Journal of anesthesia
-
Journal of anesthesia · Jan 2008
Biography Historical ArticleHarvey Cushing, a pioneer of neuroanesthesia.
Harvey Cushing's name is most frequently mentioned in conjunction with Cushing's syndrome, and Cushing's reflex following raised intracranial pressure. The aim of this review is to pay tribute to Cushing's contribution to anesthesia. Besides his own specialty, he used an anesthesia chart for the first time, he introduced blood pressure measurement and precordial auscultation to anesthesiological practice, he employed the first independent neurosurgical anesthetist, and he described the terminology of regional anesthesia.
-
Journal of anesthesia · Jan 2008
Case ReportsAdequate hypnosis at very low isoflurane concentration during craniotomy monitored by electroencephalography.
We report a patient with Parkinson's disease undergoing craniotomy for a brain tumor, who had clinically adequate hypnosis at a very low concentration of isoflurane. While the raw EEG showed low-voltage slow electrical activity, the EEG analyzer of the monitor displayed high burst suppression ratios. The role of intracranial pathology and drug therapy as possible causes of the low anesthetic requirement for adequate hypnosis are discussed. This report also draws attention to the possibility of erroneous analysis of burst suppression by EEG modules.
-
Journal of anesthesia · Jan 2008
Randomized Controlled TrialEffects of landiolol on the cardiovascular response during tracheal extubation.
The objective of this study was to investigate the effect of landiolol on the cardiovascular responses to emergence from anesthesia and tracheal extubation. Fifty-nine patients without cardiovascular disorders who were scheduled for tympanoplasty were randomly allocated to receive a loading dose of landiolol at 0.125 mg x kg(-1) x min(-1) for 1 min, followed by an infusion at 0.01 mg x kg(-1) x min(-1) (group L1), 0.02 mg x kg(-1) x min(-1) (group L2), 0.03 mg x kg(-1) x min(-1) (group L3), or 0.04 mg x kg(-1) x min(-1) (group L4). ⋯ Just after extubation compared with the baseline, the MAP increased significantly in all groups; the HR increased in groups L1 and L2; and the RPP increased in all groups, except for group L4. Continuous administration of landiolol, at 0.03 or 0.04 mg x kg(-1) x min(-1), may prevent the increases in HR and RPP, respectively, that occur at the emergence from anesthesia and tracheal extubation.
-
Journal of anesthesia · Jan 2008
Case ReportsMalignant hyperthermia developing during esophageal resection in an 82-year-old man.
Malignant hyperthermia (MH) is a rare but fatal complication that develops under general anesthesia. Reports on MH in patients over the age of 80 years are unusual. We experienced a case of MH in an 82-year-old patient during esophageal resection. ⋯ With continuous infusion of dantrolene when the patient was transferred to the intensive care unit (ICU), BT remained within the normal range. The next day re-operation was performed, without further complications or recurrence of MH during the postoperative period. Because it is necessary to initiate treatment in the early stage of MH, as soon as possible, although MH prevalence is low in the elderly, it is important to suspect MH when hypercapnia and/or hyperthermia are seen.