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Yukio KUBOTA
1985 Volume 5 Issue 2 Pages
109-122
Published: April 15, 1985
Released on J-STAGE: December 11, 2008
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We described four interest complications as follows. Those were intragastric Xylocaine spray nozzle and its successive complications, formation of vesicle on the face possibly due to alcoholic sponge and its pressure on the skin, electric burn of the face and formation of knot of a CVP catheter.
Our measures of prevention of pulmonary complications were described such as routine preoperative supine chest x-ray, selective bronchial suctioning using curved tip catheter with a guide mark and a device of determining location of the tip of catheter. The case of atelectasis and of pulmonary edema were presented and discussed.
Three cases of cardiac arrest were occured in 55, 051 cases anesthesia at Osaka Kohseinenkin Hospital for the period of 20 years. There were one cace of cardiac arrest in 16, 234 cases of general anesthesia and two cases of cardiac arrest in 18, 372 cases of local anesthesia. There was no case of cardiac arrest either in 16, 601 cases of spinal anesthesia or in 3, 844 cases of the other types of anesthesia. One case of cardiac arrest of surgery under general anesthesia was expired from myocardial infarction. Two cases of cardiac arrest of E. N. T. under local anesthesia were successfully resuscitated without sequelae.
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[in Japanese]
1985 Volume 5 Issue 2 Pages
123-131
Published: April 15, 1985
Released on J-STAGE: December 11, 2008
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[in Japanese]
1985 Volume 5 Issue 2 Pages
132-138
Published: April 15, 1985
Released on J-STAGE: December 11, 2008
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[in Japanese]
1985 Volume 5 Issue 2 Pages
139-141
Published: April 15, 1985
Released on J-STAGE: December 11, 2008
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[in Japanese]
1985 Volume 5 Issue 2 Pages
142-145
Published: April 15, 1985
Released on J-STAGE: December 11, 2008
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[in Japanese], [in Japanese], [in Japanese], [in Japanese]
1985 Volume 5 Issue 2 Pages
146-148
Published: April 15, 1985
Released on J-STAGE: December 11, 2008
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[in Japanese]
1985 Volume 5 Issue 2 Pages
149-151
Published: April 15, 1985
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[in Japanese]
1985 Volume 5 Issue 2 Pages
152-155
Published: April 15, 1985
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[in Japanese]
1985 Volume 5 Issue 2 Pages
156-157
Published: April 15, 1985
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[in Japanese]
1985 Volume 5 Issue 2 Pages
158-161
Published: April 15, 1985
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[in Japanese]
1985 Volume 5 Issue 2 Pages
162-165
Published: April 15, 1985
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[in Japanese]
1985 Volume 5 Issue 2 Pages
166-169
Published: April 15, 1985
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[in Japanese]
1985 Volume 5 Issue 2 Pages
170-174
Published: April 15, 1985
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[in Japanese]
1985 Volume 5 Issue 2 Pages
175-178
Published: April 15, 1985
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Toshio MACHI, Haruhiro MIYAZAKI
1985 Volume 5 Issue 2 Pages
179-184
Published: April 15, 1985
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A case of trigeminal neuralgia caused by C-P angle epidermoid is reported. This 61-year-old male was first complained of dental pain in the second devision of the right trigeminal nerve seven years previously. Pain has been controlled initially by carbamazepine, later by infraorbital nerve, maxillary nerve and mandibuler nerve alcohol block because of growing pain in the second and third division of the right trigeminal nerve. Since severe pain was repeated several times, and some cranial nerve disorder was observed for the first time, CT and Metrizamide CT cisternography was performed, then the right C-P angle tumor was suspected. A right suboccipital craniotomy was performed by sitting position. Histological diagnosis was epidermoid. This epidermoid was removed with complete cure, then the trigeminal neuralgia has not reccurred. Metrizamide CT cisternography is useful in diagnosis of C-P angle epidermoid. Though it is difficult to distinguish symptomatic trigeminal neuralgia from idiopathic one, we must not overlook the possibility that minor change of sensory division as well as the motor one and decreasing of corneal reflex are growing.
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Toshiyuki SHIGEMATSU, Hiroyuki MAKI, Koichi TSUZAKI, Masao NAGANO
1985 Volume 5 Issue 2 Pages
185-191
Published: April 15, 1985
Released on J-STAGE: December 11, 2008
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Anesthetic management of one hundred and twenty seven cases of aortic aneurysm resection in the past ten years (ten-year-series), and thirty one cases of those in the last one year (new series) were surveyed. We obtained some informations from the ten-year-series, and imoproved the anesthetic management in the new series accordingly. The differences are as follows: 1. All patients were induced with diazepam, fentanyl or morphine and pancuronium after premedecation with diazepam and meperidine. 2. Endotracheal tube with bronchial blocker was used to obtain a better and quieter surgical field. 3. Epidural catheter was inserted in the cases of abdominal aneurysm to obtain postoperative analgesia and to control hypertension postoperatively. 4. Lidocaine and nitroglycerin were administered intravenously during the induction of anesthesia and the latter was used continuously through the operation to control blood pressure. 5. Many patients with thoracic aneurysm were anesthetized wiht high dose fentanyl to obtain cardiovascular stability and to facilitate postoperative ventilatory support. Consequently, we achieved lower mortality and better anesthetic management.
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Yuri TSUJI, Kazuya KIMURA, Tadashi ARIMA, Takao HORI, Iwao OOKAWA, Mas ...
1985 Volume 5 Issue 2 Pages
192-198
Published: April 15, 1985
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Bupivacaine was administered intrathecally for the operations of lower extremity or lower abdomen of 108 patients. 3.0, 3.2, 3.4, 3.6, 3.8, 4.0 or 5.0ml of 0.375% or 0.5% bupivacaine were injected between the third and fourth lumbar spine. In each case the dosage was chosen by the anesthetist who considered the age, the height, the body weight and the operative site of the patient. The onset time of sensory and motor block, the sensory block level, the durration of the both blocks and blood pressure Change were observed.
The mean and SD for all cases were as follows; the onset time of sensory block 3.52±0.87min, the onset time of motorblock 2.96±1.07min, the sensory block level Th
8-Th
10, the duration of the sensory block 218.24±51.73min, the duration of the motor block 221±53.82min, % decrease of the systolic blood pressure 20.46±8.18.
The dosage had no effect on the onset time of the both blocks.
These results suggest that intrathecal administration of 3.0-5.0ml of 0.375 or 0.5% bupivacaine is appropriate for the operations of lower body, although the dosage must be chosen with the considerations patient's age and the site and the duration of the operation.
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Kumiko FUJISE, Ryo IZUTANI, Machiko IKUTA, Keiichi HAYAMA, Takeshi KOM ...
1985 Volume 5 Issue 2 Pages
199-203
Published: April 15, 1985
Released on J-STAGE: December 11, 2008
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Continuous brachial plexus block at the axilla is very effective method for a timeconsumed operation on upper extremity and post-operative pain management. We studied the location of a catheter-tip and the spread of local anesthetic solution in brachial plexus sheath using a radiopaque epidural catheter and a different amount of contrast medium. In almost all cases, the catheter roled up and its tip could never be located above the level of clavicle. A satisfactory block, however, could be obtained when at least 40ml of local anesthetic solution was injected and the spindle shaped sheath was seen in roentgenogram.
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A Controlled Comparison with Epidural Morphine
Keizo SHIBATA, Yosiaki NOMURA, Ken YAMAMOTO, Seiitsu MURAKAMI, Shun-ic ...
1985 Volume 5 Issue 2 Pages
204-209
Published: April 15, 1985
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In a controled trial, epidural buprenorhine was compared with epidural morphine for the pain relief after the simple hysterectomy. Buprenorphine 0.1mg or morphine 2mg dissolved in 10ml of physiological saline or 1% mepivacaine were given into epidural space on demand for the first 12 hours after the operation. Buprenorphine, as judged by an assessment of pain score, produced prolonged analgesia as long as morphine, and more rapid analgesia than morphine.
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Teizo NISHIMURA, Yasuhei SEKI, Masaru ASAI, Yoshio HASHIMOTO
1985 Volume 5 Issue 2 Pages
210-217
Published: April 15, 1985
Released on J-STAGE: December 11, 2008
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Conditions of 54 neonates born from mothers given premedication of 10mg of Deazepam and 240mg of Lidocain for local anesthesia during Cesarean section under epidural lumbar anesthesia were assessed during the early neonatal period. Transmission of Diazepam from mother to child and its concentration in the blood plasma of neonate and mother were also studied.
In the 30 minutes from administration of 10mg of Diazepam to delivery, the C/M ratio was 0.47 in the case of intramuscular injection, 0.85 for intravenous injection and 0.21 for oral administration.
In 16 cases of selective cesareansection, Diazepam could hardly be detected in the neonates'plasma after 24hrs.
General assessment of 40 neonates born under selective cesarean section revealed normal spontanous motor activity and symmetrical posture and no hypotonia.
Hematoaerometer reading's indicated normal levels while no hyperventilation nor anomalous respiration patterns were observed.
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Junichi SATOH, Yukio TANAKA, Kohji SHIBA, Mutsuko ISHITAKI, Shigeaki T ...
1985 Volume 5 Issue 2 Pages
218-222
Published: April 15, 1985
Released on J-STAGE: December 11, 2008
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In lower limb surgery of 36 patients under spinal anesthesia used dibucaine the relation between tourniquet pain, ischemic time and anesthetic level were studied. Although the difference between the anesthetic levels to pin prick and to touch sensation was about 2 or 3 dermatomes, it reached mean 3.5 dermatomes after three hours. There was no tourniquet pain in all cases within 30 minutes ischemia. Ten patients complained of tourniquet pain. One of them still had analgesia to pin prick to third thoracic level. But no tourniquet pain occured if the block of touch sensation was keeped above T9. In reapplication of tourniquet, patients complained of tourniquet pain even within 30 minutes due to level down of spinal anesthesia. Tourniquet pain seems to be preventable when the block of touch sensation is maintained above T9.
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