Masui. The Japanese journal of anesthesiology
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Comparative Study Clinical Trial Controlled Clinical Trial
[Changes in epidural pressure during total intravenous anesthesia with propofol, fentanyl and ketamine].
Although ketamine elevates cerebrospinal fluid pressure (CSFP) with an increase in cerebral blood flow, sedatives such as benzodiazepines, barbiturates and opioids have been reported to inhibit it. In this study, we evaluated the changes in epidural pressure (EP) as a good index for CSFP during total intravenous anesthesia with propofol-fentanyl-ketamine (PFK) compared to isofluranenitrous oxide anesthesia (GOI). ⋯ In PFK group, epidural pressure did not increase during the anesthesia, and was significantly lower than in GOI group (30 and 180 min after induction of anesthesia, and 0, 30 and 60 min after stopping anesthetic administration). The present data suggest that PFK may safely be used for patients with intracranial hypertension.
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Comparative Study Clinical Trial Controlled Clinical Trial
[Intravenous neostigmine enhances the analgesic effect of epidural anesthesia].
A single-blind trial of the intravenous neostigmine on epidural anesthesia was carried out on 75 patients undergoing lower limb or lower abdominal surgery. They were allocated to three groups of 25: patients of group C received 2 ml of 0.9% saline, patients of group AN 1 ml (0.5 mg) of atropine and 2 ml (1 mg) of neostigmine, and patients of group N 2 ml (1 mg) of neostigmine, intravenously 5 min before epidural injection of 15 ml of 2% mepivacaine solution without epinephrine. We assessed the onset and spread of cold sensory block and analgesia, and the degree of motor block and sedation. ⋯ The incidence of bradycardia and fecal incontinence was significantly higher in group N than in groups C and AN. These results demonstrate that intravenous neostigmine potentiates the analgesic effect of epidural anesthesia mediated by a cholinergic muscarinic mechanism. However, in clinical practice, it does not seem to be useful, because of the side effects.
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Comparative Study Clinical Trial Controlled Clinical Trial
[Total intravenous anesthesia with propofol and fentanyl for laparoscopic cholecystectomy].
The postoperative antiemetic effect of total intravenous anesthesia with propofol and fentanyl was evaluated in 40 patients for laparoscopic cholecystectomy. Patients were divided into 2 groups. In group P, anesthesia was induced with intravenous fentanyl 0.1 mg and propofol 2 mg.kg-1 and maintained with continuous infusion of propofol. ⋯ No significant differences were found in the incidence of vomiting between the groups. These results suggest that total intravenous anesthesia with propofol and fentanyl is superior to inhalational anesthesia with nitrous oxide and isoflurane in postoperative nausea. This antiemetic effect is, however, limited in the early period after anesthesia.
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Randomized Controlled Trial Clinical Trial
[Influence of preanesthetic medication on the effect of a local anesthetic tape].
We investigated the influence of preanesthetic medication on the pain relieving effect of the lidocaine tape during needle insertion for venous cannulation. Ninety patients scheduled for elective surgery were randomly divided into three groups of 30 each; patients without preanesthetic medication (group N), patients who received 0.1 mg.kg-1 of diazepam (group D) and 5 micrograms.kg-1 of clonidine (group C) as a preanesthetic medication. ⋯ No significant difference of the pain score was seen between the groups. We concluded that the effect of lidocaine tape was not influenced by the preanesthetic medication.
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Comparative Study
[Assessment of the practice of endotracheal intubation by levering Laryngoscope in teaching of undergraduate medical students].
Twenty-nine inexperienced medical students tried to intubate endotracheal tubes using both levering laryngoscope (McCoy laryngoscope) and Macintosh laryngoscope in adult mannikin the Cormack and Lehane Grade 2. The number of successful intubations by McCoy type was close to those by Macintosh type. ⋯ But the grade of handling difficulty of McCoy type was significantly higher than that of Macintosh type, because Macintosh type was simpler to handle than McCoy type. It was suggested that Macintosh laryngoscope was more useful than McCoy laryngoscope for teaching of inexperienced medical students.