RII with 5% sevoflurane had a shorter induction time compared with published results on RII with other volatile anesthetics like halothane and isoflurane, and was accompanied by fewer complications. ⋯ Epidural pressure measurements are reportedly useful in monitoring intracranial pressure. Consequently, in patients with increased intracranial pressure, exhaling to residual volume and increasing arterial blood pressure during laryngoscopy and endotracheal intubation should be avoided. The results of this study suggest that RII with 5% sevoflurane in itself is safe and useful, and that it is unlikely to increase intracranial pressure as compared with rapid intravenous induction by thiopental.
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Journal of anesthesia · Mar 1995
Prophylactic hemostatic drugs do not reduce hemorrhage: Thromboelastographic study during upper abdominal surgery.
Although a number of hemostatic drugs are currently used during surgery to reduce hemorrhage, their effects on bleeding are still controversial. Furthermore, few studies have been made on their prophylactic effects. The purpose of this study was to clarify the effects of hemostatic drugs on bleeding. ⋯ No significant difference in blood loss was observed between the groups. Our findings, therefore, suggest that these two hemostatic drugs do not have prophylactic effects on intraoperative bleeding. Further studies are, however, necessary before applying these results to all surgical patients.