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Volume 7 (1987)
- Issue 6 Pages 445-
- Issue 4 Pages 355-
- Issue 3 Pages 259-
- Issue 2 Pages 127-
- Issue 1 Pages 1-
Volume 7, Issue 2
Displaying 1-17 of 17 articles from this issue
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histrorical backgroung and recent trends in JapanSeizo IWAI, [in Japanese], [in Japanese], [in Japanese], [in Japanese] ...1987 Volume 7 Issue 2 Pages 127-137
Published: March 15, 1987
Released on J-STAGE: December 11, 2008
JOURNAL FREE ACCESSAnesthesia for newborn and infants has been developed since around 1955 in Japan, and become one of the important subspeciality in clinical anesthesia.
We have discussed three topics of pediatric anestheaia as recent trends in Japan with our experiences. That is, the differences in anesthetic managements between full-term and premature babies, anesthesia for day-care surgery and airway management in surgery for tracheal stenosis.View full abstractDownload PDF (1064K) -
[in Japanese]1987 Volume 7 Issue 2 Pages 138-145
Published: March 15, 1987
Released on J-STAGE: December 11, 2008
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Mitsuaki YAMAMOTO1987 Volume 7 Issue 2 Pages 146-156
Published: March 15, 1987
Released on J-STAGE: December 11, 2008
JOURNAL FREE ACCESSProblems associated with two kinds of the pain measurement have been treated: one is for experimental pain and the other is for clinical pain. General explanations have been made concerning the measurement of experimental pain which can be produced by various kinds of noxious stimuli such as mechanical, electrical, thermal and chemical ones. Then, several representative examples of pain measurement both in the field of animal experiments and in human psychophysics have been introduced. The most quantitative method for evoking pain is based on the electrical stimulation. The methods of stimulation by temperature, such as Hardy's radiant heat, laser, thermode and so on, are also recognized as quantitatively excellent. Out of these, Hardy's radiant heat method is classical but most fundamental. With the use of modified type of Hardy's algometer, the phenomenon of deactivation has been presented, which can be observed when the heat stimuli are repeatedly delivered to the same loci on the skin of normal subjects. Furthermore the deactivation for the repeated stimuli has been more pronounced for some of the patients with pain complaints. The possibility for the clinical "intrinsic" pain to be measured objectively has been discussed in conjunction with the modulation of experimental pain by clinical pain.View full abstractDownload PDF (1293K) -
[in Japanese]1987 Volume 7 Issue 2 Pages 157-160
Published: March 15, 1987
Released on J-STAGE: December 11, 2008
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Taketoshi NAMBA, Futami KOSAKA, Shiro SHIMOSATO1987 Volume 7 Issue 2 Pages 161-167
Published: March 15, 1987
Released on J-STAGE: December 11, 2008
JOURNAL FREE ACCESSMeasurement of right ventricular ejection fraction(RVEF) by thermodilution method was evaluated and intraoperative hemodynamic changes of the patients, divided into two gruop; mitral valve disease(MVD) and coronary artery disease(CAD), were measuered by this technique. Special emphasis was placed upon the changes of RVEF and right ventricular volume.
The values of RVEF by thermodilution method and the simultaneous values by radionuclear angiography correlated significantly. Regression line between them was y=0.97x+2.2. There were no significant differences in RVEF within both group during the operation. However, RVEF in MVD werc significantly lower than those in CAD through the operation. In MVD, RVEF in the gruop which needed catecholamines in weaning from cardioplumonary bypass were significantly lower than those in the gruop which did not. In both gruop, stroke volume index correlated right ventricular end-diastolic volume rather than right atrial pressure.View full abstractDownload PDF (692K) -
Hiroyuki KANI, Kiyoshi SAITOH, Takasuke IMAI, Keiichi KATOH, Hidehiro ...1987 Volume 7 Issue 2 Pages 168-173
Published: March 15, 1987
Released on J-STAGE: December 11, 2008
JOURNAL FREE ACCESSWe Studied the right ventricular function of three groups, those of mitral valve replacement, esophageal carcinoma, and sepsis ones, by means of thermodilution method. In the former two groups, the studies were performed in immediate postoperative period. The mean values of the right ventricular ejection fraction of these three groups were 33%, 45%, and 50% respectively. The mean values of the right ventricular endodiastolic volume index of these three groups were 103ml•m-2, 103ml•m-2 and 106ml•m-2 respectively. In all groups, the correlations between the right ventricular stroke work index and the right ventricular endodiastolic volume index were much better than the correlations between the right ventricular stroke work index and the right ventricular endodiastolic pressure. We concluded that in critical patients the right ventricular function has to be evaluated based on relationship between filling volume and cardiac work.View full abstractDownload PDF (670K) -
[in Japanese], [in Japanese], [in Japanese], [in Japanese]1987 Volume 7 Issue 2 Pages 174-185
Published: March 15, 1987
Released on J-STAGE: December 11, 2008
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Influence of beta blocker and agingHisatoshi OHSUMI, Fukuichiro OKUMURA1987 Volume 7 Issue 2 Pages 186-195
Published: March 15, 1987
Released on J-STAGE: December 11, 2008
JOURNAL FREE ACCESSThe influence of 1) beta-blocker and 2) aging on the neural circulatory regulation was investigated by 10°head up tilt test in anesthetized patients. In beta-blocker study, 20 patients scheduled for coronary artery revascularization were examined. Ten of them had taken beta-blocker (mean dose was equivalent to 63mg of propranolol) orally until the operation. In the study of aging, 21 patients scheduled for the elective surgery were divided into three groups-younger (age<40 years), middle (40_??_age<60) and elder (age_??_60). The head up tilt test was performed under NLA anesthesia before commencing the operation. Direct arterial pressure, R-R interval from ECG, CVP and cardiac output was measured. By 10°head up tilting, significant reduction of arterial pressure was recognized probably due to decrease in venous return. Then, arterial pressure restored with shortening of R-R interval by the reflex. Cardiac output was decreased during head up tilt. 1) Beta-blocker attenuated shortening of R-R interval induced by the circulatory reflex, but did not affect significantly the changes in either arterial pressure or cardiac output. 2) As for the effect of aging, the reflex arterial pressure regulation was aggravated in the elder group as well as the reflex control of heart rate.View full abstractDownload PDF (998K) -
[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...1987 Volume 7 Issue 2 Pages 196-204
Published: March 15, 1987
Released on J-STAGE: December 11, 2008
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Takaaki KOZAWA, Yasuyuki KAKIUCHI, Kimiaki EZAKI, Atsuko TOYAMA, Hisay ...1987 Volume 7 Issue 2 Pages 205-212
Published: March 15, 1987
Released on J-STAGE: December 11, 2008
JOURNAL FREE ACCESSReye's syndrome is a low incidence but life-threatening illness that affects children during the recovery period of upper respiratory illness.
The etiology and pathogenesis remains obscure, but it is appeared to affect mitochondoria in the multiple organ systems. Main symptoms are encephalopathy, hepato-renal dysfunction, bleeding tendency and so on.
We experienced the anesthesia for liver biopsy of a 6 years-old child suffering from Reye's syndrome. He had the acute onset of unconsciousness, seizure attach, apnea, elevated serum transaminase and creatininephosphokinase levels and thrombocytopenia.
Intravenous administration of mannitol and hyperventilation are useful in the management of intracranial hypertention.
Anesthetic drugs and techniques should be chosen carefully in order to protect the hepato-renal function, and hypotention avoided. For the treatment of bleeding tendency, fresh frozen plasma and gabexate mesilate were used.
Critical period of this syndrome is about one week, so we recommend that the patient with Reye's syndrome should be anesthetized after recovery from the critical period of this syndrome.View full abstractDownload PDF (1201K) -
Shoji KAWACHI, Takao YAMANOUE, Osafumi YUGE, Michio MORIO1987 Volume 7 Issue 2 Pages 213-219
Published: March 15, 1987
Released on J-STAGE: December 11, 2008
JOURNAL FREE ACCESSHypermetabolism and glucose intolerance constitute much of the metabolic responces to major trauma that commonly occurs during the intraoperative periods.
Intraoperative administration of glucose are commonly used for fluid management. In group of patients who recieved only lactated Ringer solution during surgery, the RQ reduced significantly with time during operation (0.845 to 0.708). The patients who received glucose 0.5/kg/h intraoperative period showed no significant reduction at the end of operation and in patients who received 0.25g/kg/h glucose could not keep RQ as initial values intraoperative periods. This observation suggested that the patients who received glucose metabolized them as energy source immediately during operation, and that 0.25g/kg/h glucose was not enough to maintain the energy from sugar. However, in the group of patients who received 0.5g/kg/h glucose, the blood glucose levels rose up over 300mg/dl during intraoperative periods.View full abstractDownload PDF (636K) -
The differences associated with various inspired oxygen fractions used for preliminary ventilationKeiichi HAYAMA, Takeshi KOMATSU, Nobuoki TOMEMORI, Kumiko FUJISE, Kenj ...1987 Volume 7 Issue 2 Pages 220-225
Published: March 15, 1987
Released on J-STAGE: December 11, 2008
JOURNAL FREE ACCESSIn 97 adult patients, the arterial blood gases were measured immediately before and after endotracheal intubation, and the changes in blood gases during the period of apnea were studied.
According to the inspired oxygen fractions (FIO2) with which patients were ventilated for 3 minutes prior to commencing the intubation. patients were randomly devided into four groups; in G1 group, FIO2 was 1.0, and G2, 0.66, G3, 0.5, and G4, 0.33 respectively. The results are as follows;
1, PaO2 decreased significantly (p<0.05) after intubation in all groups. Especially the decrease observed in G4 was highly significant (p<0.005) and a minimum level of PaO2 was 68.5 torr in G4 group.
2, It is interesting that PaO2 sligtly increased after intubation in several cases of each group, of which mechanism remains to be studied.
3, PaCO2 increased significantly after intubation, and there was significant correlation between the increase in PaCO2 and the intubation time in G1 and G3 group.
4, PH decreased without significant change in base excess.
We conclude that when using 0.5 or greater than that of FIO2 for controled ventilation prior to tracheal intubation, no clinically serious hypoxemia may occur.View full abstractDownload PDF (545K) -
Yoshikazu SAI, Hisashi SUGIMOTO, Hisatoshi OSUMI, Yutaka KITAMURA, Nor ...1987 Volume 7 Issue 2 Pages 226-233
Published: March 15, 1987
Released on J-STAGE: December 11, 2008
JOURNAL FREE ACCESSOne hundred and eight cardiac emergency operations were performed on 95 pediatric patients from July, 1981 to June, 1985 in National Cardiovascular Center. About 92% of these patients were less than 12 months old and about 42% were less than 4 weeks old. Operations were performed in 100 cases because of either congestive heart failure, hypoxia or both which could not be controlled medically. Other reasons for surgeries were arrhythmia for 6 patients, respiratory problem for 1 and closure of the sternum for 1. On the basis of pathophysiology of the disease, these cases were classified into 6 groups; 1)low pulmonary flow group (27 patients), 2)high pulmonary flow group (32 patients), 3)pulmonary venous congestion or outlet disturbance of the heart (25 patients), 4)group with anomalies of the aortic arch (16 patients), 5)arrhythmia group (6 patients), and 6)other group (2 patients). As these cases have many high risk factors such as pediatric, cardiac and emergency, anesthesiologists should fully understand the anatomic and hemodynamic characteristics of the disease, as well as the effects of drugs and anes thetic management on the hemodynamics.View full abstractDownload PDF (793K) -
With the use of electroneuronography and palsy scoreKenichiro OKAMOTO, Hitomi HIGUCHI, Nobuko SHIMBARA, Ryo YATSUSHIRO, Yu ...1987 Volume 7 Issue 2 Pages 234-238
Published: March 15, 1987
Released on J-STAGE: December 11, 2008
JOURNAL FREE ACCESSThe purpose of this report is to evaluate the effect of stellate ganglion block (SBG) on the peripheral facial palsy, using electroneuronography (ENoG).
In 34 cases of facial palsy who were treated with SBG within 2 weeks after the onset, ENoG and palsy scores were examined simultaneously.
The patients, of whom minimal ENoG value was above 40%, compared with the intact side, were recovered completely, but the patients with under 5% of that, still remained the impaired situation.View full abstractDownload PDF (533K) -
Hiroaki KAMITANI, Ryosuke NAIKI, Yukinori ISHIHARA, Kikuzo SUGIMOTO, Y ...1987 Volume 7 Issue 2 Pages 239-244
Published: March 15, 1987
Released on J-STAGE: December 11, 2008
JOURNAL FREE ACCESSThe respiratory effects of epidural anesthesia on the patients of Cesarean section are comparatively studied with the control group of the same patients in supine position.
Sitting position without anesthesia increased ERV accompanying VC and FVC as well, while it decreased %FEV1.0, PFR, and V75. This is considered to be due to the anterior shift of the uterus and the resultant decreased tonus of the abdominal muscles.
Epidural anesthesia producing the highest level of block up to T4-T6 increased TV significantly with IRV and ERV remaining unchanged. Regardless of the level of block, epidural anesthesia significantly decreased %FEV1.0, MMF, PFR, V75, V50, and V25. This might be because the anesthesia shifted the uterus laterally and paralized the abdominal muscles partially. Sitting position and epidural anesthesia had no effects on the blood gas contents.
We concluded that the improved TV by epidural anesthesia on Cesarean section patients best justifies the indication of the anesthesia to the procedure. The accompanying complications have been sucessfully managed to the best results in our institution.View full abstractDownload PDF (609K) -
Hiroaki WATANABE, Norihiko SAKURAYA1987 Volume 7 Issue 2 Pages 245-249
Published: March 15, 1987
Released on J-STAGE: December 11, 2008
JOURNAL FREE ACCESSClinically, most recorded blood pressure waves are spiky. Then the blood pressure values are misread (high systoric blood pressure). Usually accepted main reason of this is due to feature of the catheter. But we demonstrated small air bubbles in the catheter change the pressure wave more than catheter itself. We analized direct blood pressure monitoring kits, long (for operating room) and short (for ICU) one with indwelling catheter. The latter had good frequency characteristics and less probability of air mingling, so we should select short catheter kit. Frequency characteristics of flush devices were good exept Cutter's one (count for little clinically).View full abstractDownload PDF (374K) -
Yoshito SHIRAISHI, Jun-ichirou YOKOYAMA, Hidetake KARASAWA, Kazuyuki I ...1987 Volume 7 Issue 2 Pages 250-255
Published: March 15, 1987
Released on J-STAGE: December 11, 2008
JOURNAL FREE ACCESSThree volatile anesthetic agents of halothane, enflurane and sevoflurane were compared from a metabolical point of view-uptake and elimination.
Twelve patients of ASA 1 were anesthetized with one agent of them for one hour, followed by modified NLA. The inspired and expired concentration of each agent was measured continuously together with VO2 and VCO2 simultaneously, using respiratory and metabolic monitoring system (HOPE system).
The total uptake of an agent for one hour was 805.2ml of halothane, 1540.8ml of enflurane, 469.8ml of sevoflurane, and the expired volume percent for the following one hour after the administration was 16.4% (halothane), 26.7% (enflurane), 36.0% (sevoflurane) respectively. Sevoflurane had the highest end-tidal MAC (0.96 MAC) among them, and rapid, remarkable decrease in VO2.
The rapid rise in FA/FI ratio curve of sevoflurane and its large washout volume indicate its rapid induction and emergence. The decrease in VO2 demonstrates that adequate levels of anesthesia are produced more quickly.View full abstractDownload PDF (492K)
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