Recently, there is an increasing number of patients who consult our anesthetic outpatient clinic, because of suspected allergic reactions to drugs. In every occasion, we are obliged to draw some conclusions or to do some medical proceducers. Nine cases were consulted in our outpatient clinic in these two years; seven cases troubled with local anesthetics, one with fluorescein and another with antipyretics and antibiotics.
From the investigation of these cases, following conclusion was obtained that it should be ascertained whether patient was truely allergic to drugs or have another kind of functional or organic disease, by means of the thorough anamnesis of the previous episode of adverse reaction, routine examinations including ECG and chest X-ray, and laboratory data, as well as the intra-dermal skin test and challenge test with the identical drugs.

View full abstract

Carcinomatous patients are occasionally accompanied by emotional changes such as unstableness, depression, anger due to intractable pain induced suddenly.
To investigate psychological aspects of carcinomatous patients with pain, three kinds of tests --- Yatabe Guilford test (YG), Cornell Medical Index (CMI) and Manifest Anxiety Scale (MAS) --- were applied to 37 carcinomatous patients (Group 1) and compared with other diseases with pain (Group 2) or normal persons (Group 3).
1. YG resulted in mostly type A, A', A", C and C' in group 1, while type D, D' in group 2 and 3.
2. CMI representing a neurosis indicated 57% in group 1, 42% in group 2 and 22% in group 3.
3. Mental subjective symptoms due to CMI were 35% of touchy character, 24% of a suicide trend, 11% of hopelessness and 11% of melancholy in group 1, while 28% of touchy character 14% of a suicide trend and 10% of hopelessness in group 2, and 16% of touchy character but no case of a suicide trend and hopelessness in group 3.
4. MAS representing anxiety indicated 36% of anxiety in higher grade, 29% of anxiety in middle grade and 36% of normality in group 1, 18% of anxiety in high grade, 9% of anxiety in middle grade and 73% of normality in group 2, and 19% of anxiety in higher grade, 30% of anxiety in middle grade and 51% of normality in group 3.

View full abstract

The adverse effects of high dose Fentanyl were compared with those of Morphine, given to 48 patients undergoing aorto-coronary bypass surgery from January to August 1981. In ten patients among the Fentanyl group, their cardiovascular dynamics during the induction of Fentanyl anesthesia were evaluated using Swan-Ganz catheters at the dose of 25μg/kg, 50μg/kg, 70μg/kg.
M.A.P., C.I., S.V.I., L.V.S.W.I. were decreased significantly at each dose, therefore the cardiovascular depressant effect by high dose Fentanyl was revealed. But the more stable cardiovascular conditions during anesthesia, were given by high dose Fentanyl anesthesia than Morphine anesthesia, although 33% of patients anesthetized by Fentanyl, became hypotensive during the induction, and 36% of those had hypertension and/or tachycardia on pulling epicardium.
Despite of them, the high dose Fentanyl anesthesia is recommended for the aorto-coronary bypass surgery.

View full abstract

Pediatricians and surgeons involved in the care of sick children have become increasingly a-ware that illness, hospitalization and most especially surgical operations have significant emotional and psychological impact on the growing child.
The 150 children, aged 2 to 8, with strabismus were studied and classified into 4 groups.
The assignment of these groups to treatment was randomly determined.
Group 1: children recieved no premedication and preanesthetic visit.
Group 2: children recieved a combination of hydroxyzine and atropine i.m. for premedication but no preanesthetic visit.
Group 3: children recieved no premedication but preanesthetic visit.
Group 4: children recieved a combination of same as group 2 for premedication as well as preanesthetic visit.
All of the 150 children had been psychologically prepared using photograph of the operation room and anesthetic equipment by ward nurse before operation.
All of the parent of the patient were asked to fill a questionaire containing 155 items just prior to operation and same questionaire as mailed to them 2 weeks after the operation.
Multivariate analysis was used to analyze variable of items between preoperation and postoperation.
The result of the analysis: frustration of the preoperation was significantly resolved postoperatively. (p<0.01)
The proportion of frustraion resolution of the preanesthetic visit by anesthesiologist was not significant at Osaka Children's Health Center.

View full abstract

In the spectrofluorimetric method, Pancuronium Bromide and its metabolites were taken into acount for the Pancuronium Bromide concentration in the blood. Pancuronium bromide were also known to be inactivated by binding to albumin and dissolving into lipid.
We studied the biological effective concentration of Pancuronium Bromide by means of frog-abdominal rectus muscle contraction produced by Acetylcholine. Pancuronium Bromide showed the inhibition of the muscle contraction by Acetylcholine, and it's action was lessen by serum proteine. Therefore it was concluded that the effective concentration of Pancuronium Bromide was depended on serum protein concentration. Effective concentrations of Pancuronium Bromide in 5, 30, 60 minutes following bolus intravenous injection of 4mg of Pancuronium Bromide to adult patient were 0.48±0.037μg/ml, 0.40±0.031μg/ml and 0.30±0.090μg/ml, and total Pancuronium Bromide concentrations were 0.63μg/ml, 0.52μg/ml and 0.39μg/ml respectively.

View full abstract