Journal of anesthesia
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Journal of anesthesia · Mar 1995
Auditory brainstem responses after out-of-hospital cardiac arrest: Are they useful for outcome prediction?
We evaluated whether we could predict the neurologic outcome in 55 out-of-hospital cardiac arrest patients using auditory brainstem responses (ABR). ABR patterns were classified into one of 3 types by evaluation of 5 components: type 1, with all 5 components; type 2, lack of at least one response between the 2nd and 5th components; type 3, with only the first component or no response. The relation between the ABR patterns on the 3rd day following resuscitation and the neurologic outcome on hospital discharge was evaluated. ⋯ In the type-1 ABR patients, the negative predictive value that the patients were awake was 100%. In the type-3 ABR patients, the negative predictive value that the patients became brain dead was 90.9%. These results suggest that ABR on the 3rd post-resuscitation day may not be useful for predicting if patients are awake or become brain dead, although the loss of components may be a sign of morbidity, and the presence of the 2nd or later components indicates possible future prevention of brain death.
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Journal of anesthesia · Mar 1995
Optimal administration time of intramuscular midazolam premedication.
The optimal administration time for intramuscular injection of midazolam as premedication was studied. Sixty patients ranging in age from 40 to 65 were included. A combination of atropine 0.3-0.5 mg and midazolam 0.08 mg·kg(-1) was given to four groups of 15 subjects each in intramuscular injections 45, 30, 15 min, and immediately before entering the operating room. ⋯ The depression of the root of the tongue, disappearance of verbal response, and eyelash reflex were found in the 30- and 45-min groups. The degree of sedation and amnestic effect were good except for the group who received midazolam immediately before entering the operating room. From the above results, intramuscular injection of midazolam 0.08 mg·kg(-1) with atropine 0.3-0.5 mg is considered best when administered 15 min before entering the operating room.
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Journal of anesthesia · Mar 1995
Rapid induction with 7% sevoflurane inhalation-not the single-breath method.
The usefulness of the rapid anesthesia induction method with 7% sevoflurane, not the single-breath method, was investigated in 88 patients with ASA physical status 1. Anesthesia was induced with 3 l·min(-1) nitrous oxide in 3 l·min(-1) oxygen and sevoflurane 7% for 3 min (group A), 7% for 5 min (group B), 7% for 7 min (group C), and 5% for 7 min in conventional induction (group D). There were 22 patients in each group. ⋯ The time for the loss of consciousness was shorter in groups A (47.2 s), B (44.9 s), and C (49.8 s) than in group D (73.4 s). During induction, body movements were seen in 18.2% in group A and 13.6% in the other 3 groups, but no other complications such as coughing, breath holding, or laryngospasm were seen in any group. In conclusion, the anesthesia induction method with 3 min of 7% sevoflurane inhalation was useful for rapid induction.