Journal of anesthesia
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Journal of anesthesia · Jun 1994
Single-breath induction of anesthesia: comparison of enflurane and sevoflurane.
In this study induction of anesthesia using the single-breath technique with either enflurane or sevoflurane in oxygen was compared. Each group consisted of 16 unpremedicated volunteers who breathed approximately 1.7 minimum alveolar concentration (MAC) equivalents of either vapor. There were no significant differences in the cardiovascular and respiratory variables monitored. ⋯ The enflurane group was associated with significantly more problems during induction, and showed moderate or sometimes severe excitatory movements of the extremities and/or coughing. Subjects in the enflurane group described the induction of anesthesia as less pleasant than in the sevoflurane group. We concluded that enflurane was less suitable for single-breath induction of anesthesia compared with sevoflurane.
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Journal of anesthesia · Jun 1994
Effect of prostaglandin E1 on arterial ketone body ratio in hepatectomy.
We evaluated the effect of prostaglandin E1 (PGE1) administration during hepatectomy on arterial ketone body ratio (AKBR), which is an indicator of liver function, and on other liver functions in the postoperative period. Eighteen patients were divided into two groups: Continuous intravenous administration of PGE1 (0.02 μg·kg-1·h-1) was started immediately before hepatic resection and ceased at the end of operation in nine patients (PGE1 group); the other nine did not receive PGE1 (control group). ⋯ In the PGE1 group, total bilirubin and SGOT recovered more rapidly to the preoperative level than in the control group. These findings suggested that PGE1 might have a protective effect on the liver.
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Journal of anesthesia · Jun 1994
Effects of phenylephrine and ephedrine on pulmonary arterial pressure in patients with cervical or lumbar epidural anesthesia, or enflurane anesthesia.
The authors studied systemic and pulmonary hemodynamic changes with ephedrine (EP) or phenylephrine (PH) when used to normalize arterial hypotension resulting from acute sympathectomy due to cervical or lumbar epidural anesthesia, or enflurane anesthesia in 52 patients. Both EP (0.2±0.05 mg·kg-1) and PH (0.025±0.008 mg·kg-1) produced a significant increase in pulmonary arterial pressure (PAP) with a concomitant increase in arterial pressure (AP). In the patients anesthetized with cervical epidural block and NO2-O2, systolic PAP increased from 22±5 to 28±8 mmHg with EP and from 23±6 to 32±10 mmHg with PH in response to approximately 30 mmHg increase of AP, and the ratio of the increment of systolic PAP to systolic AP (ΔPAP/ΔAP) was 0.15±0.08 with EP and 0.20±0.13 with PH (P<0.05); these changes did not differ significantly from those observed in the patients having lumbar epidural or enflurane-N2O-O2 anesthesia. ⋯ A significant relationship between PAP and AP was found in patients given EP; the regression equation was ΔPAP=0.22×ΔAP-2.9 (r=0.77). The relationship in patients given PH was less significant (r=0.38). The results indicated that EP and PH elicit pulmonary hypertensive effect similarly in the patients with a high level of epidural anesthesia and that although both drugs act differently (EP mainly due to increases in the blood flow and PH solely due to its pulmonary vasconstrictive action), the increases in PAP were predictable, to some extent, from the increase of AP in anesthetized humans without predominant cardiopulmonary disorders.
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Journal of anesthesia · Jun 1994
Effects of vasodilators on fibrin-induced pulmonary edema, so-called neurogenic pulmonary edema, in the rat.
The present study was undertaken to evaluate the effects of vasodilators on the development of neurogenic pulmonary edema. Pulmonary edema was induced by injecting fibrinogen and thrombin into the cisterna magna of vagotomized rats (fibrin-induced pulmonary edema). Before the intrathecal injections, rats were pretreated with intravenous injection of one of the following vasodilators: phentolamine, isoproterenol, nifedipine, diltiazem, isosorbide dinitrate, or substance P. ⋯ Treatment with nifedipine or diltiazem, however, diminished the blood pressure but provided less protection against the development of pulmonary edema. The blood volume in edema-positive lungs was minimally different from that in edema-negative lungs. These results suggest that the neurogenic pulmonary edema may be effectively prevented by most vasodilators except Ca++-blockers.