Masui. The Japanese journal of anesthesiology
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Clinical Trial Controlled Clinical Trial
[Pediatric anesthesia and stress response].
The hyperglycemic and adrenocortical responses to upper and lower abdominal surgery were studied in four groups of children. In F group, lower abdominal surgery was performed under light general anesthesia (halothane 0.3-0.5% plus nitrous oxide and oxygen) combined with intravenous injections of fentanyl 10-13 micrograms.kg-1. In L-E group, lower abdominal surgery was performed under light general anesthesia combined with lumbar epidural anesthesia (intermittent injections of 1.0% lidocaine). ⋯ On the other hand, in other three groups, those responses were not inhibited. Therefore we must consider the concentration and the volume of lidocaine in epidural groups. But general anesthesia combined with epidural anesthesia had a excellent effect on the postoperative pain management.
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A 27-year-old female with severe pulmonary hypertension was scheduled to undergo an elective cesarean section at the 32-week gestational age. Since the preoperative assessment revealed that the patient could not tolerate the hemodynamic changes during the operation under general anesthesia without any cardiopulmonary support, the percutaneous cardiopulmonary support (PCPS) with a centrifugal pump was applied for the anesthetic management of the patient during the operation. ⋯ The operation was finished uneventfully, and the patient could successfully emerge from the PCPS immediately after the operation. The PCPS is thought to be very useful for the anesthetic management of the patients with poor cardiopulmonary tolerance.
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Clinical Trial
[Postoperative analgesia service by continuous epidural infusion with buprenorphine].
We examined the analgesic efficacy and side effects of continuous epidural infusion with buprenorphine in 340 surgical patients. The patients received epidural injection of 0.1 mg of buprenorphine in 8 ml of 0.25% bupivacaine immediately after surgery. The patients who underwent thoracotomy or intraabdominal surgery were subsequently infused with buprenorphine 15 micrograms in 1 ml of 0.25% buprenorphine at a rate of 1 ml.h-1 for 48 h. ⋯ Visual analogue scale (VAS) was 22 +/- 2 mm at rest and 43 +/- 2 mm at movement on the postoperative day 1. Corresponding values on the postoperative day 2 were 16 +/- 2 mm and 37 +/- 2 mm, respectively. Nausea and vomiting were found in 12.4% of the patients.