Masui. The Japanese journal of anesthesiology
-
We have evaluated the effectiveness of central venous catheter placement using right atrial electrocardiography (RAECG). Consecutive patients under general anesthesia (n = 42) who required a central venous catheter underwent RAECG-guided catheter insertion procedure via right internal jugular vein. Catheter tip position was verified by post procedure portable chest radiography. ⋯ The average insertion depth of catheters was 16.4 cm. We also attempted to predict the optimal catheter insertion depth for each patient from the previous measurements of external landmarks, but it was found to be difficult to predict reliably. In this point of view, we should use RAECG technique to make sure the proper positioning of the catheter tip.
-
Randomized Controlled Trial Comparative Study Clinical Trial
[The effects of sevoflurane and isoflurane on hepatic blood flow in man].
The influences of sevoflurane and isoflurane on hepatic blood flow (HBF) in man were investigated employing the method of continuous infusion of indocyanine green. HBF and cardiac output (CO) were measured in patients before and after induction of anesthesia with thiamylal, fentanyl, and N2O, and again during isoflurane (n = 9) or sevoflurane (n = 8) anesthesia before the start of surgery. ⋯ Although CO decreased similarly in both groups during anesthesia, the HBF/CO ratio in isoflurane group increased significantly, and the ratio in sevoflurane group did not change significantly. We conclude that whereas isoflurane increases HBF, sevoflurane does not change it in anesthetized patients.
-
Case Reports Comparative Study
[Comparison of the effects of halothane, isoflurane and sevoflurane in the treatment of severe asthmatic attack: a case report].
A 19-year-old woman suffered from a severe asthmatic attack. She did not respond to any of the conventional therapies and eventually lapsed into a state of unconsciousness. ⋯ The inhalation of isoflurane, halothane and sevoflurane decreased the airway resistance and systemic vascular resistance in direct relationship to the dosage administered. Because the patient's metabolic rate is low and the occurrence of arrhythmias is rare with isoflurane, we concluded that isoflurane is the best alternative for the patient with asthma.
-
A 65 yr-old male with severe scar pain on his right lower abdomen underwent selective nerve block through epidural space using a superfine fiberscope. A12-gauge Tuohy needle (internal diameter 2.2 mm) was inserted at the intervertebral space of Th12-L1. The fiberscope (external diameter 1.1 mm) was introduced through the needle and the epidural space was observed. ⋯ Then 2% lidocaine 1.5 ml and 60% megumine sodium amidotrizoate 1.5 ml were slowly injected. Soon after injection of anesthetic, analgesia area (Th11-L1) was obtained, and Th12 nerve root was identified by X ray. Epidural blockade using a superfine fiberscope seems to be one of the useful and reliable methods for the selective nerve blockade.
-
A study using 14C propofol showed that the liver is the main eliminating organ for the agent. The current study was designed to clarify pharmacokinetics of propofol during liver transplantation in pigs. Five small pigs weighing 25.4 +/- 2.5 kg were anesthetized with isoflurane (0.5-1.5%) and mechanically ventilated under muscle paralysis with pancuronium. ⋯ We studied pharmacokinetic parameters following an intravenous bolus injection of propofol at 2 mg.kg-1 in each phase, i.e. the pre-anhepatic, anhepatic and post-anhepatic phase during liver transplantation. Pharmacokinetic analysis showed that total plasma clearance of propofol in the anhepatic phase was significantly lower than that in the post-anhepatic phase. The results suggest that propofol may be metabolized extrahepatically and can be used at reduced doses in the anhepatic phase during liver transplantation.