Masui. The Japanese journal of anesthesiology
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Clinical Trial Controlled Clinical Trial
[The effects of premedication on induction doses of propofol and hemodynamic responses during induction].
We chose five sedatives for premedication and investigated the effect of these drugs on the induction doses of propofol. One hundred patients were allocated into one of five groups of 20. These groups consisted of control group (C) given only atropine 0.5 mg i.m.; CL group (plus clonidine 0.15 mg orally); H group (plus hydroxyzine 25 mg i.m.); M group (plus midazolam 3 mg i.m.) and D group (plus diazepam 10 mg orally). ⋯ We consider that this was one of the reasons why induction doses of both H and CL group could not decrease significantly. We concluded that midazolam 3 mg decreased propofol induction dose significantly. Both midazolam 3 mg and clonidine 0.15 mg decreased RPP before induction and hemodynamic responses to induction and intubation were stable.
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A case of severe bronchospasm under epidural anesthesia with fentanyl was described. The etiology of the bronchospasm may not have been related to sympathetic nervous blockade, histamine release, or anaphylaxis. In an asthmatic patient, it should be noted that epidural anesthesia with fentanyl could develop bronchospasm.
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We report, a case of aortic dissection after the termination of cardiopulmonary bypass (CPB), which was diagnosed by transesophageal echocardiography (TEE). A 70-year old male with aortic regurgitation received aortic valve replacement. ⋯ Furthermore wall motion abnormality was found by TEE, and aorto-coronary bypass was performed after observation by TEE. This case report suggests that TEE is useful not only for diagnosis but also for therapeutic orientation of aortic dissection.
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Spinal NMDA receptors are involved in hyperalgesia and chronic pain. The activation of spinal NMDA receptor results in the production of nitric oxide in the second order neurons in the spinal cord dorsal horn. We investigated the effects of intrathecally administered nitroglycerin (NTG) which releases nitric oxide in the cell. ⋯ MK given after formalin injection had significantly less effect on the phase 2 response. L-NAME (NOS inhibitor), MB (guanylate cyclase inhibitor) and HB (nitric oxide scavenger) significantly antagonized the hyperalgesic effect of NTG in the phase 2 of the formalin test. These results show that nitric oxide plays an important role in producing hyperalgesia in the spinal cord acting postsynaptically as well as pre-synaptically.
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A 2-year-old boy was scheduled for patch closures of ASD and VSD. After anesthesia induction, infection of a double lumen central venous catheter (5 Fr, Arrow) was tried into the superior vena cava through the right jugular vein by Seldinger's method. We confirmed the placement of the catheter by drawing a small amount of blood. ⋯ Following chest X-ray examination and an aspiration of intrapleural space revealed a severe hemothorax of the right side, where catheter had been inserted. The boy recovered without any disorders. This case suggests the importance to confirm the placement of CVP catheter, and to prevent the possible complications due to the malpositioned catheter.