Masui. The Japanese journal of anesthesiology
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We reported 131 cases of ambulatory surgery in adults mainly anaesthetized with propofol infusion. Without any premedication, anesthesia was induced with propofol and fentanyl. A laryngeal mask airway was inserted using intravenous injection of vecuronium. ⋯ In 25 patients (19%) analgesics were needed for postoperative pain. Although 3 patients (2.3%) were unsuccessful as ambulatory surgery due to excessive pain, all patients including these three could be discharged within 24 hours after surgery. We conclude that combined anesthesia with propofol, fentanyl and local anesthetic is suitable for ambulatory surgery in adults.
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Comparative Study
[Comparison of epidural anesthesia and general anesthesia for patients with bronchial asthma].
We prospectively investigated the incidence of asthmatic attacks in 94 patients (1.5%) who were diagnosed as definite asthma. We separated the patients into three groups: epidural anesthesia (n = 10) including combined spinal/epidural anesthesia (n = 7), combined epidural and general anesthesia (n = 23), and general anesthesia (n = 54). General anesthesia was induced with propofol or midazolam and maintained with N2O and O2 with sevoflurane in adults. ⋯ All episodes of bronchospasm in the operative period were treated successfully. The frequency of bronchospasm did not depend on the severity of asthmatic symptoms or the chronic use of bronchodilators before operation. These findings suggest that tracheal intubation, not the choice of anesthetic, plays an important role in the pathogenesis of bronchospasm.
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Clinical Trial
[Effect of gargling the throat with Panaxylocaine as a lubricant for the laryngeal mask airway].
We used Panaxylocaine as a suitable lubricant with gargling before insertion of laryngeal mask for twenty preoperative breast cancer patients. Patients were divided into two groups; Control group (N = 10) received water-based lidocaine gel just before insertion of laryngeal mask, and Panaxylocaine group (N = 10) received Panaxylocaine as a premedication for breast cancer operation. ⋯ But there was no difference between two groups about oral paresthesia. We conclude that Panaxylocaine is a good premedication before insertion of laryngeal mask preventing oral and pharyngeal complications.
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Randomized Controlled Trial Comparative Study Clinical Trial
[Effects of infusion methods of propofol on quality of sedation and ease of sedation control during gynecological laparotomy under spinal anesthesia].
Twenty patients were prospectively and randomly studied to investigate effects of infusion methods of propofol on quality of sedation and ease of sedation control during gynecological laparotomy under spinal anesthesia. After establishment of spinal anesthesia, patients were randomly assigned to one of the following two groups, i.e. conventional continuous infusion group (Cont group) and target-controlled infusion group (TCI group). In the Cont group, propofol was started at a rate of 6 mg.kg-1.hr-1 until response to command disappeared. ⋯ Satisfaction VAS, anxiety VAS, discomfort VAS, sedation score and times of changing infusion condition were similar in both groups. Total dose of propofol was significantly less in the TCI group. In conclusion, quality of sedation and ease of control of sedation were comparable in both groups and continuous infusion method is simple.
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Randomized Controlled Trial Clinical Trial
[Pre-emptive analgesia with intravenous ketamine reduces postoperative pain in young patients after appendicectomy: a randomized control study].
Thirty-six young patients (12-17 years old) for appendicectomy were randomly allocated to receive ketamine 0.5 mg.kg-1 (K 0.5 group; n = 12), ketamine 1.0 mg.kg-1 (K 1.0 group; n = 12), or lactated Ringer's solution 5 ml (control group; n = 12), which was administered intravenously before incision. After the surgery, all patients received a nonsteroidal anti-inflammatory drug (NSAID) without limitation as requested by the patient. Pain scores at rest and on movement were assessed at 6-10 hr, 24 hr, and 48 hr post-operatively using a visual analogue scale. ⋯ The K 0.5 and K 1.0 groups each used significantly less NSAID during the 48-hr postoperative period than the control group (P < 0.05). Intravenous administration of ketamine before incision was associated with decreases in pain at rest 6-10 hr postoperatively and a reduction in NSAID requirement after appendicectomy. Administration of ketamine 1.0 mg.kg-1 prior to incision was superior to administration of 0.5 mg.kg-1 in relief of pain on movement after the surgical procedure.