Journal of anesthesia
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Journal of anesthesia · Mar 1998
Combined spinal-epidural anesthesia for cesarean section; needle-through-needle approach.
The Portex "Spinal/Epidural Set" is designed for combined spinal-epidural (CSE) anesthesia by the needle-through-needle approach. We evaluated the technical and clinical usefulness of CSE with this needle set, and also isobaric tetracaine, for cesarean section. ⋯ CSE technique by the needle-through-needle approach is easy to handle, and provides a speedy, reliable, and flexible analgesia as well as postoperative pain relief for patients undergoing cesarean section.
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The purpose of this study was to confirm the changes in extra-aand intravascular fluid distribution during an i.v. influsion of hyperoncotic Dextran solution. ⋯ One-fourth to one-third of the plasma expanding effect of 6% Dextran 70 solution was ascribed to direct fluid drawing from the extravascular space, and the rest was due to both the decrease in plasma filtration into extravascular space and the increase in lymphatic restoration of EVW.
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Journal of anesthesia · Mar 1998
Effects of reduction of carrier gas flow rate on sevoflurane and isoflurane consumption and costs.
To evaluate whether sevoflurane and isoflurane consumption would be actually halved by halving the carrier gas flow rate, as predicted by a theoretical model, we measured the consumed volume of liquid sevoflurane and isoflurane and total costs of anesthetic gas at carrier gas flow rates of 3 and 61·min-1. ⋯ Halving the carrier gas flow rates halved the consumption of isoflurane but not of sevoflurane, indicating that factors other than carrier gas flow rates are involved in determining consumption in the clinical setting.
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Journal of anesthesia · Mar 1998
Middle-ear pressure variations during total intravenous anesthesia with propofol, fentanyl, and ketamine.
As the middle-ear cavity is one of the noncompliant gas-filled cavities, an increase in middle-ear pressure (MEP) instead of volume expansion is observed with inhalation of nitrous oxide (N2O). Changes in MEP cause many complications, such as ear pain, temporary hearing impairment, and postoperative emesis. Therefore, we investigated changes in MEP during total intravenous anesthesia (TIVA) with propofol, fentanyl, and ketamine (PFK) and inhalation of N2O. ⋯ PFK had a minimal effect on MEP, whereas addition of N2O to PFK increased MEP dramatically. Therefore, TIVA, or at least PFK, would be a better choice for patients with middle-ear or upper-airway diseases.
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Journal of anesthesia · Mar 1998
Differential vascular reactivity of canine mesenteric arteries and veins to sevoflurane.
The aim of this study was to compare the vascular reactivities of canine mesenteric arteries and veins to sevoflurane and to elucidate the underlying mechanism that is responsible for sevoflurane-induced hypotension. ⋯ Sevoflurane attenuated the contractile responses to transmural ES in veins but not in arteries. The concentration responses to NE were not affected by sevoflurane in arteries or in veins. At stable precontraction induced by NE, when sevoflurane was placed in the bathing medium, arteries with intact endothelium had significant contraction at 1.7% and 3.4% sevoflurane, followed by relaxation at 5.1%. On the contrary, sevoflurane produced dose-dependent relaxation in endothelium-denuded arteries and endothelium-intact veins CONCLUSION: It is suggested that the relaxation of the veins by sevoflurane may be due to the inhibition of NE release from sympathetic nerve endings and to the direct inhibition of the contractile mechanisms of vascular smooth muscle. In arteries, sevoflurane causes endothelium-dependent vasocontraction, probably by inhibiting the release of basal endothelium-derived relaxing factor (EDRF).