Journal of anesthesia
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Journal of anesthesia · Mar 1996
Evaluation of Mapleson systems for administration of inhaled nitric oxide.
To assess the safety of nitric oxide (NO) inhalation during manual-controlled ventilation using Mapleson A, D, and F systems, we examined nitrogen dioxide (NO2) production using a chemiluminescence analyzer. The NO concentration was changed from 0 to 19 parts per million (ppm), and at each level of NO the oxygen (O2) concentration was changed from 21% to 100%. ⋯ The NO2 concentrations of the Mapleson A system were significantly higher than those of either the Mapleson D or F system at 4, 8, and 12 ppm NO and 100% O2, and than that of the Mapleson D system at 19 ppm NO and 100% O2. From the viewpoint of NO2 production, we suggest that the Mapleson D and F systems are safer than the Mapleson A system when manual-controlled ventilation is required.
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Journal of anesthesia · Mar 1996
Halothane anesthesia suppresses reflex tachycardia caused by calcitonin gene-related peptide in dogs.
Calcitonin gene-related peptide (CGRP) is known to produce vasodilation, hypotension, and tachycardia. To investigate the interaction between CGRP and anesthetics, the hemodynamic response to infusions of CGRP was studied in dogs anesthetized with halothane or pentobarbital. In halothane-anesthetized dogs given 0.4 μg·kg(-1) of CGRP, mean arterial pressure (MAP) did not change significantly. ⋯ The results show that the hemodynamic profiles induced by CGRP during halothane or pentobarbital anesthesia are a decrease in MAP accompanied by a reduction in SVR and no consistent alterations in CI. However, CGRP effects on HR showed in a different way. The results also show that HR response differs depending on the anesthetics used: HR increases during pentobarbital anesthesia, while it does not increase during halothane anesthesia.
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We compared the effects of normothermic cardiopulmonary bypass (CPB) with those of hypothermic CPB in patients who underwent coronary artery bypass grafting (CABG) with respect to hemodynamics and oxygen balance. The patients in our study were divided into two groups according to temperature during CPB: systemic normothermia combined with warm blood cardioplegia (group W,n=36) and systemic hypothermia combined with cold crystalloid cardioplegia (group C,n=26). In group W, the use of directcurrent (DC) defibrillators was less frequent after release of the cross clamp, and the duration of CPB and of reperfusion was shorter. ⋯ Mixed venous oxygen saturation ([Formula: see text]) was maintained above 65% during and after CPB in group W and group C. Our results showed that normothermia may be superior to hypothermia during CPB with respect to recovery of cardiac function and avoidance of hyperglycemia. The whole-body oxygen demand-supply balance may be preserved during normothermic as well as hypothermic CPB.
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Journal of anesthesia · Mar 1996
Prophylactic epidural administration of fentanyl for the suppression of tourniquet pain.
Severe dull pain on the side of tourniquet application and marked rises in blood pressure and heart rate associated with that pain are often observed even under adequate regional analgesia. The purpose of this study was to evaluate the effect of epidural fentanyl on the suppression of tourniquet pain during orthopedic surgical procedures. Forty-five patients undergoing orthopedic surgery of the lower extremities with a tourniquet were maintained by continuous epidural anesthesia with 2% lidocaine through an epidural indwelling polyethylene catheter (L3-4). ⋯ Blood pressure during tourniquet application in the epidural group was more stable than in the other two groups. No severe side-effects were observed in any patient. Prophylactic epidural administration of fentanyl might be useful in the suppression of tourniquet pain.