THE JOURNAL OF JAPAN SOCIETY FOR CLINICAL ANESTHESIA
Online ISSN : 1349-9149
Print ISSN : 0285-4945
ISSN-L : 0285-4945
Volume 20, Issue 10
Displaying 1-17 of 17 articles from this issue
  • [in Japanese]
    2000 Volume 20 Issue 10 Pages 559-569
    Published: December 15, 2000
    Released on J-STAGE: December 11, 2008
    JOURNAL FREE ACCESS
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  • [in Japanese]
    2000 Volume 20 Issue 10 Pages 570-573
    Published: December 15, 2000
    Released on J-STAGE: December 11, 2008
    JOURNAL FREE ACCESS
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  • [in Japanese]
    2000 Volume 20 Issue 10 Pages 574-579
    Published: December 15, 2000
    Released on J-STAGE: December 11, 2008
    JOURNAL FREE ACCESS
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  • [in Japanese]
    2000 Volume 20 Issue 10 Pages 580-583
    Published: December 15, 2000
    Released on J-STAGE: December 11, 2008
    JOURNAL FREE ACCESS
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  • [in Japanese]
    2000 Volume 20 Issue 10 Pages 584-586
    Published: December 15, 2000
    Released on J-STAGE: December 11, 2008
    JOURNAL FREE ACCESS
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  • [in Japanese]
    2000 Volume 20 Issue 10 Pages 587-590
    Published: December 15, 2000
    Released on J-STAGE: December 11, 2008
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  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    2000 Volume 20 Issue 10 Pages 591-594
    Published: December 15, 2000
    Released on J-STAGE: December 11, 2008
    JOURNAL FREE ACCESS
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  • [in Japanese]
    2000 Volume 20 Issue 10 Pages 595-597
    Published: December 15, 2000
    Released on J-STAGE: December 11, 2008
    JOURNAL FREE ACCESS
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  • [in Japanese]
    2000 Volume 20 Issue 10 Pages 598-600
    Published: December 15, 2000
    Released on J-STAGE: December 11, 2008
    JOURNAL FREE ACCESS
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  • [in Japanese]
    2000 Volume 20 Issue 10 Pages 601-606
    Published: December 15, 2000
    Released on J-STAGE: December 11, 2008
    JOURNAL FREE ACCESS
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  • [in Japanese]
    2000 Volume 20 Issue 10 Pages 607-616
    Published: December 15, 2000
    Released on J-STAGE: December 11, 2008
    JOURNAL FREE ACCESS
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  • [in Japanese]
    2000 Volume 20 Issue 10 Pages 617-622
    Published: December 15, 2000
    Released on J-STAGE: December 11, 2008
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  • Tohgen SATOH, Tetsu ONO, Michiro OZAKI, Masaki NAKAMOTO, Hideaki SAKIO ...
    2000 Volume 20 Issue 10 Pages 623-628
    Published: December 15, 2000
    Released on J-STAGE: December 11, 2008
    JOURNAL FREE ACCESS
    We evaluated the effect of prostaglandin E1 (PGE1) on lidocaine metabolism associated with thoracic epidural anesthesia in 20 patients undergoing hepatic surgery. 3.0mg•kg-1 of lidocaine was administered, followed by continuous infusion at a rate of 1.5mg•kg-1•h-1 perioperatively. In the PGE1 group (n=10), PGE1 at a rate of 0.02μg•kg-1•min-1, was infused continuously after administering the anesthesia. The plasma lidocaine concentration increased gradually in the control group, but not in the PGE1 group, suggesting increased lidocaine metabolism. The plasma MEGX/plasma lidocaine concentration ratio was elevated significantly in the PGE1 group. Our findings suggest that PGE1 may be effective for lidocaine metabolism associated with epidural anesthesia in hepatic surgery.
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  • Katsunori ASANO, Shuuichi IMAI, Wataru MISHIMA, Makoto TAMURA, Ken-ich ...
    2000 Volume 20 Issue 10 Pages 629-634
    Published: December 15, 2000
    Released on J-STAGE: December 11, 2008
    JOURNAL FREE ACCESS
    We began laparoscopic cholecystectomy as a short-stay operation at our hospital in the hope of performing it under an ambulatory setting.
    Preoperative examinations were performed and explanations given a few days or weeks before admission. The patients were admitted on the day of surgery or on the day before surgery. No premedication was given and urethral catheterization was not performed.
    General tracheal intubation was performed using propofol and vecuronium. Anesthesia was maintained by propofol infusion and epidural focal anesthetics infusion. 4 hours after surgery, patients were demanded to go to the rest room on foot. After the surgery, NSAIDs were given for pain relief on request.
    There were no problem in the operating room regarding any of the 30 patients. 94% of patients were able to void and 80% of them could walk within 6 hours after the surgery. Pain and nausea were experienced in females more than males.
    The results show that ambulatory laparoscopic cholecystectomy will be possible. However proper selection of the patients and a full explanation are very important.
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  • Chiaki TSUJI, Fumitaka MURAKAMI
    2000 Volume 20 Issue 10 Pages 635-639
    Published: December 15, 2000
    Released on J-STAGE: December 11, 2008
    JOURNAL FREE ACCESS
    A 72-year-old male with no preoperative medical problems underwent cervical laminoplasty. Anesthesia was induced with thiopental, fentanyl and vecuronium, and maintained with fentanyl and a mixture of O2-N2O and sevoflurane. Hypotension occurred when he was in the prone position, but his blood pressure was soon recovered. His intraoperative blood pressure was about 100/60 mmHg and heart rate was about 100min-1. Suddenly, the ECG monitor demonstrated R on T followed by shortrun and ventricular tachycardia. Lidocaine, dopamine and ephedrine were administerd intravenously, and the surgery was terminated. The results of the analysis of his blood gas, electrolytes, enzymes from the myocardium, echocardiogram and EGG were within normal limits.
    Although there was no ventricular arrhythmia during the postoperative period, he died from sudden cardiac arrest ten days postoperatively. The autopsy showed myocardial infarction, thrombus with intimal injury in the coronary artery lumen and inflammatory cell infiltration in the epicardium. However, coronary artery stenosis was not significant.
    These findings suggest that intraoperative ventricular tachycardia is induced by a coronary spasm, which may be caused by hypotension, the use of ephedrine or inadequate depth of anesthesia.
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  • Toshinori TSUTSUI, Kenji MURANAKA, Keiko SETOYAMA
    2000 Volume 20 Issue 10 Pages 640-645
    Published: December 15, 2000
    Released on J-STAGE: December 11, 2008
    JOURNAL FREE ACCESS
    We report consecutive carotid endarterectomy for 10 stroke patients, who were protected from cerebral ischemia with the aid of an indwelling shunt and monitoring by electroencephalogram (EEG) under general anesthesia with isoflurane.
    During the cross-clamping of the carotid arteries for the insertion of an indwelling shunt catheter, eight patients showed slowed frequencies on the EEG and three of them exhibited lowered amplitudes, indicating cerebral ischemia. These changes in the EEG patterns were soon recovered with the blood supply started from the shunt. The same abnormalities were observed during the cross-clamping for withdrawal of the shunt. Unfortunately, two patients who showed lowered amplitudes on the EEG suffered transient motor paralysis, and one patient developed a small cerebral infarction caused by the relatively long clamping time reguired for suturing the hemorrhagic carotid artery. We conclude that carotid endarterectomy should be performed with a shunt that is indwelled and withdrawn within a possibly shortened clamping time of the carotid artery and that EEG monitoring is indispensable for detecting cerebral ischemia during the course of surgery and anesthesia.
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  • Kazuyoshi ISHIDA, Kasumi ARATAKE, Atsuo YAMASHITA, Takanao MIYAZAKI, K ...
    2000 Volume 20 Issue 10 Pages 646-652
    Published: December 15, 2000
    Released on J-STAGE: December 11, 2008
    JOURNAL FREE ACCESS
    In three patients undergoing surgical resection of pheochromocytoma, blood volume (BV) was measured using pulse spectrophotometry. In the first case, BV decreased to 44∼57ml•kg-1 during tumor resection while mean pulmonary artery and right atrial pressure was normal. After removal of tumor, high dose of dopamine was required to maintain blood pressure. In other two cases, BV were maintained at higher levels, 98 to 145, and 92 to 105ml•kg-1 with mean pulmonary arterial pressure below normal (case 2, 11 to l7mmHg) or above normal (case 3, 22 to 24 mmHg). The blood pressure after tumor resection in these two patients were maintained well without vasopressor. During resection of pheochromocytoma, BV is more helpful to estimate intravascular volume than mean pulmonary artery pressure which is influenced by catecholamine level and vasoactive drugs.
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