Journal of anesthesia
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Journal of anesthesia · Sep 1994
Tolerance to the mydriatic effect of buprenorphine, butorphanol, nalbuphine, and cyclorphan, and cross-tolerance to morphine in mice.
An increase in the use of opioid derivatives in the treatment of pain syndrome in clinical practice, and especially in the treatment of cancer, has added impetus to the search for an agent which does not induce tolerance and cross-tolerance to other opiodis. The mydriatic effect of opioids in mice, the correlation between analgesia and mydriasis, and tolerance to the analgesic effect of morphine in mice were evaluated previously. ⋯ Tolerance and cross-tolerance to morphine were developed following a chronic use of buprenorphine, nalbuphine, and cyclorphan. After chronic injection of butorphanol, no tolerance or cross-tolerance to morphine was observed.
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Journal of anesthesia · Sep 1994
RETRACTED ARTICLE: Airway occlusion pressure is an indicator of respiratory depression with isoflurane.
The purpose of this study was to elucidate the respiratory depressant effects of isoflurane (0%-1.0%) using airway occlusion pressure (P0.1), a known index of the output of the respiratory centers, in ten anesthetized patients. P0.1 was measured as the pressure change obtained after the first 0.1 sec of spontaneous inspiration against the occluded airway. A significant decrease in minute volume ([Formula: see text]) and a significant increase in PaCO 2 were not observed during the periods of isoflurane 1.0% at the end-tidal concentration compared with those of control period (0% isoflurane) (P<0.05), whereas a significant decrease in P0.1 was observed during the period of isoflurane 0.5%. Our results suggested that P0.1 was a more sensitive indicator of respiratory depression than PaCO 2 or[Formula: see text], and the respiratory center was depressed with a considerably lower concentration (0.5%) of isoflurane.
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Journal of anesthesia · Sep 1994
Assessment of postoperative pain: Contributing factors to the differences between patients and doctors.
This study was undertaken to compare the assessment of pain intensity by 50 patients and by their doctors according to a visual analog scale 5 h and 20 h after major abdominal surgery, and to examine the relationships between the differences in rating of patients and doctors and the factors inherent in the patients which include preoperative expectation of pain, level of anxiety, and the surgical history of the patient. The ratings given by the patients were significantly higher than those given by the doctors at both time periods. ⋯ The results of analysis using Hayashi's quantification theory Type II indicated a moderate association between the rating difference and the patient's age, surgical history, preoperative state of anxiety, and expectation of pain. It is concluded that postoperative pain management, whether in clinical practice or in research, necessitates more consideration of the several above-mentioned individual factors and a preoperative interview in which the patient's level of anxiety and the amount of information the patient has concerning the surgery and post-operative pain is clearly assessed.