Journal of anesthesia
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Journal of anesthesia · Mar 1994
Intravenous magnesium sulfate as a preanesthetic medication: A double-blind study on its effects on hemodynamic stabilization at the time of tracheal intubation.
The effects of magnesium sulfate (MgSO4) as a preanesthetic medication were studied with regard to whether it can sedate or relieve a patient who is scheduled to undergo surgery, and whether it can control the hemodynamic response to tracheal intubation. Twenty adult patients in ASA status 1-2 undergoing elective surgery were studied. ⋯ The changes in mean arterial pressure (MAP) and rate pressure product (RPP) after the intubation were significantly suppressed in magnesium-treated patients, but a sedative effect was not observed. Therefore, MgSO4 was useful as a preanesthetic medication in suppressing the hemodynamic response associated with tracheal intubation.
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Journal of anesthesia · Mar 1994
Local cerebral blood flow measured by stable xenon CT during fentanyl-diazepam anesthesia.
We assessed the local cerebral blood flow (LCBF) in 40 patients under fentanyl-diazepam anesthesia. The measurement of LCBF was made using 50%-70% stable xenon with 20 min of inhalation interval and a shuttle method for computed tomography imaging. All patients were anesthetized with 5.95±1.76 μg·kg-1 fentanyl and 0.22±0.07 mg·kg-1 diazepam under mechanical ventilation during CBF measurement. ⋯ The cerebral carbon dioxide reactivity, expressed as percentage change in LCBF per unit change in arterial carbon dioxide partial pressure, was 5.39±1.07, and there were no significant differences of reactivity among regions studied. In conclusion, we showed reference values of LCBF and carbon dioxide reactivity, measured by stable xenon-enhanced computed tomography, in patients under fentanyl-diazepam anesthesia. Carbon dioxide reactivity was preserved in all regions including gray matter, white matter, and basal ganglia.
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Journal of anesthesia · Mar 1994
Statistical analysis of visual prognosis following stellate ganglion block treatment on patients with retinal vessel obstruction.
The visual outcome in 308 patients treated for retinal vessel obstruction was examined retrospectively and the effectiveness of each treatment was evaluated using stepwise multiple linear regression analysis and the chi-square test. Visual acuity was used as the parameter for assessing treatment effectiveness and the variables investigated included treatment factors [stellate ganglion block (SGB), urokinase administration, and prostaglandin administration] and patient factors (age, duration of visual impairment before treatment, hypertension, and diabetes mellitus). SGB treatment, the duration of visual impairment, and the presence of diabetes mellitus were significantly correlated with the visual prognosis following treatment. These results support the current hypothesis that SGB is a viable treatment for patients with obstructive disease of the retinal vessels.
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The neurophysiologic mechanism of the suppressive action of enflurane on spinal nociceptive transmission was examined in rabbits with intact and with transected spinal cords. Enflurane suppressed nociceptive responses in both intact and transected spinal cord groups. ⋯ These results suggest that enflurane suppresses nociceptive responses by activating descending inhibitory systems and directly suppressing activity at the spinal level. This suppressive action of enflurane does not interact with the opioid receptor.
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Journal of anesthesia · Mar 1994
The effects of low-dose midazolam for induction of high-dose fentanyl anesthesia for coronary artery bypass graft.
A small dose of midazolam 0.06 mg/kg or diazepam 0.15 mg/kg was used for induction of high-dose fentanyl (50 μg/kg) anesthesia in patients undergoing coronary artery bypass grafting operation. Hemodynamic variables were measured 5 min after the injection of midazolam or diazepam, after the end of the fentanyl infusion, and following endotracheal intubation. ⋯ Heart rate was decreased in the diazepam group but not in the midazolam group. Therefore, a small dose of midazolam may be a suitable induction agent for high-dose fentanyl anesthesia in patients with coronary artery disease.