Masui. The Japanese journal of anesthesiology
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Randomized Controlled Trial Clinical Trial
[Effects of nitrous oxide on electroencephalographic activity during sevoflurane anesthesia: a zero-crossing analysis].
We have investigated the influence of nitrous oxide (N2O) on central nervous system (CNS) during sevoflurane anesthesia by using zero-crossing method of EEG in 31 patients. The study was divided into three parts: Study 1 (n = 18), Study 2 (n = 6) and Study 3 (n = 7). (Study 1) After induction of anesthesia, sevoflurane 1.0 % in oxygen (O2), and sevoflurane 1.0 % with 67 % N2O in O2 were given to the patients sequentially in a random fashion, and EEG was recorded. (Study 2) Sevoflurane 1.7 % in O2, and sevoflurane 0.7 % with 67 % N2O in O2, which were considered to be the same anesthetic depth (= sevoflurane 1 MAC), were inhaled, and EEG was recorded in the same manner as in the study 1. (Study 3) We compared the effects of N2O on EEG during intravenous administration of fentanyl and midazolam with 67 % N2O, and without N2O, and EEG was recorded in the same manner. ⋯ But there were no significant changes in EEG activity of the patient with and those without N2O during intravenous anesthesia. We concluded that the influences of N2O on CNS can be evaluated by quantitative analysis of EEG.
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Randomized Controlled Trial Clinical Trial
[Changes in dementia rating scale scores of elderly patients with femoral neck fracture during perioperative period].
We evaluated changes in dementia rating scale scores in the revised version of Hasegawa's dementia scale (HDS-R), and rated dementia, 2 days before and 7 days after surgery in the elderly patients with femoral neck fracture. The 50 patients examined ranged in age from 70 years to 101 years. A perfect score in the HDS-R is 30 points, and a score below 20 points strongly suggests dementia. ⋯ In octogenarian patients, there was a negative correlation between "postoperative score minus preoperative score" and "the number of the days from suffering fracture to surgery". These results showed that general anesthesia is more advantageous than epidural anesthesia from the viewpoint of the intellectual faculty in septuagenarian and octogenarian patients with femoral neck fracture, and it is within the bounds of possibility that the intellectual faculty may decline if an octogenarian patient is operated after a long delay from the occurrence of fracture. To prevent this decline, patients must be operated on as soon as possible.
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Randomized Controlled Trial Comparative Study Clinical Trial
[Comparison of airway complications on tracheal extubation in deeply sevoflurane anesthetized versus awake children].
We investigated the incidence of respiratory complications and oxygen saturation level during emergence from sevoflurane anesthesia in children whose tracheas were extubated while they were anesthetized or after they became awake. Thirty children, aged 1-10 years, were studied. Anesthesia was induced with sevoflurane or thiopental and maintained with nitrous oxide, oxygen and sevoflurane. ⋯ There was a significantly higher incidence of the airway obstruction but less incidence of cough and breath-holding in anesthetized group. Oxygen saturation level before and after tracheal extubation was not different between the two groups. In conclusion, with proper attention to airway obstruction, it may be possible to extubate while children are deeply anesthetized with sevoflurane.
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Randomized Controlled Trial Clinical Trial
[Effects of preoperatively administered flurbiprofen axetil on the action of inhaled anesthesia and postoperative pain].
Flurbiprofen axetil (FP) was evaluated in a randomized study relative to placebo in 26 patients undergoing endonasal ethmoidectomy. The FP group (n = 13) was administrated 1 mg.kg-1 FP 15 minutes before operation during a half hour. Likewise, the control group (n = 13) received intravenous NaCl 0.9%. ⋯ Body temperature of the FP group fell significantly before infusion. The FP group showed lower pain scores and required less dicrofenac sodium than the control group (P < 0.05). This study suggests that preoperative FP infusion relieves postoperative pain, but does not affect the action of the inhalation anesthetic.
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Randomized Controlled Trial Clinical Trial
[The effect of indomethacin suppository in preventing mesenteric traction syndrome].
Mesenteric traction syndrome consists of cutaneous hyperemia with hypotension and tachycardia. NSAIDs could inhibit the phenomenon, but there are few reports about when to administer these drugs. In this study, we evaluated the effect of indomethacin on preventing mesenteric traction syndrome when administered preoperatively and just after induction of anesthesia. ⋯ The effect of indomethacin was evaluated from the extent of cutaneous hyperemia. MTS was suppressed in group P, but not in group T (P < 0.05). We concluded that indomethacin suppository just after induction could not prevent mesenteric traction syndrome.