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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 3
Displaying 1-17 of 17 articles from this issue
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WENDELL C. STEVENS1987 Volume 7 Issue 3 Pages 259-271
Published: May 15, 1987
Released on J-STAGE: December 11, 2008
JOURNAL FREE ACCESSDownload PDF (1783K) -
Satoru TSUNETO, Seiji WATANABE, Kanji KOYAMA, Kenji NAKAYAMA, Hiroshi ...1987 Volume 7 Issue 3 Pages 272-277
Published: May 15, 1987
Released on J-STAGE: December 11, 2008
JOURNAL FREE ACCESSIn our catheter laboratory, a middle aged woman fell into shock immediately after about 10ml of lidocaine, loaded into a syringe from the multipally used vial, was injected subcutaneously. She was successfully resuscitated. The lidocaine solution looked slightly pink. For the purpose of etiological investigation, skin test was performed using diluted lidocaine. The result turned out negative both to preservative free lidocaine and lidocaine with preservative (methyl parabene) from the unused vials but positive to the lidocaine, a part of the remainder in the vial on investigation. From this result, some substance other than lidocaine and methyl parabene could be an etiological factor in this case. By chromatographic analysis of the lidocaine in the same vial, Chlorhexidine (hereafter CH) was found mixed in. The CH solution contained colouring matter of pink. The skin test resulted in strong positive to CH at the concentration of 0.01% and more. While the concentration of CH at the onset of pink colouring by titrating the new lidocaine vial with CH solution (0.5%, the same concentration used in the catheter laboratory) was 0.0025%
As a matter of conclusion, CH induced anaphylactoid or anaphylaxy response at 0.0025-0.01% (0.125-0.5mg as actual amount) or more in this case. This tiny amount of CH endorced that trans-cutaneous absorption of CH through the skin, mucosa and other biological membrane was very scanty.View full abstractDownload PDF (645K) -
Akio MIZUSHIMA, Yasuhisa YAMAMOTO1987 Volume 7 Issue 3 Pages 278-282
Published: May 15, 1987
Released on J-STAGE: December 11, 2008
JOURNAL FREE ACCESSWilson's disease is a hereditary disorder with impairment of copper metabolism, which has rarely been reported in the anesthetic field.
A 26 year-old housewife with Wilson's disease being treated with D-penicillamine for 15 years, underwent cervical laminectomy for spinal canal stenosis. Her anestesia was carried out by using droperidol, fentanyl, nitrous oxide-oxygen and pancuronium. During anesthesia, no cardio-pulumonary complications were found exept for a slight rise in the body temperature. The postoperative course was uneventful and no signs of hepato-renal dysfunction or deterioration of extrapyramidal symptoms were observed,
Based on pathophysiology of Wilson's disease, selection of anesthetics and intra- and postoperative management for the disease were discussed.View full abstractDownload PDF (562K) -
Kenji NAKAZAWA, Eiichi INADA, Hisato TAKAHASHI, Nobuo FUKE, Shigeho MO ...1987 Volume 7 Issue 3 Pages 283-286
Published: May 15, 1987
Released on J-STAGE: December 11, 2008
JOURNAL FREE ACCESSPsychiatic management of patients after suicidal attempt were discussed on the basis of our experiences in the ICU. Three cases were reported. The first case was a 26 year-old female schizophrenic who suffered multiple fractures. The second case was a 46 year-old male who injested Paraquat (1, 1-dimethyl-4, 4-bipyridylium dichloride) and died of acute renal and respiratory failure on the second day. Third case was a 22 year-old female who inhaled carbon monoxide and was subsequently discharged from ICU without major sequalae. It is very important to get psychiatric consult in the early stages to manage both patient's and his or her surrounding problems. During the ICU stay, normal sleeping cycle should be preserved. In conclusion, successful management after suicidal attempt depends on the patient's effort, psychiatric consult and family support as well as the effort of the doctors in change.View full abstractDownload PDF (476K) -
Toshiyuki SHIGEMATSU, Hideki MIYAO, Kimiyasu SATO, Taro KAWAZOE1987 Volume 7 Issue 3 Pages 287-290
Published: May 15, 1987
Released on J-STAGE: December 11, 2008
JOURNAL FREE ACCESSThe distance between an incisive tooth and the bifurcation of the trachea (hereinafter referred to as "D") was determined in 86 adult surgical patients (43 males and as many females) by inserting a laryngeal fiberscope down to the bifurcation of the trachea following endotracheal intubation. D ranged from 23-29cm (26.6±1.5cm) in males and 21-27cm (23.8±1.7cm) in females. What seems clinically significant about the findings is that there were some D values around 21cm found in women who were about 150cm in height. In such patients, careless fixing of endotracheal tube on habitual assumption of position may cause touch of the tube's tip with the bifurcation of the trachea or endobronchial intubation with the resultant one-lung ventilation. Care including cautious auscultation would be necessary.View full abstractDownload PDF (354K) -
Hitoshi SHIMADA, Kazuya CHITOSE, Yoji ARAKI, Yoko KAWANA, Hironobu SAT ...1987 Volume 7 Issue 3 Pages 291-294
Published: May 15, 1987
Released on J-STAGE: December 11, 2008
JOURNAL FREE ACCESSOne case of 48-year-old female with Crow-Fukase syndrome who received cholecystectomy under general anesthesia was reported. Anesthesia was induced with thiopental and pancuronium bromide and maintained with N2O and ethrane. Blood pressure and heart rate were stable during the surgery. Following the administration of pancuronium (6mg), first twitch(T1) of TOF decreased to 6% of control, but did not disappeare completely. However, the effect of pancuronium was prolonged, and T4/T1 was near 0% for 90min. The neuromuscular blocking action was well antagonized with 50mg of edrophonium. As neurogenic muscle atrophy is a common finding of this syndrome, particular care must be taken with the use of neuromuscular blocking agent, and intensive respiratory care is necessary after surgery.View full abstractDownload PDF (378K) -
Ryosuke ISHII, Shin-ichi NAKAO, Kou MIYASHITA, Haruyuki KASUDA, Reiju ...1987 Volume 7 Issue 3 Pages 295-298
Published: May 15, 1987
Released on J-STAGE: December 11, 2008
JOURNAL FREE ACCESSContinuous axillary brachial plexus block using Tuohy needle and epidural catheter is recognized as a secure technique, seeing that no major neurovascular complication has been reported.
We describe 2 cases of venipuncture and 1 case of paresthesia associated with this technique.
We conclude that disposable Tuohy needle, which is too sharp, should not be used for this technique. Reusable metal Tuohy needle with the advantage of bluntness is recommended for it. And once click sign is obtained in the moment of neurovascular sheath puncture, the needle should not be advanced farther.View full abstractDownload PDF (379K) -
postoperative analgesia in patients with chest or upper-abdominal surgeriesTaeko FUKUDA, Seiji WATANABE, Satoru TSUNETO, Hiroshi YAMAGUCHI, Kanji ...1987 Volume 7 Issue 3 Pages 299-303
Published: May 15, 1987
Released on J-STAGE: December 11, 2008
JOURNAL FREE ACCESSThe effects of intrathecal morphine<three different dose ranges; Group (hereafter, G) 1: 0.06-0.08mg, n=44; G2: 0.10-0.12mg, n=42; G3:0.15mg, n=42; Control (hereafter, C) G, n=23>were studied in 151 patients with surgeries in which skin incisions were made in the dermatome Th2-10. Percentage of the patients who needed no analgesic for 24 hours after morphine administration was 13.0% in CG, 40.9% in G1, 50.0% in G2, and 69.0% in G3. The percentage in G1, 2 and 3 were significantly higher than that in CG (p<0.05, p<0.01, p<0.01 respectively).
Respiratory rate (less than 10/min) and/or hypercapnia (PaCO2>50mmHg), both of which were reversed by naloxone. The incidence of respiratory depression was 0% in G1, 2.4% in G2, and 19.0% in G3 (statistically significant, p<0.05 vs. G2).
In conclusion, 1) a dose-response relationship was observed within the dose range of 0.15mg or less; 2) There was an indication of monitoring on respiratory depression to the patients given more than 0.15mg of morphine intrathecally.View full abstractDownload PDF (470K) -
Hiroshi TANIZAWA, Yuichi TSUKADA, Miyuki YOKOTA, Kiyotaka TANAKA, Masa ...1987 Volume 7 Issue 3 Pages 304-309
Published: May 15, 1987
Released on J-STAGE: December 11, 2008
JOURNAL FREE ACCESSTo decrease blood loss and to obtain a good operating view in the mastectomy, induced hypotension is widely used. Nitroglycerin, hereafter called TNG, is frequently used to induce and keep up the hypotension. TNG has been reported that the platelet aggregation is lowered in vitro and that the bleeding time is extended in vivo. Therefore, to examine the influence of the induced hypotension by TNG on clotting, the authors studied bleeding time, cotting time, platelet aggregation, and platelet volume distribution curves. It has been proved that they are not affected by TNG induced hypotension and it is quite safe for the blood coagulation.View full abstractDownload PDF (607K) -
Nobuo KATAKURA, Masahiro UMINO, Masahiko SHIMADA, Hiroyuki TAKETANI, K ...1987 Volume 7 Issue 3 Pages 310-316
Published: May 15, 1987
Released on J-STAGE: December 11, 2008
JOURNAL FREE ACCESSTo evaluate the effects of the osteotomy for jaw deformities on upper airway, cephalometric radiographs taken in pre-and postoperative periods were obtained from 23 patients 17 to 34 years of age. In 21 of 23 patients, Obwegeser-Dal Pont method, sagittal osteotomy of the mandibular ramus, were performed to move mandibular body posteriorly.
The width of upper airway and madibular plane angle (MPA) were measured from lateral cephalometric radiographs. The tongue was dislocated superiorly and posteriorly because of the posterior movement of the mandibular body. There was a statistically significant decrease in upper airway width after osteotomy. Especially, oral part of the pharynx became narrower than laryngeal part. This decrease of the width of oral part of the pharynx was correlated with the rotation of the mandibular body in a sagittal plane, that is MPA (preoperative MPA-postoperative MPA).
It was concluded that osteotomy for jaw deformities caused remarkable changes of upper airway and that this morphological changes should be one of the risk factors of acute airway obstruction.
The present study emphasises the need for careful and efficient postoperative care for patients in osteotomy with intermaxillary fixation.View full abstractDownload PDF (571K) -
Hitoshi IMAIZUMI, Kazumasa TSUNODA, Akiyoshi NAMIKI, Nobuaki KURAUCHI, ...1987 Volume 7 Issue 3 Pages 317-322
Published: May 15, 1987
Released on J-STAGE: December 11, 2008
JOURNAL FREE ACCESSA 77-year-old male with chronic, drug-resistant idiopathic thrombocytopenic purpura (ITP) and bilateral bullae was scheduled for splenectomy.
In this patient, we preferred to contineous epidural anesthesia to intubated general anesthesia, because of high possibility of rupture of bullae.
Immuno-supressive therapy, plasma exchange, high-dose gammaglobulin therapy and platelet transfusions were performed for 5 days before the operation.
Bleeding time and value of platelet count were recovered within normal limit on the operative day. Epidural anesthesia was carefully performed, and platelet transfusions were done in order to supplement the loss of platelet during operation. The patient had no any complications on the intra- and post-operative courses.
We confirmed that epidural anesthesia was the first choice in anesthetic methods for the splenectomy of ITP patient with bilateral bullae.View full abstractDownload PDF (1087K) -
Satoshi TAKAHASHI1987 Volume 7 Issue 3 Pages 323-329
Published: May 15, 1987
Released on J-STAGE: December 11, 2008
JOURNAL FREE ACCESSThe clinical effects and pharmacokinetics of plain (group 1), epinephrine 1/100, 000 (group 2), 10% dextrose (group 3) and 1.8% sodium chrolide (group 4), on epidural lidocaine were studied in 69 surgical patients (45 received 2% lidocaine for clinical effects, 24 under the general anesthesia received 10ml of 1% lidocaine for pharmacokinetics). Group 2, group 3 and group 4 prolonged the anesthetic duration compared with group 1, although the difference of group 4 was not statistically significant. The mean plasma lidocaine concentrations of group 2, group 3 and group 4 were significantly lower than those of group 1 during the first phase. The pharmacokinetic analysis indicated that group 2, group 3 and group 4 decreased the amount of lidocaline into the systemic circulation during the first phase since group 2 and group 3 increased the affinity of lidocaine to the epidural tissue while group 4 delayed the absorption of lidocaine into the vascular system. It can be assumed that these two mechanisms, reduced lidocaine transfer into the systemic circulation, are attributed to the longer anesthetic duration.View full abstractDownload PDF (651K) -
Hiroko OGASAHARA, Kohichi SHINOHARA, Shigeki YAMASHITA, Kimio YOKOTA, ...1987 Volume 7 Issue 3 Pages 330-335
Published: May 15, 1987
Released on J-STAGE: December 11, 2008
JOURNAL FREE ACCESSWe investigated the effects of 0.25mg and 0.5mg i.m. atropine premedication on airway secretion and bradycardia during general anesthesia in 252 intubated patients. We also evaluated the effects of surgical positions or procedures on airway secretion.
Both 0.25mg and 0.5mg atropine premedication reduced the cases requiring airway suction significantly in comparison with the non-atropine group (P<0.05).
No significant differences were observed in bradycardia among three groups.
Although the number of cases requiring the airway suction decreased significantly with atropine premeditation, we suggest that routine use of atropine as premedication appears to be unnecessary because of negligible difference.
In respect of the surgical positions and surgical procedures, prone, knee-chest, and lateral positions required oropharyngeal suction in 36per cent and the surgical procedures, which stimulate the airway, required tracheobronchial suction in 38per cent. Premedication with atropine tended to reduce the requirement of the airway suction.
In conclusion, we consider that atropine as premedication for the surgical position increasing saliva or the surgical procedures stimulating the airway facillitate smooth conduct of anesthesia on airway secretion.View full abstractDownload PDF (607K) -
Mayumi TAKASAKI, Kaoru DEHARA, Toshihiko NAKATANI, Tadao YANAGITANI, T ...1987 Volume 7 Issue 3 Pages 336-340
Published: May 15, 1987
Released on J-STAGE: December 11, 2008
JOURNAL FREE ACCESSFifty women patients scheduled for hysterectomy received epidural injection of 12ml of 2% mepivacaine solution without epinephrine. Supplementary volume of 10ml was injected in all patients 30min after the initial injection. In 25 patients, 2% mepivacaine was continuously infused at a rate of 10ml/hr till the end of surgery immediately following the supplementary injection. In other 25 patients, the volumes of 10ml of 2% mepivacaine were injected at 1-hr intervals. The mean duration of continuous epidural infusion was 2.7±0.7hr (mean±SD). There were no significant differences in the extent of analgesia and the degree of motor nerve block 20min after the initial injection and at the end of surgery or in anesthetic effects during the surgery between the two groups. The mean arterial blood levels of mepivacaine in the continuous infusion and intermittent injection groups were 4.1±0.8 and 5.3±1.2μg/ml, respectively, 3hr after the initial injection. The mean blood mepivacaine level was significantly lower in the continuous infusion group than in the intermittent injection group. These results demonstrate that continuous epidural anesthesia following continuous epidural infusion of mepivacaine is similar to that following intermittent injections in all effects, but blood mepivacaine levels are reduced below levels seen with intermittent injections by the continuous epidural infusion.View full abstractDownload PDF (526K) -
Jun KATAGIRI, Akito OHMURA, Nobuaki MORIYASU, Midori OZAWA, Michiko YA ...1987 Volume 7 Issue 3 Pages 341-346
Published: May 15, 1987
Released on J-STAGE: December 11, 2008
JOURNAL FREE ACCESSEffects of upper chest wall vibration (CWV) during inspiration on tidal volume (VT), respiratory rate (RR) and functional residual capacity (FRC) were examined in five healthy volunteers. CWV (100Hz) was applied through two vibrators attached bilaterally at the 2nd and 3rd parasternal intercostal spaces. VT increased from 415±118ml to 593±210ml during CWV. RR either increased or decreased and the difference was not statistically significant. FRC increased by 542±172ml during CWV. The increases in FRC were observed in all subject and were able to be consistently reproduced. The increase in FRC by this method could be useful in certain clinical situations and further studies are indicated.View full abstractDownload PDF (590K) -
Kazumi OHKAWA, Hiroshi IN-NAMI, Hironori NAGAI, Kazuo OKADA, Tahei KAW ...1987 Volume 7 Issue 3 Pages 347-351
Published: May 15, 1987
Released on J-STAGE: December 11, 2008
JOURNAL FREE ACCESS1) The effect of Aspirin DL lysine (Venopirin ®) on arterial oxygenation was studied in 21 obese patients during controlled ventilation under general anesthesia with nitrous oxide, oxygen, and enflurane. 2) The administration of aspirin (10mg/kg, i.v.) produced a significant (P<0.001) increase in PaO2 from 96±18 to 107±24mmHg during a hypocapnic stage (PaCO2_??_27mmHg) in 16 patients. 3) In 5 patients, the change in PaCO2 from normocapnia to hypocapnia produced a significant (p<0.001) reduction of PaO2 from 136±22 to 99±21mmHg before the administration of aspirin.
However, after the administration of aspirin (10mg/kg), only a sight but significant (p<0.001) decrease in PaO2 from 139±24 to 107±23mmHg was induced by hypocapnia. 4) Since aspirin is known to potentiate hypoxic pulmonary vasoconstriction (HPV), it is reasonable to speculate that aspirin might have produced an increase in PaO2 by improving VA/Q mismatching through potentiating the attenuated HPV associated with hypocapnia.View full abstractDownload PDF (520K) -
1987 Volume 7 Issue 3 Pages e1
Published: 1987
Released on J-STAGE: December 11, 2008
JOURNAL FREE ACCESSDownload PDF (58K)
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