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Volume 16, Issue 10
Displaying 1-6 of 6 articles from this issue
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Sumio TSUKAHARA, Hirosato KIKUCHI, Kouichi SASA, Tadahiro KATO1996 Volume 16 Issue 10 Pages 697-700
Published: December 15, 1996
Released on J-STAGE: December 11, 2008
JOURNAL FREE ACCESSwe designed a central venous catheter with a newly developed diaphragm pressure transducer (CVPS) which is capable of measuring central venous pressure (CVP) directly, and compared CVP measured by the conventional method to that measured by a CVPS catheter in 13 patients. The CVPS catheter was inserted via the right internal jugular vein. The zero level was determined by moving the transducer until the reading agreed with the reading of the CVPS catheter. The anteroposterior distance of the chest cage (A cm) and the distance to the zero level from the posterior chest wall (B cm) were measured. The wave form and value measured by the CVPS catheter almost agreed with those measured by the conventional method. The values of B/A was 0.51±0.10 (mean±SD, n=13). This value is almost the same as the midpoint of the anteroposterior distance of the chest cage or the midaxillary line.View full abstractDownload PDF (434K) -
Toshiya KOITABASHI, Yoshihisa MORITA, Yoshio TAKINO1996 Volume 16 Issue 10 Pages 701-705
Published: December 15, 1996
Released on J-STAGE: December 11, 2008
JOURNAL FREE ACCESSWe studied the effects of 1 MAC of sevoflurane and isoflurane with 67% nitrous oxide on plasma-free catecholamine concentrations during gastrectomy.
Twenty patients were randomly divided into 2 groups: a sevoflurane group (n=10) and an isoflurane group (n=10). Anesthsia was maintained with oxygen, nitrous oxide, and end-expiratory concentration of 2.1% sevoflurane or 1.2% isoflurane.
In both groups, dopamine, noradrenaline and adrenaline concentrations significantly increased (p<0.05) 2 hours after the incision. The plasma-free adrenaline concentration in the isoflurane group was significantly higher than in the sevoflurane group (p<0.05). Blood pressure 2 hours after the incision in the isoflurane group was significantly increased (p<0.05).
In conclusion, the concentration of free adrenaline during surgical stress was more accelerated with isoflurane than with sevoflurane.View full abstractDownload PDF (592K) -
Tomoo TAKEDA, Hideki KITOH, Hiroki IIDA, Toshio ASANO, Shuichiro OHTA, ...1996 Volume 16 Issue 10 Pages 706-711
Published: December 15, 1996
Released on J-STAGE: December 11, 2008
JOURNAL FREE ACCESSContinuous epidural anesthesia is a common anesthetic technique used in surgery and pain management. The insertion of an epidural catheter may be associated with nerve root irritation or migration into epidural veins. Suspecting that the design of conventional epidural catheters caused such undesirable events, we designed a new epidural-catheter-shaped pig tail. Study 1: Twelve patients with chronic pain were studied. Epidural catheter placement under fluoroscopy revealed that this new catheter was shaped like a pig tail immediately after its insertion into the epidural space. We noticed that contrast medium (Iopamidol 3ml) extended bilaterally in eleven patients. Study 2: Fifty patients who underwent elective surgery were studied. We examined paresthesia during insertion of the catheter. After the operations, we radiologically evaluated the spread of 3 ml contrast medium. Every catheter was in a good position and contrast medium extended bilaterally. We conclude that this new pig tail catheter is very useful in pain control and clinical anesthesia.View full abstractDownload PDF (2224K) -
Masaharu KATSUNO1996 Volume 16 Issue 10 Pages 712-715
Published: December 15, 1996
Released on J-STAGE: December 11, 2008
JOURNAL FREE ACCESSObesity and prone position have anesthetic risks especially for respiratory system. The elevation of diaphragm causes hypoxemia due to unevenness of V/Q. High airway pressure is needed in order to get proper oxygenation. But high airway pressure may cause suppresion of circulation and baro trauma.
To avoid high airway pressure, spontaneous respiration was maintained using continuous endotracheal surface anesthesia in a severely obese patient for prone craniotomy. Endotracheal intubation was conducted under NLA (midazolam 2.5mg, fentanyl 0.2 mg) and then nitrous oxide (50%) and sevoflurane (1.8%) were inhalated. Every hour after intubation 2ml of 4% lidocaine were administered around the cuff of the endotracheal tube through thin catheters previously attatched to the endotracheal tube. No muscle relaxant was used and no bucking occured during the operation.
Continuous endotracheal surface anesthesia is useful for maintaining sufficient spontaneous respiration and for avoiding bucking during surgical operations.View full abstractDownload PDF (1040K) -
Hiraku SHIMOMURA, Toshiyuki MIYAKE, Toyohisa ARAI, Satoshi TAKAHASHI1996 Volume 16 Issue 10 Pages 716-721
Published: December 15, 1996
Released on J-STAGE: December 11, 2008
JOURNAL FREE ACCESSDirect arterial reconstructive surgery for large aneurysms at the vertebro-basilar junction is very difficult. The surgical approach is handicapped by the inaccessibility of the target area, the shape of the aneurysm sac, the position of the aneurysm neck, and poor visibility.
This is a report of two 46-year-old male patients who underwent surgery for vertebrobasilar junction aneurysms with opne-chest cardiopulmonary bypass. The brain was protected during surgery with barbiturates and hypothermic cardiopulmonary bypass. We continuously monitored the patients' internal jugular venous saturations using fiberoptic intravascular catheters. Direct surgery was performed with the patients' systolic blood pressures maintained at 30-50mmHg. Their body temperatures (26.5°C and at 28.8°C) were monitored rectally. Complete cardiopulmonary bypass (without circulatory arrest) was initiated and lasted for about 20min. while clipping the aneurysm neck. During the operations, the cooperation of the surgical team was essential. This team consisted of neurosurgeons, cardiovascular surgeons, artificial cardiopulmonary bypass technicians, and operating room staff.View full abstractDownload PDF (690K) -
Ken NAKATANI, Masakatu OOSHIRO, Shigeru KUNIYOSHI, Tamie YORIMITU, Kiy ...1996 Volume 16 Issue 10 Pages 722-725
Published: December 15, 1996
Released on J-STAGE: December 11, 2008
JOURNAL FREE ACCESSThe authors describe the anesthetic management of a 20-year-old woman with toxic epidermal necrolysis. Toxic epidermal necrolysis is a rare skin disease associated with a high morality rate. The disease is characterised by severe widespread erythematous rash with pain, blisters and loss of skin. While the patient was being treated with steroid and IVH, the duodenal ulcer perforated. General anesthesia was maintained by nitrous oxide and sevoflurane in oxygen with vecuronium. A trachiostomy was carried out because oral/ nasal intubation was difficult due to mucosal lesion. Her postoperative course was uneventful.View full abstractDownload PDF (990K)
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