Journal of anesthesia
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Journal of anesthesia · Jun 1995
Comparison of postoperative liver dysfunction following halothane and sevoflurane anesthesia in women undergoing mastectomy for cancer.
The incidence of an abnormal increase in the serum levels of glutamic oxaloacetic transaminase (GOT) and glutamic pyruvic transaminase (GPT) following anesthesia with halothane and 65% nitrous oxide in oxygen (halothane group) or with sevoflurane and 65% nitrous oxide in oxygen (sevoflurane group) was compared in women undergoing surgery for breast cancer. An abnormal increase in GOT and GPT, both defined as higher than 50 IU, occurred postoperatively in 2 of the 150 patients (1.7%) in the sevoflurane group, and in 37 of the 200 (18.5%) in the halothane group (P<0.001). ⋯ The results of multivariate analysis, when data from all patients were taken together, showed that the type of anesthetic (halothane) was the highest factor related to postoperative increases in GOT and GPT (odds ratio 35.85; 95% confidence interval 5.92-217.37), followed next by prior exposure to inhalation anesthetics (8.65; 2.96-25.27), postoperative radiation therapy (4.37; 1.70-11.19), and postoperative mitomycin therapy (3.56; 1.23-10.35). These data suggest that sevoflurane is less likely to cause anesthesia-related liver dysfunction than halothane.
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Journal of anesthesia · Jun 1995
Responses of interleukin-6 and tumor necrosis factor during and after cardiac surgery undergoing cardiopulmonary bypass and pancreatoduodenectomy.
To evaluate the effect of cardiopulmonary bypass on immunological function, we measured interleukin-6 (IL-6) and tumor necrosis factor (TNF) in 12 patients undergoing cardiac surgery during and after cardiopulmonary bypass, and in 10 patients with pancreatoduodenectomy. Plasma IL-6 levels were determined using the Human Interleukin 6 ELISA Kit, and TNF levels were determined using a highly sensitive sandwich enzyme immunoassay. In patients with cardiac surgery, plasma levels of IL-6 and TNF increased during cardiopulmonary bypass, and in patients with pancreatoduodenectomy, IL-6 and TNF levels significantly increased at the end of intraabdominal manipulation. These results suggest that endotoxin may have activated the immune system and stimulated cytokine production after pancreatoduodenectomy and during bypass.
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Journal of anesthesia · Jun 1995
Low reactive-level laser irradiation on the stellate ganglion in dogs.
The aim of this study was to determine what effects low reactive-level laser irradiation (LLLI) of the stellate ganglion might have on the sympathetic fibers of the stellate ganglion in dogs. Following general anesthesia, the right stellate ganglion was exposed by thoracotomy. After stabilization, the following baseline measurements were taken: mean arterial pressure, heart rate, and blood flow of the common carotid artery. ⋯ The changes in each variable were not statistically significant after LLLI. On the other hand, all variables changed significantly after the stellate ganglion blockade, including increased blood flow of the common carotid artery. In conclusion, this study demonstrated that LLLI to the stellate ganglion does not cause sympathetic blockade.
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Journal of anesthesia · Jun 1995
The effect of airway narrowing and dead space on the shape of the capnogram.
We have investigated the effects of incomplete obstruction of the endotracheal tube and the amount of additional dead space between the endotracheal tube and the capnographic sampling adapter on the shape of the capnogram. A 9.0-mm endotracheal tube was connected to a 3-L reservoir bag filled from the bottom with 5% carbon dioxide and 95% oxygen. The narrowed adapter (internal diameter: 3.0, 4.0, 6.5, and 9.0 mm), the capnographic sampling adapter, and a semiclosed respiratory system were successively connected to this endotracheal tube. ⋯ The T90% value seen in a 3.0-mm adapter did not change compared with the value in a 9.0-mm adapter, when no additional dead space was connected between the endotracheal tube and the capnographic sampling adapter. Further, the slanting upstroke of the capnogram occurred only when the endotracheal tube narrowing and a large amount of dead space between the endotracheal tube and the capnographic sampling adapter coexisted. Thus, it is unlikely that incomplete obstruction of the endotracheal tube can easily be detected by the slanting upstroke of the capnogram.
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Journal of anesthesia · Jun 1995
Protective effects of cyclosporine and allopurinol on transient global cerebral ischemia in gerbils.
The effects of cyclosporine and allopurinol on neuronal death following global cerebral ischemia were evaluated in Mongolian gerbils. The animals were randomly divided into four groups of 12 each: (1) sham operation as control, (2) occlusion of the bilateral common carotid arteries for 12 min and treatment with physiological saline, (3) occlusion plus treatment with 5 mg/kg of cyclosporine, and (4) occlusion plus treatment with 100 mg/kg of allopurinol 30 min before cerebral ischemia and daily thereafter for 6 days. On the 7th day after ischemia or sham operation, the gerbils' brains were removed. ⋯ The number of surviving pyramidal cells per mm length after ischemia in CA1 was 37±14, which was significantly smaller than 174±30 in the control group, but 78±31 following treatment with was cyclosporine, and 108±53 with allopurinol. A reduced number of necrotic pyramidal cells was associated with lower tissue chemiluminescence and lipid peroxides. The results suggest that both cyclosporine and allopurinol can inhibit neuronal death after global cerebral ischemia, and that autoimmunization and superoxide radicals are partially responsible for neuronal death.