Masui. The Japanese journal of anesthesiology
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Men and women have different body compositions such as fat and fluid, and hormonal environments which affect both pharmacokinetics and pharmacodynamics of anesthesia-related drugs. The knowledge on gender differences in the effects of these drugs has been accumulated. ⋯ Then, gender differences in the effects of commonly used anesthesia-related agents are discussed. Although there have not been remarkable differences demonstrated, better understanding of the difference may lead to satisfying perioperative anesthetic cares for each sex.
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Postoperative nausea and vomiting (PONV) are two of the commonest and most distressing complications of general anesthesia and surgery. Factors affecting PONV are patient characteristics, surgical procedure, anesthetic technique, and postoperative care. Female patients have 1.5-3 times greater incidence of PONV than males, due to increased plasma progesterone levels during their menstrual cycles. ⋯ Most of published trials indicate improved prophylaxis against PONV by avoiding risk factors and/or by using effective antiemetic therapy (e. g., traditional and non-traditional antiemetics, serotonin receptor antagonists). Non-pharmacotherapy (e. g., P6 acupressure) is also important. Knowledge regarding prophylactic antiemetic therapy is necessary to management of PONV in female patients.
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Comparative Study
[Comparative study of anesthesia with remifentanil VS fentanyl in terms of postoperative pain and shivering].
Remifentanil is reported to be cleared rapidly more than other any opioids. It is considered that this characteristic may lead to an increase in postoperative pain and shivering after general anesthesia with remifentanil. This study was aimed to examine the influence of remifentanil to these adverse symptoms in comparison with fentanyl. ⋯ Careful management of intraoperative body temperature is important to prevent the occurrence of shivering after total intravenous general anesthesia with remifentanil.
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Comparative Study
[Comparison of the changes in blood glucose levels during anesthetic management using sevoflurane and propofol].
Recent studies have shown that sevoflurane impairs glucose tolerance, but the effect of propofol on glucose metabolism is not still clear. ⋯ Results in this study imply that the effect on glucose metabolism of propofol is much less than that of sevoflurane.
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Annual surveys conducted by the Japanese Society of Anesthesiologists repeatedly show that hemorrhage is the leading cause of life-threatening events in the operating room. ⋯ Undertransfusion may occur in 16.7-28.3% of cases of massive hemorrhage in the operating room, and the rate of emergency blood transfusion was much lower than this percentage. To avoid operation-associated deaths from hemorrhage, the improvement of hospital systems for emergency blood transfusion, including the active use of intraoperative blood salvage, should be promoted.