Journal of anesthesia
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Journal of anesthesia · Jan 2006
Clinical effects of a neutrophil elastase inhibitor, sivelestat, in patients with acute respiratory distress syndrome.
We assessed the effects of a neutrophil elastase inhibitor, sivelestat, on respiratory and organ functions as well as on the mortality of patients with acute respiratory distress syndrome (ARDS) associated with systemic inflammatory response syndrome (SIRS). ⋯ Our results suggested that sivelestat has a beneficial effect only on the pulmonary function of ARDS patients with SIRS.
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Journal of anesthesia · Jan 2006
Case ReportsTwo cases of spinal epidural abscess with granulation tissue associated with epidural catheterization.
Two cases of spinal epidural abscess are reported whose abscesses became granulated after epidural catheterization. Although emergency surgical intervention was performed almost within 24 h after the diagnosis of epidural abscess in case 1, the patient revealed a poor outcome. After laminoplasty, case 2 received lumbar epidural catheterization, and he had a complete recovery. ⋯ Those findings suggest the midpoint of the abscess is the puncture site and that MSSA is found in or around the catheter. Infection at epidural catheterization seems to be caused by catheter insertion or skin contamination after catheterization. As those catheterizations were completed in the outpatient theater, we conclude that epidural catheterization should be performed in the operating room or with a restricted aseptic technique.
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Journal of anesthesia · Jan 2006
Case ReportsPostoperative airway obstruction after airway tumor debulking.
Postoperative airway obstruction is a relatively common complication after anesthesia, occurring most often after head and neck surgery. We present a case of postoperative airway obstruction in a patient who underwent airway tumor debulking. This case demonstrates that, in high-risk patients, despite the traditional methods of determining eligibility for extubation, postoperative airway obstruction can still occur, and alternative means of extubation should be considered.
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Journal of anesthesia · Jan 2006
Effects of intravenous lidocaine prior to intubation on postoperative airway symptoms.
We investigated whether intravenous lidocaine prior to endotracheal intubation influences the postoperative airway symptoms of sore throat, cough, and sputum. After ethics committee approval, 80 patients undergoing elective operations were studied. A total of 20 patients were given lidocaine 1.0 mg.kg(-1) (group L1), 20 patients were given lidocaine 1.5 mg.kg(-1) (group L2), and 40 patients received normal saline (group C). ⋯ There were significant differences in the incidences (P < 0.01) and severity (P < 0.01) of sore throat and cough in groups C and L (groups L1 + L2). There were no significant differences between groups in terms of the incidence or severity of sputum. In conclusion, intravenous lidocaine prior to endotracheal intubation decreased the incidence of postoperative sore throat and cough.
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Journal of anesthesia · Jan 2006
Effect of Ono-EI-600 elastase inhibitor on high-tidal-volume-induced lung injury in rats.
We tested the effect of Ono-EI-600, an elastase inhibitor that suppresses cytokine release, on ventilator-induced lung injury in a rat model. After Wistar rats (aged 8-11 weeks) were anesthetized and tracheostomized, they were randomly assigned to four groups: high tidal volume (V(T)) group (H group: n = 10) receiving peak inspiratory pressure (PIP) 30 cmH(2)O for 240 min; high V(T) with drug group (HD group: n = 10) receiving the same ventilation settings as H group and also intravenous infusion 10 mg x kg(-1) x h(-1) of Ono-EI-600 during the protocol; the lower V(T) group (L group: n = 5) receiving PIP 10 cmH(2)O for 240 min; and control group (C group: n = 5) receiving the same ventilation as L group for 30 min. ⋯ However, for the H and HD groups, no differences were found in arterial blood gas data, cytokine levels in BALF, and histological injury scores. Our experiment provided no evidence that elastase inhibitor Ono-EI-600 protects against lung injury induced by high V(T) ventilation.