Journal of anesthesia
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Journal of anesthesia · Mar 1994
Changes of oxygen transport variables and serum lactate during open-chest cardiac massage in dogs.
The aim of this study was to investigate the influence of critically low cardiac output (CO) upon oxygen transport. We especially focused on the changes of mixed venous oxygen saturation (S-vO2) in the presence of oxygen consumption ([Formula: see text]) debts. Additionally, we examined the correlation between the cumulative oxygen deficit (Def[Formula: see text]) and serum lactate. ⋯ Supplydependent[Formula: see text] was observed when CO decreased below 40 ml·min-1·kg-1. The mean value of S-vO2 in the range of supply-dependent[Formula: see text] was 13±2% and did not change significantly during 1 h of CPR. The changes of lactate from baseline values were linearly correlated with Def[Formula: see text] (r=0.62,P<0.01), but absolute values of serum lactate were not.
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Journal of anesthesia · Mar 1994
Does intraoperative analgesia modify the immune response in surgical patients?
The effect of epidural analgesia combined with inhalational anesthesia on the perioperative immune response was measured by using two-color analysis for the classification of functional lymphocyte subpopulations. Twenty-eight patients undergoing upper abdominal surgery were divided into four groups: group 1, isoflurane and with N2O group 2, sevoflurane with N2O; group 3, epidural analgesia plus isoflurane with N2O; and group 4, epidural analgesia and sevoflurane with N2O. Peripheral lymphocyte subpopulations were measured before, during, and after the operation by using anti-CD4 and anti-CD8 monoclonal antibodies. ⋯ Additionally, stress hormones such as epinephrine (EP), norepinephrine (NE), and cortisol (CO) were measured. EP was increased during and after the operation in groups 1 and 2, and after the operation in group 4, but the level was maintained throughout the study in group 3. In conclusion, prevention of noxious stimuli originating from operative fields by epidural block could prevent the increase in EP and the reduction of helper-inducer T cells in patients undergoing upper abdominal surgery.
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Journal of anesthesia · Mar 1994
Preoperative estimation of pulmonary extravascular thermal volume in patients undergoing pneumonectomy.
Pulmonary extravascular thermal volume (PETV) was measured during pulmonary artery occlusion in 18 patients preoperatively and 7 patients postoperatively who were undergoing pneumonectomy. We found that the PETV decreased from 6.6±2.3 ml·kg-1 before occlusion to 4.1±1.6 ml·kg-1 during occlusion. ⋯ There was a significant correlation between the PETV during occlusion and that at 3 weeks after pneumonectomy (r=0.66,P<0.05). In conclusion, PETV during pulmonary artery occlusion is a reliable baseline value in the assessment of postoperative pneumonectomy values.
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Journal of anesthesia · Mar 1994
Subanesthetic sevoflurane does not affect sympathetic or parasympathetic function.
To evaluate the effects of subanesthetic enflurane and sevoflurane on the sympathetic nervous system (SNS) and the parasympathetic nervous system (PNS), the blood level of norepinephrine (NE) and fluctuations in the R-R intervals were measured on electrocardiogram in humans given either 0.5 MAC enflurane or sevoflurane. Enflurane suppressed circulating plasma NE and elevated coefficients of variation (CV) of R-R intervals after 20 and 30 min of inhalation. ⋯ Sevoflurane lowered the CV to 84% of control after 30 min of inhalation. These results indicate that subanesthetic concentrations of sevoflurane are unlikely to perturb sympathetic and parasympathetic activities in humans without surgical stimulation when compared with enflurane.