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Hiroyuki KINOSHITA, Kenichiro UCHIDA, Takashi YAMASAKI, Hideo OKA, Nao ...
1995 Volume 15 Issue 1 Pages
78-82
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We investigated whether fentanyl pretreatment can attenuate isoflurane-induced circulatory responses and affect changes in norepinephrine (NE) and epinephrine (E) concentration before and during induction. Ten patients scheduled for elective hysterectomy were allocated to two groups of 5 patients each. One group inhaled 5.0% isoflurane (I group), while the other inhaled 5.0% isoflurane and was given fentanyl 2μg/kg intravenously 2min before induction (F group). Anesthesia was induced with thiamylal followed by vecuronium. The lungs were ventilated with 100% oxygen and 5.0% isoflurane by face mask. Arterial blood samples were drawn from a catheter placed in the radial artery. In the I group, a significant increase in heart rate (HR) was found compared with the baseline value (2min before induction). In the F group, this increase in HR was not noted. Change in mean arterial pressure (MAP) was not found in either group during induction. NE concentrations significantly increased with time compared with the baseline value in both groups, with no differences noted between the I and F groups. No change was found in E concentrations in either group. These results suggest that fentanyl attenuates the enhancement of HR from face mask inhalation of a high concentration of isoflurane and that this effect of fentanyl is not caused by attenuation of NE and E release.
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Tetsu KIMURA, Seiji WATANABE, Reiko TAKESHIMA, Akihiko SUGA, Yuichi YA ...
1995 Volume 15 Issue 1 Pages
83-88
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The Department of Anesthesiology of Mito Saiseikai General Hospital, which is adjacent to Ibaraki Perinatal Center, cooperates with the Center regarding anesthetic management of emergency operation and clinical management of critically ill term patients. During the 16 months since the Center opened, 677 patients were admitted, including 104 patients who were transferred by ambulance. Caesarean sections were performed in 98 patients, most of them on an emergency basis. They were in hypovolemic shock resulting from unexpected massive bleeding. We also participated in intensive treatment of patients who had severe systemic diseases including status asthmaticus, meningitis, disseminated intravascular coagulation syndrome, severe toxemia of pregnancy. More effort is needed to improve the prognosis not only of mothers but also of fetuses.
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