Journal of anesthesia
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Journal of anesthesia · Jan 2006
Randomized Controlled TrialSite of fresh gas inlet and ratios of the delivered fraction and inspired fraction of inhaled isoflurane and sevoflurane in low-flow anesthesia.
The use of low-flow anesthesia causes a discrepancy between the delivered fraction (FD) and the inspired fraction (FI) of inhaled gases. We compared the FI/FD ratios of a new circle (fresh gas inlet located between the inspiratory valve and the patient) to those of the conventional circle (fresh gas inlet located between the inspiratory valve and the CO2 absorber) in low-flow isoflurane and sevoflurane anesthesia, using three anesthetic machines (Dräger NM-GS, Dräger Fabius-GS, and ACOMA KMA-1300-III). ⋯ The positioning of the fresh gas inlet between the inspiratory valve and the patient improved the FI/FD ratios of both isoflurane and sevoflurane during low-flow anesthesia in two decoupling-style anesthetic machines (ACOMA and Fabius).
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Journal of anesthesia · Jan 2006
Randomized Controlled TrialEffect-compartment equilibrium rate constant (keo) for propofol during induction of anesthesia with a target-controlled infusion device.
The effect-compartment concentration (C(e)) of a drug at a specific pharmacodynamic endpoint should be independent of the rate of drug injection. We used this assumption to derive an effect-compartment equilibrium rate constant (k(eo)) for propofol during induction of anesthesia, using a target controlled infusion device (Diprifusor). Eighteen unpremedicated patients were induced with a target blood propofol concentration of 5 microg x ml(-1) (group 1), while another 18 were induced with a target concentration of 6 microg x ml(-1) (group 2). ⋯ Using this population technique, we found the k(eo) to be 0.57 min(-1). The mean (SD) effect compartment concentration at loss of the eyelash reflex was 2.39 (0.70) microg x ml(-1). This means that to achieve a desired C(e) within 3 min of induction, the initial target blood concentration should be set at 1.67 times that of the desired C(e) for 1 min, after which it should revert to the desired concentration.
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Journal of anesthesia · Jan 2006
Randomized Controlled TrialEffects of a protease inhibitor, ulinastatin, on coagulation and fibrinolysis in abdominal surgery.
Ulinastatin is well known to inhibit the activity of polymorphonuclear leukocyte elastase (PMNE). The PMNE concentration correlates with the activities of coagulation and fibrinolysis. The purpose of the present study was to investigate the effects of ulinastatin, a protease inhibitor, on coagulation and fibrinolysis in abdominal surgery. ⋯ Ulinastatin could inhibit coagulation and fibrinolysis in abdominal surgery.
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Journal of anesthesia · Jan 2006
Randomized Controlled TrialEffect of peak inspiratory flow on gas exchange, pulmonary mechanics, and lung histology in rabbits with injured lungs.
The aim of this study was to evaluate, using a rabbit model, the little-known effect of different levels of peak inspiratory flow on acutely injured lungs. ⋯ In rabbits with injured lungs, high peak inspiratory flow with high tidal volume (V(T)) reduces the Pa(O(2))/FI(O(2)) ratio and increases the lung wet-to-dry ratio.
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Journal of anesthesia · Jan 2006
Randomized Controlled TrialFlexible, tapered-tip tube facilitates conventional orotracheal intubation by novice intubators.
Orotracheal intubation is the standard technique for airway management, but several untoward airway complications are possible with this method. To avoid airway trauma caused by the tube tip during intubation, the Parker Flex-Tip tube (PFT), which has a flexible, tapered tip, was developed. It has been reported that the PFT facilitates fiberoptic orotracheal intubation and introducer-guided tracheal intubation. ⋯ PFT did not shorten the time required for intubation and did not reduce the incidence of sore throat and hoarseness. However, a detailed analysis revealed that the PFT decreased the time required for intubation in the anesthesia trainee group. The PFT may help novice intubators to conduct a smooth intubation.