Journal of anesthesia
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Journal of anesthesia · Sep 1994
High incidence of postoperative pulmonary complications after orthotopic liver transplantation in children.
Postoperative pulmonary complications were investigated in a total of 41 pediatric recipients who underwent orthotopic liver transplantation (OLT) between January, 1990 and March, 1992 at the Royal Children's Hospital, Brisbane. Atelectasis was seen in 40 cases (98%) of the 41 recipients, and occurred in the left lower lobe in 28 cases (68%), and in the right upper lobe in 25 cases (61%). Radiographic pulmonary edema occurred on 23 occasions in 18 recipients (45%). ⋯ Pneumothorax occurred in three cases. Pyothorax, hemothorax, bronchial asthma, and subglottic granulation occurred in one case each. The present study demonstrated that postoperative pulmonary complications are frequently observed in pediatric recipients undergoing OLT.
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Journal of anesthesia · Sep 1994
The effect of pH adjustment of 1% lidocaine on the onset of sensory and motor blockade of epidural anesthesia in nonpregnant gynecological patients.
Using a double-blind randominzed study protocol, we examined the distribution of sensory blockade and the quality of motor blockade after epidural anesthesia with 1% lidocaine with or without bicarbonate in nonpregnant gynecological patients. Alkalinization significantly decreased the time to onset of sensory blockade. However, there were no statistically significant differences between the low-pH and high-pH groups with respect to motor blockade or the distribution of sensory blockade. We conclude that pH-adjusted 1% lidocaine offers the advantage of a more rapid onset of sensory blockade, while motor blockade and the distribution of anesthesia are unaffected by pH change in epidural anesthesia.
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Journal of anesthesia · Sep 1994
The effect of prostaglandin E1 on the increase of serum lactate and plasma granulocyte elastase activity during radical surgery for esophageal cancer.
Serum lactate concentrations and the lactate/pyruvate (L/P) ratio were measured in two groups of patients undergoing radical esophagectomy, as an indicator of tissue hypoxia, and β-glucuronidase and granulocyte elastase as indicators of tissue damage. One group received prostaglandin E1 (PGE1) and the other group received nothing. Serum lactate concentrations and the L/P ratio increased significantly 30 min after starting thoracotomy in the patients who were not treated with PGE1. ⋯ There was no change in serum β-glucuronidase activity in both groups. This study suggests that low doses of PGE1 maintain organ blood flow without affecting blood pressure. However, these low doses of PGE1 could not suppress granulocyte elastase release.
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Journal of anesthesia · Sep 1994
Effects of halothane and enflurane on the peripheral vasoconstriction and shivering induced by internal body cooling in rabbits.
General anesthetic agents have central and peripheral effects on body temperature regulation, and its alterations are related to the depth of anesthesia. To evaluate the effect of halothane and enflurane on thermoregulation, we investigated the threshold of body core temperatures to induce peripheral vasoconstriction and shivering in spontaneously breathing rabbits. Rabbits were anesthetized with halothane or enflurane at 0.0 (control), 0.2, and 0.4 MAC (minimum alveolar concentration). ⋯ The incidence of peripheral vasoconstriction was not significantly affected by halothane or enflurane. However, the incidence of shivering decreased in a dose-dependent fashion with both anesthetic agents. At 0.2 MAC, the incidence of shivering in the enflurane group was significantly higher than that in the halothane group, suggesting that suppression of shivering by halothane is stronger than enflurane.
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Journal of anesthesia · Sep 1994
Differential effects of halothane and enflurane on end-systolic pressure-diameter relationship in anesthetized, mechanically ventilated dogs.
To clarify the difference of negative inotropic effects, we evaluated the effects of 0, 0.5, and 1 MAC halothane and enflurane on systolic performance in anesthetized, mechanically ventilated, vagotomized dogs. Left ventricular myocardial contractility was assessed by the slope of the end-systolic pressure-diameter relationship (EES), which have been reported to be independent of alterations in preload and afterload but sensitive to changes in myocardial contractility. Both anesthetics decreased heart rate and dose-dependently decreased left ventricular systolic pressure. ⋯ TheEES was decreased with increasing concentrations of enflurane. TheEES was significantly larger (P<0.05) with 1 MAC of halothane than with 1 MAC enflurane. These results suggest that halothane preserves myocardial contractility better than enflurane in the presence of fentanyl.