Masui. The Japanese journal of anesthesiology
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The authors evaluated the efficacy of anesthetic management by total intravenous anesthesia with propofol, pentazocine and ketamine. ⋯ Total intravenous anesthesia with propofol, pentazocine and ketamine would be useful to stabilize hemodynamic state, to obtain rapid recovery and to provide effective postoperative pain relief.
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To protect the spinal cord during thoracoabdominal aortic aneurysm repair, motor evoked potentials (MEP) monitoring and cerebrospinal fluid drainage are often employed. Herein, we report a case, where intraoperative diminishment of motor evoked potentials was accompanied by multiple cerebral infarction. A 63-year-old man underwent elective surgery for both thoracoabdominal aortic aneurysm and abdominal aortic aneurysm. ⋯ On the postoperative day 4, when we stopped the cerebrospinal fluid drainage and propofol administration, his level of consciousness was poor and brain CT revealed multiple cerebral infarction. On the postoperative day 30, he was discharged from an intensive care unit with complications of hemiplagia and paraplegia. Although cerebrospinal fluid drainage may be recommended to protect spinal cord during thoracoabdominal aortic aneurysm repair, we should consider performing brain CT to exclude a risk of brain herniation secondary to cerebrospinal fluid drainage if there is a possibility of cerebral incidents.
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Historical Article
[New study on the history of anesthesiology--(11) three Japanese doctors who observed William TG Morton's ether anesthesia at the Gross Clinic in 1860].
In January of 1860 the Tokugawa Shogunate dispatched a group of Japanese mission headed by Masaoki Niimi, the first ambassador, to Washington D. C. to exchange ratification of Japan-United States treaty of commerce and amity. On May 22nd the ratification was approved. ⋯ In Philadelphia three Japanese medical doctors visited Jefferson Medical College to observe an operation of lithotomy by Dr Samuel D Gross, professor of surgery. Ether was given by Dr William TG Morton, the man that had succeeded in the public demonstration of ether anesthesia at Massachusetts General Hospital in Boston on October 16, 1846. The doctors might have brought new information on ether anesthesia to Japan, but they only left few traces of providing the information to medical professionals in Japan.
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Although anesthetics have been often used clinically, the mechanisms of action of anesthetics have not yet been clarified. Recently, major advances have been made in our understanding of the physiology and pharmacology of G-protein-coupled receptor (GPCR)-mediated signaling. ⋯ Given that known GPCRs are targets for anesthetics, these oGPCRs may represent a rich group of receptor targets for anesthetics. This review highlights the effects of anesthetics on Gq-coupled receptors, and discusses whether GPCRs other than Gq-coupled receptors, and proteins that convey GPCR signals are also targets for anesthetics.
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Comparative Study Clinical Trial
[Effects of simultaneous epidural administration of ropivacaine and morphine on the post-operative pain in the gynecologic patients].
We examined the effects of simultaneous epidural administration of ropivacaine with morphine on the level of the post-operative ⋯ These data suggested that simultaneous epidural administration of ropivacaine with morphine produces no beneficial effect as compared with morphine alone.