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Volume 15, Issue 9
Displaying 1-12 of 12 articles from this issue
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[in Japanese], [in Japanese], [in Japanese]1995 Volume 15 Issue 9 Pages 599-601
Published: November 15, 1995
Released on J-STAGE: December 11, 2008
JOURNAL FREE ACCESSDownload PDF (399K) -
[in Japanese], [in Japanese]1995 Volume 15 Issue 9 Pages 602-607
Published: November 15, 1995
Released on J-STAGE: December 11, 2008
JOURNAL FREE ACCESSDownload PDF (618K) -
[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...1995 Volume 15 Issue 9 Pages 608-611
Published: November 15, 1995
Released on J-STAGE: December 11, 2008
JOURNAL FREE ACCESSDownload PDF (458K) -
[in Japanese]1995 Volume 15 Issue 9 Pages 612-615
Published: November 15, 1995
Released on J-STAGE: December 11, 2008
JOURNAL FREE ACCESSDownload PDF (392K) -
Osamu SATHO, Masayuki MIYABE, Mikito KAWAMATA, Yuri NAKAE, Keiichi OMO ...1995 Volume 15 Issue 9 Pages 616-619
Published: November 15, 1995
Released on J-STAGE: December 11, 2008
JOURNAL FREE ACCESSWe measured arterial plasma concentrations of lidocaine by FPIA in 10 patients receiving total pharyngo-laryngectomy under continuous cervical epidural anesthesia. The patients were first given 3mg/kg of 2 % lidocaine with 1/200, 000 epinephrine into the cervical epidural space. After that, 1∼2mg/kg of 1.5% lidocaine with epinephrine were administered per hour. The mean total amount of lidocaine administered was 893mg.
Plasma lidocaine levels reached a plateau during repeated extradural bolus injections and finally stabilized at about 2.6μg/ml. The mean maximum blood concentration of lidocaine was 3.2μ3g/ml.
We used cervical epidural anesthesia for postoperative pain relief, and no patients showed signs of ICU syndrome.
We conclude that it is safe to use continuous cervical epidural anesthesia under general anesthesia for long periods in pharyngo-laryngectomy patients because the plasma concentration of lidocaine does not reach the toxic level.View full abstractDownload PDF (443K) -
Hisato SUZUKI, Kohtaro TAKAHASHI, Mikako SAKAI, Masahiro YANAGIMOTO, Y ...1995 Volume 15 Issue 9 Pages 620-623
Published: November 15, 1995
Released on J-STAGE: December 11, 2008
JOURNAL FREE ACCESSWe measured the cross-sectional area of the internal jugular vein using a portable ultrasonic device in 50 artificially ventilated patients. Measurement was preformed at end-expiration, end-inspiration and end-inspiration with plateau pressure of 20cm H2O for 3seconds, as well as at three Trendelenburg positions 0, 10, and 20 degrees.1. The cross-sectional area increased from 0.54±0.22cm2 at end-expiration to 0.79±0.26cm2 at end-inspiration, and to 1.18±0.04cm2 at plateau of 20cm2 H2O.2. At the Trendelenburg position of 20 degrees, the cross-sectional area increased to 0.69±0.28cm2 at the end-expiration, and to 0.89±0.32cm2 at the end-inspiration.3. The effect of the Trendelenburg position was smaller than that of positive pressure ventilation.View full abstractDownload PDF (1068K) -
Evaluation with Transesophageal EchocardiographyToshihito TSUBO, Isao ARAKI, Hironori ISHIHARA, Akitomo MATSUKI1995 Volume 15 Issue 9 Pages 624-627
Published: November 15, 1995
Released on J-STAGE: December 11, 2008
JOURNAL FREE ACCESSWe investigated the effects of intermittent positive pressure ventilation on hemodynamics using transesophageal echocardiography (TEE). Twenty-three orthopedic patients were the subjects in this study. Superior vena cava diameter, right atrial and right ventricular area, velocity of pulmonary artery and vein flow, and left atrial dimension were evaluated at end-inspiratory and end-expiratory points.
The superior vena cava diameter increased from 1.13±0.08 cm at the end-inspiratory period to 1.37±0.08cm at the end-expiratory period (mean±SE, p<0.05). Pulmonary artery flow and right atrial and right ventricular area were greater at the end-expiratory point than at the end-inspiratory point. There were no changes in the left atrial diameter or systolic pulmonary venous flow during ventilation. Using TEE, we confirmed that the reduction of preload in the right heart system caused the hemodynamic changes during intermittent positive pressure ventilation.View full abstractDownload PDF (448K) -
Setsu KURAMITSU, Ryuichi KAWATA, Mari MURAKAMI, Yasuhiro KURODA, Toshi ...1995 Volume 15 Issue 9 Pages 628-632
Published: November 15, 1995
Released on J-STAGE: December 11, 2008
JOURNAL FREE ACCESSWe evaluated the analgesic effect of intra-articular injection of morphine (lmg), fentanyl (30μg), and buprenorphine (60μg) in 66 patients (ASA physical status 1∼2, age 15∼67 yrs) after elective arthroscopic knee surgery. The drugs were diluted in 20ml of saline and injected at the end of surgery. Patients were divided into two groups depending on whether synovectomy was performed or not (n=33, each). Patients who underwent surgical proce-dures such as relevant debridement, arthrotomy and postoperative drainage were excluded.
Postoperative pain was assessed using 100mm visual analogue scale at 1, 2, 3, 4, 6, 24 and48hr after intra-articular injection. Supplemental analgesic requirement were recorded.
Patients who underwent synovectomy tended to show higher visual analogue scale compared with patients who underwent non synovectomy knee surgery, irrespective of intra -articular treatment. No significant differences between the two groups in visual analogue scale were detected. In contrast, morphine lowered visual analogue scale at 24 and 48hrafter surgery in the patients without synovectomy knee surgery. No adverse effects relatedto the analgesics examined were noted.
Intra-articular injection of morphine can provide postoperative pain relief followingarthroscopic knee surgery without synovectomy.View full abstractDownload PDF (616K) -
Hideaki OBATA, Nao FUJITA, Yoshiaki FUSE, Kazuaki HAGIWARA, Yukiko TAJ ...1995 Volume 15 Issue 9 Pages 633-638
Published: November 15, 1995
Released on J-STAGE: December 11, 2008
JOURNAL FREE ACCESSWe studied the effect of continuous epidural block initiated before or after surgery on postoperative pain.
Eighty patients scheduled to undergo thoracotomy were allocated randomly to receive a thoracic continuous epidural block either initiated 20 min before surgical incision (PRE-group, n=40) or at the completion of surgery (POST-group, n=40). General anesthesia was maintained with N20, O2 and Isoflurane in all patients. The continuous epidural block consisted of a bolus injection of 4ml of Mepivacaine 1.5%, followed by continuous infusion of Mepivacaine 1.5%, at a rate of 4ml/h, for 72hrs after surgery in each group. Visual analogue scale (VAS) at rest was assessed 4, 24, 48, 72, 96, 120, 144, and 168hrs after surgery. If pain relief was inadequate, indomethacin suppositories (25mg) were administered and the daily cumulative dose of indomethacin was recorded. VAS was significantly less in the PRE-group than in the POST-group 4, 24, 48, and 72hrs after surgery (p<0.05). The daily indomethacin dose in the PRE-group were significantly less than in the POST-group during the first 24hrs after surgery (p<0.05). These results suggest that preemptive analgesia using thoracic continuous epidural block with Mepivacaine may reduce post-thoracotomy pain.View full abstractDownload PDF (669K) -
Tatsuo WATANABE, Ikuma KOSHI, Kumiko TSUKADA, Hiroshi KASAHARA1995 Volume 15 Issue 9 Pages 639-643
Published: November 15, 1995
Released on J-STAGE: December 11, 2008
JOURNAL FREE ACCESSTo reduce the pain of venipuncture we used a combination of iontophoresis of lidocaine and infiltration anesthesia with a very fine needle before venous puncture to obtain an analgesic effect around the vessel. We examined the analgesic effect of this method compared with the usual topical anesthesia of lidocaine. After obtaining informed consent, 20 healthy volunteers between the ages of 25 and 56 were studied. we chose both contralateral veins at the dorsal part of the hand or the cephalic vein at the wrist for venous puncture. We applied silicon-rubber frames packed with cotton fiber immersed in 10% lidocaine liquid on the skin over both veins. One side was the experimental site, where lidocaine iontophoresis was applied at the rate of one mA for ten minutes, and the opposite site was the control, where lidocaine iontophoresis was not applied. The sites using ionto-phoresis were allocated randomly to each hand. We performed a double-blind comparison in this study.
The combination of 10% lidocaine iontophoresis and intradermal Prilocaine infiltration with a very fine needle provided effective skin analgesia for venipuncture. The mean VAS score (maximum: 100) of venipuncture was 11±16 SD (control: 20±23 SD) when using this method.View full abstractDownload PDF (555K) -
Masaaki NISHIZAWA, Kumiko KAZAMA, Masahiro NARITA, Naomi ANDO, Akira I ...1995 Volume 15 Issue 9 Pages 644-648
Published: November 15, 1995
Released on J-STAGE: December 11, 2008
JOURNAL FREE ACCESSA 53-year-old healthy female developed severe fat embolism syndrome (FES) during uncemented total hip arthroplasty under general anesthesia. During the surgical course, her arterial blood pressure, heart rate and expiratory end-tidal carbon dioxide tension remained stable except for a transient drop in percutaneous hemoglobin oxygen saturation from 99% to 95% approximately 20 min after the insertion of a femoral component. After the operation, she did not regain consciousness, and neurological signs were recognized. The clinical diagnosis of FES was made postoperatively by intracerebral high signal intensity spots on the T2-weighed MRI scan, hypoxemia consistent with pulmonary edema on the chest radiograph, petechiae on the palpebral conjunctiva and the anterior chest, laboratory findings indicating disseminated intravascular coagulopathy and fat globules in the urine. She suffered from hypoxemia, hypotension and abnormal bleeding from all skin wounds in the intensive care unit. Ventilatory and hemodynamic supports and therapy for coagulopathy were successful by the 5th postoperative day, but she did not recover con-sciousness. Her impaired consciousness has shown no significant improvement in the ten months since surgery.View full abstractDownload PDF (1095K) -
Shun SATOH, Daizoh SATOH, Atsushi KAISE, Yasuhiko HASHIMOTO1995 Volume 15 Issue 9 Pages 649-653
Published: November 15, 1995
Released on J-STAGE: December 11, 2008
JOURNAL FREE ACCESSWe anesthetized a 70-year-old patient with cryoglobulinemia for open-heart surgery under normothermic cardiopulmonary bypass (CPB), using various anesthetic agents. Patients undergoing normothermic CPB have predictably higher cerebral oxygen demand and may be at higher risk for ischemic brain injury than those undergoing hypothermic CPB. Balanced anesthesia with inhaled and intravenous anesthetic agents without administration of vasodilators provided excellent hemodynamics and keep anesthetic level as deep as possible during normothermic CPB in this patient. Since anesthetic requirements during normothermic CPB have not been clarified, further studies are required.View full abstractDownload PDF (664K)
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