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
Effects of saikosaponins on hepatic damage induced by halothane and hypoxia in phenobarbital-pretreated rats.
The effects of saikosaponins-a.-b1,-b2,-c, and-d on hepatic damage induced by halothane and hypoxia were investigated in the rat. Inhalation of halothane under a hypoxic condition significantly increased serum glutamic oxaloacetic transaminase (GOT) and glutamic pyruvic transaminase (GPT) levels in rats pretreated with phenobarbital compared with rats pretreated without phenobarbital. ⋯ Saikosaponins-a and-d, the most effective saikosaponins against hepatic damage, inhibited the increases in cytochrome P450 and NADPH-cytochromec reductase activity which are induced by phenobarbital treatment. Therefore, it is suggested that the cytoprotective effect of saikosaponin against halothane-induced hepatitis under hypoxia is caused by inhibition of phenobarbital stimulation of the enzyme system for hepatic drug metabolism.
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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
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.