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Volume 8 (1962)
- Issue 4 Pages 243-
- Issue 3 Pages 173-
- Issue 2 Pages 79-
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Volume 8, Issue Supplement2
Displaying 1-3 of 3 articles from this issue
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Shinji Yoshida1962 Volume 8 Issue Supplement2 Pages 35-123
Published: March 15, 1962
Released on J-STAGE: May 10, 2013
JOURNAL FREE ACCESS1. 2, 198 cases of insufflation were performed on children under 12 years of age and 2, 733 cases of drip anesthesia were conducted on adults and children over 12 years of age. The experiences obtained from those operations on ear, nose, throat, larynx, neck etc. indicated that these general anesthesia could be performed with considerable safety. General anesthesia was successfully administered in 32 cases of old men, the oldest patient being 84 years old and suffering from cancer of tonsil. These experiences showed that drip anesthesia is also available to elderly patients without much danger.
2. Advantages of drip anesthesia
(1) The route of anesthesia does not interfere with the operation field in nose and throat, since no tracheal tube is necessary, thus giving excellent view.
(2) No expensive equipment like gas machine is required and the administration of anesthetics is a simple one.
(3) No tracheal stimulation, displeasure, nausea, vomiting and headache occur during introduction and recovery period of anesthesia, thus making it comparable to daily sleep.
3. Disadvantages of drip anesthesia
(1) Longer time is required for awakening. The patient should be controlled and watched for subsequent five to six hours or more until he awakes.
However, late awakening could be counted as advantage since the patient will be spared from pains or discomfort occurring right after the operation.
(2) No disadvantage was found in the operation of ear, but in case of nose and throat operations, blood will be aspirated in trachea and bronchi during the operation and cause anoxia. A new “Cocktail M-L-Y”, in which Lorfan is mixed in premedication and in cocktail, is recommended. Its short-coming could be overcome by intravenous injection of ACTH, hydrocortisone, glucose or saline solution and blood transfusion.
(3) The drip anesthesia should not be applied for children under 12 years of age, because the tolerance of the function of suprarenal cortex is considered to be small. The study on the relations between cocktail lytique and hormone of suprarenal cortex are being conducted and the results will be presented before long.View full abstractDownload PDF (15198K) -
Shinji Yoshida1962 Volume 8 Issue Supplement2 Pages 124-129
Published: March 15, 1962
Released on J-STAGE: May 10, 2013
JOURNAL FREE ACCESS1, 402 cases of bronchoscopy and esophagoscopy were performed during seven years under local anesthesia using 1 per cent solution of T-caine*, pantocaine (2 per cent) and xylocaine (2 per cent).
Among the seven cases, in which shock reaction was observed, T-caine was used in six cases and in one case pantocaine was used, though no error in either dosis or premedication were noticed.
Bronchoscopy was succesfully performed repeatedly 18 times in one case of tuberculous bronchitis. However, shock had occured in the subsequent bronchoscopy trial, though the same anesthetica was used. Similar case was encountered in case of benign bronchial tumour, in which bronchoscopy was performed 8 times and shock had occurred in the subsequent trial. In the other case esophagoscopy was performed two times by another docter before during the past two months.
During the third esophagoscopy death had occurred because of the shock, though only 2 ml of T-caine was used.
In view of the studies on the cases in which shock was encountered, the following points should be kept in mind.
1. Perhaps patient's constitution has some bearing on the occurrence of shock. However, other possible causes should also be emphasized.
2. Special care must be taken in case of hypotension. Premedication and relaxation before operation are also important. 3. Extraordinary care should be taken in patients who are accustomed to take cortisone or in patients who have possible suprenal disorders.
As a result of the studies presented in the present communication, following measures recommended.
1. Bronchoscopy should be performed as quickly as possible. Drug solution and secretions which remain in trachea and bronchi should be removed by suction so as to keep airway clear.
2. In case of serious convulsion, barbiturates are advisable. Special care should be taken for dosis in order to avoid respiratory depression.
3. Sufficient quantity of oxygen should be provided by means of intubation and resuscitator.
4. Vagopressor should be used against hypotension-such as intravenous and intracardiac injection of noradrenaline, neosynephrine, ephedrine ete.
5. Intravenous drip of glucose or saline solution with hydrocortisone or ACTH, cardiac stimulants, vitamines and blood transfusion will be helpful.View full abstractDownload PDF (778K) -
Shinji Yoshida, Hiromichi Okuda1962 Volume 8 Issue Supplement2 Pages 130-134
Published: March 15, 1962
Released on J-STAGE: May 10, 2013
JOURNAL FREE ACCESSBronchoscopies were made immediately after the operations in 64 cases including submucous resection, radical operation of maxillary, ethmoidal sinusitis, pansinectomy and adenotonsillectomy, which were performed using insufflation method, endotracheal anesthesia and drip anesthesia with cocktail lytique.
Under bronchoscopy the volume of aspirated blood in trachea and bronchi was estimated.
The method of estimation is based on the determination of CN-met-Hb produced using photoelectriccolorimeter after the addition of KCN and K3Fe (CN)6 to blood.
Considerable volume of blood was found to be aspirated into trachea and bronchi during operation, even though endotracheal anesthesia which is considered to be the safest was used. The volume of the blood aspirated averages 3ml, while as much as 15ml of blood was found in trachea and bronchi in one case.View full abstractDownload PDF (569K)
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