Journal of anesthesia
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Journal of anesthesia · Mar 1995
Effects of rapid inhalation induction with sevoflurane-oxygen anesthesia on epidural pressure in humans.
In this study, we chose sevoflurane as the volatile anesthetic for rapid inhalation induction (RII) and investigated its usefulness. We also assessed how RII with sevoflurane affected epidural pressure, and compared RII with rapid intravenous induction by thiopental on epidural pressure. The results were as follows: RII with 5% sevoflurane had a shorter induction time compared with published results on RII with other volatile anesthetics like halothane and isoflurane, and was accompanied by fewer complications. ⋯ Epidural pressure measurements are reportedly useful in monitoring intracranial pressure. Consequently, in patients with increased intracranial pressure, exhaling to residual volume and increasing arterial blood pressure during laryngoscopy and endotracheal intubation should be avoided. The results of this study suggest that RII with 5% sevoflurane in itself is safe and useful, and that it is unlikely to increase intracranial pressure as compared with rapid intravenous induction by thiopental.
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Journal of anesthesia · Mar 1995
Transcutaneous electrical acupoint-stimulation potentiates the anesthetic effect of enflurane in humans.
The effect of transcutaneous electrical acupoint stimulation (TEAS) on enflurane anesthesia and hemodynamic changes during craniotomy was studied. Eighty neurosurgical patients were randomly divided into two groups. Anesthesia was induced with fentanyl, droperidol, thiopental, and suxamethonium by intubation. ⋯ The results showed that the ratio between expired concentration and minimum alveolar concentration of enflurane during operation in group B was 37.8%-47% lower than that in group A, and that the hemodynamics were more stable during operation. The results also demonstrated that the patients in Group B recovered faster after operation. It was concluded that TEAS with HANS significantly potentiated the anesthetic effect of enflurane.
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Journal of anesthesia · Mar 1995
Attenuation of the vagolytic effect of atropine during high thoracic epidural anesthesia by heart rate fluctuation analysis.
Fifteen surgical patients received an epidural injection of 12 ml of 1.5% lidocaine through a catheter placed at C7-T1, followed by further injection as required. An intravenous bolus of 0.5 mg of atropine sulfate was administered simultaneously with the initial epidural injection. ⋯ At 90 min, the HFC showed gradual recovery to 69% whereas the LFC remained low (22%). These results indicate that 0.5 mg of intravenous atropine reduces the autonomic imbalance that occurs under high thoracic epidural anesthesia, but its duration is too short to be effective throughout the course of anesthesia.