Journal of anesthesia
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Journal of anesthesia · Mar 1994
Relief of intractable perineal pain by coccygeal nerve block in anterior sacrococcygeal ligament after surgery for rectal cancer.
Intractable perineal pain often appears in the anal region following abdominoperineal resection for the treatment of rectal cancer. In such cases, a subarachnoid block or transsacral block is generally used to control pain. However, these procedures sometimes cause complications such as dysuria or sensory paralysis of the pudendum. ⋯ Absolute alcohol was injected into this space. It is essential that the neurolytic agent remain localized in this space to avoid complications and to successfully block perineal pain. In all patients, we found that this method was extremely effective in blocking localized perineal pain without any complications.
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Journal of anesthesia · Mar 1994
Clonidine premedication for sevoflurane anesthesia in upper abdominal surgery.
The effects of clonidine as a preanesthetic medication were compared with diazepam on clinical courses of sevoflurane anesthesia in 22 patients undergoing upper abdominal surgery. The patients were divided into two groups of 11 patients each according to preanesthetic medication: atropine 0.5 mg i.m. plus clonidine 0.3 mg p.o., or atropine 0.5 mg i.m. plus diazepam 10 mg p.o. 60-90 min prior to induction of anesthesia. Anesthesia was induced with fentanyl and thiopental, and was maintained with sevoflurane, 0.5%-1.5%, nitrous oxide and oxygen, supplemented with fentanyl, 0.5 μg·kg-1·hr-1. ⋯ Pain score after extubation was higher in the diazepam group than in the clonidine group. The time when patients responded to verbal command after discontinuation of anesthetics was similar in both groups. Therefore, clonidine pretreatment was useful for sevoflurane anesthesia in upper abdominal surgery.
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Journal of anesthesia · Mar 1994
Effects and interaction of nicardipine and volatile anesthetics in the rat heart-lung preparation.
The effects of the calcium channel blocker nicardipine (N) and the volatile anesthetics halothane (H), enflurane (E), isoflurane (I), and sevoflurane (S) on myocardial metabolism after postischemic reperfusion were assessed in the isolated rat heart-lung preparation. Wistar-ST rats were randomly divided into six groups (each groupn=9) as follows: control (C) group, no drugs; N group, N (100 ng·ml-1); H group, 1% H and N; E group, 2.2% E and N; I group, 1.5% I and N; and the S group, 3.3% S and N. In the presence of the volatile anesthetics, the preparations were perfused for 10 min, made globally ischemic for 8 min, and then reperfused for 10 min. ⋯ Although there was no significant difference in myocardial lactate concentrations among the groups, ATP content in the N, H, E, I and S groups was significantly higher than in controls. Glycogen content in the N, E, I and S groups was also significantly higher than in controls. These results suggest that N improves myocardial recovery from ischemia; however, in the presence of H or E it may cause significant myocardial depression.
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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.